Organization Active NPI

Delacotera Health Care Association

  • Family Medicine Physician
  • Shenandoah, TX
National Provider Identifier
1013984558
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M1621 Issued in TX
Legal business name
DELACOTERA HEALTH CARE ASSOCIATION
Practice address
129 Vision Park Blvd Ste 200
Shenandoah, TX 77384-3024
Phone
(281) 248-8872
Fax
(281) 248-8875
NPI assigned
Mar 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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

Authorized official

Name
Rodrigo De la Cotera Jule, M.D.NPI 1235126319
Title
Owner/ Doctor
Phone
(281) 248-8872

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X M1621 TX Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

129 Vision Park Blvd Ste 200
Shenandoah, TX 77384-3024

Mailing address

129 Vision Park Blvd Ste 200
Shenandoah, TX 77384-3024
Phone (281) 248-8872

Other identifiers 1

IdentifierTypeStateIssuer
178522201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050919001002 TX Part B Supplier - Clinic/Group Practice 5496789547 Receives reassigned benefits from 1 practitioner
Practice locations: Shenandoah, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2119028Delacotera Health Care Association129 Vision Park Blvd, # 200, Shenandoah, TX 77384Certificate of waiverSep 18, 2026

National Provider Directory

National Provider Directory

Locations

17045 Saint Edwards Dr
Ste 300
Houston, TX 77090
Phone (281) 248-8872

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CGFIBD

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758153600000",
    "number": "1013984558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 VISION PARK BLVD STE 200",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773843024",
            "telephone_number": "281-248-8872",
            "fax_number": "281-248-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 VISION PARK BLVD STE 200",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773843024",
            "telephone_number": "281-248-8872",
            "fax_number": "281-248-8875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELACOTERA HEALTH CARE ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-03",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A",
        "authorized_official_last_name": "DE LA COTERA JULE",
        "authorized_official_first_name": "RODRIGO",
        "authorized_official_title_or_position": "OWNER/ DOCTOR",
        "authorized_official_telephone_number": "281-248-8872",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M1621",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178522201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.