Organization Active NPI

Life Healthcare Medical Services

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1124915954
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LIFE HEALTHCARE MEDICAL SERVICES
Practice address
9100 Southwest Fwy Ste 247
Houston, TX 77074-1531
Phone
(949) 431-9939
Fax
(714) 784-5438
NPI assigned
Jun 23, 2025
Last updated
Jun 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Authorized official

Name
Mr. Sam Jeffery
Title
Business Head
Phone
(716) 301-2036

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Clinic/Center 261Q00000X NU

Addresses

Primary practice location

9100 Southwest Fwy Ste 247
Houston, TX 77074-1531

Mailing address

9100 Southwest Fwy Ste 247
Houston, TX 77074-1531

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251010001259 TX Part B Supplier - Clinic/Group Practice 1658878046 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Locations

9100 Southwest Fwy
Ste 247
Houston, TX 77074
Phone (949) 431-9939

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1750636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750636800000",
    "number": "1124915954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 SOUTHWEST FWY STE 247",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770741531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 SOUTHWEST FWY STE 247",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770741531",
            "telephone_number": "949-431-9939",
            "fax_number": "714-784-5438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE HEALTHCARE MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-23",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A",
        "authorized_official_last_name": "JEFFERY",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "BUSINESS HEAD",
        "authorized_official_telephone_number": "716-301-2036",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Jun 23, 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.