Organization Active NPI

Clinica Familiar Kyle LLC

  • Family Nurse Practitioner
  • Kyle, TX
National Provider Identifier
1033975933
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
CLINICA FAMILIAR KYLE LLC
Practice address
21511 Ih 35 Ste 105
Kyle, TX 78640-6683
Phone
(512) 262-7307
Fax
(512) 262-0049
NPI assigned
Feb 27, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Authorized official

Name
Greysi Tamayo Gonzalez, FNPNPI 1770351785
Title
FNP
Phone
(512) 262-7307

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
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

21511 Ih 35 Ste 105
Kyle, TX 78640-6683

Mailing address

21511 Ih 35 Ste 105
Kyle, TX 78640-6683
Phone (512) 262-7307

Other names 1

  • CLINICA FAMILIAR KYLE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240523001477 TX Part B Supplier - Clinic/Group Practice 4587006473 Receives reassigned benefits from 1 practitioner
Practice locations: Kyle, 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
45D2283007Clinica Familiar Kyle21511 Ih 35, Suite 105, Kyle, TX 78640Certificate of waiverMay 30, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1708992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708992000000",
    "number": "1033975933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21511 IH 35 STE 105",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786406683",
            "telephone_number": "512-262-7307",
            "fax_number": "512-262-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21511 IH 35 STE 105",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786406683",
            "telephone_number": "512-262-7307",
            "fax_number": "512-262-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA FAMILIAR KYLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A",
        "authorized_official_last_name": "TAMAYO GONZALEZ",
        "authorized_official_first_name": "GREYSI",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "512-262-7307",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLINICA FAMILIAR KYLE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kyle, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; 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.