| Innovista Medical Center Of Texas Pa | |
|
12586 Westheimer Rd Houston TX 77077-5865 | |
| (305) 470-2929 | |
| Not Available |
| Full Name | Innovista Medical Center Of Texas Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 12586 Westheimer Rd, Houston, Texas |
| Authorized Official Name and Position | Mia Willhite (COO) |
| Authorized Official Contact | 2697207042 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovista Medical Center Of Texas Pa 12586 Westheimer Rd Houston TX 77077-5865 Ph: (305) 470-2929 | Innovista Medical Center Of Texas Pa 12586 Westheimer Rd Houston TX 77077-5865 Ph: (305) 470-2929 |
| NPI Number | 1568016061 |
|---|---|
| Provider Enumeration Date | 08/01/2019 |
| Last Update Date | 04/25/2024 |
| Medicare PECOS PAC ID | 6901235423 |
|---|---|
| Medicare Enrollment ID | O20200406000046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568016061 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | David L Heredia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104980408 PECOS PAC ID: 9234112731 Enrollment ID: I20040607001519 |
| Provider Name | Lacrecia K Foster |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811959281 PECOS PAC ID: 9931178431 Enrollment ID: I20040930001093 |
| Provider Name | Mabel Anderson Perez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578595369 PECOS PAC ID: 6608832506 Enrollment ID: I20041202000508 |
| Provider Name | Mai L Somphet |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962603126 PECOS PAC ID: 3577738491 Enrollment ID: I20111205000459 |
| Provider Name | Nathan Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487971719 PECOS PAC ID: 9739334178 Enrollment ID: I20130308000424 |
| Provider Name | Afreen S Pappa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457431876 PECOS PAC ID: 6204077738 Enrollment ID: I20130726000092 |
| Provider Name | Diana S Look |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417196130 PECOS PAC ID: 6901128032 Enrollment ID: I20141201000922 |
| Provider Name | Katrina S Chea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831561158 PECOS PAC ID: 5496054223 Enrollment ID: I20160429000828 |
| Provider Name | Bhavana Y Mocherla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568680593 PECOS PAC ID: 9638191943 Enrollment ID: I20170127000821 |
| Provider Name | Nereida Maria Manuel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760772560 PECOS PAC ID: 2961790001 Enrollment ID: I20190603002509 |
| Provider Name | Alaa Masjune |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063895324 PECOS PAC ID: 0648569996 Enrollment ID: I20200611002924 |
| Provider Name | Hector Castillo Becerra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215524566 PECOS PAC ID: 3779996913 Enrollment ID: I20210108000304 |
| Provider Name | Alicia M Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346856408 PECOS PAC ID: 5092129411 Enrollment ID: I20210126003462 |
| Provider Name | Tomas Flores |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003187048 PECOS PAC ID: 2264652494 Enrollment ID: I20210804003289 |
| Provider Name | Maung Htain Lin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720477029 PECOS PAC ID: 2062783707 Enrollment ID: I20210813001618 |
| Provider Name | Jolson Korah Tharakan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275784555 PECOS PAC ID: 5496937419 Enrollment ID: I20210913000153 |
| Provider Name | Jaram Lim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235893736 PECOS PAC ID: 8123417649 Enrollment ID: I20211122002140 |
| Provider Name | Alyssa Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942796784 PECOS PAC ID: 8820481526 Enrollment ID: I20220201001642 |
| Provider Name | Muhammad M Nazim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952500522 PECOS PAC ID: 9234223496 Enrollment ID: I20220808002344 |
| Provider Name | Monsurat A Shoola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447894266 PECOS PAC ID: 7810363355 Enrollment ID: I20221025000357 |
| Provider Name | Recarda G Dankyi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033859160 PECOS PAC ID: 6406228808 Enrollment ID: I20230213001344 |
| Provider Name | Franco Porto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366107112 PECOS PAC ID: 1658761697 Enrollment ID: I20230426000715 |
| Provider Name | Shaun Ingram |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093377194 PECOS PAC ID: 0648604223 Enrollment ID: I20230601002786 |
| Provider Name | Niurka Blanco Benavides |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134768625 PECOS PAC ID: 1658733951 Enrollment ID: I20230818000744 |
| Provider Name | Alexandru Stefan Durgheu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922761758 PECOS PAC ID: 3274907332 Enrollment ID: I20230823001526 |
| Provider Name | Leyvis Arrieta Wambrug |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174247779 PECOS PAC ID: 0941658876 Enrollment ID: I20231202000047 |
| Provider Name | Vineet Sandhu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891083127 PECOS PAC ID: 5597905679 Enrollment ID: I20240102002272 |
| Provider Name | Yali Tu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215645940 PECOS PAC ID: 1153765862 Enrollment ID: I20240221003252 |
| Provider Name | Naila Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386684876 PECOS PAC ID: 3173566866 Enrollment ID: I20240313000851 |
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