Individual provider Active NPI

Donna Pham, OD

  • Optometrist
  • Houston, TX
National Provider Identifier
1992537682
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11171 Issued in TX
Practice address
13615 Bellaire Blvd
Houston, TX 77083-1714
Phone
(281) 933-3446
Fax
(281) 933-6865
NPI assigned
Aug 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11171 TX Primary

Addresses

Primary practice location

13615 Bellaire Blvd
Houston, TX 77083-1714

Mailing address

13615 Bellaire Blvd
Houston, TX 77083-1714

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
I20240916001250 TX Practitioner - Optometry 0941741169 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11171TXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bruce Wick OD PHD PA Optometrist CurrentSince Sep 1, 2024 Accepting new patients

Locations

13615 Bellaire Blvd
Houston, TX 77083
Phone (281) 933-3446

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": "1724112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1992537682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13615 BELLAIRE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770831714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13615 BELLAIRE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770831714",
            "telephone_number": "281-933-3446",
            "fax_number": "281-933-6865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "DONNA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-20",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "11171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.