South Main Clinic, Inc

Primary specialty

Legal MedicineTaxonomy code 173000000X

Legal business name

SOUTH MAIN CLINIC, INC

Practice address

12333 Main St
Houston, TX 77035-6205

Phone

(713) 729-7600

Fax

(713) 729-7603

NPI assigned

Jul 20, 2006

Last updated

Apr 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Alvaro PinillaNPI 1972290526

Title

President Owner

Phone

(713) 729-7600

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 5

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.

• Danielle Nichole Brown, MD

  • Family Medicine Physician
  • Houston, TX
  • NPI 1306194329
  Medicare reassignment NPD
• Rodolfo Mendez-Cancel, MD

  • Internal Medicine Physician
  • Houston, TX
  • NPI 1649491648
  Medicare reassignment NPD
• Miguel A Nieto, D.O.

  • Emergency Medicine Physician
  • Houston, TX
  • NPI 1003263468
  Medicare reassignment NPD
• Ryan T. Thai, MD

  • Family Medicine Physician
  • Houston, TX
  • NPI 1568463891
  Medicare reassignment NPD
• Alvaro Pinilla, PA

  • Medical Physician Assistant
  • Phoenix, AZ
  • NPI 1972290526
  NPD Authorized official

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1326068933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12333 MAIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770356205",
            "telephone_number": "713-729-7600",
            "fax_number": "713-729-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12333 MAIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770356205",
            "telephone_number": "713-729-7600",
            "fax_number": "713-729-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH MAIN CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "PINILLA",
        "authorized_official_first_name": "ALVARO",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "713-729-7600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0087MG",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. MONTGOMERY NPI",
            "identifier": "1427078674",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Limestone Hospital District (Terra Bella Health and Wellness Suites)
• South Loop Dental Services, PLLC
• South Loop Dentistry, P.C.
• South Loop MRI LP
• South Main Clinic Inc
• South Main Medical Clinic
• South Main Surgery Alliance PLLC
• South Plains Renal Associates
• South Post Oak Medical Supply LLC
• South Post Oak Pharmacy

• Legal Medicine in Houston, TX
• Providers in Houston, TX by specialty
• Legal Medicine in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.