NPIMap

Organization Active NPI

Minola'S Place of Texas , Inc

  • Social Worker
  • Spring, TX
National Provider Identifier
1770812554
Registry record updated Dec 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
50907 Issued in TX
Legal business name
MINOLA'S PLACE OF TEXAS , INC
Practice address
17940 Country Walk Dr
Spring, TX 77379-6169
Phone
(281) 251-7696
NPI assigned
Dec 8, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2009

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

Authorized official

Name
Rozella Gray
Title
Director
Phone
(281) 251-7696

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 104100000X 50907 TX Primary

Addresses

Primary practice location

17940 Country Walk Dr
Spring, TX 77379-6169

Mailing address

17940 Country Walk
Spring, TX 77379
Phone (281) 251-7696

Other identifiers 1

IdentifierTypeStateIssuer
1275711947MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Minola'S Place of Texas Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1260230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260230400000",
    "number": "1770812554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17940 COUNTRY WALK",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "77379",
            "telephone_number": "281-251-7696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17940 COUNTRY WALK DR",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773796169",
            "telephone_number": "281-251-7696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINOLA'S PLACE OF TEXAS , INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-08",
        "last_updated": "2009-12-08",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "ROZELLA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "281-251-7696"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "TX",
            "license": "50907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275711947",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2009; 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.