Luis A Medina

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

K6649 Issued in TX

Practice address

3800 Highway 365
#119
Port Arthur, TX 77642-7526

Phone

(409) 722-6100

Fax

(409) 722-6109

NPI assigned

Sep 20, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380326400000",
    "number": "1164418752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3377",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776433377",
            "telephone_number": "409-722-6100",
            "fax_number": "409-722-6109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 HIGHWAY 365",
            "address_2": "#119",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776427526",
            "telephone_number": "409-722-6100",
            "fax_number": "409-722-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "LUIS",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2013-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K6649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029674101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline McNeal, FNP-C
• Christopher Lyn McZeal Sr.
• Medi Ride
• Medical Massage Therapy
• Jaqueline Medina, DDS
• Gary Roy Mennie, M.D.
• Michael C Percenti, DPM PLLC
• Keely Nicole Michalk, PHARM D, R.PH.
• Mid County Diagnostics Inc
• Mid County Medical Group PA

• Internal Medicine Physician in Port Arthur, TX
• Providers in Port Arthur, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.