NPIMap

Organization Active NPI

Texas State Optical

  • Optometrist
  • Houston, TX
National Provider Identifier
1982720637
Registry record updated Jul 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2141 Issued in TX
Legal business name
TEXAS STATE OPTICAL
Practice address
564 Northwest Mall
Houston, TX 77092-8544
Phone
(713) 681-2467
Fax
(713) 681-0537
NPI assigned
Mar 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2008

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

Authorized official

Name
Dr. Michael E Siegel, ODNPI 1063421360
Title
Owner
Phone
(713) 681-2467

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 2141 TX Primary
Eyewear Supplier 332H00000X 2141 TX

Addresses

Primary practice location

564 Northwest Mall
Houston, TX 77092-8544

Mailing address

564 Northwest Mall
Houston, TX 77092-8544
Phone (713) 681-2467

Other identifiers 8

IdentifierTypeStateIssuer
G000E92A2MedicaidTX
6306OtherTXAVESIS
902815OtherTXBLOCK VISION
16114OtherTXSPECTERA
143837OtherTXEYE MED
QMP000003344370OtherTXMOLINA
5595OtherTXSAFEGAURD
019563801OtherTXMEDICAID

National Provider Directory

National Provider Directory

Locations

564 Northwest Mall
Houston, TX 77092
Phone (713) 681-2467

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216252800000",
    "number": "1982720637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "564 NORTHWEST MALL",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770928544",
            "telephone_number": "713-681-2467",
            "fax_number": "713-681-0537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 NORTHWEST MALL",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770928544",
            "telephone_number": "713-681-2467",
            "fax_number": "713-681-0537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS STATE OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2008-07-17",
        "status": "A",
        "authorized_official_last_name": "SIEGEL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-681-2467",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2141",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "TX",
            "license": "2141",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G000E92A2",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "6306",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLOCK VISION",
            "identifier": "902815",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "16114",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYE MED",
            "identifier": "143837",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "QMP000003344370",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SAFEGAURD",
            "identifier": "5595",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "019563801",
            "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 Jul 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.