Individual provider Active NPI

Mita K. Vala, O.D.

  • Optometrist
  • Houston, TX
National Provider Identifier
1851679443
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7778T Issued in TX
Practice address
5800 Bellaire Blvd Ste 112
Houston, TX 77081-5537
Phone
(713) 771-7867
NPI assigned
Jul 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7778T TX Primary

Addresses

Primary practice location

5800 Bellaire Blvd Ste 112
Houston, TX 77081-5537

Mailing address

PO Box 1304
Bellaire, TX 77402-1304

Other practice location 1

4930 Evers Rd
San Antonio, TX 78228-2118
Phone (210) 431-0366

Other identifiers 1

IdentifierTypeStateIssuer
7778TOtherTXTEXAS OPTOMETRY LICENSE

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
I20120106000420 TX Practitioner - Optometry 1456527852 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7778TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mita Vala OD PLLC Optometrist CurrentSince Jun 8, 2023 Accepting new patients
Optical Illusionz Inc PastSince Feb 8, 2023 Accepting new patients
Aeg Texas Professional PLLC Optometrist PastSince Mar 31, 2021 Accepting new patients

Locations

5135 W Alabama St
Ste 5410
Houston, TX 77056
Phone (713) 623-0855

5800 Bellaire Blvd
Ste 112
Houston, TX 77081
Phone (713) 771-7867

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": "1311897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1851679443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1304",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774021304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 BELLAIRE BLVD STE 112",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770815537",
            "telephone_number": "713-771-7867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4930 Evers Rd",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782282118",
            "country_code": "US",
            "telephone_number": "210-431-0366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALA",
        "first_name": "MITA",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-29",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7778T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS OPTOMETRY LICENSE",
            "identifier": "7778T",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.