Individual provider Active NPI

Loan Thi Kim Lao, O.D.

  • Optometrist
  • Frisco, TX
National Provider Identifier
1760794242
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7605TG Issued in TX
Practice address
9191 Kyser Way
Suite # 600
Frisco, TX 75033-1953
Phone
(214) 705-9433
NPI assigned
Jul 13, 2010
Last updated
Jun 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7605TG TX Primary
Pediatric Optometrist 152WP0200X 7605TG TX

Addresses

Primary practice location

9191 Kyser Way
Suite # 600
Frisco, TX 75033-1953

Mailing address

9191 Kyser Way Ste 602
Frisco, TX 75033-1903
Phone (214) 705-9433

Other identifiers 2

IdentifierTypeStateIssuer
TXB115266OtherMEDICARE PTAN
219714701MedicaidTX

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
I20110114000987 TX Practitioner - Optometry 1456540897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9191 Kyser Way
Suite 602
Frisco, TX 75033-1903
Phone (214) 705-9433

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7605TXMDBehavioral Analyst
7605TGTXMDPediatric Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Family Eye Care PLLC Optometrist CurrentSince Oct 31, 2019 Accepting new patients
Martin Road Eye Care Inc Optometrist PastSince Oct 3, 2011 Accepting new patients
Eyes in Sight, PLLC Optometrist Past Accepting new patients

Locations

9191 Kyser Way
Ste 600
Frisco, TX 75033
Phone (214) 705-9433

9191 Kyser Way
Ste 602
Frisco, TX 75033
Phone (214) 705-9433

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": "1278979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1760794242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9191 KYSER WAY STE 602",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750331903",
            "telephone_number": "214-705-9433",
            "fax_number": "214-705-9318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9191 KYSER WAY",
            "address_2": "SUITE # 600",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750331953",
            "telephone_number": "214-705-9433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAO",
        "first_name": "LOAN",
        "middle_name": "THI KIM",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-13",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7605TG",
            "primary": true
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "TX",
            "license": "7605TG",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "TXB115266",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "219714701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.