NPIMap

Organization Active NPI

Ae Mgebroff & David H Watson PTR

  • Family Medicine Physician
  • Yoakum, TX
National Provider Identifier
1124135645
Registry record updated Aug 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
AE MGEBROFF & DAVID H WATSON PTR
Practice address
402 Hubbard St
Yoakum, TX 77995-4126
Phone
(361) 293-2371
Fax
(361) 741-5162
NPI assigned
Aug 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2014

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

Authorized official

Name
Diane Bridges
Title
Practice Manager
Phone
(361) 293-2371

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

402 Hubbard St
Yoakum, TX 77995-4126

Mailing address

P O Box 71
Yoakum, TX 77995-0071
Phone (361) 293-2371

Other identifiers 2

IdentifierTypeStateIssuer
094971101MedicaidTX
45D0498918OtherTNCLIA

Other names 1

  • Yoakum Medical Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

402 Hubbard St
Yoakum, TX 77995
Phone (361) 293-2371

Practitioners & affiliated clinicians

Practitioners 3

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": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407283200000",
    "number": "1124135645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 71",
            "city": "YOAKUM",
            "state": "TX",
            "postal_code": "779950071",
            "telephone_number": "361-293-2371",
            "fax_number": "361-741-5162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 HUBBARD ST",
            "city": "YOAKUM",
            "state": "TX",
            "postal_code": "779954126",
            "telephone_number": "361-293-2371",
            "fax_number": "361-741-5162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AE MGEBROFF & DAVID H WATSON PTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2014-08-06",
        "status": "A",
        "authorized_official_last_name": "BRIDGES",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "361-293-2371"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "094971101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "45D0498918",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yoakum Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yoakum, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.