Antonio Pena MD P.a.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

N1057 Issued in TX

Legal business name

ANTONIO PENA MD P.A.

Practice address

1329 N University Dr
Suite E-5
Nacogdoches, TX 75961-4232

Phone

(936) 569-0400

Fax

(936) 569-0530

NPI assigned

Dec 3, 2008

Organization subpart

No

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

Authorized official

Name

Antonio Pena, M.D.

Title

President/Owner

Phone

(936) 569-0400

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1228262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228262400000",
    "number": "1407091580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 N UNIVERSITY DR",
            "address_2": "SUITE E-5",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614232",
            "telephone_number": "936-569-0400",
            "fax_number": "936-569-0530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 N UNIVERSITY DR",
            "address_2": "SUITE E-5",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614232",
            "telephone_number": "936-569-0400",
            "fax_number": "936-569-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTONIO PENA MD P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-03",
        "last_updated": "2008-12-03",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "936-569-0400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N1057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.