Maverick County Medical Family Center

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

MAVERICK COUNTY MEDICAL FAMILY CENTER

Practice address

590 E Main St Ste a
Eagle Pass, TX 78852-4773

Phone

(830) 773-3331

Fax

(830) 773-2981

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

Elizabeth Sosa

Title

Credentialing and Enrollment Manage

Phone

(508) 213-1947

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sammy Lerma III, M.D.

  • Family Medicine Physician
  • Bastrop, TX
  • NPI 1871571950
  NPD (past)
• Lucio I Mares, PA

  • Physician Assistant
  • Eagle Pass, TX
  • NPI 1972729507
  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636502400000",
    "number": "1467583286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2239 ACAPULCO DR",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788524101",
            "telephone_number": "210-394-9171",
            "fax_number": "830-773-2981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 E MAIN ST STE A",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788524773",
            "telephone_number": "830-773-3331",
            "fax_number": "830-773-2981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAVERICK COUNTY MEDICAL FAMILY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A",
        "authorized_official_last_name": "SOSA",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "CREDENTIALING AND ENROLLMENT MANAGE",
        "authorized_official_telephone_number": "508-213-1947"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12848606",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maverick Ambulance Service, Inc
• Maverick County Association for Persons With Disabilities
• Maverick County Hospital District
• Maverick County Hospital District
• Maverick County Hospital District
• Maverick County Rural Radiologists P a
• Maverick Emergency Medicine Associates PA
• Maverick Medical Supply LLC
• Maverick Physician Services PA
• McCrae Management and Investments, LTD.

• Primary Care Clinic/Center in Eagle Pass, TX
• Providers in Eagle Pass, TX by specialty
• Primary Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; 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.