Organization Active NPI

Memorial Rheumatology PA

  • Rheumatology Physician
  • Houston, TX
National Provider Identifier
1154699049
Registry record updated May 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
N4434 Issued in TX
Legal business name
MEMORIAL RHEUMATOLOGY PA
Practice address
902 Frostwood Dr
Ste 205
Houston, TX 77024-2420
Phone
(713) 360-2020
Fax
(713) 360-2021
NPI assigned
Dec 6, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2012

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

Authorized official

Name
Dr. Alexandra Gonzalez-Fuentes, MDNPI 1265686232
Title
MD
Phone
(713) 360-2020

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
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X N4434 TX Primary

Addresses

Primary practice location

902 Frostwood Dr
Ste 205
Houston, TX 77024-2420

Mailing address

902 Frostwood Dr
Ste 205
Houston, TX 77024-2420
Phone (713) 360-2020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120625000639 TX Part B Supplier - Clinic/Group Practice 9335304344 Receives reassigned benefits from 3 practitioners
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Locations

902 Frostwood Dr
Ste 205
Houston, TX 77024
Phone (713) 360-2020

Practitioners & affiliated clinicians

Practitioners 30

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.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1323129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336348800000",
    "number": "1154699049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 FROSTWOOD DR",
            "address_2": "STE 205",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770242420",
            "telephone_number": "713-360-2020",
            "fax_number": "713-360-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 FROSTWOOD DR",
            "address_2": "STE 205",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770242420",
            "telephone_number": "713-360-2020",
            "fax_number": "713-360-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL RHEUMATOLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-06",
        "last_updated": "2012-05-07",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ-FUENTES",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "713-360-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "TX",
            "license": "N4434",
            "primary": true
        }
    ],
    "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 May 7, 2012; 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.