Individual provider Active NPI

Juan Homero Davila

  • Medical Physician Assistant
  • Edinburg, TX
National Provider Identifier
1316678071
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA18321 Issued in TX
Practice address
702 W University Dr
Edinburg, TX 78539-3242
Phone
(956) 383-0714
NPI assigned
Jun 22, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Medical Physician Assistant 363AM0700X PA18321 TX Primary

Addresses

Primary practice location

702 W University Dr
Edinburg, TX 78539-3242

Mailing address

1201 W University Dr
Edinburg, TX 78539-2909
Phone (956) 665-7049

Other practice location 1

1201 W University Dr
Edinburg, TX 78539-2909
Phone (956) 665-7049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250506002641 TX Practitioner - Physician Assistant 7113444894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sobia Nasir MD PAGroup PAC ID 3779741194, 3 clinicians

Practice addresses (Care Compare)

702 W University Dr
Edinburg, TX 78539-3242
Phone (956) 383-0714

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1316678071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W UNIVERSITY DR",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785392909",
            "telephone_number": "956-665-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 W UNIVERSITY DR",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785393242",
            "telephone_number": "956-383-0714"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 W University Dr",
            "address_purpose": "LOCATION",
            "city": "Edinburg",
            "state": "TX",
            "postal_code": "785392909",
            "country_code": "US",
            "telephone_number": "956-665-7049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVILA",
        "first_name": "JUAN",
        "middle_name": "HOMERO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-22",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA18321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

Verify at the official NPI Registry.