Active NPI
Eduardo Bautista, RT AART
- Diagnostic Radiology Physician
- Brownsville, TX
National Provider Identifier
1235242009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 17654
- Practice address
- 625 East Price Rd
Brownsville, TX 78521 - Phone
- (956) 831-2257
- NPI assigned
- Aug 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 17654 | TX | Primary |
Addresses
Primary practice location
625 East Price Rd
Brownsville, TX 78521
Mailing address
155 Lindale Dr
Brownsville, TX 78521
Phone (956) 831-2257
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17654 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192579200000",
"number": "1235242009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 LINDALE DR",
"city": "BROWNSVILLE",
"state": "TX",
"postal_code": "78521",
"telephone_number": "956-831-2257",
"fax_number": "956-831-2257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 EAST PRICE RD",
"city": "BROWNSVILLE",
"state": "TX",
"postal_code": "78521",
"telephone_number": "956-831-2257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUTISTA",
"first_name": "EDUARDO",
"name_prefix": "Mr.",
"credential": "RT AART",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-16",
"last_updated": "2007-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "TX",
"license": "17654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brownsville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.