Individual provider Active NPI

Jessica Lan To, MD

  • Pediatrics Physician
  • Katy, TX
National Provider Identifier
1023647997
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
U1147 Issued in TX
Practice address
23900 Katy Fwy
Katy, TX 77494-1323
Phone
(281) 644-7000
NPI assigned
Apr 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X U1147 TX Primary

Addresses

Primary practice location

23900 Katy Fwy
Katy, TX 77494-1323

Mailing address

6431 Fannin Street
MSB 3.151
Houston, TX 77030

Other practice location 1

6431 Fannin Street
MSB 3.151
Houston, TX 77030
Phone (832) 618-9315

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
I20231215003467 TX Practitioner - Pediatric MedicinePractitioner - Hospitalist 0749639748 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians Pediatrics CurrentSince Dec 1, 2023 Accepting new patients
Ut Physicians CurrentSince Dec 1, 2023 Accepting new patients
Memorial Hermann Health System Past Accepting new patients

Locations

6431 Fannin St
#3151
Houston, TX 77030
Phone (713) 500-5800

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

6410 Fannin St
Ste LL135
Houston, TX 77030
Phone (832) 325-6543

23900 Katy Fwy
Katy, TX 77494
Phone (281) 644-7000

Organizations & group practices 3

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": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1023647997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6431 FANNIN STREET",
            "address_2": "MSB 3.151",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23900 KATY FWY",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774941323",
            "telephone_number": "281-644-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6431 Fannin Street",
            "address_2": "MSB 3.151",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "77030",
            "country_code": "US",
            "telephone_number": "832-618-9315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TO",
        "first_name": "JESSICA",
        "middle_name": "LAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "U1147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.