Individual provider Active NPI

Jeffrey Dela Cruz Dela Cruz, MD

  • Internal Medicine Physician
  • Houston, TX
National Provider Identifier
1407041395
Registry record updated Jan 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
N3608 Issued in TX
Practice address
6550 Fannin St
Suite 1901
Houston, TX 77030-2717
Phone
(713) 441-1100
Fax
(713) 790-2643
NPI assigned
Sep 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 001933 GA
Internal Medicine Physician 207R00000X N3608 TX Primary

Addresses

Primary practice location

6550 Fannin St
Suite 1901
Houston, TX 77030-2717

Mailing address

6550 Fannin St
Suite 1901
Houston, TX 77030-2717
Phone (713) 441-1100

Other identifiers 2

IdentifierTypeStateIssuer
1407041395OtherTXBLUE CROSS BLUE SHIELD
206318201MedicaidTX

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090928000234 TX Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 6800942293 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
001933GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health and Human Services Commission CurrentSince Jan 16, 2021 Accepting new patients
Health and Human Services Commission CurrentSince Jan 16, 2021 Accepting new patients

Locations

1401 S Rangerville Rd
Harlingen, TX 78552
Phone (956) 364-8000

1401 S Rangerville Rd
#R
Harlingen, TX 78552
Phone (956) 364-8000

Organizations & group practices 2

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": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1407041395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6550 FANNIN ST",
            "address_2": "SUITE 1901",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302717",
            "telephone_number": "713-441-1100",
            "fax_number": "713-790-2643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 FANNIN ST",
            "address_2": "SUITE 1901",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302717",
            "telephone_number": "713-441-1100",
            "fax_number": "713-790-2643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELA CRUZ",
        "first_name": "JEFFREY",
        "middle_name": "DELA CRUZ",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-13",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "001933",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N3608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1407041395",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206318201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.