NPIMap

Organization Active NPI

Pristine OB-GYN Care PLLC

  • Medical Specialty Clinic/Center
  • Houston, TX
National Provider Identifier
1346514619
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
M8471 Issued in TX
Legal business name
PRISTINE OB-GYN CARE PLLC
Practice address
13523 Hargrave Rd
Houston, TX 77070-3829
Phone
(281) 206-4496
NPI assigned
Mar 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Authorized official

Name
Mrs. Iyabode Munirat Ogunlade, M.D.NPI 1366679573
Title
Manager
Phone
(281) 206-4496

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X M8471 TX Primary
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

13523 Hargrave Rd
Houston, TX 77070-3829

Mailing address

13523 Hargrave Rd
Houston, TX 77070-3829
Phone (281) 206-4496

Other practice location 1

13523 Hargrave Rd
Houston, TX 77070-3829
Phone (281) 206-4496

Other identifiers 2

IdentifierTypeStateIssuer
297102001MedicaidTX
411162701MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120529000517 TX Part B Supplier - Clinic/Group Practice 8527221662 Receives reassigned benefits from 15 practitioners
Practice locations: Cypress, TX; Houston, TX; Katy, TX; Magnolia, TX; New Caney, TX; Spring, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2044127Pristine OB-GYN Care PLLC13523 Hargrave Road, Houston, TX 77070AccreditationJan 9, 2027

National Provider Directory

National Provider Directory

Locations

13523 Hargrave Rd
Ste 1100
Houston, TX 77070

13507 Hargrave Rd
Houston, TX 77070
Phone (281) 206-4496

19792 FM 1485 Rd
New Caney, TX 77357

6617 FM 2920 Rd
#100
Spring, TX 77379

7109 FM 2920 Rd
Ste 200
Spring, TX 77379
Phone (281) 206-4496

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684454400000",
    "number": "1346514619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13523 HARGRAVE RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770703829",
            "telephone_number": "281-206-4496",
            "fax_number": "281-206-4487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13523 HARGRAVE RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770703829",
            "telephone_number": "281-206-4496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13523 Hargrave Rd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770703829",
            "country_code": "US",
            "telephone_number": "281-206-4496",
            "fax_number": "281-206-4487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRISTINE OB-GYN CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-02",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A",
        "authorized_official_last_name": "OGUNLADE",
        "authorized_official_first_name": "IYABODE",
        "authorized_official_middle_name": "MUNIRAT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "281-206-4496",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "TX",
            "license": "M8471",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "297102001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "411162701",
            "state": "TX"
        }
    ],
    "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 May 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.