NPIMap

Organization Active NPI

Utmb Faculty Group Practice

  • Obstetrics & Gynecology Physician
  • Pearland, TX
National Provider Identifier
1629019823
Registry record updated Sep 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
UTMB FACULTY GROUP PRACTICE
Practice address
4616 Broadway St
Ste. F
Pearland, TX 77581-3956
Phone
(281) 485-3220
Fax
(281) 485-3506
NPI assigned
Jun 9, 2006
Last updated
Sep 22, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2009

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

Authorized official

Name
Mrs. Cynthia L. Smith
Title
Director
Phone
(409) 772-2222

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU
Dermatology Physician 207N00000X NU
Emergency Medicine Physician 207P00000X NU
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Obstetrics & Gynecology Physician 207V00000X NU Primary
Ophthalmology Physician 207W00000X NU
Otolaryngology Physician 207Y00000X NU
Anatomic Pathology Physician 207ZP0101X NU
Pediatrics Physician 208000000X NU
Neurology Physician 2084N0400X NU
Psychiatry Physician 2084P0800X NU
Radiation Oncology Physician 2085R0001X NU
Diagnostic Radiology Physician 2085R0202X NU
Surgery Physician 208600000X NU

Addresses

Primary practice location

4616 Broadway St
Ste. F
Pearland, TX 77581-3956

Mailing address

P O Box 4797-710
Houston, TX 77210-4797
Phone (409) 772-2222

Other identifiers 1

IdentifierTypeStateIssuer
137315104MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Rick Lohstroh MD9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253577600000",
    "number": "1629019823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 4797-710",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772104797",
            "telephone_number": "409-772-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4616 BROADWAY ST",
            "address_2": "STE. F",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775813956",
            "telephone_number": "281-485-3220",
            "fax_number": "281-485-3506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTMB FACULTY GROUP PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2009-09-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "409-772-2222",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137315104",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2009; 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.