ALICE CIVITELLO (NPI# 1922402841) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922402841 |
| Entity Type | Individual |
| Full Name | ALICE CIVITELLO |
| Credential | PA - C |
| Practice Address |
6620 Main St Ste 1225 Houston TX 77030-2348 |
| Mailing Address |
1 Baylor Plz Houston TX 77030-3411 |
| Practice Telephone | 7137982545 |
| Practice Fax Number | 7137982578 |
| Mailing Telephone | 7137984951 |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2014-10-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA00385 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | TEXAS MEDICAL LICENSE | PA00385 | 01 |
| Street Address |
6620 MAIN ST STE 1225 |
| City | HOUSTON |
| State | TX |
| Zip Code | 77030-2348 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215930276 | Texas International Endoscopy Center, Lp | Clinic/Center | 6620 Main St, Ste 1500, Houston, TX 77030-2331 | 2005-05-24 |
| 1770102287 | Scott Zhou | Student in an Organized Health Care Education/Training Program | 6620 Main St, Houston, TX 77030-2348 | 2020-04-14 |
| 1831678788 | Anam Rahim | Nurse Practitioner | 6620 Main St, Houston, TX 77030-2348 | 2018-08-11 |
| 1679076103 | Saleema Ali | Nurse Practitioner | 6620 Main St, Houston, TX 77030-2348 | 2018-03-11 |
| 1447768346 | Jennifer Alicia Cabrera | Nurse Practitioner | 6620 Main St, Houston, TX 77030-2348 | 2018-01-14 |
| 1609303536 | Jacqueline Florence Birnbaum | Internal Medicine | 6620 Main St, Houston, TX 77030-2348 | 2017-05-23 |
| 1952838567 | Paola Matheus | General Acute Care Hospital | 6620 Main St, Suite 11d.32.8, Houston, TX 77030-2348 | 2017-05-12 |
| 1497203640 | Michael Byrd | Nurse Practitioner | 6620 Main St, Suite 1350, Houston, TX 77030-2348 | 2016-09-16 |
| 1285181305 | Kathryn Elizabeth Kenny King | Physician Assistant | 6620 Main St, Suite 1350, Houston, TX 77030-2348 | 2016-09-07 |
| 1629425103 | Thomas Joseph Quehl | Internal Medicine | 6620 Main St, 11th Floor - Bcm 620, Houston, TX 77030-2348 | 2016-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770852 | Mchaji Celestaine | Pharmacist | Medvamc 2002 Holcombe Blvd, Outpatient Pharmacy, Houston, TX 77030 | 2020-11-04 |
| 1730702598 | Christopher A Mcmillian | Student in an Organized Health Care Education/Training Program | Houston Methodist Department of Surgery, 6550 Fannin St., Smith Tower 1661, Houston, TX 77030 | 2020-05-27 |
| 1245852698 | Mostafa Hotait | Student in an Organized Health Care Education/Training Program | 7200 Cambridge Street 9a, Houston, TX 77030 | 2020-05-08 |
| 1790307288 | Ayushi Jayesh Shah | Student in an Organized Health Care Education/Training Program | 6560 Fannin St, Department of Neurology, Houston Method, Suite 802, Scurlock. 8thfloor, Houston, TX 77030 | 2020-05-07 |
| 1932720836 | Vera Whole Health Wa, PC | Clinic/Center | 6620 Main St, 12th Flr, Ste 1225, Houston, TX 77030 | 2020-05-01 |
| 1548881808 | Mobitz Heart and Rhythm Center Pllc | Internal Medicine | Scurlock Tower, 6560 Fannin St., Houston, TX 77030 | 2020-04-28 |
| 1710516513 | Thomas Chi Han Lu | Student in an Organized Health Care Education/Training Program | 6431 Fannin Street, Msb 3.151, Houston, TX 77030 | 2020-04-03 |
| 1063041085 | Kevin Tang | Student in an Organized Health Care Education/Training Program | 7200 Cambridge., Bcm 903, Suite A10.202, Houston, Texas, TX 77030 | 2020-04-02 |
| 1831728898 | Taylor Renbarger | Student in an Organized Health Care Education/Training Program | 6431 Fannin St Suite Jjl 431, Houston, TX 77030 | 2020-04-02 |
| 1972131423 | Sindhu R Rao | Student in an Organized Health Care Education/Training Program | 7200 Cambridge Street, 9th Floor, Suite 9a, Houston, TX 77030 | 2020-03-31 |
| Find all providers in zip 77030 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619591864 | Today Telemedicine Pllc | Physician Assistant | 404 Oxford St Apt 2219, Houston, TX 77007-2679 | 2020-06-03 |
| 1114558335 | Erin Lynn Brown | Physician Assistant | 1504 Taub Loop Houston, Houston, TX 77030 | 2020-01-27 |
| 1720649478 | Teresa Garcia | Physician Assistant | 12911 Hawthorne Shores Dr, Houston, TX 77044-1258 | 2019-06-24 |
| 1407328578 | Brenda Guzman Castillo | Physician Assistant | 3003 Navigation Boulevard, Houston, TX 77003 | 2018-12-29 |
| 1518442649 | Alexander De Jesus Hadded | Physician Assistant | 3651 Weslayan St Ste 106, Houston, TX 77027-6643 | 2018-09-25 |
| 1003395872 | Silas Steven Luna | Physician Assistant | 427 W 20th St Ste 210, Houston, TX 77008-2400 | 2018-08-12 |
| 1619490901 | Dona Le | Physician Assistant | 11119 Fern Terrace Dr, Houston, TX 77075 | 2017-07-19 |
| 1043761455 | Lorena Michelle Sumner-nassif | Physician Assistant | 9809 Rowlett Rd # A1, Houston, TX 77075-3438 | 2016-10-20 |
| 1851760243 | Lauren K Duerst | Physician Assistant | 6550 Fannin St Ste 1701, Houston, TX 77030-2709 | 2015-09-16 |
| 1982081568 | Lundy Saing | Physician Assistant | 6431 Fannin St Msb 2.130, Houston, TX 77030 | 2015-05-02 |
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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.