Individual provider Active NPI

Ronald Wayne Killam, MD

  • Internal Medicine Physician
  • Houston, TX
National Provider Identifier
1013960228
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
H5715 Issued in TX
Practice address
11110 East Fwy Ste 100a
Houston, TX 77029-1914
Phone
(713) 330-0766
Fax
(877) 862-8370
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X H5715 TX Primary

Addresses

Primary practice location

11110 East Fwy Ste 100a
Houston, TX 77029-1914

Mailing address

PO Box 96706
Houston, TX 77213-6706
Phone (713) 330-0766

Other practice location 1

11821 East Fwy Ste 175
Houston, TX 77029-1960
Phone (713) 330-0766

Other identifiers 10

IdentifierTypeStateIssuer
111525501MedicaidTX
111525504MedicaidTX
810621291OtherTXTAX IDENTIFICATION
8Z1542OtherTXBLUECROSS BLUESHIELD
111525505MedicaidTX
460986471OtherTXTAX IDENTIFICATION
8K3280OtherTXBLUE CROSS SHIELD
1518219104OtherTXGROUP NPI
00511BOtherTXBLUECROSS BLUESHIELD
10014941MedicaidTX

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050525000986 TX Practitioner - Internal Medicine 0648212027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Medical School at Houston, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11110 E Fwy
Suite 100a
Houston, TX 77029-1914
Phone (713) 330-0766

Hospital & facility affiliations

  • Ipr Healthcare Systems, Inc Home health agency, Houston, TX, CCN 458306
  • Harbor Hospice of Baytown LP Hospice, Baytown, TX, CCN 671645
  • St Luke'S Patients Medical Center Hospital, Pasadena, TX, CCN 670031
  • Baylor St Lukes Medical Center Hospital, Houston, TX, CCN 450193

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
H5715TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Houston Physicians Group, PA Internal Medicine CurrentSince Oct 30, 2012 Accepting new patients
Doc on the Bay Associated Enterprises Incorporated Internal Medicine PastSince Jul 1, 2003 Accepting new patients
PMC Hospital, LLC Past Accepting new patients
Chca Bayshore LP Past Accepting new patients

Locations

11110 East Fwy
Ste 100A
Houston, TX 77029
Phone (713) 330-0766

11821 I 10 East Fwy
Ste 175
Houston, TX 77029
Phone (713) 330-0766

13111 East Fwy
Ste 303
Houston, TX 77015
Phone (281) 768-7672

Networks

  • TX HMO

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: easthoustonmd@ehpg-tx.direct.office.nextgen.com

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1013960228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96706",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772136706",
            "telephone_number": "713-330-0766",
            "fax_number": "877-862-8370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11110 EAST FWY STE 100A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770291914",
            "telephone_number": "713-330-0766",
            "fax_number": "877-862-8370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11821 East Fwy Ste 175",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770291960",
            "country_code": "US",
            "telephone_number": "713-330-0766",
            "fax_number": "877-862-8370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILLAM",
        "first_name": "RONALD",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "H5715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111525501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111525504",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION",
            "identifier": "810621291",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "8Z1542",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111525505",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION",
            "identifier": "460986471",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS SHIELD",
            "identifier": "8K3280",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1518219104",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "00511B",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10014941",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.