Individual provider Active NPI

Padhmalatha Segu, O.D.

  • Optometrist
  • Houston, TX
National Provider Identifier
1780686956
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4707 Issued in TX
Practice address
4407 Martin Luther King Blvd
Houston, TX 77204-2020
Phone
(713) 743-2020
Fax
(713) 743-0963
NPI assigned
Jun 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4707TG TX
Optometrist 152W00000X 4707 TX Primary

Addresses

Primary practice location

4407 Martin Luther King Blvd
Houston, TX 77204-2020

Mailing address

4407 Martin Luther King Blvd
Houston, TX 77204-2020
Phone (713) 743-2020

Other identifiers 1

IdentifierTypeStateIssuer
040370101MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040825000337 TX Practitioner - Optometry 5890769806 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4707TXMDChiropractor
4707TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Houston CurrentSince Aug 1, 1994 Accepting new patients
University of Houston System Optometrist CurrentSince Aug 1, 1994 Accepting new patients

Locations

190 Heights Blvd
Houston, TX 77007
Phone (713) 527-8480

4401 Martin Luther King Blvd
Houston, TX 77204
Phone (713) 743-1921

505 J Davis Armistead Bldg
Houston, TX 77204
Phone (713) 743-1921

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1780686956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4407 MARTIN LUTHER KING BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772042020",
            "telephone_number": "713-743-2020",
            "fax_number": "713-743-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4407 MARTIN LUTHER KING BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772042020",
            "telephone_number": "713-743-2020",
            "fax_number": "713-743-0963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGU",
        "first_name": "PADHMALATHA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-01",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4707TG",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040370101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.