Executive Medical Clinic

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

EXECUTIVE MEDICAL CLINIC

Practice address

2601 Hospital Blvd
Ste 117
Corpus Christi, TX 78405-1815

Phone

(361) 884-8209

Fax

(361) 882-6649

NPI assigned

Jun 4, 2007

Organization subpart

No

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

Authorized official

Name

Mr. C.J. Burgin

Title

President

Phone

(210) 767-9042

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265634083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 HOSPITAL BLVD",
            "address_2": "STE 117",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784051815",
            "telephone_number": "361-884-8209",
            "fax_number": "361-882-6649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 HOSPITAL BLVD",
            "address_2": "STE 117",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784051815",
            "telephone_number": "361-884-8209",
            "fax_number": "361-882-6649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURGIN",
        "authorized_official_first_name": "C.J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-767-9042",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.