Individual provider Active NPI

Sidney Imperial, OD

  • Optometrist
  • Houston, TX
National Provider Identifier
1811223530
Registry record updated Feb 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6305 Issued in TX
Practice address
1909 Taylor St
Ste B
Houston, TX 77007-3950
Phone
(713) 862-3937
NPI assigned
Oct 30, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6305 TX Primary

Addresses

Primary practice location

1909 Taylor St
Ste B
Houston, TX 77007-3950

Mailing address

1909 Taylor St
Ste B
Houston, TX 77007-3950
Phone (713) 862-3937

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
I20041005001317 TX Practitioner - Optometry 7416916481 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
International American University at Puerto Rico - School of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Imperial Vision, PLLCGroup PAC ID 6901083468, 2 clinicians

Practice addresses (Care Compare)

16126 Southwest Fwy
Suite 180
Sugar Land, TX 77479-2639
Phone (281) 916-2020

1909 Taylor St
Suite B
Houston, TX 77007-3987
Phone (713) 862-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6305TXMDIndependent Medical Examiner Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Imperial Vision Sugar Land, PLLC Optometrist CurrentSince Jun 3, 2020 Accepting new patients
Imperial Vision, PLLC Optometrist CurrentSince Mar 6, 2011 Accepting new patients
Harvey L Carter III MD PA PastSince Jan 19, 1994 Accepting new patients

Locations

1909 Taylor St
Ste B
Houston, TX 77007
Phone (713) 862-3937

16126 Southwest Fwy
Ste 180
Sugar Land, TX 77479
Phone (281) 313-0234

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1256860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580774400000",
    "number": "1811223530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 TAYLOR ST",
            "address_2": "STE B",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770073950",
            "telephone_number": "713-862-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 TAYLOR ST",
            "address_2": "STE B",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770073950",
            "telephone_number": "713-862-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMPERIAL",
        "first_name": "SIDNEY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-30",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.