Childrens Critical Care of San Antonio PA

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

M3009 Issued in TX

Legal business name

CHILDRENS CRITICAL CARE OF SAN ANTONIO PA

Practice address

5925 Kirby Dr
E354
Houston, TX 77005-2546

Phone

(210) 785-8282

Fax

(210) 785-8288

NPI assigned

Dec 1, 2006

Last updated

Oct 16, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John W Marcum, MD

Title

President

Phone

(210) 785-8282

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255651200000",
    "number": "1225106875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5925 KIRBY DR",
            "address_2": "E354",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770052546",
            "telephone_number": "210-785-8282",
            "fax_number": "210-785-8288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5925 KIRBY DR",
            "address_2": "E354",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770052546",
            "telephone_number": "210-785-8282",
            "fax_number": "210-785-8288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS CRITICAL CARE OF SAN ANTONIO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2009-10-16",
        "status": "A",
        "authorized_official_last_name": "MARCUM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-785-8282",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "TX",
            "license": "M3009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0014NH",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178280701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Critical Care Medicine Physician in Houston, TX
• Providers in Houston, TX by specialty
• Pediatric Critical Care Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2009; 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.