Organization Active NPI

Premier NW Houston Medical Group, PA

  • Internal Medicine Physician
  • Cypress, TX
National Provider Identifier
1124115308
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M0840 Issued in TX
Legal business name
PREMIER NW HOUSTON MEDICAL GROUP, PA
Practice address
7025 Fry Rd Ste 500
Cypress, TX 77433-8150
Phone
(281) 758-1022
Fax
(281) 758-1032
NPI assigned
Oct 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2022

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

Authorized official

Name
Dr. Janette Nguyen, M.D.NPI 1912994104
Title
Physician Owner
Phone
(281) 758-1022

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X M0840 TX Primary

Addresses

Primary practice location

7025 Fry Rd Ste 500
Cypress, TX 77433-8150

Mailing address

PO Box 691524
Houston, TX 77269-1524
Phone (281) 758-1022

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070205000542 TX Part B Supplier - Clinic/Group Practice 7517969561 Receives reassigned benefits from 6 practitioners
Practice locations: Cypress, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1063165Premier NW Houston Medical Group, PA7025 Fry Rd, Ste 500, Cypress, TX 77433Certificate of waiverJan 7, 2027

National Provider Directory

National Provider Directory

Locations

7025 Fry Rd
Ste 500
Cypress, TX 77433
Phone (281) 758-1022

13203 Fry Rd
Ste 800
Cypress, TX 77433
Phone (281) 517-0025

Practitioners & affiliated clinicians

Practitioners 6

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": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652400000000",
    "number": "1124115308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 691524",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772691524",
            "telephone_number": "281-758-1022",
            "fax_number": "281-758-1032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7025 FRY RD STE 500",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774338150",
            "telephone_number": "281-758-1022",
            "fax_number": "281-758-1032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER NW HOUSTON MEDICAL GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2022-05-13",
        "certification_date": "2021-10-08",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "JANETTE",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "281-758-1022",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M0840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.