Texas Family Clinic LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

TEXAS FAMILY CLINIC LLC

Practice address

18980 N Memorial Dr Ste 240
Humble, TX 77338-4216

Phone

(240) 338-8331

NPI assigned

Jan 31, 2019

Organization subpart

No

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

Authorized official

Name

Olubunmi Ogundadegbe, MDNPI 1821347279

Title

Ceo

Phone

(713) 904-3455

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Olubunmi Ogundadegbe

  • Internal Medicine Physician
  • Humble, TX
  • NPI 1821347279
  Medicare reassignment NPD Authorized official
• Kiara Mardra Terrell, APRN

  • Family Nurse Practitioner
  • Humble, TX
  • NPI 1962083113
  Medicare reassignment NPD

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617753600000",
    "number": "1437613742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18980 N MEMORIAL DR STE 240",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773384216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18980 N MEMORIAL DR STE 240",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773384216",
            "telephone_number": "240-338-8331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS FAMILY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-31",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A",
        "authorized_official_last_name": "OGUNDADEGBE",
        "authorized_official_first_name": "OLUBUNMI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "713-904-3455",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Texas Healthcare & Wellness, Inc.
• Texas Healthcare Network, Inc.

• Internal Medicine Physician in Humble, TX
• Providers in Humble, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.