Organization Active NPI

Pine Forrest Functional Medicine

  • Family Medicine Physician
  • Spring, TX
National Provider Identifier
1154915205
Registry record updated Nov 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PINE FORREST FUNCTIONAL MEDICINE
Practice address
25312 I H 45
Spring, TX 77386-1449
Phone
(346) 418-9642
Fax
(713) 513-5524
NPI assigned
Mar 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2025

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

Authorized official

Name
Thu Anh Hoang, MDNPI 1801821699
Title
Owner
Phone
(972) 743-5136

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
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

25312 I H 45
Spring, TX 77386-1449

Mailing address

25312 I H 45
Spring, TX 77386-1449
Phone (346) 418-9642

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210412000388 TX Part B Supplier - Clinic/Group Practice 5395153472 Receives reassigned benefits from 2 practitioners
Practice locations: Shenandoah, TX

National Provider Directory

National Provider Directory

Locations

150 Pine Forest Dr
Shenandoah, TX 77384
Phone (281) 351-8100

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761955200000",
    "number": "1154915205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25312 I H 45",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773861449",
            "telephone_number": "346-418-9642",
            "fax_number": "713-513-5524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25312 I H 45",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773861449",
            "telephone_number": "346-418-9642",
            "fax_number": "713-513-5524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE FORREST FUNCTIONAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-01",
        "last_updated": "2025-11-01",
        "certification_date": "2025-11-01",
        "status": "A",
        "authorized_official_last_name": "HOANG",
        "authorized_official_first_name": "THU",
        "authorized_official_middle_name": "ANH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-743-5136",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2025; 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.