Organization Active NPI

Primary Care of Texas PLLC

  • Family Nurse Practitioner
  • New Braunfels, TX
National Provider Identifier
1619698651
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
PRIMARY CARE OF TEXAS PLLC
Practice address
1712 Chardonnay
New Braunfels, TX 78132-1885
Phone
(210) 473-7815
Fax
(833) 464-2984
NPI assigned
Sep 8, 2022
Last updated
Apr 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Authorized official

Name
Mr. Michael Aguilar Davila, FNP-CNPI 1891037123
Title
President and Provider
Phone
(210) 473-7815

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
Clinic/Center 261Q00000X
Family Nurse Practitioner 363LF0000X Primary

Addresses

Primary practice location

1712 Chardonnay
New Braunfels, TX 78132-1885

Mailing address

1712 Chardonnay
New Braunfels, TX 78132-1885
Phone (210) 473-7815

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230109000008 TX Part B Supplier - Clinic/Group Practice 5799155735 Receives reassigned benefits from 1 practitioner
Practice locations: New Braunfels, TX

National Provider Directory

National Provider Directory

Locations

831 Landa St
Ste A
New Braunfels, TX 78130

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/27217/brand/1/csg/1/fhir/r4

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": "1662595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681776000000",
    "number": "1619698651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1712 CHARDONNAY",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781321885",
            "telephone_number": "210-473-7815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712 CHARDONNAY",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781321885",
            "telephone_number": "210-473-7815",
            "fax_number": "833-464-2984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE OF TEXAS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-08",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A",
        "authorized_official_last_name": "DAVILA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "AGUILAR",
        "authorized_official_title_or_position": "PRESIDENT AND PROVIDER",
        "authorized_official_telephone_number": "210-473-7815",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Braunfels, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.