NPIMap

Organization Active NPI

Professional Dental Group P.a.

  • Dentist
  • Pharr, TX
National Provider Identifier
1508259706
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22574 Issued in TX
Legal business name
PROFESSIONAL DENTAL GROUP P.A.
Practice address
1002 W Sam Houston Blvd Ste 6
Pharr, TX 78577-5198
Phone
(956) 782-6767
Fax
(956) 782-6768
NPI assigned
Mar 12, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

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

Authorized official

Name
Dr. Iris Barrera, DDSNPI 1265531289
Title
Dentist
Phone
(956) 782-6767

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 22574 TX Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 28917 TX
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 29092 TX

Addresses

Primary practice location

1002 W Sam Houston Blvd Ste 6
Pharr, TX 78577-5198

Mailing address

1002 W Sam Houston Blvd Ste 6
Pharr, TX 78577-5198
Phone (956) 782-6767

National Provider Directory

National Provider Directory
Tax ID family
Professional Dental Group 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.

Locations

1002 W Sam Houston Blvd
Ste 6
Pharr, TX 78577
Phone (956) 781-8880

Practitioners & affiliated clinicians

Practitioners 4

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": "1426118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426636800000",
    "number": "1508259706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 W SAM HOUSTON BLVD STE 6",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785775198",
            "telephone_number": "956-782-6767",
            "fax_number": "956-782-6768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 W SAM HOUSTON BLVD STE 6",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785775198",
            "telephone_number": "956-782-6767",
            "fax_number": "956-782-6768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL GROUP P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-12",
        "last_updated": "2015-03-18",
        "status": "A",
        "authorized_official_last_name": "BARRERA",
        "authorized_official_first_name": "IRIS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "956-782-6767",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "22574",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "28917",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "29092",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pharr, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; 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.