Active NPI
Roland Deddeh
- Contractor
- Katy, TX
National Provider Identifier
1508303850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- Practice address
- 5106 Smokey River Dr
Katy, TX 77449-6017 - Phone
- (281) 746-1292
- NPI assigned
- Jan 25, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | TX | Primary |
Addresses
Primary practice location
5106 Smokey River Dr
Katy, TX 77449-6017
Mailing address
5106 Smokey River Dr
Katy, TX 77449-6017
Phone (281) 746-1292
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Angelic Care Group LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Katy, TX
- NPI 1396204160
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551657600000",
"number": "1508303850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5106 SMOKEY RIVER DR",
"city": "KATY",
"state": "TX",
"postal_code": "774496017",
"telephone_number": "281-746-1292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5106 SMOKEY RIVER DR",
"city": "KATY",
"state": "TX",
"postal_code": "774496017",
"telephone_number": "281-746-1292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEDDEH",
"first_name": "ROLAND",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-01-25",
"last_updated": "2019-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "TX",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.