Medagene Clinic , P.a.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E1956 Issued in TX

Legal business name

MEDAGENE CLINIC , P.A.

Practice address

5373 W Alabama St
Houston, TX 77056-5930

Phone

(713) 779-1633

NPI assigned

Jun 19, 2006

Last updated

Apr 24, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gonzalo UribeboteroNPI 1023052164

Title

Owner

Phone

(713) 779-1633

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• MedAGene Clinic , P.A. Former legal business name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Tax ID family

Medagene Clinic PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Medagene Clinic PA

  • Pediatrics Physician
  • Bellaire, TX
  • NPI 1932487949
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gonzalo Uribebotero, MD

  • Family Medicine Physician
  • Houston, TX
  • NPI 1023052164
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776988800000",
    "number": "1437194685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9606 S RICE AVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770964136",
            "telephone_number": "713-779-1633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5373 W ALABAMA ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770565930",
            "telephone_number": "713-779-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDAGENE CLINIC , P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A",
        "authorized_official_last_name": "URIBEBOTERO",
        "authorized_official_first_name": "GONZALO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-779-1633"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "E1956",
            "primary": true
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "TX",
            "license": "E1956",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "E1956",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137927302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "45D0965514",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedAGene Clinic , P.A.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Family Medicine Physician in Houston, TX
• Providers in Houston, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2026; 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.