Active NPI
Lee R Colosimo MD PA
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Humble, TX
National Provider Identifier
1780868265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- G1636
- Legal business name
- LEE R COLOSIMO MD PA
- Practice address
- 19411 McKay Blvd
Suite 250
Humble, TX 77338-5713 - Phone
- (281) 540-3838
- Fax
- (281) 540-6773
- NPI assigned
- Dec 20, 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
- Dr. Lee Ralph Colosimo, M.D.
- Title
- Physician Owner
- Phone
- (281) 540-3838
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | G1636 | TX | Primary |
Addresses
Primary practice location
19411 McKay Blvd
Suite 250
Humble, TX 77338-5713
Mailing address
19411 McKay Blvd
Suite 250
Humble, TX 77338-5713
Phone (281) 540-3838
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8511K0 | Other | TX | BLUE CROSS OF TEXAS |
National Provider Directory
National Provider DirectoryLocations
9950 Memorial Blvd
Ste 101
Humble, TX 77338
Phone (281) 358-7890
Interoperability endpoints
- https://api.platform.athenahealth.com/381/brand/1/csg/1/fhir/r4
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198108800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1198108800000",
"number": "1780868265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19411 MCKAY BLVD",
"address_2": "SUITE 250",
"city": "HUMBLE",
"state": "TX",
"postal_code": "773385713",
"telephone_number": "281-540-3838",
"fax_number": "281-540-6773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19411 MCKAY BLVD",
"address_2": "SUITE 250",
"city": "HUMBLE",
"state": "TX",
"postal_code": "773385713",
"telephone_number": "281-540-3838",
"fax_number": "281-540-6773"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LEE R COLOSIMO MD PA",
"organizational_subpart": "NO",
"enumeration_date": "2007-12-20",
"last_updated": "2007-12-20",
"status": "A",
"authorized_official_last_name": "COLOSIMO",
"authorized_official_first_name": "LEE",
"authorized_official_middle_name": "RALPH",
"authorized_official_title_or_position": "PHYSICIAN OWNER",
"authorized_official_telephone_number": "281-540-3838",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "208G00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "TX",
"license": "G1636",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF TEXAS",
"identifier": "8511K0",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Humble, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.