Organization Active NPI

Family Medicine Clinic

  • Health Maintenance Organization
  • Houston, TX
National Provider Identifier
1750563276
Registry record updated Aug 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
K9230 Issued in TX
Legal business name
FAMILY MEDICINE CLINIC
Practice address
17203 Red Oak Dr
Suite 201
Houston, TX 77090-2640
Phone
(281) 880-9710
Fax
(281) 880-9711
NPI assigned
Nov 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2013

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

Authorized official

Name
Rafael G Borges, MD
Title
Doctor
Phone
(281) 880-9710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X K9230 TX Primary

Addresses

Primary practice location

17203 Red Oak Dr
Suite 201
Houston, TX 77090-2640

Mailing address

PO Box 11220
Houston, TX 77293-1220
Phone (281) 880-9710

Other identifiers 3

IdentifierTypeStateIssuer
042969802MedicaidTX
TXB110824OtherTXMEDICARE GROUP PTAN
8AJ811OtherTXB/C B/S OF TEXAS

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DEIHAD

NPI Registry JSON

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377043200000",
    "number": "1750563276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11220",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772931220",
            "telephone_number": "281-880-9710",
            "fax_number": "281-880-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17203 RED OAK DR",
            "address_2": "SUITE 201",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770902640",
            "telephone_number": "281-880-9710",
            "fax_number": "281-880-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICINE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-27",
        "last_updated": "2013-08-21",
        "status": "A",
        "authorized_official_last_name": "BORGES",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "281-880-9710",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "TX",
            "license": "K9230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042969802",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "TXB110824",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B/C B/S OF TEXAS",
            "identifier": "8AJ811",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.