NPIMap

Organization Active NPI

Ut Physicians Specialty Services

Doing business as Ut Physicians Aco LBJ Clinic

  • Pediatrics Physician
  • Houston, TX
National Provider Identifier
1568937100
Registry record updated Oct 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
UT PHYSICIANS SPECIALTY SERVICES
Doing business as
Ut Physicians Aco LBJ Clinic
Practice address
5656 Kelley St
Houston, TX 77026-1967
Phone
(713) 566-5656
Fax
(713) 500-5484
NPI assigned
Oct 10, 2018
Last updated
Oct 10, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2018

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

Authorized official

Name
Andrew Casas
Title
Chief Operating Officer
Phone
(832) 325-7325

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

5656 Kelley St
Houston, TX 77026-1967

Mailing address

PO Box 301448
Dallas, TX 75303-1448
Phone (832) 325-6500

Other identifiers 1

IdentifierTypeStateIssuer
195996728MedicaidTX

Other names 1

  • UT PHYSICIANS ACO LBJ CLINIC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ut Physicians Specialty Services21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539129600000",
    "number": "1568937100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 301448",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753031448",
            "telephone_number": "832-325-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5656 KELLEY ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770261967",
            "telephone_number": "713-566-5656",
            "fax_number": "713-500-5484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UT PHYSICIANS SPECIALTY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-10",
        "last_updated": "2018-10-10",
        "status": "A",
        "authorized_official_last_name": "CASAS",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "832-325-7325"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195996728",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UT PHYSICIANS ACO LBJ CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 10, 2018; 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.