Individual provider Active NPI

Bambi Lynn Leis Hoefner, M.D.

  • Pediatrics Physician
  • Houston, TX
National Provider Identifier
1811005069
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
L6428 Issued in TX
Practice address
3275 W Alabama St
Suite B
Houston, TX 77098-1701
Phone
(713) 524-4477
Fax
(713) 524-9977
NPI assigned
Aug 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X L6428 TX Primary

Addresses

Primary practice location

3275 W Alabama St
Suite B
Houston, TX 77098-1701

Mailing address

11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-4997

Other practice location 1

1111 Augusta Dr
Houston, TX 77057-2209
Phone (713) 442-2400

Other identifiers 1

IdentifierTypeStateIssuer
175259401MedicaidTX

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
I20050827000221 TX Practitioner - Pediatric Medicine 5597796714 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey-Seybold Medical Group, PLLC Pediatrics CurrentSince Sep 12, 2022 Accepting new patients
River Oaks Pediatrics, PA Pediatrics Past Accepting new patients

Locations

11284 Westheimer Rd
Houston, TX 77042
Phone (713) 442-7700

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

1111 Augusta Dr
Houston, TX 77057
Phone (713) 442-2400

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

Interoperability endpoints

  • Direct secure messaging: bhoefner45116@direct.kelsey-seybold.com

Organizations & group practices 2

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": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1811005069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3275 W ALABAMA ST",
            "address_2": "SUITE B",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770981701",
            "telephone_number": "713-524-4477",
            "fax_number": "713-524-9977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 Augusta Dr",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770572209",
            "country_code": "US",
            "telephone_number": "713-442-2400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOEFNER",
        "first_name": "BAMBI",
        "middle_name": "LYNN LEIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L6428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175259401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.