Organization Active NPI

Katy Diabetes and Endocrinology PLLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Katy, TX
National Provider Identifier
1639881048
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
KATY DIABETES AND ENDOCRINOLOGY PLLC
Practice address
26077 Nelson Way Ste 1201
Katy, TX 77494-6698
Phone
(832) 437-6531
Fax
(832) 437-6548
NPI assigned
Dec 16, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

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

Authorized official

Name
Johanna Vivienne Leyco-Policarpio, MD
Title
Owner/Physician
Phone
(832) 437-6531

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

26077 Nelson Way Ste 1201
Katy, TX 77494-6698

Mailing address

26077 Nelson Way Ste 1201
Katy, TX 77494-6698
Phone (832) 437-6531

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230502001320 TX Part B Supplier - Clinic/Group Practice 8022473776 Receives reassigned benefits from 2 practitioners
Practice locations: Katy, TX

National Provider Directory

National Provider Directory

Locations

26077 Nelson Way
Ste 1201
Katy, TX 77494
Phone (832) 437-6531

Practitioners & affiliated clinicians

Practitioners 2

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": "1671148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671148800000",
    "number": "1639881048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26077 NELSON WAY STE 1201",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774946698",
            "telephone_number": "832-437-6531",
            "fax_number": "832-437-6548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26077 NELSON WAY STE 1201",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774946698",
            "telephone_number": "832-437-6531",
            "fax_number": "832-437-6548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATY DIABETES AND ENDOCRINOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-16",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A",
        "authorized_official_last_name": "LEYCO-POLICARPIO",
        "authorized_official_first_name": "JOHANNA",
        "authorized_official_middle_name": "VIVIENNE",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "832-437-6531",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "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 Dec 16, 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.