Organization Active NPI

Phenomenal Health Care, PLLC

  • Primary Care Clinic/Center
  • Houston, TX
National Provider Identifier
1629777966
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PHENOMENAL HEALTH CARE, PLLC
Practice address
17030 Nanes Dr Ste 110
Houston, TX 77090-2504
Phone
(713) 489-2570
NPI assigned
Feb 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Authorized official

Name
Fuchsia Flint, NPNPI 1346838380
Title
Chief Executive Officer
Phone
(713) 489-2570

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
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

17030 Nanes Dr Ste 110
Houston, TX 77090-2504

Mailing address

2129 FM 2920
Ste 190 #210
Spring, TX 77388
Phone (713) 489-2570

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260323000675 TX Part B Supplier - Clinic/Group Practice 4981188513 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

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
45D2290885Phenomenal Health Care17030 Nanes Dr Suite 110, Houston, TX 77090Certificate of waiverOct 2, 2027

National Provider Directory

National Provider Directory

Locations

17030 Nanes Dr
Ste 110
Houston, TX 77090
Phone (713) 489-2570

5252 Hollister St
Ste 112
Houston, TX 77040

Practitioners & affiliated clinicians

Practitioners 1

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": "1677456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745452800000",
    "number": "1629777966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2129 FM 2920",
            "address_2": "STE 190 #210",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "77388",
            "telephone_number": "713-489-2570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17030 NANES DR STE 110",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770902504",
            "telephone_number": "713-489-2570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHENOMENAL HEALTH CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-27",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A",
        "authorized_official_last_name": "FLINT",
        "authorized_official_first_name": "FUCHSIA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "713-489-2570",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.