Medsource

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

007971 Issued in TX

Legal business name

MEDSOURCE

Practice address

1630 Hilton Head Dr
Missouri City, TX 77459-3420

Phone

(713) 532-7311

Fax

(713) 532-7399

NPI assigned

Dec 14, 2007

Last updated

Dec 14, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Sylvia Boards

Title

Owner

Phone

(713) 532-7311

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197590400000",
    "number": "1235312000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 HILTON HEAD DR",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774593420",
            "telephone_number": "713-532-7311",
            "fax_number": "713-532-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 HILTON HEAD DR",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774593420",
            "telephone_number": "713-532-7311",
            "fax_number": "713-532-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSOURCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-14",
        "last_updated": "2007-12-14",
        "status": "A",
        "authorized_official_last_name": "BOARDS",
        "authorized_official_first_name": "SYLVIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-532-7311",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "007971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ericka D Medinger, DNP
• Medium Brand LLC (Singularity Health)
• Medlin Pharmacy Inc
• Georgetta Marie Medlock, LPC, NCC
• Keeleey Medlow
• Medsource Pharmacy, LLC
• Medxas2
• Mega Health Care Providers, Inc.
• Willow Meline, DMD
• Melissa Earls, LPC (Peace of Mind Counseling)

• Ambulatory Surgical Clinic/Center in Missouri City, TX
• Providers in Missouri City, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; 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.