Active NPI 1003806431 Individual Practitioner Male Practitioner

Dr. Glenn R Davis , MD

Internal Medicine • Spring, TX

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Glenn Davis, MD is a certified Internal Medicine practicing in Spring, TX. With approximately 29 years of clinical experience since graduating from Baylor College Of Medicine in 1997, Dr. Davis delivers high-quality medical care to the local community at 2255 E MOSSY OAKS RD STE 680.

Dr. Davis maintains professional affiliations with Variety Care, Inc., Health Hub Physicians Inc, Stigler Health And Wellness Center Inc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include chronic care management services, first, chronic care management services for two or more chronic conditions, additional, established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

2255 E Mossy Oaks Rd Ste 680

Spring, TX 773891812

Telephone 2815370300

Fax 2815370315

Associated Practice Facility / Clinic

🏢 Cypress Physicians Association Facility NPI 1295919223

Medicare Profile & Education

Medical School

Baylor College Of Medicine

Graduation Year

1997

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Spring, TX

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

29 Yrs +6.0 yrs vs City Avg

City Avg: 23.0 Yrs

State Avg: 26.2 Yrs

Regional Practice Density

36 Specialists

Practicing in Spring, TX (9538 Statewide)

Telehealth Adoption Rate

36.1% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

49.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Davis (29 Years) 29 Yrs

Spring Specialty Average (23.0 Years) 23.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	1,285	135	$122.00	$62.93
99439 Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month	1,118	130	$92.00	$48.12
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	695	413	$249.02	$127.19
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	508	317	$50.00	$16.45
G0444 Annual depression screening, 5 to 15 minutes	267	267	$39.55	$18.72
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	216	216	$245.00	$129.19
99489 Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month	142	43	$137.00	$72.52
99487 Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month	72	43	$258.00	$132.77
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	66	28	$81.00	$41.87
99213 Established patient office or other outpatient visit, typically 15 minutes	44	42	$176.00	$91.45
81003 Automated urinalysis test	33	27	$15.00	$2.20
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	24	21	$99.87	$53.53
93000 Routine ekg using at least 12 leads including interpretation and report	22	22	$28.00	$14.41
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	19	19	$300.00	$162.20
G0506 Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)	15	15	$175.00	$62.67
87811 Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)	12	12	$65.67	$39.99

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	1,525	160	$96.00	$63.29
99439 Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month	1,373	152	$70.68	$47.79
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	954	500	$236.51	$126.33
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	248	248	$245.00	$130.57
99489 Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month	115	32	$124.33	$71.03
G0444 Annual depression screening, 5 to 15 minutes	101	101	$38.32	$18.62
99213 Established patient office or other outpatient visit, typically 15 minutes	71	60	$167.21	$90.78
81003 Automated urinalysis test	62	51	$15.00	$2.20
99487 Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month	46	32	$234.52	$134.17
87804 Detection test by immunoassay with direct visual observation for influenza virus	34	19	$41.12	$16.22
93000 Routine ekg using at least 12 leads including interpretation and report	32	29	$70.75	$14.74
87811 Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)	24	23	$28.33	$27.77
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	18	13	$81.22	$41.26
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	14	14	$38.07	$15.95
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	14	14	$309.64	$163.43
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	12	12	$102.75	$50.97

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	1,729	176	$80.00	$65.03
99439 Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month	1,681	170	$60.00	$49.19
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	862	476	$227.61	$127.54
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	228	228	$245.00	$134.60
G0444 Annual depression screening, 5 to 15 minutes	199	199	$40.00	$19.08
99489 Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month	133	38	$90.00	$71.80
99213 Established patient office or other outpatient visit, typically 15 minutes	66	59	$160.00	$88.23
99497 Advance care planning, first 30 minutes	55	55	$200.00	$86.37
99487 Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month	55	38	$150.00	$136.76
81003 Automated urinalysis test	38	31	$15.00	$2.22
93000 Routine ekg using at least 12 leads including interpretation and report	32	32	$85.00	$14.78
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	14	14	$345.00	$165.71
87811 Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)	12	12	$20.00	$19.72
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	11	11	$105.00	$54.72

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	2,035	221	$50.04	$42.25
99439 Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month	1,501	210	$50.01	$38.65
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	903	482	$225.00	$133.70
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	234	234	$245.00	$136.54
G0444 Annual depression screening, 5 to 15 minutes	209	209	$40.00	$19.36
99489 Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month	136	46	$55.00	$45.11
99213 Established patient office or other outpatient visit, typically 15 minutes	82	75	$160.00	$93.92
99487 Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month	72	47	$105.00	$94.31
81003 Automated urinalysis test	43	38	$15.00	$2.20
93000 Routine ekg using at least 12 leads including interpretation and report	35	35	$85.00	$15.37
99497 Advance care planning, first 30 minutes	33	33	$200.00	$88.03
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	30	30	$341.67	$168.29
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	22	22	$339.09	$167.53
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	14	14	$300.00	$177.29

