Phenomenal Outreach Center

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

PHENOMENAL OUTREACH CENTER

Practice address

6102 Laura Koppe Rd
Houston, TX 77016-5440

Phone

(832) 877-2207

NPI assigned

Oct 29, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Mary Helen Jackson

Title

Owner/Program Manager

Phone

(832) 877-2207

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1319846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320624000000",
    "number": "1063798452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6102 LAURA KOPPE RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770165440",
            "telephone_number": "832-877-2207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6102 LAURA KOPPE RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770165440",
            "telephone_number": "832-877-2207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHENOMENAL OUTREACH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-29",
        "last_updated": "2011-11-07",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "HELEN",
        "authorized_official_title_or_position": "OWNER/PROGRAM MANAGER",
        "authorized_official_telephone_number": "832-877-2207",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lachure Phelps
• Myra Phelps, LCSW
• Shawna Rene Phelps, PTA
• Traci Phelps
• Phenomenal Health Care, PLLC
• Kobe Phetnavong
• Angela Phettaphong
• Anthony Hoang Phi, M.D.
• Crystal Van Anh Phi, DDS
• Phico Health Care Services, Inc

• Health Maintenance Organization in Houston, TX
• Providers in Houston, TX by specialty
• Health Maintenance Organization in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.