Organization Active NPI

Katy Gaston Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Katy, TX
National Provider Identifier
1619640489
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
KATY GASTON URGENT CARE PLLC
Practice address
6940 Katy Gaston Rd
Katy, TX 77494-6480
Phone
(713) 392-1627
NPI assigned
Jul 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Authorized official

Name
Omobolaji Olutimehin, MDNPI 1851321582
Title
Owner
Phone
(713) 392-1627

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

6940 Katy Gaston Rd
Katy, TX 77494-6480

Mailing address

6940 Katy Gaston Rd
Katy, TX 77494-6480
Phone (713) 392-1627

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211213000573 TX Part B Supplier - Clinic/Group Practice 7315337078 Receives reassigned benefits from 6 practitioners
Practice locations: Katy, TX

National Provider Directory

National Provider Directory

Locations

6940 Katy Gaston Rd
Katy, TX 77494
Phone (832) 425-3773

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1619640489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6940 KATY GASTON RD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774946480",
            "telephone_number": "713-392-1627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6940 KATY GASTON RD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774946480",
            "telephone_number": "713-392-1627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATY GASTON URGENT CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-28",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "OLUTIMEHIN",
        "authorized_official_first_name": "OMOBOLAJI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-392-1627",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "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 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.