Individual provider Active NPI

Kanza Soomro, DO

  • Internal Medicine Physician
  • Houston, TX
National Provider Identifier
1770022279
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
T4680 Issued in TX
Practice address
12121 Richmond Ave Ste 212
Houston, TX 77082-2422
Phone
(816) 167-2992
Fax
(281) 223-1011
NPI assigned
Feb 16, 2017
Last updated
Apr 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS15728 FL
Geriatric Medicine (Internal Medicine) Physician 207RG0300X T4680 TX
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X T4680 TX Primary

Addresses

Primary practice location

12121 Richmond Ave Ste 212
Houston, TX 77082-2422

Mailing address

1643 NW 136 Ave
BLDG. H Ste. 100
Sunrise, FL 33323-2857

Other practice location 1

7206 Wild Violet Dr
Humble, TX 77346-2025
Phone (281) 616-7299

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
I20220118001063 TX Practitioner - Internal Medicine 9931448628 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Faiz Javed DO PLLCGroup PAC ID 6709249279, 2 clinicians
CS Pacs 3 Southwest, LLCGroup PAC ID 1254879620, 23 clinicians

Practice addresses (Care Compare)

12121 Richmond Ave
Suite 212
Houston, TX 77082-2422
Phone (956) 975-5152

310 E Lawrence St
Dayton, TX 77535-1805
Phone (936) 258-7227

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
CS Pacs 3 Southwest, LLC Internal Medicine CurrentSince Sep 9, 2024 Accepting new patients
Ipc Pac Healthcare Services of Texas PLLC Internal Medicine CurrentSince Jan 7, 2022 Accepting new patients
Faiz Javed DO PLLC Geriatric Medicine CurrentSince Sep 1, 2023 Accepting new patients
NV Pacs 2 LLC CurrentSince Jan 7, 2022 Accepting new patients
Lonestar Hospital Medicine Associates, PA Internal Medicine CurrentSince Jan 12, 2025 Accepting new patients
Fpacp Humble LLC Past Accepting new patients
South Limestone Hospital District Past Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

999 Raintree Cir
Allen, TX 75013
Phone (972) 390-8088

901 W Ben White Blvd
Austin, TX 78704
Phone (512) 342-2382

3500 W Wheatland Rd
Dallas, TX 75237
Phone (214) 947-5950

310 E Lawrence St
Dayton, TX 77535
Phone (936) 258-7227

5400 Clearfork Main St
Fort Worth, TX 76109
Phone (817) 433-7000

201 Sycamore School Rd
#R
Fort Worth, TX 76134
Phone (817) 293-7610

6301 Oakmont Blvd
Ft Worth, TX 76132
Phone (682) 250-4055

415 Indian Oaks Dr
Harker Hts, TX 76548
Phone (254) 699-5051

721 W Mulberry St
Holiday Lakes, TX 77515
Phone (979) 848-0279

12121 Richmond Ave
Ste 212
Houston, TX 77082
Phone (281) 759-2273

3625 Green Crest Dr
Houston, TX 77082
Phone (281) 558-1166

13500 Breton Ridge St
Houston, TX 77070
Phone (281) 807-4744

2101 W Northgate Dr
Irving, TX 75062
Phone (972) 255-4460

208 S Utah St
La Porte, TX 77571
Phone (281) 471-1810

413 Garland Dr
Lake Jackson, TX 77566
Phone (979) 297-3266

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

811 Garner Rd
Pasadena, TX 77502
Phone (713) 473-8573

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

6211 S New Braunfels Ave
#T
San Antonio, TX 78223
Phone (210) 531-0569

424 Tarpey Rd
#C
Texas City, TX 77591
Phone (409) 938-8431

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Focused Care at HumbleHumble, TX, CCN 675127 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Mar 30, 2022
Mar 30, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1487203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1770022279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1643 NW 136 AVE",
            "address_2": "BLDG. H STE. 100",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12121 RICHMOND AVE STE 212",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770822422",
            "telephone_number": "816-167-2992",
            "fax_number": "281-223-1011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7206 Wild Violet Dr",
            "address_purpose": "LOCATION",
            "city": "Humble",
            "state": "TX",
            "postal_code": "773462025",
            "country_code": "US",
            "telephone_number": "281-616-7299",
            "fax_number": "281-223-1011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOOMRO",
        "first_name": "KANZA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-16",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS15728",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "T4680",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T4680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.