Organization Active NPI

Physician Care & Diagnostics Center, LLC

  • Sonography Specialist/Technologist Cardiovascular
  • Corpus Christi, TX
National Provider Identifier
1124004148
Registry record updated Feb 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sonography Specialist/Technologist CardiovascularTaxonomy code 246XS1301X
Legal business name
PHYSICIAN CARE & DIAGNOSTICS CENTER, LLC
Practice address
3829 Saratoga Blvd
Corpus Christi, TX 78415-5814
Phone
(361) 225-2624
NPI assigned
Dec 21, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2014

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

Authorized official

Name
Mr. Rodolfo Maldonado
Title
Member
Phone
(832) 692-6560

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sonography Specialist/Technologist CardiovascularGroup: 193200000X MULTI-SPECIALTY GROUP 246XS1301X TX Primary

Addresses

Primary practice location

3829 Saratoga Blvd
Corpus Christi, TX 78415-5814

Mailing address

PO Box 420719
Houston, TX 77242-0719

Other identifiers 2

IdentifierTypeStateIssuer
0330DCOtherTXBC/BS OF TEXAS
160385401MedicaidTX

National Provider Directory

National Provider Directory

Locations

6550 Mapleridge St
Ste 103
Houston, TX 77081
Phone (713) 668-6200

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392076800000",
    "number": "1124004148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 420719",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772420719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3829 SARATOGA BLVD",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784155814",
            "telephone_number": "361-225-2624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN CARE & DIAGNOSTICS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-21",
        "last_updated": "2014-02-11",
        "status": "A",
        "authorized_official_last_name": "MALDONADO",
        "authorized_official_first_name": "RODOLFO",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "832-692-6560",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "246XS1301X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist Cardiovascular, Sonography",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF TEXAS",
            "identifier": "0330DC",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160385401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; 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.