Individual provider Active NPI

Douglas Moodie, MD

  • Pediatric Cardiology Physician
  • Houston, TX
National Provider Identifier
1336191592
Registry record updated Jun 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
TEMP Issued in TX
Practice address
1504 Taub Loop
Houston, TX 77030-1608
Phone
(713) 873-2000
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X MD.14384R LA
Pediatric Cardiology Physician 2080P0202X TEMP TX Primary

Addresses

Primary practice location

1504 Taub Loop
Houston, TX 77030-1608

Mailing address

2 Greenway PLZ
Suite 900
Houston, TX 77046-0297
Phone (713) 798-1835

Other identifiers 1

IdentifierTypeStateIssuer
14384RMedicaidLA

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
I20100512001044 TX Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 4981732997 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.14384RLAMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Jul 1, 2011 Accepting new patients
Texas Children's Physician Group CurrentSince Mar 2, 2010 Accepting new patients
Baylor College of Medicine CurrentSince Jul 1, 2011 Accepting new patients

Locations

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

2450 Holcombe Blvd
Ste NB34L
Houston, TX 77021
Phone (713) 796-0003

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275955200000",
    "number": "1336191592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 GREENWAY PLZ",
            "address_2": "SUITE 900",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770460297",
            "telephone_number": "713-798-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 TAUB LOOP",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301608",
            "telephone_number": "713-873-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODIE",
        "first_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2010-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "LA",
            "license": "MD.14384R",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "TX",
            "license": "TEMP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14384R",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.