NPIMap

Organization Active NPI

Crystal City Isd

  • Student Health Clinic/Center
  • Crystal City, TX
National Provider Identifier
1093188690
Registry record updated Nov 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
License
AT5507 Issued in TX
Legal business name
CRYSTAL CITY ISD
Practice address
805 E Crockett St
Crystal City, TX 78839-2711
Phone
(830) 374-2341
NPI assigned
Nov 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2015

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

Authorized official

Name
Mr. Andres Rodriguez Jr., LAT
Title
Athletic Trainer
Phone
(830) 374-2341

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X AT5507 TX Primary

Addresses

Primary practice location

805 E Crockett St
Crystal City, TX 78839-2711

Mailing address

805 E Crockett St
Crystal City, TX 78839-2711
Phone (830) 374-2341

National Provider Directory

National Provider Directory
Tax ID family
Crystal City Independent School Distritct2 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.

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": "1446595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446595200000",
    "number": "1093188690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 E CROCKETT ST",
            "city": "CRYSTAL CITY",
            "state": "TX",
            "postal_code": "788392711",
            "telephone_number": "830-374-2341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 E CROCKETT ST",
            "city": "CRYSTAL CITY",
            "state": "TX",
            "postal_code": "788392711",
            "telephone_number": "830-374-2341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL CITY ISD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-04",
        "last_updated": "2015-11-04",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "ANDRES",
        "authorized_official_title_or_position": "ATHLETIC TRAINER",
        "authorized_official_telephone_number": "830-374-2341",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LAT"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "TX",
            "license": "AT5507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.