Kinghaven Medical System Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

KINGHAVEN MEDICAL SYSTEM INC

Practice address

6335 Gulfton St Ste 103
Suite 103
Houston, TX 77081-1112

Phone

(713) 457-3200

NPI assigned

Mar 5, 2015

Last updated

Aug 1, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Lamide Olagundoye

Title

Cfo

Phone

(713) 457-3200

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1425513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470009600000",
    "number": "1659764330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6335 GULFTON ST STE 103",
            "address_2": "SUITE 103",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770811112",
            "telephone_number": "713-457-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6335 GULFTON ST STE 103",
            "address_2": "SUITE 103",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770811112",
            "telephone_number": "713-457-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGHAVEN MEDICAL SYSTEM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-05",
        "last_updated": "2016-08-01",
        "status": "A",
        "authorized_official_last_name": "OLAGUNDOYE",
        "authorized_official_first_name": "LAMIDE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "713-457-3200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3585879-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kingdom Retreat Salon and More LLC
• Kingdom Transport
• Kingfisher Senior Living LLC (Ella Springs Senior Living Community)
• Kinghaven Counseling Group Inc
• Kinghaven Investments Inc. (Hitech Medical Services)
• Kinghaven Therapy Services LLC (Kinghaven Therapy Services)
• Shannon Frances Kingrey, PT, DPT
• Kingsarm Healthcare LLC
• Kingsbridge RX Pharmacy Inc (KB Medical Supply)
• Kingsland Advanced Health & Chiropractic Clinic (Victory Distributors, LLC)

• Multi-Specialty Clinic/Center in Houston, TX
• Providers in Houston, TX by specialty
• Multi-Specialty Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2016; 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.