Penn Imaging of Humble, LP

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

PENN IMAGING OF HUMBLE, LP

Practice address

9802 FM 1960 Bypass Rd W Ste 100
Humble, TX 77338-3572

Phone

(281) 358-3800

Fax

(281) 358-3910

NPI assigned

Sep 1, 2006

Organization subpart

No

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

Authorized official

Name

Gracie De Leon

Title

Administrator

Phone

(281) 358-3800

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Green Oak Diagnostics Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392768000000",
    "number": "1215039367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9802 FM 1960 BYPASS RD W STE 100",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773383572",
            "telephone_number": "281-358-3800",
            "fax_number": "281-358-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9802 FM 1960 BYPASS RD W STE 100",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773383572",
            "telephone_number": "281-358-3800",
            "fax_number": "281-358-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENN IMAGING OF HUMBLE, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2014-02-19",
        "status": "A",
        "authorized_official_last_name": "DE LEON",
        "authorized_official_first_name": "GRACIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "281-358-3800"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173119201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Green Oak Diagnostics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dorothy Pei, M.D.
• Erica L Pelote, MD
• Kristi Pena, PT
• Nayona Pena, LMSW
• Ruby Pena, DDS
• Holly Peralez, LAC
• Chondra Adele Perdue, MS LPC LCPC LCDC NCC
• Jessica Pereira, BCBA
• Angelique Garza Perez, DDS
• Maria Gabriela Perez, DDS

• Physiological Laboratory in Humble, TX
• Providers in Humble, TX by specialty
• Physiological Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.