Individual provider Active NPI

Endia Walls, M.D.

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1295843621
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L5175 Issued in TX
Practice address
4405 Griggs Rd
Houston, TX 77021-2815
Phone
(713) 748-4662
NPI assigned
Aug 27, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036148013 IL
Family Medicine Physician 207Q00000X L5175 TX Primary

Addresses

Primary practice location

4405 Griggs Rd
Houston, TX 77021-2815

Mailing address

PO Box 300221
Houston, TX 77230-0221
Phone (314) 518-4192

Other identifiers 1

IdentifierTypeStateIssuer
160286402MedicaidTX

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040304001262 TX Practitioner - Family Practice 0749178515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Midtown Clinical Assoc, PA Family Medicine CurrentSince Jan 5, 2004 Accepting new patients
Endia Walls, PA Family Medicine Past Accepting new patients
Christopher R Lockhart MD, PA Family Medicine Past Accepting new patients
Doctor on Demand Professionals of California Family Medicine Past Accepting new patients

Locations

4405 Griggs Rd
Houston, TX 77021
Phone (713) 748-4662

5320 Griggs Rd
Ste A
Houston, TX 77021
Phone (713) 748-4662

Interoperability endpoints

  • Direct secure messaging: endia.walls.2@13131.direct.athenahealth.com

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1295843621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 300221",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772300221",
            "telephone_number": "314-518-4192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 GRIGGS RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770212815",
            "telephone_number": "713-748-4662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLS",
        "first_name": "ENDIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036148013",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L5175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160286402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.