Providence Family Practice PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PROVIDENCE FAMILY PRACTICE PA

Practice address

9798 Bellaire Blvd
Suite D
Houston, TX 77036-3427

Phone

(713) 270-7224

Fax

(713) 270-0084

NPI assigned

Mar 16, 2006

Organization subpart

No

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

Authorized official

Name

Khanh N Ngo, DONPI 1245299841

Title

President

Phone

(713) 270-7224

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 2

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

• Khanh N Ngo, DO

  • Family Medicine Physician
  • Houston, TX
  • NPI 1245299841
  Medicare reassignment Care Compare group NPD Authorized official
• Susan T Lee, DO

  • Family Medicine Physician
  • Houston, TX
  • NPI 1629039573
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1255300612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9798 BELLAIRE BLVD",
            "address_2": "SUITE D",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770363427",
            "telephone_number": "713-270-7224",
            "fax_number": "713-270-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9798 BELLAIRE BLVD",
            "address_2": "SUITE D",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770363427",
            "telephone_number": "713-270-7224",
            "fax_number": "713-270-0084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE FAMILY PRACTICE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-16",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "NGO",
        "authorized_official_first_name": "KHANH",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-270-7224",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z4078R6",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Providence Clearlake Specialty Hospital LLC (Clearlake Specialty Hospital)
• Providence EMS LLC
• Providence ER of Clearlake, PLLC (Houston Medical ER)
• Providence ER of Northwest PLLC (Cypress Creek ER)
• Providence Everly Haven Home Healthcare, LLC
• Providence Healthcare of TX (PHT Heal)
• Providence Home Dialysis LLC
• Providence Hospice Care Inc
• Providence Hospital of North Houston LLC
• Providence Pharmacy & Medical Supplies, Inc. (Providence Pharmacy)

• Family Medicine Physician in Houston, TX
• Providers in Houston, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.