Individual provider Active NPI

Tara Brooke Bailey, O.D.

  • Optometrist
  • Waller, TX
National Provider Identifier
1750517348
Registry record updated Mar 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7454T Issued in TX
Practice address
12007 Schmidt Rd
Waller, TX 77484-5060
Phone
(281) 757-4030
NPI assigned
Jun 9, 2009
Last updated
Mar 23, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 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 7454T TX Primary

Addresses

Primary practice location

12007 Schmidt Rd
Waller, TX 77484-5060

Mailing address

12007 Schmidt Rd
Waller, TX 77484-5060
Phone (281) 757-4030

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
I20101221001154 TX Practitioner - Optometry 6608064365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Tara B. Bailey, O.D., P.a.Group PAC ID 4981849932, 2 clinicians

Practice addresses (Care Compare)

31315 FM 2920 Rd
Waller, TX 77484-8049
Phone (936) 372-3644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7454TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Tara B. Bailey, O.D., P.a. Optometrist CurrentSince Jan 1, 2013 Accepting new patients
LHN Vision PA Optometrist PastSince Jun 23, 2008 Accepting new patients

Locations

31315 FM 2920 Rd
Ste 19
Waller, TX 77484
Phone (936) 372-3644

Organizations & group practices 2

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": "1244505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300838400000",
    "number": "1750517348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12007 SCHMIDT RD",
            "city": "WALLER",
            "state": "TX",
            "postal_code": "774845060",
            "telephone_number": "281-757-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12007 SCHMIDT RD",
            "city": "WALLER",
            "state": "TX",
            "postal_code": "774845060",
            "telephone_number": "281-757-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "TARA",
        "middle_name": "BROOKE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-09",
        "last_updated": "2011-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7454T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waller, TX

Sources for this page

Verify at the official NPI Registry.