Individual provider Active NPI

Ernest A Barbosa, D.D.S

  • General Practice Dentistry
  • Brownsville, TX
National Provider Identifier
1124030077
Registry record updated Jan 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15843 Issued in TX
Practice address
1205 N Expressway Ste B
1205 N Expressway Ste B
Brownsville, TX 78520-8622
Phone
(956) 542-1545
Fax
(956) 542-3094
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 15843 TX Primary

Addresses

Primary practice location

1205 N Expressway Ste B
1205 N Expressway Ste B
Brownsville, TX 78520-8622

Mailing address

1552 Palm Boulevard
#21 Palm Village Shopping Center
Brownsville, TX 78520
Phone (956) 542-1545

Other identifiers 3

IdentifierTypeStateIssuer
75-2300597OtherTXTAX ID #
1350373-02MedicaidTX
B15843-1OtherTXTEXAS CHIPS #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
15843TXMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359590400000",
    "number": "1124030077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1552 PALM BOULEVARD",
            "address_2": "#21 PALM VILLAGE SHOPPING CENTER",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "78520",
            "telephone_number": "956-542-1545",
            "fax_number": "956-542-3094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 N EXPRESSWAY STE B",
            "address_2": "1205 N EXPRESSWAY STE B",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785208622",
            "telephone_number": "956-542-1545",
            "fax_number": "956-542-3094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARBOSA",
        "first_name": "ERNEST",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2013-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "15843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "75-2300597",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1350373-02",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS CHIPS #",
            "identifier": "B15843-1",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; 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.