Organization Active NPI

Premier Houston Area Family Medical Clinics

  • Family Medicine Physician
  • Pearland, TX
National Provider Identifier
1669412250
Registry record updated Jul 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
F5827 Issued in TX
Legal business name
PREMIER HOUSTON AREA FAMILY MEDICAL CLINICS
Practice address
2211 A E. Broadway
Pearland, TX 77581
Phone
(281) 485-6144
Fax
(281) 485-6146
NPI assigned
Jun 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2010

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

Authorized official

Name
Ms. Marie D. Mengarelli
Title
Credentialing
Phone
(713) 946-6081

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X F5827 TX Primary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X F5827 TX

Addresses

Primary practice location

2211 A E. Broadway
Pearland, TX 77581

Mailing address

2211 A E. Broadway
Pearland, TX 77581
Phone (281) 485-6144

Other identifiers 1

IdentifierTypeStateIssuer
080069001MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040511001785 TX Part B Supplier - Clinic/Group Practice 9335138510 Receives reassigned benefits from 3 practitioners
Practice locations: Pearland, TX

National Provider Directory

National Provider Directory

Locations

2334 N Main St
Pearland, TX 77581
Phone (281) 997-3336

2506 Westminister St
Pearland, TX 77581
Phone (281) 412-4949

Practitioners & affiliated clinicians

Practitioners 5

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": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278892800000",
    "number": "1669412250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 A E. BROADWAY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "77581",
            "telephone_number": "281-485-6144",
            "fax_number": "281-485-6146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 A E. BROADWAY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "77581",
            "telephone_number": "281-485-6144",
            "fax_number": "281-485-6146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER HOUSTON AREA FAMILY MEDICAL CLINICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2010-07-12",
        "status": "A",
        "authorized_official_last_name": "MENGARELLI",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "713-946-6081",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "F5827",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "F5827",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080069001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2010; 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.