Northstar PCP Network, LLC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

NORTHSTAR PCP NETWORK, LLC

Practice address

2918 San Jacinto St
Suite 150
Houston, TX 77004-2708

Phone

(734) 709-6477

NPI assigned

Jun 17, 2016

Organization subpart

Yes

Parent organization

NORTHSTAR PCP NETWORK, LPAs reported in NPPES

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

Authorized official

Name

Arley Gonzalez Sr.

Title

Ceo

Phone

(713) 478-3313

Specialties & licenses 1

Addresses

Other names 1

• PrimeCare MSO Doing business as

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

{
    "created_epoch": "1466121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466121600000",
    "number": "1134579303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4114 SABLEMIST CT",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770142032",
            "telephone_number": "713-478-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2918 SAN JACINTO ST",
            "address_2": "SUITE 150",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770042708",
            "telephone_number": "734-709-6477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSTAR PCP NETWORK, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHSTAR PCP NETWORK, LP",
        "enumeration_date": "2016-06-17",
        "last_updated": "2016-06-17",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "ARLEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "713-478-3313",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PrimeCare MSO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Northstar Pain Management, P. a.
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• Northwest Ambulatory Surgery Center
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• Northwest Anesthesiology & Pain Services, P.a.
• Northwest Anesthesiology and Pain Associates, PLLC

• Preferred Provider Organization in Houston, TX
• Providers in Houston, TX by specialty
• Preferred Provider Organization in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.