NPIMap

Organization Active NPI

St Teresa Clinic PA

  • Family Medicine Physician
  • Mission, TX
National Provider Identifier
1124385950
Registry record updated Mar 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST TERESA CLINIC PA
Practice address
10900 N 103Rd St
Mission, TX 78573-0979
Phone
(956) 583-4233
Fax
(956) 580-7631
NPI assigned
Apr 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2013

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

Authorized official

Name
Dr. Jeselle Mathews, M.D.
Title
Manager
Phone
(956) 583-4233

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X

Addresses

Primary practice location

10900 N 103Rd St
Mission, TX 78573-0979

Mailing address

PO Box 4262
Mission, TX 78573-0073
Phone (956) 583-4233

National Provider Directory

National Provider Directory

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": "1334707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362355200000",
    "number": "1124385950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4262",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785730073",
            "telephone_number": "956-583-4233",
            "fax_number": "956-580-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10900 N 103RD ST",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785730979",
            "telephone_number": "956-583-4233",
            "fax_number": "956-580-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST TERESA CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-18",
        "last_updated": "2013-03-04",
        "status": "A",
        "authorized_official_last_name": "MATHEWS",
        "authorized_official_first_name": "JESELLE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "956-583-4233",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.