Individual provider Active NPI

Theresa E. Bosanek, PA-C

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1467699959
Registry record updated Mar 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10694 Issued in TX
Practice address
6400 Fannin St Ste 2800
Houston, TX 77030-1534
Phone
(713) 704-7100
Fax
(713) 704-1262
NPI assigned
Jan 21, 2009
Last updated
Mar 21, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10694 TX Primary

Addresses

Primary practice location

6400 Fannin St Ste 2800
Houston, TX 77030-1534

Mailing address

6400 Fannin St Ste 2070
Houston, TX 77030-1541
Phone (713) 704-6731

Other identifiers 2

IdentifierTypeStateIssuer
8964MAOtherTXBLUE CROSS BLUE SHIELD OF TEXAS
362899201MedicaidTX

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160827000133 TX Practitioner - Physician Assistant 6406913748 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TMH Physician Associates PLLCGroup PAC ID 4486711744, 1,881 clinicians
Houston Methodist Specialty PhysiciansGroup PAC ID 5193239796, 1,498 clinicians

Practice addresses (Care Compare)

Houston, TX 77070
Phone (281) 737-0899

13300 Hargrave Rd
Houston, TX 77070-4374

18220 State Hwy 249
Houston, TX 77070-4347
Phone (281) 737-8300

6445 Main St
Suite 2500
Houston, TX 77030-1502
Phone (713) 441-3150

7575 San Felipe St
Suite 155
Houston, TX 77063-1777
Phone (713) 266-9955

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
TMH Physician Associates PLLC CurrentSince Mar 6, 2023 Accepting new patients
TMH Physician Associates PLLC CurrentSince Mar 6, 2023 Accepting new patients
Houston Methodist Specialty Physicians CurrentSince Oct 17, 2025 Accepting new patients

Locations

6445 Main St
Ste 2500
Houston, TX 77030
Phone (713) 441-3150

6565 Fannin St
#623
Houston, TX 77030
Phone (713) 363-8584

7575 San Felipe St
Ste 155
Houston, TX 77063
Phone (713) 266-9955

16605 Southwest Fwy
Ste 400
Sugar Land, TX 77479
Phone (281) 275-0800

Interoperability endpoints

  • Direct secure messaging: tbosanek439980@directhoustonmethodist.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1467699959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 FANNIN ST STE 2070",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301541",
            "telephone_number": "713-704-6731",
            "fax_number": "713-704-6889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 FANNIN ST STE 2800",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301534",
            "telephone_number": "713-704-7100",
            "fax_number": "713-704-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSANEK",
        "first_name": "THERESA",
        "middle_name": "E.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-21",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF TEXAS",
            "identifier": "8964MA",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "362899201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.