Active NPI
Latha Mary Brubaker, MD
- Family Medicine Physician
- Houston, TX
National Provider Identifier
1043280886
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD00041537
- Practice address
- 12345 Katy Fwy
Suite 200
Houston, TX 77079-1503 - Phone
- (281) 679-5600
- Fax
- (281) 679-6510
- NPI assigned
- Jan 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD00041537 | WA | Primary |
Addresses
Primary practice location
12345 Katy Fwy
Suite 200
Houston, TX 77079-1503
Mailing address
5080 Spectrum Dr
Suite 1200 West
Addison, TX 75001-4648
Phone (800) 232-3550
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8322117 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| King County Public Hospital District No. 2 | Past | Accepting new patients | |
| Shoreline Family Practice LLP | Family Medicine | Past | Accepting new patients |
Organizations & group practices 2
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.
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-
- Family Medicine Physician
- Seattle, WA
- NPI 1942242342
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238457600000",
"number": "1043280886",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5080 SPECTRUM DR",
"address_2": "SUITE 1200 WEST",
"city": "ADDISON",
"state": "TX",
"postal_code": "750014648",
"telephone_number": "800-232-3550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12345 KATY FWY",
"address_2": "SUITE 200",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770791503",
"telephone_number": "281-679-5600",
"fax_number": "281-679-6510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUBAKER",
"first_name": "LATHA",
"middle_name": "MARY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-24",
"last_updated": "2009-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD00041537",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8322117",
"state": "WA"
}
],
"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 Mar 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.