Organization Active NPI

Craig Cardiovascular Center, PA

  • Specialist
  • Gonzales, TX
National Provider Identifier
1316209380
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
H1058 Issued in TX
Legal business name
CRAIG CARDIOVASCULAR CENTER, PA
Practice address
1110 N Sarah Dewitt Dr
Gonzales, TX 78629-3311
Phone
(830) 672-3845
Fax
(830) 672-4746
NPI assigned
Jun 14, 2012
Last updated
Mar 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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

Authorized official

Name
Jeanie Rodriguez
Title
Practice Administrator
Phone
(210) 396-7056

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X H1058 TX Primary

Addresses

Primary practice location

1110 N Sarah Dewitt Dr
Gonzales, TX 78629-3311

Mailing address

PO Box 2507
San Antonio, TX 78299-2507
Phone (830) 672-3845

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121009000248 TX Part B Supplier - Clinic/Group Practice 3072762905 Receives reassigned benefits from 6 practitioners
Practice locations: Gonzales, TX; Yoakum, TX; San Antonio, TX; Seguin, 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
45D2048903Craig Cardiovascular Center PA1110 Sarah Dewitt Drive, Gonzales, TX 78629Certificate of waiverOct 24, 2026

National Provider Directory

National Provider Directory

Locations

12501 Judson Rd
Ste 202
Live Oak, TX 78233
Phone (210) 599-4086

250 E Basse Rd
Ste 207
San Antonio, TX 78209
Phone (210) 614-9955

1348 E Walnut St
Seguin, TX 78155
Phone (512) 551-3490

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.347892

Practitioners & affiliated clinicians

Practitioners 11

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": "1339632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772409600000",
    "number": "1316209380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2507",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782992507",
            "telephone_number": "830-672-3845",
            "fax_number": "830-672-4746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 N SARAH DEWITT DR",
            "city": "GONZALES",
            "state": "TX",
            "postal_code": "786293311",
            "telephone_number": "830-672-3845",
            "fax_number": "830-672-4746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAIG CARDIOVASCULAR CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-14",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "JEANIE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "210-396-7056"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "H1058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gonzales, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2026; 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.