Organization Active NPI

Orange Family Clinic

  • Specialist
  • Orange, TX
National Provider Identifier
1083683098
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
H0730 Issued in TX
Legal business name
ORANGE FAMILY CLINIC
Practice address
3306 Ridgemont Dr
Orange, TX 77630-4236
Phone
(409) 882-0995
Fax
(409) 883-4440
NPI assigned
Mar 14, 2006
Reactivated
May 21, 2009
Last updated
May 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Authorized official

Name
Nick Pomonis, DONPI 1225034168
Title
Owner
Phone
(409) 738-2882

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
Specialist 174400000X H0730 TX Primary

Addresses

Primary practice location

3306 Ridgemont Dr
Orange, TX 77630-4236

Mailing address

PO Box 669386
Dallas, TX 75266-9386
Phone (877) 896-6474

Other identifiers 1

IdentifierTypeStateIssuer
45D0973723OtherTXCLIA CERTIFICATE

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
45D0973723Orange Family Clinic3306 Ridgemont, Orange, TX 77630Certificate of waiverMay 21, 2028

National Provider Directory

National Provider Directory

Locations

3306 Ridgemont Dr
Orange, TX 77630
Phone (409) 882-0995

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1083683098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 669386",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752669386",
            "telephone_number": "877-896-6474",
            "fax_number": "409-883-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3306 RIDGEMONT DR",
            "city": "ORANGE",
            "state": "TX",
            "postal_code": "776304236",
            "telephone_number": "409-882-0995",
            "fax_number": "409-883-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGE FAMILY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "deactivation_date": "2009-03-02",
        "reactivation_date": "2009-05-21",
        "status": "A",
        "authorized_official_last_name": "POMONIS",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-738-2882",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "H0730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA CERTIFICATE",
            "identifier": "45D0973723",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.