Active NPI
Phillip G Sutton, M.D.
- Specialist
- Houston, TX
National Provider Identifier
1083617914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- E2891
- Practice address
- 17203 Red Oak Dr
Suite 103
Houston, TX 77090-2612 - Phone
- (281) 893-2288
- Fax
- (281) 893-2882
- NPI assigned
- May 24, 2005
- Last updated
- May 28, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | E2891 | TX | Primary |
Addresses
Primary practice location
17203 Red Oak Dr
Suite 103
Houston, TX 77090-2612
Mailing address
17203 Red Oak Dr
Suite 103
Houston, TX 77090-2640
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 031953501 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080226000699 | TX | Practitioner - General Surgery | 0840374096 | Practice locations: Houston, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E2891 | TX | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phillip G Sutton MD PA | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Surgery Physician
- Houston, TX
- NPI 1669646535
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275004800000",
"number": "1083617914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17203 RED OAK DR",
"address_2": "SUITE 103",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770902640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17203 RED OAK DR",
"address_2": "SUITE 103",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770902612",
"telephone_number": "281-893-2288",
"fax_number": "281-893-2882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTTON",
"first_name": "PHILLIP",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-05-24",
"last_updated": "2010-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "TX",
"license": "E2891",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "031953501",
"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 May 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.