Jose R Etienne, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10643 Issued in TX

Practice address

4057 Riley Fuzzel Rd Ste 1100B
Spring, TX 77386-4632

Phone

(281) 907-4863

NPI assigned

Jan 13, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Memorial Hermann Urgent Care PLLCGroup PAC ID 4880071679, 115 clinicians

TMC Provider Group PLLCGroup PAC ID 6305149121, 213 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jose.etienne@ghuc.eclinicaldirectplus.com

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.

• Memorial Hermann Urgent Care PLLC

  • Family Medicine Physician
  • Sugar Land, TX
  • NPI 1730821208
  Medicare reassignment Care Compare group
• TMC Provider Group PLLC

  • Urgent Care Clinic/Center
  • San Antonio, TX
  • NPI 1053784660
  Medicare reassignment Care Compare group
• Next Level MV LLC

  • Urgent Care Clinic/Center
  • Pearland, TX
  • NPI 1013432285
  Medicare reassignment NPD
• Conroe Doctors Urgent Care LLC

  • Urgent Care Clinic/Center
  • Conroe, TX
  • NPI 1710493655
  Medicare reassignment
• Doctors Urgent Care LLC

  • Urgent Care Clinic/Center
  • Spring, TX
  • NPI 1356096564
  Medicare reassignment
• Nluc PLLC

  • Urgent Care Clinic/Center
  • Houston, TX
  • NPI 1518209113
  Medicare reassignment
• Providence Physician Associates

  • Urgent Care Clinic/Center
  • Houston, TX
  • NPI 1760919880
  Medicare reassignment
• Ag Urgent Care, P.C.

  • Urgent Care Clinic/Center
  • Brooklyn, NY
  • NPI 1992116701
  Medicare reassignment
• Nluc PLLC

  • Urgent Care Clinic/Center
  • League City, TX
  • NPI 1043814049
  NPD
• TMC Provider Group PLLC

  • Urgent Care Clinic/Center
  • San Antonio, TX
  • NPI 1033968789
  NPD
• TMC Provider Group, PLLC

  • Urgent Care Clinic/Center
  • Spring Branch, TX
  • NPI 1306325618
  NPD
• Brazos Medical Center

  • Family Medicine Physician
  • Houston, TX
  • NPI 1811453293
  NPD (past)

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

{
    "created_epoch": "1421107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1407245558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4057 RILEY FUZZEL RD STE 1100B",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773864632",
            "telephone_number": "281-907-4863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4057 RILEY FUZZEL RD STE 1100B",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773864632",
            "telephone_number": "281-907-4863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETIENNE",
        "first_name": "JOSE",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-13",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "018374",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Demetreonta Estes
• Andrea Mariana Estrada
• Lauren Estrada
• Ricardo Estrada, CPHT
• Nativida Etienne-Maule, DNP, FNP-BC
• Eudaimonia Mindscape Counseling
• Euston Associates, P.a.
• Gregory Evans
• Laney Evans, M.S., CCC-SLP
• Nicole Evans

• Physician Assistant in Spring, TX
• Providers in Spring, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.
• 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.