Southeast Houston Two Medical Group, PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

SOUTHEAST HOUSTON TWO MEDICAL GROUP, PLLC

Practice address

16131 N Eldridge Pkwy Ste 100
Tomball, TX 77377-9130

Phone

(281) 429-8525

NPI assigned

Aug 18, 2021

Organization subpart

No

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

Authorized official

Name

Welton Wayne Wilson

Title

Manager

Phone

(281) 429-8525

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1629244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1154097319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16131 N ELDRIDGE PKWY STE 100",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773779130",
            "telephone_number": "281-429-8525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16131 N ELDRIDGE PKWY STE 100",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773779130",
            "telephone_number": "281-429-8525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST HOUSTON TWO MEDICAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-18",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "WELTON",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "281-429-8525"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kentola Sok, CNIM
• Sloane Grey Soler, RBT
• Southeast Fort Worth Two Medical Group, PLLC
• Southeast Four Medical Group, PLLC
• Southeast Houston Three Medical Group, PLLC
• Southeast Midland One Medical Group, PLLC
• Southeast Three Medical Group, PLLC
• Southeast Two Medical Group, PLLC
• Southern Knights
• Southern Knights, Inc.

• Primary Care Clinic/Center in Tomball, TX
• Providers in Tomball, TX by specialty
• Primary Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; 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.