NPIMap

Organization Active NPI

La Providence Medical Center

  • Pediatrics Physician
  • Houston, TX
National Provider Identifier
1063824829
Registry record updated Jul 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
201564 Issued in LA
Legal business name
LA PROVIDENCE MEDICAL CENTER
Practice address
9644 Court Glen Dr
Houston, TX 77099-2541
Phone
(713) 909-3139
Fax
(713) 909-6002
NPI assigned
May 28, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2014

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

Authorized official

Name
Dr. Ifeyinwa Onwudiwe, M.D.NPI 1285842724
Title
Owner/MD
Phone
(713) 909-3139

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 201564 LA Primary

Addresses

Primary practice location

9644 Court Glen Dr
Houston, TX 77099-2541

Mailing address

9644 Court Glen Dr
Houston, TX 77099-2541
Phone (713) 909-3139

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1401235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406246400000",
    "number": "1063824829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9644 COURT GLEN DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770992541",
            "telephone_number": "713-909-3139",
            "fax_number": "713-909-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9644 COURT GLEN DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770992541",
            "telephone_number": "713-909-3139",
            "fax_number": "713-909-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA PROVIDENCE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-28",
        "last_updated": "2014-07-25",
        "status": "A",
        "authorized_official_last_name": "ONWUDIWE",
        "authorized_official_first_name": "IFEYINWA",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "713-909-3139",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "201564",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 25, 2014; 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.