Organization Active NPI

Outlook Eye and Laser Center

  • Ophthalmology Physician
  • Sugar Land, TX
National Provider Identifier
1770912503
Registry record updated Apr 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
P6649 Issued in TX
Legal business name
OUTLOOK EYE AND LASER CENTER
Practice address
3507 Town Center Blvd S
Sugar Land, TX 77479-2654
Phone
(281) 242-1242
Fax
(281) 886-8687
NPI assigned
Nov 2, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2014

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

Authorized official

Name
Dip Sureshkumar Jadav, M.D.NPI 1497908883
Title
Managing Member
Phone
(281) 242-1242

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 P6649 TX Primary

Addresses

Primary practice location

3507 Town Center Blvd S
Sugar Land, TX 77479-2654

Mailing address

PO Box 16789
Sugar Land, TX 77496-6789
Phone (281) 242-1242

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131122000488 TX Part B Supplier - Clinic/Group Practice 7618103649 Receives reassigned benefits from 1 practitioner
Practice locations: Sugar Land, TX

National Provider Directory

National Provider Directory

Locations

3507 Town Center Blvd S
Sugar Land, TX 77479
Phone (281) 242-1242

3507 Town Center Blvd S
Ste B
Sugar Land, TX 77479
Phone (281) 242-1242

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": "1383350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397433600000",
    "number": "1770912503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16789",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774966789",
            "telephone_number": "281-242-1242",
            "fax_number": "281-886-8687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3507 TOWN CENTER BLVD S",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774792654",
            "telephone_number": "281-242-1242",
            "fax_number": "281-886-8687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTLOOK EYE AND LASER CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-02",
        "last_updated": "2014-04-14",
        "status": "A",
        "authorized_official_last_name": "JADAV",
        "authorized_official_first_name": "DIP",
        "authorized_official_middle_name": "SURESHKUMAR",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "281-242-1242",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "P6649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; 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.