Individual provider Active NPI

Priyanka Patel

  • Optometrist
  • Houston, TX
National Provider Identifier
1790409894
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10643 Issued in TX
Practice address
1020 Willowbrook Mall Ste 1020
Houston, TX 77070-5788
Phone
(281) 894-5300
NPI assigned
Oct 3, 2022
Last updated
Oct 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10643 TX Primary

Addresses

Primary practice location

1020 Willowbrook Mall Ste 1020
Houston, TX 77070-5788

Mailing address

1433 W 23Rd St Unit H
Houston, TX 77008-2169

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
I20221207000217 TX Practitioner - Optometry 6709255102 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10643TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Eyecare PC Optometrist CurrentSince Mar 1, 2024 Accepting new patients
Champions Eyecare PC Optometrist Past Accepting new patients
Briargrove Eyecare PC Optometrist Past Accepting new patients

Locations

5774 FM 1960 Rd W
Houston, TX 77069
Phone (281) 440-5887

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": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1790409894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1433 W 23RD ST UNIT H",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770082169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 WILLOWBROOK MALL STE 1020",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770705788",
            "telephone_number": "281-894-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRIYANKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.