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	2,635	329	$50.00	$42.85
G2058 Chronic care management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (list separately in addition to code for primary procedure). (do not report g2058 fo	1,089	290	$39.85	$38.38
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	859	493	$224.98	$111.22
99489 Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month	314	119	$55.00	$45.39
99487 Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month	221	152	$105.00	$93.57
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	192	192	$245.00	$119.47
G0444 Annual depression screening, 5 to 15 minutes	186	186	$40.00	$18.63
99497 Advance care planning, first 30 minutes	139	138	$200.00	$88.67
99213 Established patient office or other outpatient visit, typically 15 minutes	101	60	$160.00	$77.02
G0506 Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)	64	63	$70.00	$64.32
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	63	59	$300.00	$150.78
81003 Automated urinalysis test	36	35	$15.00	$2.23
93000 Routine ekg using at least 12 leads including interpretation and report	33	31	$85.00	$17.55
87804 Detection test by immunoassay with direct visual observation for influenza virus	30	15	$40.00	$16.22
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	26	15	$50.00	$13.78
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	17	17	$317.35	$170.05

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,354	613	$212.57	$109.68
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	538	236	$50.00	$42.41
G0506 Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)	300	296	$70.00	$63.81
G0444 Annual depression screening, 5 to 15 minutes	169	169	$26.86	$18.45
99487 Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month	167	163	$103.58	$93.24
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	132	107	$285.19	$146.80
99213 Established patient office or other outpatient visit, typically 15 minutes	110	87	$144.73	$74.85
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	86	86	$226.62	$118.63
87804 Detection test by immunoassay with direct visual observation for influenza virus	58	28	$40.00	$16.22
81003 Automated urinalysis test	57	51	$15.00	$2.44
93000 Routine ekg using at least 12 leads including interpretation and report	50	50	$84.00	$17.40
99489 Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month	47	40	$49.98	$46.75
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	46	12	$50.00	$14.58
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	24	14	$85.00	$42.06
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	22	22	$208.68	$110.55
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	19	17	$40.00	$16.20
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	17	17	$298.00	$166.42
G0328 Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous	16	16	$55.00	$17.69
94640 Inhalation treatment for airway obstruction or sputum production	15	15	$40.00	$18.47
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	14	14	$105.00	$54.33
83036 Hemoglobin A1C level	13	13	$30.00	$10.57
G0102 Prostate cancer screening; digital rectal examination	11	11	$41.64	$22.89

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,334	581	$206.00	$108.40
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	152	104	$277.00	$147.47
G0444 Annual depression screening, 5 to 15 minutes	139	139	$24.60	$18.10
99213 Established patient office or other outpatient visit, typically 15 minutes	119	100	$139.00	$74.32
81003 Automated urinalysis test	87	66	$15.00	$2.71
87804 Detection test by immunoassay with direct visual observation for influenza virus	82	40	$40.00	$15.90
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	47	47	$214.00	$118.33
93000 Routine ekg using at least 12 leads including interpretation and report	40	40	$85.00	$17.24
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	30	16	$85.00	$42.35
G0008 Administration of influenza virus vaccine	29	29	$30.00	$20.73
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	27	11	$50.00	$20.07
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	26	26	$105.00	$54.54
G0009 Administration of pneumococcal vaccine	24	24	$30.00	$20.73
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	17	17	$40.00	$16.20
94640 Inhalation treatment for airway obstruction or sputum production	15	14	$40.00	$19.03
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	15	15	$298.00	$165.16
90662 Influenza vaccine split virus, preservative free	12	12	$75.00	$48.76
90670 Pneumococcal vaccine for injection into muscle	11	11	$250.00	$191.01

