Organization Active NPI

Laredo Minor Emergency Clinic, PA

  • Family Medicine Physician
  • Laredo, TX
National Provider Identifier
1316239155
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K8049 Issued in TX
Legal business name
LAREDO MINOR EMERGENCY CLINIC, PA
Practice address
904 Corpus Christi St
Laredo, TX 78040-5277
Phone
(956) 725-0300
Fax
(956) 722-6174
NPI assigned
May 12, 2011
Organization subpart
Yes
Parent organization
LAREDO MINOR EMERGENCY CLINIC PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 30, 2019

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

Authorized official

Name
Melchor Pablo Cardenas, M.D
Title
Medical Doctor
Phone
(956) 725-0300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X K8049 TX Primary

Addresses

Primary practice location

904 Corpus Christi St
Laredo, TX 78040-5277

Mailing address

904 Corpus Christi St
Laredo, TX 78040-5277
Phone (956) 725-0300

Other identifiers 1

IdentifierTypeStateIssuer
353461201MedicaidTX

Other names 1

  • Laredo Family Health Clinic LLC Doing business as

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
45D0862586Laredo Minor Emergency Clinic PA904 Corpus Christi Street, Laredo, TX 78040Certificate of waiverOct 15, 2027

National Provider Directory

National Provider Directory
Part of
Laredo Minor Emergency Clinic PA

NPI Registry JSON

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564444800000",
    "number": "1316239155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 CORPUS CHRISTI ST",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780405277",
            "telephone_number": "956-725-0300",
            "fax_number": "956-722-6174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 CORPUS CHRISTI ST",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780405277",
            "telephone_number": "956-725-0300",
            "fax_number": "956-722-6174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAREDO MINOR EMERGENCY CLINIC, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAREDO MINOR EMERGENCY CLINIC PA",
        "enumeration_date": "2011-05-12",
        "last_updated": "2019-07-30",
        "status": "A",
        "authorized_official_last_name": "CARDENAS",
        "authorized_official_first_name": "MELCHOR",
        "authorized_official_middle_name": "PABLO",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "956-725-0300",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K8049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "353461201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laredo Family Health Clinic LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laredo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.