Diverse Community Healthcare PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

DIVERSE COMMUNITY HEALTHCARE PLLC

Practice address

21898 FM 1314 Rd Ste B
Porter, TX 77365-7061

Phone

(281) 354-2417

Fax

(281) 786-0267

NPI assigned

Feb 14, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Randall Roland, DONPI 1275912354

Title

Owner/Provider

Phone

(281) 354-2417

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 3

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

• Randall Kwarteng Roland, D.O

  • Internal Medicine Physician
  • Porter, TX
  • NPI 1275912354
  Medicare reassignment Care Compare group NPD Authorized official
• Charles Amoafo Amelemah, MD

  • Internal Medicine Physician
  • Houston, TX
  • NPI 1356788178
  Medicare reassignment Care Compare group NPD
• Gayana Grigoryan Roland, D.O.

  • Emergency Medicine Physician
  • Porter, TX
  • NPI 1225464860
  Medicare reassignment NPD

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550275200000",
    "number": "1295291367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21898 FM 1314 RD STE B",
            "city": "PORTER",
            "state": "TX",
            "postal_code": "773657061",
            "telephone_number": "281-354-2417",
            "fax_number": "281-786-0267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21898 FM 1314 RD STE B",
            "city": "PORTER",
            "state": "TX",
            "postal_code": "773657061",
            "telephone_number": "281-354-2417",
            "fax_number": "281-786-0267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSE COMMUNITY HEALTHCARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-14",
        "last_updated": "2019-02-16",
        "status": "A",
        "authorized_official_last_name": "ROLAND",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "281-354-2417",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula Jo Davis, LM
• Sherrill Taren Davis, LCDC-I 37787
• Klara De la Garza
• Debra Anne Decato, LSA
• Andrea Danielle Dillon, COTA
• Diverse Community Urgent Care PLLC
• Whitnee Drake, PT, DPT
• Drose Investments
• Lieu Ngo Duran, MD
• East Texas Hydration Solutions LLC

• Internal Medicine Physician in Porter, TX
• Providers in Porter, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2019; 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.