Active NPI
Laredo Minor Emergency Clinic, PA
- Family Medicine Physician
- Laredo, TX
National Provider Identifier
1316239155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- K8049
- 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 PA
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 353461201 | Medicaid | TX |
Other names 1
- Laredo Family Health Clinic LLC
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D0862586 | Laredo Minor Emergency Clinic PA | Certificate of waiver | Oct 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.