Organization Active NPI

Custom Eyes of Pearland, LLC

  • Optometrist
  • Pearland, TX
National Provider Identifier
1811233836
Registry record updated Mar 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7074T Issued in TX
Legal business name
CUSTOM EYES OF PEARLAND, LLC
Practice address
11126 Broadway St
Suite 200
Pearland, TX 77584-9754
Phone
(713) 436-6000
Fax
(713) 436-6004
NPI assigned
Dec 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2016

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

Authorized official

Name
Sejal P. Patel, OD
Title
OD/Owner
Phone
(713) 436-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 7074T TX Primary

Addresses

Primary practice location

11126 Broadway St
Suite 200
Pearland, TX 77584-9754

Mailing address

11150 Broadway St
Suite 100
Pearland, TX 77584-2473
Phone (713) 436-6000

Other names 1

  • CustomEyes Doing business as

National Provider Directory

National Provider Directory

Locations

11150 Broadway St
Ste 100
Pearland, TX 77584
Phone (713) 436-6000

11126 Broadway St
Ste 200
Pearland, TX 77584
Phone (713) 436-6000

11150 Broadway St
Pearland, TX 77584
Phone (713) 436-6000

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": "1355875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458086400000",
    "number": "1811233836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11150 BROADWAY ST",
            "address_2": "SUITE 100",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775842473",
            "telephone_number": "713-436-6000",
            "fax_number": "713-436-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11126 BROADWAY ST",
            "address_2": "SUITE 200",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775849754",
            "telephone_number": "713-436-6000",
            "fax_number": "713-436-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM EYES OF PEARLAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-19",
        "last_updated": "2016-03-16",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "SEJAL",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "OD/OWNER",
        "authorized_official_telephone_number": "713-436-6000",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7074T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CustomEyes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pearland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.