Individual provider Active NPI

Carolyn Leigh Davis-Teague, MSN, FNP-BC

  • Nurse Practitioner
  • Houston, TX
National Provider Identifier
1790943660
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP120773 Issued in TX
Practice address
1500 Citywest Blvd
Ste. 300
Houston, TX 77042-2300
Phone
(713) 620-4000
Fax
(713) 458-4229
NPI assigned
May 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP120773 TX Primary

Addresses

Primary practice location

1500 Citywest Blvd
Ste. 300
Houston, TX 77042-2300

Mailing address

PO Box 840853
Dallas, TX 75284-0853
Phone (972) 715-5000

Other identifiers 4

IdentifierTypeStateIssuer
P01553405OtherTXRR MEDICARE
296115302MedicaidTX
8N0160OtherTXBCBS
296115303MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
AP120773TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
U S Anesthesia Partners of Texas, PA Nurse Practitioner CurrentSince May 30, 2012 Accepting new patients
MHS Physicians of Texas CurrentSince Sep 7, 2011 Accepting new patients
Memorial Hermann Neighborhood Health Centers, PLLC Current Accepting new patients
MHS Physicians of Texas CurrentSince Sep 7, 2011 Accepting new patients
U. S. Anesthesia Partners of Texas, P.a., Nurse Practitioner CurrentSince May 30, 2012 Accepting new patients

Locations

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

1800 W 26th St
Ste 103
Houston, TX 77008
Phone (713) 957-8400

1500 Citywest Blvd
Ste 300
Houston, TX 77042
Phone (713) 458-4185

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

14023 Southwest Fwy
#A
Sugar Land, TX 77478

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1790943660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840853",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840853",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CITYWEST BLVD",
            "address_2": "STE. 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770422300",
            "telephone_number": "713-620-4000",
            "fax_number": "713-458-4229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS-TEAGUE",
        "first_name": "CAROLYN",
        "middle_name": "LEIGH",
        "credential": "MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP120773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01553405",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "296115302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8N0160",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "296115303",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.