Organization Active NPI

Texas Integrated Care Group, PLLC

  • Internal Medicine Physician
  • Conroe, TX
National Provider Identifier
1124982863
Registry record updated Aug 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
TEXAS INTEGRATED CARE GROUP, PLLC
Practice address
186 Moon Dance CT
Conroe, TX 77304-2240
Phone
(940) 331-6734
NPI assigned
Dec 15, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2026

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

Authorized official

Name
Basil Nduma, MDNPI 1891436713
Title
Member
Phone
(940) 331-6734

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 Primary

Addresses

Primary practice location

186 Moon Dance CT
Conroe, TX 77304-2240

Mailing address

186 Moon Dance CT
Conroe, TX 77304-2240
Phone (940) 331-6734

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260513000186 TX Part B Supplier - Clinic/Group Practice 7810466406 Receives reassigned benefits from 1 practitioner
Practice locations: Conroe, TX

National Provider Directory

National Provider Directory

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": "1765756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787961600000",
    "number": "1124982863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 MOON DANCE CT",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042240",
            "telephone_number": "940-331-6734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 MOON DANCE CT",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042240",
            "telephone_number": "940-331-6734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS INTEGRATED CARE GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-15",
        "last_updated": "2026-08-29",
        "certification_date": "2026-08-29",
        "status": "A",
        "authorized_official_last_name": "NDUMA",
        "authorized_official_first_name": "BASIL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "940-331-6734",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2026; 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.