Individual provider Active NPI

Jack Price, M.D.

  • Pediatric Cardiology Physician
  • Houston, TX
National Provider Identifier
1225118649
Registry record updated Sep 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
L6586 Issued in TX
Practice address
6621 Fannin St
Mc19345-C
Houston, TX 77030-2303
Phone
(832) 826-5664
Fax
(832) 825-1906
NPI assigned
Oct 17, 2006
Last updated
Sep 21, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X L6586 TX Primary

Addresses

Primary practice location

6621 Fannin St
Mc19345-C
Houston, TX 77030-2303

Mailing address

6621 Fannin St
Houston, TX 77030-2303
Phone (832) 826-5664

Other identifiers 1

IdentifierTypeStateIssuer
149794301MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080215000071 TX Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 8022191972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Cardiovascular Disease (Cardiology)
Education
University of Oklahoma College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Childrens Physician GroupGroup PAC ID 4385722081, 661 clinicians

Practice addresses (Care Compare)

17600 Interstate 45 S
The Woodlands, TX 77384-4193
Phone (832) 828-3660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
39872TXMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children's Physician Group CurrentSince Nov 5, 2020 Accepting new patients

Locations

6621 Fannin St
Houston, TX 77030
Phone (832) 824-1866

6621 Fannin St
Ste 19345C
Houston, TX 77030
Phone (832) 826-5600

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

101 W Expressway 83
McAllen, TX 78503
Phone (956) 661-9840

17600 Interstate 45 S
The Woodlands, TX 77384
Phone (936) 267-5000

Interoperability endpoints

  • Direct secure messaging: jprice5874@prddirect.texaschildrens.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190332800000",
    "number": "1225118649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302303",
            "telephone_number": "832-826-5664",
            "fax_number": "832-825-1906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST",
            "address_2": "MC19345-C",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302303",
            "telephone_number": "832-826-5664",
            "fax_number": "832-825-1906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICE",
        "first_name": "JACK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "TX",
            "license": "L6586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149794301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.