NPIMap

Organization Active NPI

Texas Health Foundation, Inc

  • Obstetrics & Gynecology Physician
  • Beaumont, TX
National Provider Identifier
1992473391
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
TEXAS HEALTH FOUNDATION, INC
Practice address
3610 Stagg Dr
Beaumont, TX 77701-3713
Phone
(409) 923-0012
NPI assigned
Aug 31, 2021
Last updated
Aug 31, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Authorized official

Name
Kimberly A Wilson
Title
President
Phone
(409) 923-0012

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Lactation Consultant (Registered Nurse)Group: 193200000X MULTI-SPECIALTY GROUP 163WL0100X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary
Health Service Clinic/Center 261QH0100X
Multi-Specialty Clinic/Center 261QM1300X
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

3610 Stagg Dr
Beaumont, TX 77701-3713

Mailing address

PO Box 7072
Beaumont, TX 77726-7072
Phone (409) 923-0012

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL texascenterforhealth.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211028001587 TX Part B Supplier - Clinic/Group Practice 5597153221 Receives reassigned benefits from 18 practitioners
Practice locations: Beaumont, TX; Houston, 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
45D2247966Texas Health Foundation, Inc3610 Stagg Drive, Beaumont, TX 77701Certificate of waiverJan 10, 2028

National Provider Directory

National Provider Directory

Locations

12727 Kimberley Ln
Ste 202
Houston, TX 77024
Phone (713) 275-2990

8731 Katy Fwy
Houston, TX 77024
Phone (281) 586-4275

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630368000000",
    "number": "1992473391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7072",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777267072",
            "telephone_number": "409-923-0012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 STAGG DR",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777013713",
            "telephone_number": "409-923-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS HEALTH FOUNDATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "409-923-0012"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "texascenterforhealth.com",
            "affiliation": "N",
            "address_1": "3610 Stagg Dr",
            "city": "Beaumont",
            "state": "TX",
            "country_code": "US",
            "postal_code": "777013713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.