Organization Active NPI

Nuphysicia Health of Texas

  • Community Health Worker
  • Houston, TX
National Provider Identifier
1629524376
Registry record updated Aug 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
G2256 Issued in TX
Legal business name
NUPHYSICIA HEALTH OF TEXAS
Practice address
4625 Southwest Fwy
Suite 142
Houston, TX 77027-7100
Phone
(713) 358-9271
Fax
(713) 358-9269
NPI assigned
Aug 31, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2016

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

Authorized official

Name
Dr. Oscar William Boultinghouse, M.D.
Title
Medical Director
Phone
(713) 358-9271

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 172V00000X G2256 TX Primary

Addresses

Primary practice location

4625 Southwest Fwy
Suite 142
Houston, TX 77027-7100

Mailing address

4625 Southwest Freeway
Suite 142
Houston, TX 77027
Phone (713) 358-9271

Other identifiers 1

IdentifierTypeStateIssuer
G2256OtherTXMEDICAL LISCENSE

Other names 1

  • NHOT Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1096334Nuphysicia Health of Texas4625 Southwest Freeway, Suite 142, Houston, TX 77027Certificate of waiverMar 2, 2027

National Provider Directory

National Provider Directory

Locations

4625 Southwest Fwy
Ste 142
Houston, TX 77027
Phone (713) 358-9271

NPI Registry JSON

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472601600000",
    "number": "1629524376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4625 SOUTHWEST FREEWAY",
            "address_2": "SUITE 142",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77027",
            "telephone_number": "713-358-9271",
            "fax_number": "713-358-9269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4625 SOUTHWEST FWY",
            "address_2": "SUITE 142",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770277100",
            "telephone_number": "713-358-9271",
            "fax_number": "713-358-9269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUPHYSICIA HEALTH OF TEXAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-31",
        "last_updated": "2016-08-31",
        "status": "A",
        "authorized_official_last_name": "BOULTINGHOUSE",
        "authorized_official_first_name": "OSCAR",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "713-358-9271",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Community Health Worker",
            "state": "TX",
            "license": "G2256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LISCENSE",
            "identifier": "G2256",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NHOT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Aug 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.