MD Medical Management LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

J3003 Issued in TX

Legal business name

MD MEDICAL MANAGEMENT LLC

Practice address

1140 Westmont Dr Ste 515
Houston, TX 77015-4365

Phone

(832) 623-5583

Fax

(832) 802-6171

NPI assigned

Nov 22, 2017

Organization subpart

No

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

Authorized official

Name

Office Credentialin

Title

Credentialing Officer

Phone

(832) 623-5583

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1511308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1578077871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 WESTMONT DR STE 515",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770154365",
            "telephone_number": "832-623-5583",
            "fax_number": "832-623-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 WESTMONT DR STE 515",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770154365",
            "telephone_number": "832-623-5583",
            "fax_number": "832-802-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD MEDICAL MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-22",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "CREDENTIALIN",
        "authorized_official_first_name": "OFFICE",
        "authorized_official_title_or_position": "CREDENTIALING OFFICER",
        "authorized_official_telephone_number": "832-623-5583"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "TX",
            "license": "J3003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Houston, TX
• Providers in Houston, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; 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.