Individual provider Active NPI

Phillip G Sutton, M.D.

  • Specialist
  • Houston, TX
National Provider Identifier
1083617914
Registry record updated May 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
E2891 Issued in TX
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, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
031953501MedicaidTX

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
E2891TXMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Phillip G Sutton MD PA PastSince Jan 1, 1990 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.

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

Verify at the official NPI Registry.