DR. LATHA MARY BRUBAKER (NPI# 1043280886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043280886 |
| Entity Type | Individual |
| Full Name | DR. LATHA MARY BRUBAKER |
| Credential | MD |
| Practice Address |
12345 Katy Fwy Suite 200 Houston TX 77079-1503 |
| Mailing Address |
5080 Spectrum Dr Suite 1200 West Addison TX 75001-4648 |
| Practice Telephone | 2816795600 |
| Practice Fax Number | 2816796510 |
| Mailing Telephone | 8002323550 |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2009-03-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD00041537 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 8322117 | 05 |
| Street Address |
12345 KATY FWY SUITE 200 |
| City | HOUSTON |
| State | TX |
| Zip Code | 77079-1503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801866611 | Rajesh Rao | Emergency Medicine | 12345 Katy Fwy, Houston, TX 77079-1503 | 2006-01-24 |
| 1295294650 | Eric Thomas Zimicki | Physical Therapist | 12345 Katy Fwy, Houston, TX 77079-1503 | 2019-03-15 |
| 1821521832 | Breanna Range | Physical Therapist | 12345 Katy Fwy, Houston, TX 77079-1503 | 2017-04-06 |
| 1639557259 | Jansen Yamout | Physical Therapist | 12345 Katy Fwy, Houston, TX 77079-1503 | 2015-05-14 |
| 1407185721 | Teri Morris | Physician Assistant | 12345 Katy Fwy, Houston, TX 77079 | 2009-12-15 |
| 1659557551 | Funke F Agbasi | Family Medicine | 12345 Katy Fwy, Houston, TX 77079-1503 | 2008-01-10 |
| 1285834192 | Tesfamariam Mebrahtom Tedla | Family Medicine | 12345 Katy Fwy, Houston, TX 77079-1503 | 2007-07-19 |
| 1457483687 | Ronald M Beberniss | Preventive Medicine | 12345 Katy Fwy, Houston, TX 77079-1503 | 2007-03-12 |
| 1043357338 | Mary Z Kleypas | Physical Therapist | 12345 Katy Fwy, Houston, TX 77079-1503 | 2007-01-30 |
| 1033256250 | Jennifer R Kuck | Physical Therapist | 12345 Katy Fwy, Houston, TX 77079-1503 | 2007-01-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982213542 | Apg Ancillaries LLC | Durable Medical Equipment & Medical Supplies | 14811 Saint Marys Ln Ste 152, Houston, TX 77079 | 2020-07-29 |
| 1982244174 | Agatha Nwosu | Registered Nurse | 1155 Dairy Ashford Rd Suite 560, Houston, TX 77079 | 2020-01-15 |
| 1164924650 | Victoria Okon | Licensed Vocational Nurse | 14461 Still Meadow Dr., Houston, TX 77079 | 2018-03-01 |
| 1649711623 | Deon Flenoy | Case Manager/Care Coordinator | 14027 Memorial Dr # 419, Houston, TX 77079 | 2017-03-10 |
| 1396298428 | Supriya Krishnan | Optometrist | 14634 Memorial Dr, Houston, TX 77079 | 2016-07-25 |
| 1942670401 | Medfast Pediatric & Family Clinic | Nurse Practitioner | 14520 Old Katy Rd, St 109, Houston, TX 77079 | 2015-09-28 |
| 1558742106 | Evan Christopher Adams | Dentist | 909 Dairy Ashford Rd Ste 104, Houston, TX 77079 | 2015-06-09 |
| 1114313152 | Yun Li | Internal Medicine | 13140 Trail Hollow Dr, Houston, TX 77079 | 2015-04-07 |
| 1629460308 | Michelle Maligaya | Registered Nurse | 1201 N Dairy Ashford Rd Ste 100, Houston, TX 77079 | 2015-03-04 |
| 1144611989 | Ryan M Keutzer | Hearing Instrument Specialist | 12900 Queensbury Ln #100, Houston, TX 77079 | 2015-02-16 |
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| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871194670 | Priscilla Tehrani | Family Medicine | 615 North Loop E Unit 100, Houston, TX 77022-5934 | 2020-11-06 |
| 1871100032 | Umedly | Family Medicine | 708 Main St Fl 10, Houston, TX 77002-3246 | 2020-09-30 |
| 1255945010 | Steven X Nguyen Inc | Family Medicine | 6112 Bellaire Blvd Ste D, Houston, TX 77081-4913 | 2020-08-31 |
| 1871105023 | Health Right Choice | Family Medicine | 17550 W Little York Rd Ste 10, Houston, TX 77084-6321 | 2020-08-19 |
| 1275145625 | Global Health Equity Pllc | Family Medicine | 1232 Westheimer Rd, Houston, TX 77006-2641 | 2020-08-18 |
| 1083223804 | Patricia Nmukoso Enyi | Family Medicine | 2646 S Loop W Ste 270, Houston, TX 77054-5608 | 2020-07-28 |
| 1972121416 | Community Medical Clinic LLC | Family Medicine | 10008 Bellaire Blvd, Suite 108, Houston, TX 77072 | 2020-07-10 |
| 1164048526 | Clinica San Lucas Fuqua | Family Medicine | 11019 Fuqua St, Houston, TX 77089-2510 | 2020-06-22 |
| 1699397240 | Urgent Health Solutions Woodlake | Family Medicine | 9668 Westheimer Rd Ste 600, Houston, TX 77063-3252 | 2020-05-16 |
| 1649899964 | Lermnaim LLC | Family Medicine | 2919 Fm 1960 Rd Ste 120, Houston, TX 77073-2621 | 2020-04-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.