Active NPI
Eduardo Caballero, M.D.
- Family Medicine Physician
- Mercedes, TX
National Provider Identifier
1043370836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- H4883
- Practice address
- 520 W 3Rd St
Mercedes, TX 78570-3045 - Phone
- (956) 565-1872
- Fax
- (956) 565-6581
- NPI assigned
- Dec 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | H4883 | TX | Primary |
Addresses
Primary practice location
520 W 3Rd St
Mercedes, TX 78570-3045
Mailing address
520 W 3Rd St
Mercedes, TX 78570-3045
Phone (956) 565-1872
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 091766801 | Medicaid | TX | |
| 091766802 | Medicaid | TX | |
| 122152 | Other | TX | CHIP |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100713000712 | TX | Practitioner - General Practice | 9133251002 | Practice locations: Mercedes, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043370836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 W 3RD ST",
"city": "MERCEDES",
"state": "TX",
"postal_code": "785703045",
"telephone_number": "956-565-1872",
"fax_number": "956-565-6581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 W 3RD ST",
"city": "MERCEDES",
"state": "TX",
"postal_code": "785703045",
"telephone_number": "956-565-1872",
"fax_number": "956-565-6581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CABALLERO",
"first_name": "EDUARDO",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "H4883",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "091766801",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "091766802",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHIP",
"identifier": "122152",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mercedes, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.