Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Provisioncare Medical

Organization Family Medicine Physician · NPI 1144884826

Provisioncare Medical is a Family Medicine Physician in Humble, Texas. Registered with an NPI since 2019.

In the registry since
2019

Practice location Address checks out

11501 N Sam Houston Pkwy E Ste A
Humble, TX 77396-4635
Phone: (281) 652-5612
Fax: (346) 980-4054
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1144884826
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Derrick Traylor — Ceo · (503) 901-5733
Other names Mancavemd
NPI enumeratedApril 28, 2019
Last updated in NPPESJune 11, 2019
Mailing address14700 Woodson Park Dr Apt 1512, Houston, TX 77044-4531

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