Individual provider Active NPI

Raissa Elaine Tanqueco

  • Psychiatry Physician
  • Harlingen, TX
National Provider Identifier
1154614311
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
S3322 Issued in TX
Practice address
2601 Veterans Dr
Harlingen, TX 78550-8942
Phone
(956) 291-9000
NPI assigned
May 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 292914 NY
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X S3322 TX Primary
Psychiatry Physician 2084P0800X A155382 CA

Addresses

Primary practice location

2601 Veterans Dr
Harlingen, TX 78550-8942

Mailing address

2601 Veterans Dr
Harlingen, TX 78550-8942

Other practice location 1

1356 Lusitana St Fl 4
Department of Psychiatry
Honolulu, HI 96813-2409
Phone (808) 586-2903

Other practice location 2

105 Duane St Apt 52G
New York, NY 10007
Phone (808) 586-7425

Other practice location 3

393 E Walnut St
Pasadena, CA 91188-0001
Phone (877) 230-9627

Other practice location 4

393 E Walnut St
Pasadena, CA 91188-0001
Phone (877) 230-9627

Other practice location 5

901 E Hackberry Ave
McAllen, TX 78501-6502
Phone (956) 618-7100

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
A155382CAMDPsychiatry Physician
292914NYMDPsychiatry Physician
S3322TXMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1305849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1154614311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 VETERANS DR",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785508942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 VETERANS DR",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785508942",
            "telephone_number": "956-291-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1356 Lusitana St Fl 4",
            "address_2": "Department of Psychiatry",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968132409",
            "country_code": "US",
            "telephone_number": "808-586-2903",
            "fax_number": "808-586-2940",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 Duane St Apt 52G",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10007",
            "country_code": "US",
            "telephone_number": "808-586-7425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "393 E Walnut St",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911880001",
            "country_code": "US",
            "telephone_number": "877-230-9627",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "393 E Walnut St",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911880001",
            "country_code": "US",
            "telephone_number": "877-230-9627",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 E Hackberry Ave",
            "address_purpose": "LOCATION",
            "city": "McAllen",
            "state": "TX",
            "postal_code": "785016502",
            "country_code": "US",
            "telephone_number": "956-618-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANQUECO",
        "first_name": "RAISSA ELAINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-20",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "292914",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "S3322",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A155382",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlingen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.