NPIMap

Organization Active NPI

Jacinto Medical Group P a

  • Family Medicine Physician
  • Baytown, TX
National Provider Identifier
1265474597
Registry record updated Feb 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
816738-03 Issued in TX
Legal business name
JACINTO MEDICAL GROUP P A
Practice address
2800 Garth Rd
Baytown, TX 77521-3947
Phone
(281) 425-3800
Fax
(281) 425-3992
NPI assigned
Jun 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2012

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

Authorized official

Name
Mrs. Maggie Khan
Title
Credentialing Coordinator
Phone
(281) 425-3844

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 816738-03 TX Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 816738-03 TX
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X 816738-03 TX

Addresses

Primary practice location

2800 Garth Rd
Baytown, TX 77521-3947

Mailing address

2800 Garth Rd
Baytown, TX 77521-3947
Phone (281) 425-3800

Other identifiers 2

IdentifierTypeStateIssuer
00U80BOtherTXBCBS
085781501MedicaidTX

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

11006 Spencer Hwy
La Porte, TX 77571
Phone (281) 470-2100

Practitioners & affiliated clinicians

Practitioners 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329091200000",
    "number": "1265474597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 GARTH RD",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775213947",
            "telephone_number": "281-425-3800",
            "fax_number": "281-425-3992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 GARTH RD",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775213947",
            "telephone_number": "281-425-3800",
            "fax_number": "281-425-3992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACINTO MEDICAL GROUP P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2012-02-13",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "MAGGIE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "281-425-3844",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "816738-03",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "816738-03",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "816738-03",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00U80B",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085781501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baytown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; 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.