NPIMap

Organization Active NPI

Victoria Women'S Clinic Associates

  • Obstetrics Physician
  • Victoria, TX
National Provider Identifier
1366483257
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
Legal business name
VICTORIA WOMEN'S CLINIC ASSOCIATES
Practice address
110 Medical Dr
Suite 100
Victoria, TX 77904-3126
Phone
(361) 578-5233
NPI assigned
Jun 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mark Hager, M.D.
Title
Partner
Phone
(361) 578-5233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VX0000X Primary

Addresses

Primary practice location

110 Medical Dr
Suite 100
Victoria, TX 77904-3126

Mailing address

110 Medical Dr
Suite 100
Victoria, TX 77904-3126
Phone (361) 578-5233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040401001036 TX Part B Supplier - Clinic/Group Practice 2961494646 Receives reassigned benefits from 10 practitioners
Practice locations: Victoria, TX

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
45D0498770Victoria Women'S Clinic110 Medical Dr Suite 100, Victoria, TX 77904AccreditationDec 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
Detar Healthcare System2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

110 Medical Dr
Ste 100
Victoria, TX 77904
Phone (361) 578-5233

2705 Hospital Dr
Ste 300
Victoria, TX 77901
Phone (361) 574-1569

110 Medical Dr
Victoria, TX 77904

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366483257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MEDICAL DR",
            "address_2": "SUITE 100",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779043126",
            "telephone_number": "361-578-5233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MEDICAL DR",
            "address_2": "SUITE 100",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779043126",
            "telephone_number": "361-578-5233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIA WOMEN'S CLINIC ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAGER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "361-578-5233",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.