Active NPI
Family Medicine Clinic
- Health Maintenance Organization
- Houston, TX
National Provider Identifier
1750563276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Maintenance Organization
- License
- K9230
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 042969802 | Medicaid | TX | |
| TXB110824 | Other | TX | MEDICARE GROUP PTAN |
| 8AJ811 | Other | TX | B/C B/S OF TEXAS |
National Provider Directory
National Provider DirectoryInteroperability endpoints
- 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.