Pasadena Community Health Group LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

J6641 Issued in TX

Legal business name

PASADENA COMMUNITY HEALTH GROUP LLC

Practice address

4002 Burke Rd
Pasadena, TX 77504-3451

Phone

(281) 606-2020

Fax

(281) 606-2021

NPI assigned

Oct 1, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Stanton Packard, M.D.NPI 1902902257

Title

President

Phone

(281) 606-2020

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stanton C. Packard, M.D.

  • Family Medicine Physician
  • Pasadena, TX
  • NPI 1902902257
  NPD (past) Authorized official

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

{
    "created_epoch": "1285891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285891200000",
    "number": "1841509395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4002 BURKE RD",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775043451",
            "telephone_number": "281-606-2020",
            "fax_number": "281-606-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 BURKE RD",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775043451",
            "telephone_number": "281-606-2020",
            "fax_number": "281-606-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASADENA COMMUNITY HEALTH GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-01",
        "last_updated": "2010-10-01",
        "status": "A",
        "authorized_official_last_name": "PACKARD",
        "authorized_official_first_name": "STANTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-606-2020",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TX",
            "license": "J6641",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "J6641",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "TX",
            "license": "J6641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Pasadena, TX
• Providers in Pasadena, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2010; 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.