Organization Active NPI

Specialty Clinics of Space City PA

  • Internal Medicine Physician
  • Webster, TX
National Provider Identifier
1376974519
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SPECIALTY CLINICS OF SPACE CITY PA
Practice address
560 Blossom St Ste C
Webster, TX 77598-4237
Phone
(832) 905-6141
Fax
(832) 200-3259
NPI assigned
Dec 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Authorized official

Name
Dr. Aruna Agraharkar, MDNPI 1316044126
Title
President
Phone
(832) 905-6141

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

560 Blossom St Ste C
Webster, TX 77598-4237

Mailing address

2301 Carina CT
League City, TX 77573-2879
Phone (713) 589-3320

Other practice location 1

2301 Carina Ct
League City, TX 77573-2879
Phone (713) 589-3320

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140603001243 TX Part B Supplier - Clinic/Group Practice 7810110244 Receives reassigned benefits from 1 practitioner
Practice locations: Webster, TX

National Provider Directory

National Provider Directory

Locations

6510 Memorial Dr
Texas City, TX 77591
Phone (409) 933-0733

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738713600000",
    "number": "1376974519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 CARINA CT",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775732879",
            "telephone_number": "713-589-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 BLOSSOM ST STE C",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984237",
            "telephone_number": "832-905-6141",
            "fax_number": "832-200-3259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Carina Ct",
            "address_purpose": "LOCATION",
            "city": "League City",
            "state": "TX",
            "postal_code": "775732879",
            "country_code": "US",
            "telephone_number": "713-589-3320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPECIALTY CLINICS OF SPACE CITY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-12",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A",
        "authorized_official_last_name": "AGRAHARKAR",
        "authorized_official_first_name": "ARUNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "832-905-6141",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.