Organization Active NPI

Elite Breast & Trauma Care

  • Plastic and Reconstructive Surgery Physician
  • Houston, TX
National Provider Identifier
1275071292
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
Legal business name
ELITE BREAST & TRAUMA CARE
Practice address
7400 Fannin St # 700C
Houston, TX 77054-1920
Phone
(713) 678-0019
NPI assigned
Feb 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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

Authorized official

Name
Caine Linville, MD
Title
Ceo
Phone
(573) 353-9413

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0122X Primary

Addresses

Primary practice location

7400 Fannin St # 700C
Houston, TX 77054-1920

Mailing address

7400 Fannin St # 700C
Houston, TX 77054-1920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171020002366 TX Part B Supplier - Clinic/Group Practice 0648546572 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486598400000",
    "number": "1275071292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 FANNIN ST # 700C",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770541920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 FANNIN ST # 700C",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770541920",
            "telephone_number": "713-678-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE BREAST & TRAUMA CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-09",
        "last_updated": "2017-02-09",
        "status": "A",
        "authorized_official_last_name": "LINVILLE",
        "authorized_official_first_name": "CAINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-353-9413",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.