Elexis Pantoja

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

82293 Issued in TX

Practice address

3925 Fairmont Pkwy
Pasadena, TX 77504-3013

Phone

(713) 873-6300

NPI assigned

May 29, 2024

Last updated

Jul 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Baylor College of Medicine

  dba HCHD Community Medicine

  • Family Medicine Physician
  • Houston, TX
  • NPI 1053352914
  Medicare reassignment NPD
• Baylor College of Medicine

  • Internal Medicine Physician
  • Houston, TX
  • NPI 1104867175
  NPD

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

{
    "created_epoch": "1716940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720137600000",
    "number": "1760222566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15819 MISSION VIEW CT",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770835354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 FAIRMONT PKWY",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775043013",
            "telephone_number": "713-873-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTOJA",
        "first_name": "ELEXIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "82293",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "82293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peyman Pakzaban, MD
• Shea Palamountain, M.D.
• Calvin W Palmer Jr., PSYCHOLOGY DEGREE
• Priti Palvadi, M.D.
• Brandi Caylin Pando
• Jung Park
• Karen Hyechin Park, R.PH.
• Sueng K Park, M.D.
• Latonya Renee Parker, NP
• Monica Maxine Parker

• Professional Counselor in Pasadena, TX
• Providers in Pasadena, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.