Organization Active NPI

David Meduna, M.D., P.a.

  • Obstetrics & Gynecology Physician
  • College Station, TX
National Provider Identifier
1407060783
Registry record updated Jul 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
DAVID MEDUNA, M.D., P.A.
Practice address
1602 Rock Prairie Rd
Ste 3100
College Station, TX 77845-8306
Phone
(979) 764-6868
Fax
(979) 694-8804
NPI assigned
May 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2008

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

Authorized official

Name
Dr. David Meduna, M.D.
Title
Director
Phone
(979) 764-6868

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

1602 Rock Prairie Rd
Ste 3100
College Station, TX 77845-8306

Mailing address

1602 Rock Prairie Rd
Ste 3100
College Station, TX 77845-8306
Phone (979) 764-6868

Other identifiers 6

IdentifierTypeStateIssuer
1275726853OtherTXCOLLEGE STATION CLINIC
187842302MedicaidTX
1821185299OtherTXBVCAA AGENCY
0026PVOtherTXBLUE CROSS BLUE SHIELD OF TEXAS
184841802MedicaidTX
187842301MedicaidTX

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18429/brand/1/csg/1/fhir/r4

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": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216080000000",
    "number": "1407060783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 ROCK PRAIRIE RD",
            "address_2": "STE 3100",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458306",
            "telephone_number": "979-764-6868",
            "fax_number": "979-694-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 ROCK PRAIRIE RD",
            "address_2": "STE 3100",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458306",
            "telephone_number": "979-764-6868",
            "fax_number": "979-694-8804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID MEDUNA, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2008-07-15",
        "status": "A",
        "authorized_official_last_name": "MEDUNA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "979-764-6868",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLLEGE STATION CLINIC",
            "identifier": "1275726853",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187842302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BVCAA AGENCY",
            "identifier": "1821185299",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF TEXAS",
            "identifier": "0026PV",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184841802",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187842301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.