Katy Pediatric Associates

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

KATY PEDIATRIC ASSOCIATES

Practice address

2051 Greenhouse Rd Ste 120
Houston, TX 77084-7305

Phone

(281) 492-7676

Fax

(281) 492-8133

NPI assigned

Jan 7, 2008

Organization subpart

No

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

Authorized official

Name

Kristin Fullen, NPNPI 1134531122

Title

Nurse Practioner

Phone

(281) 492-7676

Specialties & licenses 1

Addresses

Other identifiers 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

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

• Kristin Fullen

  • Pediatric Nurse Practitioner
  • Houston, TX
  • NPI 1134531122

  Pediatrics

  NPD Authorized official
• Heba K Aboul-Fotouh

  • Pediatrics Physician
  • Houston, TX
  • NPI 1205193919

  Single Specialty

  NPD
• Asmaa Tohami Fotouh, MD

  • Pediatrics Physician
  • Houston, TX
  • NPI 1225149404
  NPD
• Lesley Davis Gibson, M.D.

  • Pediatrics Physician
  • Houston, TX
  • NPI 1093093833
  NPD
• Tabassum Zaffar Imam, M.D.

  • Pediatrics Physician
  • Houston, TX
  • NPI 1639245905
  NPD
• Anju Annie Mammen, MD

  • Pediatrics Physician
  • Katy, TX
  • NPI 1073572525
  NPD (past)

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738886400000",
    "number": "1003091356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 GREENHOUSE RD STE 120",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770847305",
            "telephone_number": "281-492-7676",
            "fax_number": "281-492-8133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 GREENHOUSE RD STE 120",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770847305",
            "telephone_number": "281-492-7676",
            "fax_number": "281-492-8133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATY PEDIATRIC ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-07",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A",
        "authorized_official_last_name": "FULLEN",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "NURSE PRACTIONER",
        "authorized_official_telephone_number": "281-492-7676",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE BLUE SHIELD OF TEXAS",
            "identifier": "0016KB",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121010602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katy Freeway Medical Center
• Katy Internists, MD PA
• Katy Neuro & Wellness Center PLLC
• Katy Ortho Supplies LLC
• Katy Orthopedics & Sports Medicine PA
• Katy PT Clinic, L.L.C.
• Katy Sa Services, Inc
• Katy Surgery Center, P.a.
• Katy Vein Center
• Katy Welch Counseling, PLLC

• Pediatrics Physician in Houston, TX
• Providers in Houston, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.

Verify at the official NPI Registry.