Active NPI
Mario a Lammoglia MD PA
- Cardiovascular Disease Physician
- College Station, TX
National Provider Identifier
1053598755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- K1859
- Legal business name
- MARIO A LAMMOGLIA MD PA
- Practice address
- 1721 Birmingham Dr
College Station, TX 77845-4082 - Phone
- (979) 764-1474
- Fax
- (979) 764-9249
- NPI assigned
- Jan 24, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Montana Oliver
- Title
- Patient Account Manager
- Phone
- (979) 764-1474
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | K1859 | TX | Primary |
Addresses
Primary practice location
1721 Birmingham Dr
College Station, TX 77845-4082
Mailing address
1721 Birmingham Rd
College Station, TX 77845-4082
Phone (979) 764-1474
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 199331301 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
1721 Birmingham Rd
College Station, TX 77845
Phone (979) 695-9540
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Cardiovascular Disease Physician
- College Station, TX
- NPI 1174575104
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201132800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1741824000000",
"number": "1053598755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1721 BIRMINGHAM RD",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "778454082",
"telephone_number": "979-764-1474",
"fax_number": "979-764-9249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1721 BIRMINGHAM DR",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "778454082",
"telephone_number": "979-764-1474",
"fax_number": "979-764-9249"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARIO A LAMMOGLIA MD PA",
"organizational_subpart": "NO",
"enumeration_date": "2008-01-24",
"last_updated": "2025-03-13",
"certification_date": "2025-03-13",
"status": "A",
"authorized_official_last_name": "OLIVER",
"authorized_official_first_name": "MONTANA",
"authorized_official_title_or_position": "PATIENT ACCOUNT MANAGER",
"authorized_official_telephone_number": "979-764-1474"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "TX",
"license": "K1859",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "199331301",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in College Station, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.