NPIMap

Organization Active NPI

Idjagboro Healthcare and Medical Services Inc

  • Primary Care Clinic/Center
  • Houston, TX
National Provider Identifier
1912061276
Registry record updated Apr 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
PA03357 Issued in TX
Legal business name
IDJAGBORO HEALTHCARE AND MEDICAL SERVICES INC
Practice address
9999 W Montgomery Rd
Suite B
Houston, TX 77088-3100
Phone
(832) 598-2571
Fax
(832) 598-2572
NPI assigned
Dec 21, 2006
Last updated
Apr 25, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2009

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

Authorized official

Name
Mr. Damian Okpako Idjagboro, PA-CNPI 1982635876
Title
Ceo
Phone
(956) 536-1403

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X PA03357 TX Primary

Addresses

Primary practice location

9999 W Montgomery Rd
Suite B
Houston, TX 77088-3100

Mailing address

9999 W Montgomery Rd
Suite B
Houston, TX 77088-3100
Phone (832) 598-2571

National Provider Directory

National Provider Directory

Locations

15655 Westheimer Rd
Ste 102103
Houston, TX 77082
Phone (281) 741-4689

9999 W Montgomery Rd
Ste B
Houston, TX 77088
Phone (281) 445-5900

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240617600000",
    "number": "1912061276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9999 W MONTGOMERY RD",
            "address_2": "SUITE B",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770883100",
            "telephone_number": "832-598-2571",
            "fax_number": "832-598-2572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9999 W MONTGOMERY RD",
            "address_2": "SUITE B",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770883100",
            "telephone_number": "832-598-2571",
            "fax_number": "832-598-2572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDJAGBORO HEALTHCARE AND MEDICAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2009-04-25",
        "status": "A",
        "authorized_official_last_name": "IDJAGBORO",
        "authorized_official_first_name": "DAMIAN",
        "authorized_official_middle_name": "OKPAKO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "956-536-1403",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "PA03357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2009; 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.