Concho Valley Medicine, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CONCHO VALLEY MEDICINE, LLC

Practice address

225 S Abe St
San Angelo, TX 76903-6305

Phone

(407) 414-6102

NPI assigned

Feb 24, 2023

Last updated

Feb 24, 2023By 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. Bryan A Mejia, MDNPI 1114107828

Title

Provider

Phone

(407) 414-6102

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bryan Armando Mejia, MD

  • Internal Medicine Physician
  • San Angelo, TX
  • NPI 1114107828
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1677196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677196800000",
    "number": "1225737539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 S ABE ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769036305",
            "telephone_number": "325-374-0821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 S ABE ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769036305",
            "telephone_number": "407-414-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCHO VALLEY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-24",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A",
        "authorized_official_last_name": "MEJIA",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "407-414-6102",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD",
            "identifier": "P9224",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Concho Valley Errand Services
• Concho Valley Family Dental
• Concho Valley Family Dental, P.a. (Dolce Vita Wellness & Dental Spa)
• Concho Valley Hematology & Oncology, PLLC
• Concho Valley HHC of West TX LLC (Concho Valley Home Health Care)
• Concho Valley Rehab, P.a.
• Kathe Ann Conner, RN/FNP BC
• Alicia Connolly, MS, MAT, LAT, ATC
• Quintin Brice Conoly, PHARMD
• Rachael A Conover, CNS

• Internal Medicine Physician in San Angelo, TX
• Providers in San Angelo, 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 Feb 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.