Individual provider Active NPI

Ryann Matthew Donaldson, OD

  • Optometrist
  • Katy, TX
National Provider Identifier
1720152051
Registry record updated Mar 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TX5390TG Issued in TX
Practice address
1534 S Grand Parkway
Katy, TX 77494
Phone
(281) 693-3937
Fax
(281) 693-2832
NPI assigned
Nov 20, 2006
Last updated
Mar 1, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TX5390TG TX Primary

Addresses

Primary practice location

1534 S Grand Parkway
Katy, TX 77494

Mailing address

1534 S Grand Parkway
Katy, TX 77494
Phone (281) 693-3937

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
I20071227000466 TX Practitioner - Optometry 6305926619 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TX5390TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Med Southwest, PLLC Optometrist CurrentSince Nov 2, 2020 Accepting new patients
Med Southwest, PLLC Optometrist Current Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Nov 2, 2020 Accepting new patients

Locations

1534 W Grand Pkwy S
Katy, TX 77494
Phone (281) 693-3937

2703 Richmond Rd
Texarkana, TX 75503
Phone (903) 838-0783

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298937600000",
    "number": "1720152051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1534 S GRAND PARKWAY",
            "city": "KATY",
            "state": "TX",
            "postal_code": "77494",
            "telephone_number": "281-693-3937",
            "fax_number": "281-693-2832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1534 S GRAND PARKWAY",
            "city": "KATY",
            "state": "TX",
            "postal_code": "77494",
            "telephone_number": "281-693-3937",
            "fax_number": "281-693-2832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONALDSON",
        "first_name": "RYANN",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2011-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "TX5390TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.