Individual provider Active NPI

Koyoh John Ngala, O.D.

  • Optometrist
  • Galveston, TX
National Provider Identifier
1821078684
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5306TG Issued in TX
Practice address
6191 Central City Blvd
Galveston, TX 77551-3818
Phone
(409) 744-4940
Fax
(409) 744-6036
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5306TG TX Primary

Addresses

Primary practice location

6191 Central City Blvd
Galveston, TX 77551-3818

Mailing address

6191 Central City Blvd
Galveston, TX 77551-3818
Phone (409) 744-4940

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
I20060817000146 TX Practitioner - Optometry 8123021938 Practice locations: Silsbee, TX

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1100 US Hwy 96 N
Silsbee, TX 77656-7298
Phone (409) 386-6694

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5306TGTXMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1821078684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6191 CENTRAL CITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775513818",
            "telephone_number": "409-744-4940",
            "fax_number": "409-744-6036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6191 CENTRAL CITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775513818",
            "telephone_number": "409-744-4940",
            "fax_number": "409-744-6036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGALA",
        "first_name": "KOYOH",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5306TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.