NPIMap

Organization Active NPI

Panamericana Family Medicine Clinic PLLC

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1063917896
Registry record updated Mar 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PANAMERICANA FAMILY MEDICINE CLINIC PLLC
Practice address
1900 Blalock Rd # 1900M
Houston, TX 77080-5450
Phone
(713) 480-9129
NPI assigned
Mar 26, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2018

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

Authorized official

Name
Mrs. Carmen E. Vega, FNP-BCNPI 1689102782
Title
Manager
Phone
(713) 480-9129

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 Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1900 Blalock Rd # 1900M
Houston, TX 77080-5450

Mailing address

7126 Rancheria Dr
Houston, TX 77083-4330
Phone (713) 240-1221

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180612000781 TX Part B Supplier - Clinic/Group Practice 5092060202 Receives reassigned benefits from 2 practitioners
Practice locations: Houston, TX; Katy, 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
45D2151306Panamericana Family Medicine Clinic, PLLC1900 Blalock Rd Suite M, Houston, TX 77080Certificate of waiverJul 16, 2028

National Provider Directory

National Provider Directory
Tax ID family
Panamericana Family Medicine Clinic PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1900 Blalock Rd
#1900M
Houston, TX 77080
Phone (713) 480-9129

9683 Southwest Fwy
Houston, TX 77074
Phone (832) 623-7347

9919 North Fwy
Ste M
Houston, TX 77037

1900 Blalock Rd
Ste M
Houston, TX 77080
Phone (281) 206-7562

347 S Mason Rd
Katy, TX 77450
Phone 2812067562406

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17945/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 12

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": "1522022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522022400000",
    "number": "1063917896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7126 RANCHERIA DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770834330",
            "telephone_number": "713-240-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 BLALOCK RD # 1900M",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770805450",
            "telephone_number": "713-480-9129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANAMERICANA FAMILY MEDICINE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-26",
        "last_updated": "2018-03-26",
        "status": "A",
        "authorized_official_last_name": "VEGA",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "713-480-9129",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2018; 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.