Individual provider Active NPI

Denise Metry, MD

  • Pediatrics Physician
  • Houston, TX
National Provider Identifier
1154401560
Registry record updated Nov 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
K9616 Issued in TX
Practice address
6701 Fannin St
8TH Floor
Houston, TX 77030-2316
Phone
(832) 822-3557
Fax
(832) 825-3722
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X K9616 TX Primary
Dermatology Physician 207N00000X K9616 TX

Addresses

Primary practice location

6701 Fannin St
8TH Floor
Houston, TX 77030-2316

Mailing address

6621 Fannin St
Cc620.16
Houston, TX 77030-2303
Phone (832) 822-3557

Other identifiers 1

IdentifierTypeStateIssuer
106155801MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101102001218 TX Practitioner - Dermatology 6507050663 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
K9616TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Physician Services of South Texas Pediatrics CurrentSince Sep 1, 2024 Accepting new patients
Children'S Physician Services of South Texas CurrentSince Sep 1, 2024 Accepting new patients

Locations

3533 S Alameda St
Corpus Christi, TX 78411
Phone (361) 694-5445

3533 S Alameda St
Ste 203
Corpus Christi, TX 78411

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289865600000",
    "number": "1154401560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST",
            "address_2": "CC620.16",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302303",
            "telephone_number": "832-822-3557",
            "fax_number": "832-825-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 FANNIN ST",
            "address_2": "8TH FLOOR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302316",
            "telephone_number": "832-822-3557",
            "fax_number": "832-825-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METRY",
        "first_name": "DENISE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2010-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K9616",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "K9616",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106155801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.