Individual provider Active NPI

Brenda Hakemack, M.D.

  • Pediatrics Physician
  • Houston, TX
National Provider Identifier
1407858491
Registry record updated Mar 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
H7611 Issued in TX
Practice address
1919 S Braeswood Blvd
5TH Floor
Houston, TX 77030-4412
Phone
(832) 824-6633
NPI assigned
Aug 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X H7611 TX Primary

Addresses

Primary practice location

1919 S Braeswood Blvd
5TH Floor
Houston, TX 77030-4412

Mailing address

PO Box 841969
Dallas, TX 75284-1969

Other identifiers 2

IdentifierTypeStateIssuer
132591209OtherTXCSHCN
132591205MedicaidTX

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
I20041004000533 TX Practitioner - Pediatric Medicine 5799744025 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H7611TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians Pediatrics CurrentSince Feb 13, 2011 Accepting new patients
Ut Physicians CurrentSince Feb 13, 2011 Accepting new patients
Pasadena Health Center, Inc Past Accepting new patients
TCH Pediatric Associates, Inc Pediatrics Past Accepting new patients
Harris County Hospital District Past Accepting new patients
Ut Physicians Pediatrics Past Accepting new patients

Locations

1919 S Braeswood Blvd
Fl 5
Houston, TX 77030
Phone (832) 824-6633

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

524 Pasadena Blvd
Pasadena, TX 77506
Phone (713) 475-0111

524 Pasadena Blvd
Ste 1001
Pasadena, TX 77506
Phone (713) 554-1091

Interoperability endpoints

  • Direct secure messaging: bhakemack11176@direct.uth.org

Organizations & group practices 6

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205107200000",
    "number": "1407858491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841969",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752841969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 S BRAESWOOD BLVD",
            "address_2": "5TH FLOOR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304412",
            "telephone_number": "832-824-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAKEMACK",
        "first_name": "BRENDA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-10",
        "last_updated": "2008-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "H7611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "132591209",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132591205",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.