Organization Active NPI

Pabj LP

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1063468445
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
PABJ LP
Practice address
11800 FM 1960 Rd W
Houston, TX 77065-3840
Phone
(281) 664-2107
Fax
(281) 955-5875
NPI assigned
May 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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

Authorized official

Name
David R Mack, MD
Title
Managing Partner
Phone
(281) 664-2107

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X TX
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA05232 TX
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X TX
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA02925 TX
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA01427 TX

Addresses

Primary practice location

11800 FM 1960 Rd W
Houston, TX 77065-3840

Mailing address

11800 FM 1960 Rd W
Houston, TX 77065-3840
Phone (281) 664-2107

Other identifiers 1

IdentifierTypeStateIssuer
0033NLOtherTXBC/BS PIN

National Provider Directory

National Provider Directory

Locations

13300 Hargrave Rd
Ste 400
Houston, TX 77070
Phone (281) 664-2107

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480464000000",
    "number": "1063468445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 FM 1960 RD W",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770653840",
            "telephone_number": "281-664-2107",
            "fax_number": "281-955-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 FM 1960 RD W",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770653840",
            "telephone_number": "281-664-2107",
            "fax_number": "281-955-5875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PABJ LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2016-11-30",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "281-664-2107",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05232",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02925",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA01427",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PIN",
            "identifier": "0033NL",
            "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 Nov 30, 2016; 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.