Active NPI
Robert Destefano, MD
- Family Medicine Physician
- Baytown, TX
National Provider Identifier
1174612576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- F6222
- Practice address
- 306 Pin Oak Dr.
Baytown, TX 77520-1217 - Phone
- (281) 427-8255
- Fax
- (281) 422-9973
- NPI assigned
- Oct 12, 2006
- Last updated
- Sep 27, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | F6222 | TX | Primary |
Addresses
Primary practice location
306 Pin Oak Dr.
Baytown, TX 77520-1217
Mailing address
306 Pin Oak Dr.
Baytown, TX 77520-1217
Phone (281) 427-8255
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0347049-01 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- rdestefano27104@directhoustonmethodist.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727395200000",
"number": "1174612576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 PIN OAK DR.",
"city": "BAYTOWN",
"state": "TX",
"postal_code": "775201217",
"telephone_number": "281-427-8255",
"fax_number": "281-422-9973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 PIN OAK DR.",
"city": "BAYTOWN",
"state": "TX",
"postal_code": "775201217",
"telephone_number": "281-427-8255",
"fax_number": "281-422-9973"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESTEFANO",
"first_name": "ROBERT",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2024-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "F6222",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0347049-01",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baytown, TX
- Ellie Rose Courtney Denbigh, MS, CCC-SLP
- Denis K. Hoasjoe MD PA (Dr. Denis K. Hoasjoe)
- Nicolas Joshua Denney
- Donna Denny, A-SLP
- Susan Gail Depusoir
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- Developmental Neurology Associates PC
- Developmental Neurology Associates PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.