Individual provider Active NPI

Mark Ward, MD

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Houston, TX
National Provider Identifier
1679653919
Registry record updated Dec 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
G0258 Issued in TX
Practice address
6621 Fannin St, MC A1170
Houston, TX 77030-2303
Phone
(832) 824-1177
Fax
(832) 825-1187
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X G0258 TX Primary

Addresses

Primary practice location

6621 Fannin St, MC A1170
Houston, TX 77030-2303

Mailing address

6621 Fannin St., MC A1170
Houston, TX 77030-2303
Phone (832) 824-1177

Other identifiers 1

IdentifierTypeStateIssuer
134038201MedicaidTX

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
I20110412000750 TX Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 2567646706 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G0258TXMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Sep 22, 2015 Accepting new patients
Baylor College of Medicine CurrentSince Sep 22, 2015 Accepting new patients
Texas Children'S Physician Group Past Accepting new patients

Locations

6621 Fannin St
Ste A1170
Houston, TX 77030
Phone (832) 824-1177

1102 Bates Ave
Houston, TX 77030
Phone (832) 822-4556

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

6701 Fannin St
Ste 1420
Houston, TX 77030
Phone (832) 822-4240

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324598400000",
    "number": "1679653919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST., MC A1170",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302303",
            "telephone_number": "832-824-1177",
            "fax_number": "832-825-1187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST, MC A1170",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302303",
            "telephone_number": "832-824-1177",
            "fax_number": "832-825-1187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2011-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "TX",
            "license": "G0258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134038201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.