Organization Active NPI

Rocky Creek Family Medicine PLLC

  • Family Medicine Physician
  • Missouri City, TX
National Provider Identifier
1982109096
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ROCKY CREEK FAMILY MEDICINE PLLC
Practice address
3281 Rocky Creek Dr Ste 500
Missouri City, TX 77459-4756
Phone
(281) 206-0068
Fax
(281) 499-5045
NPI assigned
Mar 29, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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

Authorized official

Name
Deidre McMullen, MD
Title
President
Phone
(281) 206-0068

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3281 Rocky Creek Dr Ste 500
Missouri City, TX 77459-4756

Mailing address

3281 Rocky Creek Dr Ste 500
Missouri City, TX 77459-4756
Phone (281) 206-0068

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180626000052 TX Part B Supplier - Clinic/Group Practice 4587919980 Receives reassigned benefits from 3 practitioners
Practice locations: Missouri City, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1028224Rocky Creek Family Medicine, PLLC3281 Rocky Creek Drive, Suite # 500 and Suite #100, Missouri City, TX 77459Certificate of waiverJul 20, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522281600000",
    "number": "1982109096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3281 ROCKY CREEK DR STE 500",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774594756",
            "telephone_number": "281-206-0068",
            "fax_number": "281-499-5045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3281 ROCKY CREEK DR STE 500",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774594756",
            "telephone_number": "281-206-0068",
            "fax_number": "281-499-5045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY CREEK FAMILY MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-29",
        "last_updated": "2018-03-29",
        "status": "A",
        "authorized_official_last_name": "MCMULLEN",
        "authorized_official_first_name": "DEIDRE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-206-0068",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missouri City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.