NPIMap

Organization Active NPI

Tmp413Llc

Doing business as ClinicaAngelica

  • Primary Care Clinic/Center
  • Houston, TX
National Provider Identifier
1265913057
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
TMP413LLC
Doing business as
ClinicaAngelica
Practice address
601 S Wayside Dr # B
Houston, TX 77011-4603
Phone
(832) 475-4430
NPI assigned
Aug 28, 2018
Last updated
Aug 28, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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

Authorized official

Name
Eunice Mbesa, FNP
Title
Family Nurse Practitioner
Phone
(832) 475-4430

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

601 S Wayside Dr # B
Houston, TX 77011-4603

Mailing address

16858 Big Reed Dr
Humble, TX 77346-4203

Other identifiers 1

IdentifierTypeStateIssuer
1679814115MedicaidTX

Other names 1

  • ClinicaAngelica Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535414400000",
    "number": "1265913057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16858 BIG REED DR",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773464203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S WAYSIDE DR # B",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770114603",
            "telephone_number": "832-475-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TMP413LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-28",
        "last_updated": "2018-08-28",
        "status": "A",
        "authorized_official_last_name": "MBESA",
        "authorized_official_first_name": "EUNICE",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "832-475-4430",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679814115",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ClinicaAngelica",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; 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.