Active NPI
Kim Dung Tran, O.D.
- Optometrist
- Pearland, TX
National Provider Identifier
1891840716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 6661T
- Practice address
- 1919 N. Main
Pearland, TX 77581-3305 - Phone
- (281) 485-7672
- Fax
- (281) 997-0071
- NPI assigned
- Jan 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 6661T | TX | Primary |
Addresses
Primary practice location
1919 N. Main
Pearland, TX 77581-3305
Mailing address
2410 Havencrest CRT
Pearland, TX 77584-1225
Phone (832) 640-5015
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120105000994 | TX | Practitioner - Optometry | 1254507619 | Practice locations: Pearland, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6661T | TX | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sean Ta, O.D., P.a. | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Optometrist
- Pearland, TX
- NPI 1013062934
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323043200000",
"number": "1891840716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2410 HAVENCREST CRT",
"city": "PEARLAND",
"state": "TX",
"postal_code": "775841225",
"telephone_number": "832-640-5015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1919 N. MAIN",
"city": "PEARLAND",
"state": "TX",
"postal_code": "775813305",
"telephone_number": "281-485-7672",
"fax_number": "281-997-0071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAN",
"first_name": "KIM",
"middle_name": "DUNG",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-23",
"last_updated": "2011-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "6661T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Dec 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.