Active NPI
Andrew Mario Archila, O.D.
- Optometrist
- Houston, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 10187
- Practice address
- 4401 Martin Luther King Blvd
Houston, TX 77204-2020 - Phone
- (713) 743-2020
- Fax
- (713) 743-0963
- NPI assigned
- Jan 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | ODP-1007 | ID | |
| Optometrist | 152W00000X | 10187 | TX | Primary |
Addresses
Primary practice location
4401 Martin Luther King Blvd
Houston, TX 77204-2020
Mailing address
4401 Martin Luther King Blve
Houston, TX 77204-2020
Phone (713) 743-2020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 429529701 | Medicaid | TX |
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
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of Houston - College of Optometry, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
190 Heights Blvd
Houston, TX 77007-3729
Phone (713) 527-8480
4401 Martin Luther King Blvd
Houston, TX 77204-2020
Phone (713) 743-2020
4849 Calhoun Rd
Suite 104
Houston, TX 77204-2020
Phone (713) 743-2020
4901 Calhoun Rd
Houston, TX 77204-2020
Phone (713) 743-2020
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3074 | WI | MD | Social Worker |
| 10187 | TX | MD | Chiropractor |
| ODP-1007 | ID | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Houston System | Optometrist | Current | Accepting new patients |
| University of Houston | Current | Accepting new patients | |
| Stein Optical Inc. | Optometrist | Past | Accepting new patients |
Locations
190 Heights Blvd
Houston, TX 77007
Phone (713) 527-8480
4901 Calhoun Rd
Houston, TX 77204
Phone (713) 743-1921
4401 Martin Luther King Blvd
Houston, TX 77204
Phone (713) 743-1921
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.
-
- Optometrist
- Houston, TX
- NPI 1861493140
-
- Community Health Worker
- Houston, TX
- NPI 1366081622
-
- Optometrist
- Milwaukee, WI
- NPI 1801829551
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661212800000",
"number": "1922087261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4401 MARTIN LUTHER KING BLVE",
"city": "HOUSTON",
"state": "TX",
"postal_code": "772042020",
"telephone_number": "713-743-2020",
"fax_number": "713-743-0963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4401 MARTIN LUTHER KING BLVD",
"city": "HOUSTON",
"state": "TX",
"postal_code": "772042020",
"telephone_number": "713-743-2020",
"fax_number": "713-743-0963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARCHILA",
"first_name": "ANDREW",
"middle_name": "MARIO",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-14",
"last_updated": "2022-08-23",
"certification_date": "2022-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "ID",
"license": "ODP-1007",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "10187",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "429529701",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.