NPIMap

Organization Active NPI

Pre Diabetes Physician Services Inc

  • Specialist
  • Stafford, TX
National Provider Identifier
1154732535
Registry record updated May 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
J4115 Issued in TX
Legal business name
PRE DIABETES PHYSICIAN SERVICES INC
Practice address
12603 Southwest Fwy Ste 600
Stafford, TX 77477-3838
Phone
(512) 623-4900
NPI assigned
May 19, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2014

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

Authorized official

Name
Mr. Randy Marfin
Title
Ceo
Phone
(512) 623-4919

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X J4115 TX Primary

Addresses

Primary practice location

12603 Southwest Fwy Ste 600
Stafford, TX 77477-3838

Mailing address

3721 Executive Center Dr Ste 160
Austin, TX 78731-1607
Phone (512) 623-4900

National Provider Directory

National Provider Directory
Tax ID family
Pre Diabetes Physician Services Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3721 Executive Center Dr
Ste 160
Austin, TX 78731
Phone (512) 623-4900

NPI Registry JSON

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400457600000",
    "number": "1154732535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3721 EXECUTIVE CENTER DR STE 160",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787311607",
            "telephone_number": "512-623-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12603 SOUTHWEST FWY STE 600",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774773838",
            "telephone_number": "512-623-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRE DIABETES PHYSICIAN SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-19",
        "last_updated": "2014-05-19",
        "status": "A",
        "authorized_official_last_name": "MARFIN",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "512-623-4919",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "J4115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2014; 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.