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PROVIDENCE FAMILY CARE
NPI 1366988412
Clinic/Center - Primary Care in Coldspring, TX

Active since January 12, 2017CLIA 45D2131012 · Waiver
21 ALPINE ST, COLDSPRING, TX 77331(936) 647-2227(936) 647-2202 Get Directions Write a Review

NPPES record last updated: March 8, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 8, 2020, Apr 23, 2018, Jun 8, 2017 and 1 more (4 updates tracked since 2017).

About Providence Family Care NPPES

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

PROVIDENCE FAMILY CARE (NPI 1366988412) is a healthcare organization registered as a primary care in Coldspring, Texas and active in the NPI registry since January 2017. The organization holds a CLIA Waiver certificate valid through May 21, 2027 and lists Jennifer Nguyen, Business Account Manager, as its authorized official.

NPPES Registry Identity

NPI1366988412
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NamePROVIDENCE MISSION MINISTRY LLC
Location Address21 ALPINE STColdspring, TX 77331-8058
Mailing AddressPo Box 1293New Caney, TX 77357-1293 · (281) 774-8785 · Fax (832) 543-5006
Phone(936) 647-2227
Fax(936) 647-2202
Organization SubpartNo
Authorized OfficialJennifer NguyenBusiness Account Manager · (281) 774-8785
Enumeration DateJanuary 12, 2017
Last NPPES UpdateMarch 8, 20204 updates tracked since enumeration
NPPES CertifiedMarch 8, 2020
✔ NPI 1366988412 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
21 ALPINE ST, Coldspring, TX 77331
Open in Google Maps ↗

Other Names 1

Doing Business AsProvidence Family Care

Other Identifiers 1

Medicaid371798501TX

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Providence Family Care is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Providence Family Care, which bills Medicare for the services this clinician delivers.

Clinician (1)

Tri Le, MD
Family Practice
NPI 1205848033
21 ALPINE ST
Coldspring, TX 77331
(936) 647-2227
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 45D2131012

Providence Family Care · Coldspring, TX
Active · expires May 21, 2027
CLIA Number45D2131012
Laboratory TypePhysician Office
Certificate Effective DateMay 22, 2025
Certificate Expiration DateMay 21, 2027
Laboratory DirectorTri M. Le
Laboratory Phone(936) 653-8851
Laboratory LocationProvidence Family Care21 Alpine Street, Coldspring, TX 77331
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Providence Mission Ministry LLC's NPI number?

The NPI number for Providence Mission Ministry LLC is 1366988412. It was assigned to this organization in the NPPES registry on January 12, 2017. The provider is doing business as Providence Family Care.

Where is Providence Mission Ministry LLC located?

Providence Mission Ministry LLC is located at 21 Alpine St, Coldspring, TX 77331. The listed phone number is (936) 647-2227.

What is Providence Mission Ministry LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Providence Mission Ministry LLC enrolled in Medicare?

Yes. Providence Mission Ministry LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Providence Mission Ministry LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Providence Mission Ministry LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Providence Mission Ministry LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2131012) is associated with this NPI, valid through May 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Providence Mission Ministry LLC was last updated on March 8, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.