Individual provider Active NPI

Latashia Renae Hicks, M.D.

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1639581911
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
S3679 Issued in TX
Practice address
2000 S Dairy Ashford Rd Ste 575
Houston, TX 77077-5737
Phone
(713) 659-9309
NPI assigned
May 21, 2014
Last updated
Feb 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X S3679 TX Primary
Family Medicine Physician 207Q00000X 308433 LA

Addresses

Primary practice location

2000 S Dairy Ashford Rd Ste 575
Houston, TX 77077-5737

Mailing address

7614 Claiborne St
Houston, TX 77016-3908
Phone (832) 277-5843

Other names 1

  • Latashia Renae Irving Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210607002584 TX Practitioner - Family Practice 3779877998 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
308433LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Medical Group PLLC CurrentSince Apr 14, 2021 Accepting new patients
Jackson County Hospital District CurrentSince Jan 1, 2026 Accepting new patients
Jackson County Hospital District CurrentSince Jul 1, 2025 Accepting new patients
Totality Medical Group CurrentSince Mar 3, 2024 Accepting new patients
Jackson County Hospital District CurrentSince Jul 1, 2025 Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Apr 14, 2021 Accepting new patients
Baptist Health System, Inc. Past Accepting new patients
Exceptional Care Elite Professional Limited Liability Company Family Medicine PastSince Feb 8, 2023 Accepting new patients

Locations

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

304 S Daugherty Ave
Eastland, TX 76448
Phone (254) 629-2601

1013 S Wells St
Edna, TX 77957
Phone (361) 782-5241

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

2000 S Dairy Ashford Rd
Ste 575
Houston, TX 77077
Phone (832) 808-0425

Interoperability endpoints

  • Direct secure messaging: latashia.irving.1@19483.direct.athenahealth.com
  • Direct secure messaging: latashia.irving@42242842558468.direct.elationemr.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1400630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1639581911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7614 CLAIBORNE ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770163908",
            "telephone_number": "832-277-5843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S DAIRY ASHFORD RD STE 575",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770775737",
            "telephone_number": "713-659-9309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "LATASHIA",
        "middle_name": "RENAE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-21",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S3679",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "308433",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LATASHIA",
            "last_name": "IRVING",
            "middle_name": "RENAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.