NPIMap

Organization Active NPI

Clinica San Martin de Porres

  • Health Service Clinic/Center
  • McAllen, TX
National Provider Identifier
1114166014
Registry record updated Mar 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
N1626 Issued in TX
Legal business name
CLINICA SAN MARTIN DE PORRES
Practice address
6101 N 23Rd St
Suite F
McAllen, TX 78504-3929
Phone
(956) 627-2752
Fax
(956) 627-2754
NPI assigned
Feb 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2012

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

Authorized official

Name
Dr. Abdias D Etienne, MDNPI 1972764827
Title
President
Phone
(917) 204-6110

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
Health Service Clinic/Center 261QH0100X N1626 TX Primary

Addresses

Primary practice location

6101 N 23Rd St
Suite F
McAllen, TX 78504-3929

Mailing address

6101 N 23Rd St
Suite F
McAllen, TX 78504-3929
Phone (956) 627-2752

National Provider Directory

National Provider Directory

Locations

6101 N 23rd St
Ste F
McAllen, TX 78504
Phone (956) 627-2752

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": "1234828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333065600000",
    "number": "1114166014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 N 23RD ST",
            "address_2": "SUITE F",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785043929",
            "telephone_number": "956-627-2752",
            "fax_number": "956-627-2754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 N 23RD ST",
            "address_2": "SUITE F",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785043929",
            "telephone_number": "956-627-2752",
            "fax_number": "956-627-2754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA SAN MARTIN DE PORRES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-17",
        "last_updated": "2012-03-30",
        "status": "A",
        "authorized_official_last_name": "ETIENNE",
        "authorized_official_first_name": "ABDIAS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-204-6110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "TX",
            "license": "N1626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McAllen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2012; 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.