Active NPI
Tewlyn Ramsaye Yoburn, PA-C
- Physician Assistant
- Houston, TX
National Provider Identifier
1053635425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA06646
- Practice address
- 1515 Holcombe Blvd
Houston, TX 77030-4009 - Phone
- (713) 792-6161
- NPI assigned
- Mar 15, 2010
- Last updated
- Oct 14, 2010
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA06646 | TX | Primary |
Addresses
Primary practice location
1515 Holcombe Blvd
Houston, TX 77030-4009
Mailing address
P O Box 4439
Houston, TX 77210-4439
Phone (713) 792-2991
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 818N94 | Other | TX | BCBS |
| 213591501 | Medicaid | TX |
Other names 1
- Tewlyn Ramsaye Underwood
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: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Interoperability endpoints
- tyoburn46613@utmdandersoncc.direct-ci.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Houston, TX
- NPI 1073574810
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287014400000",
"number": "1053635425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P O BOX 4439",
"city": "HOUSTON",
"state": "TX",
"postal_code": "772104439",
"telephone_number": "713-792-2991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 HOLCOMBE BLVD",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770304009",
"telephone_number": "713-792-6161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOBURN",
"first_name": "TEWLYN",
"middle_name": "RAMSAYE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-03-15",
"last_updated": "2010-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA06646",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "818N94",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "213591501",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "TEWLYN",
"last_name": "UNDERWOOD",
"middle_name": "RAMSAYE",
"code": "5",
"type": "Other Name"
}
]
}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 Oct 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.