Organization Active NPI

Decordova Eyewear LLC

  • Optometrist
  • Humble, TX
National Provider Identifier
1730613076
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DECORDOVA EYEWEAR LLC
Practice address
12230 West Lake Houston Parkway
Suite 155
Humble, TX 77044
Phone
(281) 763-2006
NPI assigned
Apr 13, 2017
Last updated
Sep 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Authorized official

Name
Dr. Kerr-Ann Coombs, OD
Title
Owner
Phone
(281) 763-2006

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

12230 West Lake Houston Parkway
Suite 155
Humble, TX 77044

Mailing address

27390 Pendleton Trace Dr
Spring, TX 77386-4267
Phone (281) 630-7994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171003006709 TX Part B Supplier - Clinic/Group Practice 4183999014 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Locations

12230 W Lake Houston Pkwy
Houston, TX 77044
Phone (346) 570-5366

12230 W Lake Houston Pkwy
Ste 155
Houston, TX 77044
Phone (281) 763-2006

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1492041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759190400000",
    "number": "1730613076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27390 PENDLETON TRACE DR",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773864267",
            "telephone_number": "281-630-7994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12230 WEST LAKE HOUSTON PARKWAY",
            "address_2": "SUITE 155",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "77044",
            "telephone_number": "281-763-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECORDOVA EYEWEAR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-13",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A",
        "authorized_official_last_name": "COOMBS",
        "authorized_official_first_name": "KERR-ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-763-2006",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.