NPIMap

Organization Active NPI

Life Span Clinic Inc

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1487066957
Registry record updated Jun 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LIFE SPAN CLINIC INC
Practice address
6201 Bonhomme Rd
Suite # 472S
Houston, TX 77036-4385
Phone
(713) 325-2198
Fax
(713) 325-2968
NPI assigned
Jun 2, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2014

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

Authorized official

Name
Melissa A. Smed
Title
Ceo
Phone
(713) 325-2198

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X

Addresses

Primary practice location

6201 Bonhomme Rd
Suite # 472S
Houston, TX 77036-4385

Mailing address

6201 Bonhomme Rd
Suite # 472S
Houston, TX 77036-4385
Phone (713) 325-2198

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402272000000",
    "number": "1487066957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 BONHOMME RD",
            "address_2": "SUITE # 472S",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770364385",
            "telephone_number": "713-325-2198",
            "fax_number": "713-325-2968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 BONHOMME RD",
            "address_2": "SUITE # 472S",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770364385",
            "telephone_number": "713-325-2198",
            "fax_number": "713-325-2968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE SPAN CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-02",
        "last_updated": "2014-06-09",
        "status": "A",
        "authorized_official_last_name": "SMED",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "713-325-2198"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Jun 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.