Stockton Vitality, LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

STOCKTON VITALITY, LLC

Doing business as

Sauceda Urgent Care

Practice address

703 N Main St
Fort Stockton, TX 79735-5627

Phone

(432) 360-3029

Fax

(855) 893-1617

NPI assigned

Oct 5, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Sandra Lou Sauceda

Title

Owner

Phone

(210) 430-0720

Specialties & licenses 1

Addresses

Other names 1

• Sauceda Urgent Care Doing business as

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18510/brand/1/csg/1/fhir/r4

Practitioners 1

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

• Alberto Sauceda, PA-C

  • Medical Physician Assistant
  • Fort Stockton, TX
  • NPI 1356768915
  NPD (past)

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

{
    "created_epoch": "1538697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546041600000",
    "number": "1316412372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S MAIN ST STE B",
            "city": "FORT STOCKTON",
            "state": "TX",
            "postal_code": "797356807",
            "telephone_number": "432-360-3029",
            "fax_number": "855-893-1617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 N MAIN ST",
            "city": "FORT STOCKTON",
            "state": "TX",
            "postal_code": "797355627",
            "telephone_number": "432-360-3029",
            "fax_number": "855-893-1617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOCKTON VITALITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-05",
        "last_updated": "2018-12-29",
        "status": "A",
        "authorized_official_last_name": "SAUCEDA",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "LOU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-430-0720",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sauceda Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alberto Sauceda, PA-C
• Keith William Seidel, NP
• Kasi Lynn Shock, RN, CA-SANE
• Glenn Short, LPC
• Lorenzo Spratt, M.D.
• Subodh K Mallik MD PA
• Subodh K Mallik, MD, PA
• Rosalie M Sullivan, FAMILY NURSE PRACTIT
• Sheri Jo Talley, M.D
• Irene Thammasithiboon, D.D.S.

• Urgent Care Clinic/Center in Fort Stockton, TX
• Providers in Fort Stockton, TX by specialty
• Urgent Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2018; 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.