Active NPI
Julio Duarte Sr., LSA
- Surgical Assistant
- Cypress, TX
National Provider Identifier
1396811162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- SA00118
- Practice address
- 20935 South Amber Willow Trail
Cypress, TX 77433-6041 - Phone
- (281) 460-8771
- Fax
- (281) 256-9416
- NPI assigned
- Nov 25, 2006
- Last updated
- Aug 19, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | SA00118 | TX | |
| Surgical Assistant | 246ZC0007X | SA00118 | TX | Primary |
Addresses
Primary practice location
20935 South Amber Willow Trail
Cypress, TX 77433-6041
Mailing address
P.O. Box 1062
20935 South Amber Willow Trail
Cypress, TX 77410-1062
Phone (281) 460-8771
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA00118 | TX | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DMT Surgical Assistant Services | Single Specialty | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629331200000",
"number": "1396811162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 1062",
"address_2": "20935 SOUTH AMBER WILLOW TRAIL",
"city": "CYPRESS",
"state": "TX",
"postal_code": "774101062",
"telephone_number": "281-460-8771",
"fax_number": "281-256-9416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20935 SOUTH AMBER WILLOW TRAIL",
"city": "CYPRESS",
"state": "TX",
"postal_code": "774336041",
"telephone_number": "281-460-8771",
"fax_number": "281-256-9416"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUARTE",
"first_name": "JULIO",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"credential": "LSA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-25",
"last_updated": "2021-08-19",
"certification_date": "2021-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "TX",
"license": "SA00118",
"primary": false
},
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "TX",
"license": "SA00118",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cypress, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.