Individual provider Active NPI

Kim Dung Tran, O.D.

  • Optometrist
  • Pearland, TX
National Provider Identifier
1891840716
Registry record updated Dec 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6661T Issued in TX
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

Updated by the provider on Dec 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120105000994 TX Practitioner - Optometry 1254507619 Practice locations: Pearland, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6661TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.