Individual provider Active NPI

Alvaro Abdiel Medina, D.C.

  • Chiropractor
  • Sugar Land, TX
National Provider Identifier
1306108261
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11837 Issued in TX
Practice address
2743 Imperia Dr Ste 201
Sugar Land, TX 77479-8988
Phone
(832) 939-9929
Fax
(832) 939-8594
NPI assigned
Jun 15, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 11837 TX Primary

Addresses

Primary practice location

2743 Imperia Dr Ste 201
Sugar Land, TX 77479-8988

Mailing address

2743 Imperia Dr Ste 201
Sugar Land, TX 77479-8988
Phone (832) 939-9929

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

LicenseStateTypeSpecialty
11837TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Medina Chiropractic Sports and Spine, PLLC Chiropractor Past Accepting new patients
Stafford Chiropractic Sports & Wellness Chiropractor PastSince Apr 1, 2014 Accepting new patients
Stafford Chiropractic Sport and Wellness Inc. Chiropractor Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1306108261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2743 IMPERIA DR STE 201",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774798988",
            "telephone_number": "832-939-9929",
            "fax_number": "832-939-8594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2743 IMPERIA DR STE 201",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774798988",
            "telephone_number": "832-939-9929",
            "fax_number": "832-939-8594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "ALVARO",
        "middle_name": "ABDIEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-15",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; 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.