Organization Active NPI

Evergreen Physiatry, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Houston, TX
National Provider Identifier
1114754066
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
EVERGREEN PHYSIATRY, PLLC
Practice address
13031 Wortham Center Dr
Houston, TX 77065-5662
Phone
(214) 970-6817
Fax
(844) 803-4513
NPI assigned
Sep 16, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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

Authorized official

Name
Lesley Abraham Thomas, MDNPI 1982090049
Title
Owner
Phone
(214) 970-6817

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
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

13031 Wortham Center Dr
Houston, TX 77065-5662

Mailing address

2637 N 400 E Ste 164
North Ogden, UT 84414-2240
Phone (214) 970-6817

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241211001022 TX Part B Supplier - Clinic/Group Practice 1850827007 Receives reassigned benefits from 1 practitioner
Practice locations: Austin, TX; Houston, TX

National Provider Directory

National Provider Directory

Locations

5900 Balcones Dr
#8695
Austin, TX 78731

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": "1726444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767052800000",
    "number": "1114754066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2637 N 400 E STE 164",
            "city": "NORTH OGDEN",
            "state": "UT",
            "postal_code": "844142240",
            "telephone_number": "214-970-6817",
            "fax_number": "844-803-4513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13031 WORTHAM CENTER DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770655662",
            "telephone_number": "214-970-6817",
            "fax_number": "844-803-4513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN PHYSIATRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-16",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "LESLEY",
        "authorized_official_middle_name": "ABRAHAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-970-6817",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "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 Dec 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.