Individual provider Active NPI

Kathleen Tye, M.D.

  • Family Medicine Physician
  • Tomball, TX
National Provider Identifier
1710051735
Registry record updated May 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J6782 Issued in TX
Practice address
605 Holderrieth Blvd
Tomball, TX 77375-6445
Phone
(281) 401-7988
Fax
(281) 401-7883
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X J6782 TX
Family Medicine Physician 207Q00000X J6782 TX Primary

Addresses

Primary practice location

605 Holderrieth Blvd
Tomball, TX 77375-6445

Mailing address

19503 Sapphire Cir
Magnolia, TX 77355-1835

Other identifiers 2

IdentifierTypeStateIssuer
115602809MedicaidTX
8AP268OtherTXBCBS

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
I20040105000545 TX Practitioner - Emergency MedicinePractitioner - Family Practice 1355240714 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J6782TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Emergency Services Physician Group-Houston PLLC Emergency Medicine CurrentSince Apr 1, 2020 Accepting new patients
Acs Primary Care Physicians Southwest, PA Emergency Medicine CurrentSince Feb 1, 2018 Accepting new patients
Bellville Hospital District Emergency Medicine Past Accepting new patients
Medical Center Emergency Physicians PA Emergency Medicine Past Accepting new patients
Trepa PA Emergency Medicine Past Accepting new patients

Locations

5000 Hopyard Rd
Ste 100
Pleasanton, CA 94588
Phone (480) 861-4015

27800 NW Freeway
Cypress, TX 77433
Phone (346) 231-4000

540 Interstate 45 S
Ste E
Huntsville, TX 77340
Phone (936) 755-8288

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

5161 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (281) 810-9326

11713 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 793-4600

Organizations & group practices 5

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210118400000",
    "number": "1710051735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19503 SAPPHIRE CIR",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773551835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 HOLDERRIETH BLVD",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773756445",
            "telephone_number": "281-401-7988",
            "fax_number": "281-401-7883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYE",
        "first_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2008-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "J6782",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J6782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115602809",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8AP268",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tomball, TX

Sources for this page

Verify at the official NPI Registry.