Organization Active NPI

Nasa Casa de Ninos Pediatric Center, PA

  • Pediatrics Physician
  • Houston, TX
National Provider Identifier
1023329117
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
J5879 Issued in TX
Legal business name
NASA CASA DE NINOS PEDIATRIC CENTER, PA
Practice address
13630 Beamer Rd Ste 108
Houston, TX 77089
Phone
(281) 464-3780
Fax
(281) 464-3832
NPI assigned
Jun 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Authorized official

Name
Idalia R Rivera-Matos, MDNPI 1508936576
Title
President
Phone
(281) 323-9724

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X J5879 TX Primary

Addresses

Primary practice location

13630 Beamer Rd Ste 108
Houston, TX 77089

Mailing address

13630 Beamer Rd Ste 108
Houston, TX 77089-6037
Phone (281) 464-3780

Other practice location 1

4014 Woodlawn Ave Ste A
Pasadena, TX 77504-1921
Phone (713) 239-0980

National Provider Directory

National Provider Directory

Locations

13630 Beamer Rd
Ste 108
Houston, TX 77089
Phone (281) 464-3780

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1023329117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13630 BEAMER RD STE 108",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770896037",
            "telephone_number": "281-464-3780",
            "fax_number": "281-464-3832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13630 BEAMER RD STE 108",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77089",
            "telephone_number": "281-464-3780",
            "fax_number": "281-464-3832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4014 Woodlawn Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "TX",
            "postal_code": "775041921",
            "country_code": "US",
            "telephone_number": "713-239-0980",
            "fax_number": "832-831-8623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NASA CASA DE NINOS PEDIATRIC CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-23",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A",
        "authorized_official_last_name": "RIVERA-MATOS",
        "authorized_official_first_name": "IDALIA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-323-9724",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "J5879",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 29, 2024; 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.