Organization Active NPI

Xplosion Technology Corporation

  • Family Medicine Physician
  • Missouri City, TX
National Provider Identifier
1699573733
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
XPLOSION TECHNOLOGY CORPORATION
Practice address
1803 Ambassador CT
Missouri City, TX 77459-3758
Phone
(832) 969-3686
NPI assigned
Mar 5, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Authorized official

Name
Isis Ashford
Title
Coo
Phone
(832) 969-3686

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133N00000X
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Health EducatorGroup: 193200000X MULTI-SPECIALTY GROUP 174H00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364S00000X

Addresses

Primary practice location

1803 Ambassador CT
Missouri City, TX 77459-3758

Mailing address

1803 Ambassador CT
Missouri City, TX 77459-3758
Phone (832) 969-3686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20251028001101 TX Part B Supplier - Clinic/Group Practice 3375032659 Receives reassigned benefits from 1 practitioner
Practice locations: Missouri City, TX
O20260123000963 FL Part B Supplier - Clinic/Group Practice 3375032659 Receives reassigned benefits from 1 practitioner
Practice locations: Orlando, FL

National Provider Directory

National Provider Directory

Locations

5900 Balcones Dr
#24993
Austin, TX 78731

Practitioners & affiliated clinicians

Practitioners 4

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": "1741132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741132800000",
    "number": "1699573733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 AMBASSADOR CT",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774593758",
            "telephone_number": "832-969-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 AMBASSADOR CT",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774593758",
            "telephone_number": "832-969-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "XPLOSION TECHNOLOGY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-05",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A",
        "authorized_official_last_name": "ASHFORD",
        "authorized_official_first_name": "ISIS",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "832-969-3686"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missouri City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; 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.