Healthcare Provider Details

I. General information

NPI: 1154018174
Provider Name (Legal Business Name): NEVIN THOMAS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2023
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6411 FANNIN ST
HOUSTON TX
77030-1501
US

IV. Provider business mailing address

6431 FANNIN ST JJL 270
HOUSTON TX
77030-1501
US

V. Phone/Fax

Practice location:
  • Phone: 713-704-4000
  • Fax:
Mailing address:
  • Phone: 713-500-7116
  • Fax: 713-500-0625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberW3318
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: