Active NPI
West Texas Medical Associates
- Family Medicine Physician
- San Angelo, TX
National Provider Identifier
1457339525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- WEST TEXAS MEDICAL ASSOCIATES
- Practice address
- 3605 Executive Dr
San Angelo, TX 76904 - Phone
- (325) 949-9555
- NPI assigned
- Jan 9, 2006
- Last updated
- Dec 5, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Tommy McMahon
- Title
- Administrator
- Phone
- (325) 949-9555
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | |||
| Anesthesiology Physician | 207L00000X | |||
| Family Medicine Physician | 207Q00000X | Primary | ||
| Internal Medicine Physician | 207R00000X | |||
| Cardiovascular Disease Physician | 207RC0000X | |||
| Gastroenterology Physician | 207RG0100X | |||
| Hematology & Oncology Physician | 207RH0003X | |||
| Obstetrics & Gynecology Physician | 207V00000X | |||
| Ophthalmology Physician | 207W00000X | |||
| Orthopaedic Surgery Physician | 207X00000X | |||
| Otolaryngology Physician | 207Y00000X | |||
| Pediatrics Physician | 208000000X | |||
| Surgery Physician | 208600000X | |||
| Urology Physician | 208800000X | |||
| Nurse Practitioner | 363L00000X |
Addresses
Primary practice location
3605 Executive Dr
San Angelo, TX 76904
Mailing address
3605 Executive Dr
San Angelo, TX 76904-6884
Phone (325) 949-9555
Other practice location 1
3555 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone (325) 949-9555
Other practice location 2
3555 Knickerbocker Rd
San Angelo, TX 76904-7610
Phone (325) 949-9555
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 135031603 | Medicaid | TX | |
| 135031604 | Medicaid | TX | |
| 00F634 | Other | TX | BLUE CROSS BLUE SHIELD |
| 135031606 | Medicaid | TX |
National Provider Directory
National Provider DirectoryLocations
3555 Knickerbocker Rd
#16
San Angelo, TX 76904
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136764800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1543968000000",
"number": "1457339525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3605 EXECUTIVE DR",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769046884",
"telephone_number": "325-949-9555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3605 EXECUTIVE DR",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "76904",
"telephone_number": "325-949-9555"
}
],
"practiceLocations": [
{
"address_1": "3555 Knickerbocker Rd",
"address_purpose": "LOCATION",
"city": "San Angelo",
"state": "TX",
"postal_code": "769047610",
"country_code": "US",
"telephone_number": "325-949-9555",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3555 Knickerbocker Rd",
"address_purpose": "LOCATION",
"city": "San Angelo",
"state": "TX",
"postal_code": "769047610",
"country_code": "US",
"telephone_number": "325-949-9555",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "WEST TEXAS MEDICAL ASSOCIATES",
"organizational_subpart": "NO",
"enumeration_date": "2006-01-09",
"last_updated": "2018-12-05",
"status": "A",
"authorized_official_last_name": "MCMAHON",
"authorized_official_first_name": "TOMMY",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "325-949-9555",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RH0003X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Hematology & Oncology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Orthopaedic Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Otolaryngology",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Urology",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "135031603",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "135031604",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "00F634",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "135031606",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Angelo, TX
- West Texas E.a.R.S, (Answer Angelo)
- West Texas Healthcare LLC (Paradigm Home Health)
- West Texas LTC Partners, Inc.
- West Texas Medical Associates
- West Texas Medical Associates
- West Texas Medical Associates
- West Texas Nephrology Associates
- West Texas Nephrology Associates
- West Texas Renal Care Center Inc
- Casey Westmoreland, PA-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.