Active NPI
Quincy Raglan Rene Walker, DDS
- Dentist
- Houston, TX
National Provider Identifier
1396400834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 37674
- Practice address
- 2313 Edwards St
Houston, TX 77007-3859 - Phone
- (337) 396-7218
- NPI assigned
- Oct 31, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 37674 | TX | Primary |
Addresses
Primary practice location
2313 Edwards St
Houston, TX 77007-3859
Mailing address
320 Jackson Hill St Apt 155
Houston, TX 77007-7447
Phone (337) 396-7218
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231023000053 | TX | Order and Referring Only - Dentist | 7911353362 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635638400000",
"number": "1396400834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 JACKSON HILL ST APT 155",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770077447",
"telephone_number": "337-396-7218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2313 EDWARDS ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770073859",
"telephone_number": "337-396-7218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "QUINCY",
"middle_name": "RAGLAN RENE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-10-31",
"last_updated": "2021-10-31",
"certification_date": "2021-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "37674",
"primary": true
}
],
"identifiers": [],
"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 Oct 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.