1960 Family Practice PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

1960 FAMILY PRACTICE PA

Practice address

837 Cypress Creek Pkwy
Suite 105
Houston, TX 77090-3423

Phone

(281) 586-3888

Fax

(281) 440-2020

NPI assigned

May 26, 2006

Organization subpart

No

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

Authorized official

Name

Ana Borja

Title

Credentialing Department

Phone

(281) 453-7017

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376438400000",
    "number": "1760438840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4356",
            "address_2": "DEPARTMENT 667",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772104356",
            "telephone_number": "281-586-3888",
            "fax_number": "281-440-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "837 CYPRESS CREEK PKWY",
            "address_2": "SUITE 105",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770903423",
            "telephone_number": "281-586-3888",
            "fax_number": "281-440-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1960 FAMILY PRACTICE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2013-08-14",
        "status": "A",
        "authorized_official_last_name": "BORJA",
        "authorized_official_first_name": "ANA",
        "authorized_official_title_or_position": "CREDENTIALING DEPARTMENT",
        "authorized_official_telephone_number": "281-453-7017"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "C16759",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080982401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Houston, TX
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.