Individual provider Active NPI

Noha Mataoui, MD

  • Family Medicine Physician
  • Corsicana, TX
National Provider Identifier
1366670440
Registry record updated Jul 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P4887 Issued in TX
Practice address
400 Hospital Dr
Suite 104
Corsicana, TX 75110-2489
Phone
(903) 641-3848
Fax
(903) 641-3847
NPI assigned
Jun 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X P4887 TX Primary

Addresses

Primary practice location

400 Hospital Dr
Suite 104
Corsicana, TX 75110-2489

Mailing address

400 Hospital Dr
Suite 104
Corsicana, TX 75110-2489
Phone (903) 641-3848

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
I20130316000018 TX Practitioner - Family Practice 0345485546 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P4887TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Nov 3, 2014 Accepting new patients
Healthtexas Provider Network Family Medicine Current Accepting new patients
Regional Employee Assistance Program Inc Family Medicine CurrentSince Jan 8, 2013 Accepting new patients
Regional Employee Assistance Program Inc Family Medicine CurrentSince Jan 8, 2013 Accepting new patients
Healthtexas Provider Network Family Medicine CurrentSince Nov 3, 2014 Accepting new patients
Paul Phillips III, M.D., P.a. Past Accepting new patients
CD Urgent Care Center 5, PLLC Past Accepting new patients

Locations

400 Hospital Dr
Ste 104
Corsicana, TX 75110
Phone (903) 641-4856

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Organizations & group practices 7

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": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374624000000",
    "number": "1366670440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HOSPITAL DR",
            "address_2": "SUITE 104",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751102489",
            "telephone_number": "903-641-3848",
            "fax_number": "903-641-3847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HOSPITAL DR",
            "address_2": "SUITE 104",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751102489",
            "telephone_number": "903-641-3848",
            "fax_number": "903-641-3847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATAOUI",
        "first_name": "NOHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-26",
        "last_updated": "2013-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P4887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corsicana, TX

Sources for this page

Verify at the official NPI Registry.