Organization Active NPI

Minuteclinic Diagnostic of Texas PLLC

  • Family Nurse Practitioner
  • Round Rock, TX
National Provider Identifier
1609076330
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
MINUTECLINIC DIAGNOSTIC OF TEXAS PLLC
Practice address
1855 Gattis School Rd
Round Rock, TX 78664-7428
Phone
(866) 389-2727
NPI assigned
Jul 20, 2007
Last updated
Jul 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Authorized official

Name
Deborah Pincince
Title
Administrator
Phone
(401) 770-3813

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

1855 Gattis School Rd
Round Rock, TX 78664-7428

Mailing address

PO Box 772 Minuteclinic Credentialing
Woonsocket, RI 02895-0784
Phone (866) 389-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080204000113 TX Part B Supplier - Clinic/Group Practice 7416039177 Receives reassigned benefits from 494 practitioners
1 other NPI on this enrollment

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1059827Minuteclinic Diagnostic of Texas, PLLC1855 Gattis School Road, Round Rock, TX 78664Certificate of waiverOct 5, 2026

National Provider Directory

National Provider Directory

Locations

11725 Ranch Road 620 N
Austin, TX 78750
Phone (512) 635-9591

601 N Industrial Blvd
Bedford, TX 76021
Phone (817) 283-0161

3614 Camp Bowie Blvd
Ft Worth, TX 76107
Phone (817) 478-6041

5702 Lavon Dr
Garland, TX 75040
Phone (877) 512-5442

1003 Richmond Ave
Houston, TX 77006
Phone (713) 807-8491

6220 Sienna Pkwy
Missouri City, TX 77459
Phone (281) 257-4320

2900 Broadway St
Pearland, TX 77581
Phone (281) 997-4400

2013 Kelly Ln
Pflugerville, TX 78660
Phone (512) 990-0814

501 University Blvd
Round Rock, TX 78665
Phone (512) 310-8791

1301 N Saginaw Blvd
Saginaw, TX 76179
Phone (817) 247-4333

103 SW Military Dr
San Antonio, TX 78221
Phone (210) 927-6755

7603 Culebra Rd
San Antonio, TX 78251
Phone (210) 680-0299

2693 Roy Richard Dr
Schertz, TX 78154
Phone (210) 658-3087

24802 Aldine Westfield Rd
Spring, TX 77373
Phone (281) 288-1561

24048 Kuykendahl Rd
Tomball, TX 77375
Phone (281) 255-3897

Practitioners & affiliated clinicians

Practitioners 510

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.

View all 510

NPI Registry JSON

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719878400000",
    "number": "1609076330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772 MINUTECLINIC CREDENTIALING",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028950784",
            "telephone_number": "866-389-2727",
            "fax_number": "401-406-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 GATTIS SCHOOL RD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786647428",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINUTECLINIC DIAGNOSTIC OF TEXAS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-20",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "PINCINCE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "401-770-3813"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.