Organization Active NPI

Greater Texan Health LLC

  • General Practice Physician
  • Houston, TX
National Provider Identifier
1053762104
Registry record updated Dec 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
Q2911 Issued in TX
Legal business name
GREATER TEXAN HEALTH LLC
Practice address
10021 Main St
Suite B-2
Houston, TX 77025-5224
Phone
(713) 248-1895
Fax
(713) 668-6248
NPI assigned
Jun 29, 2016
Last updated
Dec 13, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2016

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

Authorized official

Name
Azim Karim, MDNPI 1407119076
Title
Manager
Phone
(713) 248-1895

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
General Practice Physician 208D00000X Q2911 TX Primary

Addresses

Primary practice location

10021 Main St
Suite B-2
Houston, TX 77025-5224

Mailing address

10021 Main St
Suite B-2
Houston, TX 77025-5224
Phone (713) 248-1895

Other identifiers 1

IdentifierTypeStateIssuer
399618ZM80OtherTXMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170125001859 TX Part B Supplier - Clinic/Group Practice 1850673948 Receives reassigned benefits from 4 practitioners
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Locations

10021 Main St
Ste B2
Houston, TX 77025
Phone (713) 248-1895

Practitioners & affiliated clinicians

Practitioners 4

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": "1467158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481587200000",
    "number": "1053762104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10021 MAIN ST",
            "address_2": "SUITE B-2",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770255224",
            "telephone_number": "713-248-1895",
            "fax_number": "713-668-6248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10021 MAIN ST",
            "address_2": "SUITE B-2",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770255224",
            "telephone_number": "713-248-1895",
            "fax_number": "713-668-6248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER TEXAN HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-29",
        "last_updated": "2016-12-13",
        "status": "A",
        "authorized_official_last_name": "KARIM",
        "authorized_official_first_name": "AZIM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "713-248-1895",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "Q2911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "399618ZM80",
            "state": "TX"
        }
    ],
    "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 Dec 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.