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,605	673	$206.00	$107.69
99213 Established patient office or other outpatient visit, typically 15 minutes	370	247	$139.00	$73.17
G0008 Administration of influenza virus vaccine	174	172	$30.00	$25.60
90662 Influenza vaccine split virus, preservative free	165	163	$69.85	$47.68
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	124	77	$277.00	$143.88
81003 Automated urinalysis test	115	90	$15.00	$3.02
G0009 Administration of pneumococcal vaccine	114	114	$30.00	$25.38
90670 Pneumococcal vaccine for injection into muscle	98	98	$211.43	$180.04
93000 Routine ekg using at least 12 leads including interpretation and report	95	91	$85.00	$16.85
87804 Detection test by immunoassay with direct visual observation for influenza virus	69	35	$40.00	$16.11
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	56	56	$214.00	$116.76
99202 New patient office or other outpatient visit, typically 20 minutes	47	47	$80.00	$75.51
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	38	13	$50.00	$25.77
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	32	32	$208.00	$109.34
G0444 Annual depression screening, 5 to 15 minutes	28	28	$19.89	$18.15
69210 Removal of impacted ear wax	25	22	$101.00	$49.67
82274 Stool analysis for blood, by fecal hemoglobin determination by immunoassay	24	24	$55.00	$21.38
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	23	22	$75.00	$44.02
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	16	16	$140.00	$93.06
94640 Inhalation treatment for airway obstruction or sputum production	15	14	$40.00	$18.55
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	14	14	$40.00	$16.11
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	14	14	$288.91	$162.21
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	11	11	$320.00	$153.18

Medical Specialties & State Licenses

CMS Verified: 2022-10-17

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License TX K5503

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Internal Medicine

NUCC Taxonomy Code: 207R00000X

State License OK 38899

Pediatrics

NUCC Taxonomy Code: 208000000X

State License TX K5503

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Medicare Railroad Pin

110240334 (TX)

Hospital & Practice Group Affiliations

Stigler Health And Wellness Center Inc

806 Hwy 2 N, Wilburton, OK 745783625

Phone: 8006409741

Stigler Health And Wellness Center Inc

1505 E Main St, Stigler, OK 744622914

Phone: 8006409741

Variety Care, Inc.

3000 N Grand Blvd, Oklahoma City, OK 731071818

Phone: 4056326688

Health Hub Physicians Inc

602 W Oreilly St, Presidio, TX 798452055

Phone: 4322896356

Variety Care, Inc.

201 W 1st St, Grandfield, OK 735469236

Phone: 4056326688

Stigler Health And Wellness Center Inc

111 Forest Dr, Eufaula, OK 744324010

Phone: 8006409741

Cypress Physicians Association

2255 E Mossy Oaks Rd, Spring, TX 773891812

Phone: 2815370300

Secondary Practice Locations

3000 N Grand Blvd

Oklahoma City, OK 731071818

Phone: 4056326688

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

11 Associated Practitioners

Dr. Kathryn Ziegler , MD

Internal Medicine

NPI 1114111408

Doctor of Medicine (M.D.)

Dr. Nairobi Martindale , DO

Family Medicine

NPI 1144425729

Doctor of Osteopathic Medicine (D.O.)

Melinda Guerry , PA

Internal Medicine

NPI 1275921579

Physician Assistant

Elizabeth Andrus , FNP

Nurse Practitioner

NPI 1295194967

Family Nurse Practitioner

Claire Chou , PA-C

Internal Medicine

NPI 1366271439

Physician Assistant (Certified)

Dr. Christina St Michel , MD

Family Medicine

NPI 1467483388

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 17, 2022

Internal Medicine (License #38899 in OK)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) December 11, 2019

Internal Medicine (License #K5503 in TX)

✅

NPI Profile Active March 05, 2018

NPI status registered as active in NPPES database

📍

Updated Practice Location March 05, 2018

Registered at 2255 E MOSSY OAKS RD STE 680, SPRING, TX 773891812 (Tel: 2815370300)

📍

Updated Business Mailing Address March 05, 2018

Registered at 2255 E MOSSY OAKS RD STE 680, SPRING, TX 773891812 (Tel: 2815370300)

👤

Provider Name / Credentials Updated March 05, 2018

Recorded as GLENN DAVIS, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 05, 2018

Pediatrics (License #K5503 in TX)

✅

NPI Profile Active September 28, 2011

NPI status registered as active in NPPES database

📍

Updated Practice Location September 28, 2011

Registered at 1250 CYPRESS STATION DR, SUITE B, HOUSTON, TX 770903004 (Tel: 2815370300)

📍

Updated Business Mailing Address September 28, 2011

Registered at 1250 CYPRESS STATION DR, SUITE B, HOUSTON, TX 770903052 (Tel: 2815370300)

👤

Provider Name / Credentials Updated September 28, 2011

Recorded as GLENN DAVIS, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 28, 2011

Internal Medicine (License #K5503 in TX)

🟢

Initial NPI Registration & Enumeration October 26, 2005

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1003806431

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: October 26, 2005

Last Update: October 17, 2022

Sole Proprietor: No

Update or Correct Profile

Mailing Address

2255 E Mossy Oaks Rd Ste 680

Spring, TX 773891812

Phone: 2815370300

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.