Individual provider Active NPI

Vincent Daquila Gubatanga, NP

  • Primary Care Nurse Practitioner
  • Katy, TX
National Provider Identifier
1295607125
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
1057440 Issued in TX
Practice address
20710 Westheimer Pkwy
Katy, TX 77450-6256
Phone
(281) 646-9000
NPI assigned
Sep 20, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 1057440 TX
Primary Care Nurse Practitioner 363LP2300X 1057440 TX Primary

Addresses

Primary practice location

20710 Westheimer Pkwy
Katy, TX 77450-6256

Mailing address

4645 Sweetwater Blvd Ste 200
Sugar Land, TX 77479-3016
Phone (713) 684-9895

Other practice location 1

10496 Katy Fwy Ste 130
Houston, TX 77043-5269
Phone (713) 464-0762

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260121001076 TX Practitioner - Nurse Practitioner 3870070923 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

333 Dominion Dr
Apt 115a
Katy, TX 77450-2043

341 Cool Springs Blvd
Suite 305
Franklin, TN 37067-7221

4645 Sweetwater Blvd
Suite 200
Sugar Land, TX 77479-3016

5115 Fannin St
Suite 801
Houston, TX 77004-5805

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1057440TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Houston Cardiovascular Assoc PA CurrentSince Dec 9, 2025 Accepting new patients
Houston in Patient Physician Associates PLLC CurrentSince Feb 20, 2026 Accepting new patients
Houston Cardiovascular Assoc PA CurrentSince Dec 9, 2025 Accepting new patients

Locations

341 Cool Springs Blvd
Ste 305
Franklin, TN 37067
Phone (972) 391-1915

6441 Main St
Houston, TX 77030
Phone (713) 790-0500

10496 Katy Fwy
Ste 130
Houston, TX 77043
Phone (281) 392-3401

20710 Westheimer Pkwy
Katy, TX 77450
Phone (281) 646-9000

4645 Sweetwater Blvd
Ste 200
Sugar Land, TX 77479
Phone (281) 565-1112

16605 Southwest Fwy
Ste 360
Sugar Land, TX 77479
Phone (713) 558-9508

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1758326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1295607125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4645 SWEETWATER BLVD STE 200",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774793016",
            "telephone_number": "713-684-9895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20710 WESTHEIMER PKWY",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774506256",
            "telephone_number": "281-646-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10496 Katy Fwy Ste 130",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770435269",
            "country_code": "US",
            "telephone_number": "713-464-0762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUBATANGA",
        "first_name": "VINCENT",
        "middle_name": "DAQUILA",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-20",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1057440",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "1057440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.