Provider Health Services LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PROVIDER HEALTH SERVICES LLC

Practice address

1906 Treble Dr Ste 18
Humble, TX 77338-5284

Phone

(281) 305-8633

Fax

(281) 305-8633

NPI assigned

Dec 12, 2023

Organization subpart

No

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

Authorized official

Name

Victor Mzyece, APRNNPI 1659732345

Title

President

Phone

(281) 305-8633

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Texas PHS Professional Association

  • Family Medicine Physician
  • Austin, TX
  • NPI 1093020760
  NPPES parent name

Practitioners 2

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

• Victor Mzyece, FNP-C

  • Family Nurse Practitioner
  • Humble, TX
  • NPI 1659732345

  TX

  Medicare reassignment NPD Authorized official
• Ramiro Echeverry, MD

  • Family Medicine Physician
  • Houston, TX
  • NPI 1063767382

  Family Medicine, TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1702339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712016000000",
    "number": "1831967561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14511 EMMA SPRINGS CT",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773964893",
            "telephone_number": "281-305-8633",
            "fax_number": "281-305-8633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 TREBLE DR STE 18",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773385284",
            "telephone_number": "281-305-8633",
            "fax_number": "281-305-8633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDER HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-12",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A",
        "authorized_official_last_name": "MZYECE",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-305-8633",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Humble, TX
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.