Alice Rock, MD
Individual provider Active NPI Pediatrics Physician · Houston, TX
NPI 1497723027 · NPPES record last updated Apr 29, 2019
Key facts
- NPI
- 1497723027
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 29505-20 (WI)
- Practice address
- 6431 Fannin St.
Suite MSB5.111
Houston, TX 77030-5389 - Phone
- (713) 500-6325
- Fax
- (713) 500-0706
- NPI assigned
- Mar 9, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Pediatric Medicine
- Education
- Southern Illinois University School of Medicine, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Professional Imaging PLLC
Practice addresses (Care Compare)
1717 Rotary Dr
Humble, TX 77338-5235
Phone (281) 272-6277
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241030004526 | TX | Practitioner - Pediatric Medicine | 1456302017 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29505-20 | WI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Imaging, PLLC | Current |
Accepting new patients | |
| Childrens Health Care Associates of New Jersey PC | Pediatrics | Past | Accepting new patients |
Locations
1112 Smith Dr
Alvin, TX 77511
Phone (281) 331-3001
2019 N Frazier St
Conroe, TX 77301
Phone (936) 441-2120
419 S Cockrell Hill Rd
Duncanville, TX 75116
Phone (410) 552-4800
1500 Sunset Dr
Friendswood, TX 77546
Phone (281) 922-4300
3301 View St
Ft Worth, TX 76103
Phone (817) 531-3616
4400 Gulf Ave
Groves, TX 77619
Phone (409) 962-5785
1717 Rotary Dr
Humble, TX 77338
Phone (817) 296-7282
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 29505-20 | WI | Yes |
Addresses
Primary practice location
6431 Fannin St.
Suite MSB5.111
Houston, TX 77030-5389
Mailing address
6431 Fannin St
Suite MSB 5.111
Houston, TX 77030-5389
Phone (713) 500-6325
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 063644D6X | Medicaid | PA |
Other names
- Alice Rock Keaton
Other providers in Houston, TX
- Rock Castle E.M.S Inc.
- Rock Orareign Group
- Rock Rehabilitation LLC
- Rock Soterion Kingdom Counseling Center
- Rock Sports & Spine Therapy PLLC
- Amber Nicole Rock
- Craig Rock
- Rockcastle Medical Clinics
- Rocket Labs LLC
- Andrea K Rockett
All providers in Houston, TX · Pediatrics Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.