Individual provider Active NPI

Paul Tran, OD., PC

  • Corneal and Contact Management Optometrist
  • Laredo, TX
National Provider Identifier
1710034913
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
4722TG Issued in TX
Practice address
5702 McPherson Rd Ste 21
Laredo, TX 78041-6884
Phone
(916) 791-5967
Fax
(916) 791-5969
NPI assigned
Jan 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 1171290001
Corneal and Contact Management Optometrist 152WC0802X 4722TG TX Primary

Addresses

Primary practice location

5702 McPherson Rd Ste 21
Laredo, TX 78041-6884

Mailing address

5702 McPherson Rd Ste 21
Laredo, TX 78041-6884
Phone (916) 791-5967

Other identifiers 1

IdentifierTypeStateIssuer
019176901MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101124000475 TX Practitioner - Optometry 1759577133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paul Tran OD, PAGroup PAC ID 8820284151, 2 clinicians

Practice addresses (Care Compare)

5702 McPherson Rd
Suite 21
Laredo, TX 78041-6884
Phone (956) 791-5967

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4722TGTXMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Paul Tran OD, PA CurrentSince Jul 11, 2010 Accepting new patients

Locations

5702 McPherson Rd
Ste 21
Laredo, TX 78041
Phone (956) 791-5967

502 W Calton Rd
Ste 308
Laredo, TX 78041
Phone (956) 791-5967

502 W Calton Rd
Ste 308B
Laredo, TX 78041
Phone (956) 791-5967

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1710034913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5702 MCPHERSON RD STE 21",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780416884",
            "telephone_number": "916-791-5967",
            "fax_number": "916-791-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5702 MCPHERSON RD STE 21",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780416884",
            "telephone_number": "916-791-5967",
            "fax_number": "916-791-5969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "PAUL",
        "credential": "OD., PC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": "1171290001",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "4722TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019176901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.