Ana M Avalos Mishaan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

N0616 Issued in TX

Practice address

825 E Rundberg LN Ste B1
Austin, TX 78753-4860

Phone

(512) 978-9600

Fax

(512) 978-9601

NPI assigned

Jul 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: aavalosmishaan270495@prddirect.texaschildrens.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• TCH Pediatric Associates, Inc

  • Pediatrics Physician
  • Houston, TX
  • NPI 1225038326
  NPD (past)
• TCH Pediatric Associates, Inc

  • Pediatrics Physician
  • Sugar Land, TX
  • NPI 1861492654
  NPD (past)

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506902400000",
    "number": "1528099058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 E RUNDBERG LN STE B1",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787534860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 E RUNDBERG LN STE B1",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787534860",
            "telephone_number": "512-978-9600",
            "fax_number": "512-978-9601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6421 McCart Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761334702",
            "country_code": "US",
            "telephone_number": "817-263-7500",
            "fax_number": "817-423-4140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AVALOS MISHAAN",
        "first_name": "ANA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2017-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N0616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN GROUP",
            "identifier": "137345810",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP",
            "identifier": "140442852",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "197453702",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "368699535B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1750369203",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197453701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn M. Autrey
• Debra Lynn Autry, LVN
• Mary Ellen P Autry, RD
• Alyssa Autterson
• Timothy Auvenshine, CST/CSFA
• Juana Estrella Avalos-Garcia
• Elmer Avalos
• Izela Abigail Avalos
• Jesus Javier Avalos, LMT
• Sophia Avalos

• Pediatrics Physician in Austin, TX
• Providers in Austin, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.