NPIMap

Organization Active NPI

Victoria Pediatrics & Adolescents Assoc.

  • Primary Care Clinic/Center
  • Victoria, TX
National Provider Identifier
1033128772
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
E9354 Issued in TX
Legal business name
VICTORIA PEDIATRICS & ADOLESCENTS ASSOC.
Practice address
4304 Retama Cir
Victoria, TX 77901-2767
Phone
(361) 576-2134
Fax
(361) 578-0221
NPI assigned
Aug 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Authorized official

Name
Felix F RegueiraNPI 1033127733
Title
President
Phone
(361) 576-2134

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X E9354 TX Primary

Addresses

Primary practice location

4304 Retama Cir
Victoria, TX 77901-2767

Mailing address

4304 Retama Cir
Victoria, TX 77901-2767
Phone (361) 576-2134

Other identifiers 6

IdentifierTypeStateIssuer
0059DJOtherTXBLUE CROSS BLUE SHIELD
092298101MedicaidTX
092298102MedicaidTX
4331614OtherTXAETNA
82920XOtherTXBLUE CROSS BLUE SHIELD
060378901MedicaidTX

National Provider Directory

National Provider Directory

Locations

4304 Retama Cir
Victoria, TX 77901
Phone (361) 576-2134

Practitioners & affiliated clinicians

Practitioners 6

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": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1033128772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4304 RETAMA CIR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779012767",
            "telephone_number": "361-576-2134",
            "fax_number": "361-578-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4304 RETAMA CIR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779012767",
            "telephone_number": "361-576-2134",
            "fax_number": "361-578-0221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIA PEDIATRICS & ADOLESCENTS ASSOC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "REGUEIRA",
        "authorized_official_first_name": "FELIX",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "361-576-2134"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "E9354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0059DJ",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092298101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092298102",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4331614",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "82920X",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060378901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.