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CENTRUM MEDICAL GROUP, PLLC
NPI 1184379521
General Practice in Houston, TX

Active since February 15, 2022CLIA 45D2270922 · Waiver
10725 EASTEX FREEWAY, HOUSTON, TX 77093(800) 218-8989(786) 558-0242 Get Directions Write a Review

NPPES record last updated: February 15, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Centrum Medical Group, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CENTRUM MEDICAL GROUP, PLLC (NPI 1184379521) is a healthcare organization registered as a general practice in Houston, Texas and active in the NPI registry since February 2022. The organization holds a CLIA Waiver certificate valid through October 23, 2026 and lists Graciela Victorero, C00, as its authorized official.

NPPES Registry Identity

NPI1184379521
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameCENTRUM MEDICAL GROUP, PLLC
Location Address10725 EASTEX FREEWAYHouston, TX 77093
Mailing Address9250 Nw 36th St Ste 420Doral, FL 33178-2775 · (305) 266-2929
Phone(800) 218-8989
Fax(786) 558-0242
Organization SubpartNo
Authorized OfficialGraciela VictoreroC00 · (305) 266-2929
Enumeration DateFebruary 15, 2022
NPPES CertifiedJanuary 31, 2022
✔ NPI 1184379521 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

10725 EASTEX FREEWAY, Houston, TX 77093
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2270922

Centrum Medical Group, PLLC · Houston, TX
Active · expires Oct 23, 2026
CLIA Number45D2270922
Laboratory TypePhysician Office
Certificate Effective DateOctober 24, 2024
Certificate Expiration DateOctober 23, 2026
Laboratory DirectorAyesha Sultana Khan
Laboratory Phone(484) 640-3643
Laboratory LocationCentrum Medical Group, PLLC10725 Eastex Fwy, Houston, TX 77093
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions

What is CENTRUM MEDICAL GROUP, PLLC's NPI number?

The NPI number assigned to this healthcare provider is 1184379521, enumerated as an "organization" on February 15, 2022.

Where is the provider located?

The provider is located at 10725 EASTEX FREEWAY HOUSTON, TX 77093 and the phone number is (800) 218-8989.

What is the provider's specialty?

General Practice with taxonomy code 208D00000X.