Individual provider Active NPI

George Thomas Mandy, MD

  • Neonatal-Perinatal Medicine Physician
  • Houston, TX
National Provider Identifier
1710979117
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
K4947 Issued in TX
Practice address
6621 Fannin St
Houston, TX 77030-2399
Phone
(832) 826-1380
Fax
(832) 825-2799
NPI assigned
Aug 22, 2005
Last updated
Oct 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X K4947 TX Primary

Addresses

Primary practice location

6621 Fannin St
Houston, TX 77030-2399

Mailing address

6621 Fannin St Ste W6104
Houston, TX 77030-2399
Phone (832) 826-1380

Other identifiers 2

IdentifierTypeStateIssuer
2321526MedicaidOH
64085855MedicaidKY

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
I20111229000290 TX Practitioner - Pediatric Medicine 8022090190 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Oct 1, 2011 Accepting new patients
Baylor College of Medicine CurrentSince Oct 1, 2011 Accepting new patients
Pediatric Academic Association, Inc. Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Texas Children's Hospital Past Accepting new patients

Locations

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

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

6621 Fannin St
Houston, TX 77030
Phone (832) 824-1866

6621 Fannin St
Ste W6104
Houston, TX 77030
Phone (832) 826-1309

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

Interoperability endpoints

  • Direct secure messaging: gmandy9660@prddirect.texaschildrens.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1710979117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST STE W6104",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302399",
            "telephone_number": "832-826-1380",
            "fax_number": "832-825-2799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302399",
            "telephone_number": "832-826-1380",
            "fax_number": "832-825-2799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDY",
        "first_name": "GEORGE",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "TX",
            "license": "K4947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2321526",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64085855",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.