Organization Active NPI

Linda Velasquez MD PA

Doing business as Presidio Pediatrics

  • Pediatrics Physician
  • El Paso, TX
National Provider Identifier
1306107594
Registry record updated Jun 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
M6437 Issued in TX
Legal business name
LINDA VELASQUEZ MD PA
Doing business as
Presidio Pediatrics
Practice address
9740 Dyer St Ste 112
El Paso, TX 79924-4760
Phone
(915) 500-5030
Fax
(915) 500-5001
NPI assigned
Jun 4, 2012
Last updated
Jun 4, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2012

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

Authorized official

Name
Dr. Linda Velasquez, M.D.
Title
President/Owner
Phone
(915) 500-5030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X M6437 TX Primary

Addresses

Primary practice location

9740 Dyer St Ste 112
El Paso, TX 79924-4760

Mailing address

9740 Dyer St Ste 112
El Paso, TX 79924-4760
Phone (915) 500-5030

Other identifiers 1

IdentifierTypeStateIssuer
190698402MedicaidTX

Other names 1

  • Presidio Pediatrics Doing business as

National Provider Directory

National Provider Directory

Locations

9740 Dyer St
Ste 112
El Paso, TX 79924
Phone (915) 500-5030

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1338768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338768000000",
    "number": "1306107594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9740 DYER ST STE 112",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799244760",
            "telephone_number": "915-500-5030",
            "fax_number": "915-500-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9740 DYER ST STE 112",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799244760",
            "telephone_number": "915-500-5030",
            "fax_number": "915-500-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINDA VELASQUEZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-04",
        "last_updated": "2012-06-04",
        "status": "A",
        "authorized_official_last_name": "VELASQUEZ",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "915-500-5030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M6437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190698402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Presidio Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.