Organization Active NPI

Community Retina Group PA

  • Ophthalmology Physician
  • Houston, TX
National Provider Identifier
1750604898
Registry record updated Jan 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
H1981 Issued in TX
Legal business name
COMMUNITY RETINA GROUP PA
Practice address
6550 Fannin St
Suite 2317
Houston, TX 77030-2723
Phone
(281) 407-3033
Fax
(281) 763-2623
NPI assigned
Mar 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2012

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

Authorized official

Name
Helen K. Li, MDNPI 1598824740
Title
MD
Phone
(281) 407-3033

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X H1981 TX Primary

Addresses

Primary practice location

6550 Fannin St
Suite 2317
Houston, TX 77030-2723

Mailing address

6550 Fannin Street
Suite 2317
Houston, TX 77030-2723
Phone (281) 407-3033

Other identifiers 2

IdentifierTypeStateIssuer
217695001MedicaidTX
H1981OtherTXMEDICAL LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100610000264 TX Part B Supplier - Clinic/Group Practice 0941330476 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Locations

10001 Westheimer Rd
Ste 2910
Houston, TX 77042
Phone (713) 977-0725

6550 Fannin St
Ste 2317
Houston, TX 77030
Phone (281) 407-3033

Interoperability endpoints

  • Direct secure messaging: hli@crtx.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1267574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327622400000",
    "number": "1750604898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6550 FANNIN STREET",
            "address_2": "SUITE 2317",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302723",
            "telephone_number": "281-407-3033",
            "fax_number": "281-763-2623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 FANNIN ST",
            "address_2": "SUITE 2317",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302723",
            "telephone_number": "281-407-3033",
            "fax_number": "281-763-2623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY RETINA GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-03",
        "last_updated": "2012-01-27",
        "status": "A",
        "authorized_official_last_name": "LI",
        "authorized_official_first_name": "HELEN",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "281-407-3033",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "H1981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "217695001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "H1981",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; 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.