Organization Active NPI

Alberto R de la Cruz MD PA

  • Surgery Physician
  • Winnsboro, TX
National Provider Identifier
1609184555
Registry record updated Sep 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
F7443 Issued in TX
Legal business name
ALBERTO R DE LA CRUZ MD PA
Practice address
719 W Coke Rd
Ste.7
Winnsboro, TX 75494-3011
Phone
(903) 342-4242
Fax
(903) 342-4055
NPI assigned
Sep 14, 2010
Organization subpart
Yes
Parent organization
ALBERTO R DE LA CRUZ MD PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 14, 2010

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

Authorized official

Name
Dr. Alberto R De la Cruz, MD
Title
Owner
Phone
(903) 342-4242

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208600000X F7443 TX Primary

Addresses

Primary practice location

719 W Coke Rd
Ste.7
Winnsboro, TX 75494-3011

Mailing address

719 W Coke Rd
Ste.7
Winnsboro, TX 75494-3011
Phone (903) 342-4242

Other identifiers 1

IdentifierTypeStateIssuer
128113102MedicaidTX

National Provider Directory

National Provider Directory
Part of
Alberto R de la Cruz MD PA

Locations

719 W Coke Rd
Ste 7
Winnsboro, TX 75494
Phone (903) 342-4242

NPI Registry JSON

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284422400000",
    "number": "1609184555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 W COKE RD",
            "address_2": "STE.7",
            "city": "WINNSBORO",
            "state": "TX",
            "postal_code": "754943011",
            "telephone_number": "903-342-4242",
            "fax_number": "903-342-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 W COKE RD",
            "address_2": "STE.7",
            "city": "WINNSBORO",
            "state": "TX",
            "postal_code": "754943011",
            "telephone_number": "903-342-4242",
            "fax_number": "903-342-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBERTO R DE LA CRUZ MD PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALBERTO R DE LA CRUZ MD PA",
        "enumeration_date": "2010-09-14",
        "last_updated": "2010-09-14",
        "status": "A",
        "authorized_official_last_name": "DE LA CRUZ",
        "authorized_official_first_name": "ALBERTO",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-342-4242",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "TX",
            "license": "F7443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128113102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winnsboro, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; 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.