Organization Active NPI

Tyler Family Medical Plaza MD PA

  • Family Medicine Physician
  • Harlingen, TX
National Provider Identifier
1306966403
Registry record updated Jun 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K6169 Issued in TX
Legal business name
TYLER FAMILY MEDICAL PLAZA MD PA
Practice address
922 E Tyler Ave
Harlingen, TX 78550-7134
Phone
(956) 400-7000
Fax
(956) 400-7042
NPI assigned
Mar 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2010

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

Authorized official

Name
Dr. Prasad V Movva, M.D.NPI 1053319897
Title
Dr.
Phone
(956) 440-7000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X K6169 TX Primary

Addresses

Primary practice location

922 E Tyler Ave
Harlingen, TX 78550-7134

Mailing address

922 E Tyler Ave
Harlingen, TX 78550-7134
Phone (956) 400-7000

Other identifiers 1

IdentifierTypeStateIssuer
143023038MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041111000041 TX Part B Supplier - Clinic/Group Practice 3173586039 Receives reassigned benefits from 1 practitioner
Practice locations: Harlingen, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0996435Tyler Family Medical Plaza922 E Tyler, Harlingen, TX 78550AccreditationOct 12, 2026

National Provider Directory

National Provider Directory

Locations

922 E Tyler Ave
Harlingen, TX 78550
Phone (956) 440-7000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BIFIBA

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276041600000",
    "number": "1306966403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 E TYLER AVE",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785507134",
            "telephone_number": "956-400-7000",
            "fax_number": "956-400-7042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 E TYLER AVE",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785507134",
            "telephone_number": "956-400-7000",
            "fax_number": "956-400-7042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYLER FAMILY MEDICAL PLAZA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2010-06-09",
        "status": "A",
        "authorized_official_last_name": "MOVVA",
        "authorized_official_first_name": "PRASAD",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "DR.",
        "authorized_official_telephone_number": "956-440-7000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K6169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143023038",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlingen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.