Champions Spine Center PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

N3996 Issued in TX

Legal business name

CHAMPIONS SPINE CENTER PA

Doing business as

Lake Jackson Family Practice PA

Practice address

135 Oyster Creek Dr Ste W
Lake Jackson, TX 77566-4117

Phone

(979) 299-1200

Fax

(979) 299-1205

NPI assigned

Aug 9, 2011

Last updated

Aug 9, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

CHAMPIONS SPINE CENTER PAAs reported in NPPES

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

Authorized official

Name

Mr. Thomas Nguyen

Title

Billing Manager

Phone

(713) 774-5462

Specialties & licenses 1

Addresses

Other names 1

• LAKE JACKSON FAMILY PRACTICE PA Doing business as

Part of

Champions Spine Center PA

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Champions Spine Center PA

  dba Lake Jackson Family Practice, PA

  • Orthopaedic Surgery of the Spine Physician
  • Houston, TX
  • NPI 1568691327
  NPPES parent name

Practitioners 1

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.

• Saqib A Siddiqui, MD

  • Orthopaedic Surgery of the Spine Physician
  • San Antonio, TX
  • NPI 1083686539
  NPD (past)

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312848000000",
    "number": "1053690016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14450 TC JESTER BLVD STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770141332",
            "telephone_number": "713-774-5462",
            "fax_number": "713-774-5478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 OYSTER CREEK DR STE W",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775664117",
            "telephone_number": "979-299-1200",
            "fax_number": "979-299-1205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPIONS SPINE CENTER PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHAMPIONS SPINE CENTER PA",
        "enumeration_date": "2011-08-09",
        "last_updated": "2011-08-09",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "713-774-5462",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N3996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAKE JACKSON FAMILY PRACTICE PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• April Christine Caudillo
• Philip Floyd Carpio Cauli, PHARMD, RPH
• Maritza Cervantes
• Kati Paige Chamberlain, PTA
• Amanda Lee Champion, MS,CCC-SLP
• Tasha Chaoman, FNP-C
• Janet Chen, PHARM.D., R.PH
• Adnan Chowdhury
• Christopher Morales (Baker Chiropractic Center)
• Jennifer Michelle Cisneros, SLP

• Family Medicine Physician in Lake Jackson, TX
• Providers in Lake Jackson, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; 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.