Individual provider Active NPI

Linda Raquel Camacho, MD

  • Pediatrics Physician
  • Houston, TX
National Provider Identifier
1013470343
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
T8775 Issued in TX
Practice address
7520 Brompton St Apt 736
Houston, TX 77025-2257
Phone
(956) 455-9617
NPI assigned
Apr 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X T8775 TX Primary

Addresses

Primary practice location

7520 Brompton St Apt 736
Houston, TX 77025-2257

Mailing address

451 Myrtle Ave Uppr
Albany, NY 12208-3514

Other practice location 1

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-5347

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220915001726 TX Practitioner - Pediatric Medicine 2365779378 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Community Health Services, Inc Pediatrics CurrentSince Aug 29, 2022 Accepting new patients
Legacy Community Health Services, Inc CurrentSince Aug 29, 2022 Accepting new patients

Locations

12667 Bissonnet St
Houston, TX 77099
Phone (281) 498-6100

12345 Bissonnet St
Houston, TX 77099

6441 High Star Dr
Houston, TX 77074
Phone (832) 548-5300

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1013470343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 MYRTLE AVE UPPR",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7520 BROMPTON ST APT 736",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770252257",
            "telephone_number": "956-455-9617"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Nicolls Rd",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117940001",
            "country_code": "US",
            "telephone_number": "631-444-5347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "LINDA",
        "middle_name": "RAQUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-12",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "T8775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.