NPIMap

Organization Active NPI

Idoc Virtual Telehealth Texas

  • Specialist
  • Houston, TX
National Provider Identifier
1275098568
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
IDOC VIRTUAL TELEHEALTH TEXAS
Practice address
2311 W Main St
Houston, TX 77098-3218
Phone
(713) 913-1422
Fax
(303) 922-4640
NPI assigned
Jan 31, 2019
Last updated
Aug 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Authorized official

Name
Evette Lewis
Title
Practice Manager
Phone
(503) 421-5124

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X
Neurocritical Care PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084A2900X
Critical Care Registered Respiratory TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2279C0205X

Addresses

Primary practice location

2311 W Main St
Houston, TX 77098-3218

Mailing address

4635 Southwest Fwy Ste 525
Houston, TX 77027-7157
Phone (713) 234-4431

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190821000408 TX Part B Supplier - Clinic/Group Practice 4587992102 Receives reassigned benefits from 17 practitioners
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1275098568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4635 SOUTHWEST FWY STE 525",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770277157",
            "telephone_number": "713-234-4431",
            "fax_number": "877-712-5707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 W MAIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770983218",
            "telephone_number": "713-913-1422",
            "fax_number": "303-922-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDOC VIRTUAL TELEHEALTH TEXAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-31",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "EVETTE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "503-421-5124"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2279C0205X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Respiratory Therapist, Registered, Critical Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Aug 21, 2024; 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.