St. Patrick Medical

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA 0556 Issued in TX

Legal business name

ST. PATRICK MEDICAL

Practice address

4315 Lockwood Dr
Suite 8
Houston, TX 77026-4117

Phone

(713) 878-4661

Fax

(713) 748-7212

NPI assigned

Mar 4, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Patrick Omouryi, LVN

Title

Administer

Phone

(713) 878-4661

Specialties & licenses 7

Addresses

Locations

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

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267660800000",
    "number": "1366765307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4315 LOCKWOOD DR",
            "address_2": "SUITE 8",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770264117",
            "telephone_number": "713-878-4661",
            "fax_number": "713-784-7211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 LOCKWOOD DR",
            "address_2": "SUITE 8",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770264117",
            "telephone_number": "713-878-4661",
            "fax_number": "713-748-7212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. PATRICK MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-04",
        "last_updated": "2010-03-04",
        "status": "A",
        "authorized_official_last_name": "OMOURYI",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "ADMINISTER",
        "authorized_official_telephone_number": "713-878-4661",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LVN"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA 0556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in Houston, TX
• Providers in Houston, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.