Organization Active NPI

Prime Vital

  • Multi-Specialty Clinic/Center
  • Conroe, TX
National Provider Identifier
1184501413
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PRIME VITAL
Practice address
2017 N Frazier St Ste G8A
Conroe, TX 77301-1248
Phone
(936) 703-3468
Fax
(936) 703-3469
NPI assigned
Aug 19, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Authorized official

Name
Clara Ike, FNP-CNPI 1699278960
Title
Owner
Phone
(832) 656-6790

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
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

2017 N Frazier St Ste G8A
Conroe, TX 77301-1248

Mailing address

2257 N Loop 336 W Ste 140-246
Conroe, TX 77304-3566
Phone (832) 656-6790

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260108004151 TX Part B Supplier - Clinic/Group Practice 9436635414 Receives reassigned benefits from 1 practitioner
Practice locations: Conroe, TX

National Provider Directory

National Provider Directory

Locations

2017 N Frazier St
Ste G8A
Conroe, TX 77301

2257 N Loop 336 W
Ste 140246
Conroe, TX 77304
Phone (832) 656-6790

2757 N Loop 336 W
Ste 140 246
Conroe, TX 77304

Practitioners & affiliated clinicians

Practitioners 1

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": "1755561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785801600000",
    "number": "1184501413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2257 N LOOP 336 W STE 140-246",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043566",
            "telephone_number": "832-656-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 N FRAZIER ST STE G8A",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773011248",
            "telephone_number": "936-703-3468",
            "fax_number": "936-703-3469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME VITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-19",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A",
        "authorized_official_last_name": "IKE",
        "authorized_official_first_name": "CLARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "832-656-6790",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; 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.