Individual provider Active NPI

Oyediya Emole, OD

  • Optometrist
  • Houston, TX
National Provider Identifier
1942870530
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10352T Issued in TX
Practice address
1250 Cypress Station Dr Ste a
Houston, TX 77090-3047
Phone
(281) 444-1677
NPI assigned
Jun 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10352T TX Primary

Addresses

Primary practice location

1250 Cypress Station Dr Ste a
Houston, TX 77090-3047

Mailing address

2855 Gramercy St Ste 400
Houston, TX 77025-1756
Phone (713) 668-6828

Other identifiers 1

IdentifierTypeStateIssuer
425465802MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address emoleoyediya@houstoneye.direct.eyemdemr.com Direct

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
I20210712003985 TX Practitioner - Optometry 8123420213

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10352TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Legendary Vision Center, PLLC Optometrist Current Accepting new patients

Locations

8401 Westheimer Rd
Ste 180
Houston, TX 77063
Phone (281) 944-8864

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": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1942870530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 GRAMERCY ST STE 400",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770251756",
            "telephone_number": "713-668-6828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 CYPRESS STATION DR STE A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770903047",
            "telephone_number": "281-444-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMOLE",
        "first_name": "OYEDIYA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10352T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "425465802",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emoleoyediya@houstoneye.direct.eyemdemr.com",
            "affiliation": "N",
            "endpointDescription": "direct message address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1250 Cypress Station Dr Ste A",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770903047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.