NPIMap

Organization Active NPI

Eduardo a Mejia DDS PA

  • Dentist
  • Conroe, TX
National Provider Identifier
1558819615
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22766 Issued in TX
Legal business name
EDUARDO A MEJIA DDS PA
Practice address
2257 N Loop 336 W Ste 120
Conroe, TX 77304-3566
Phone
(936) 588-9303
Fax
(936) 756-9393
NPI assigned
Sep 19, 2016
Last updated
Jan 31, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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

Authorized official

Name
Dr. Eduardo A. MejiaNPI 1649490509
Title
Owner
Phone
(936) 588-9303

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 22766 TX Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

2257 N Loop 336 W Ste 120
Conroe, TX 77304-3566

Mailing address

2257 N Loop 336 W Ste 120
Conroe, TX 77304-3566
Phone (936) 588-9303

National Provider Directory

National Provider Directory

Locations

2257 N Loop 336 W
Ste 120
Conroe, TX 77304
Phone (936) 588-9303

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485820800000",
    "number": "1558819615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2257 N LOOP 336 W STE 120",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043566",
            "telephone_number": "936-588-9303",
            "fax_number": "936-756-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2257 N LOOP 336 W STE 120",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043566",
            "telephone_number": "936-588-9303",
            "fax_number": "936-756-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDUARDO A MEJIA DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-19",
        "last_updated": "2017-01-31",
        "status": "A",
        "authorized_official_last_name": "MEJIA",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-588-9303",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "22766",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; 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.