Individual provider Active NPI

Tara Phillipp Vierra, M.D.

  • Pediatrics Physician
  • Edinburg, TX
National Provider Identifier
1629323118
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
P9274 Issued in TX
Practice address
4150 Crosspoint Blvd
Edinburg, TX 78539-1803
Phone
(956) 296-1960
Fax
(956) 381-5397
NPI assigned
Jul 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X P9274 TX Primary

Addresses

Primary practice location

4150 Crosspoint Blvd
Edinburg, TX 78539-1803

Mailing address

PO Box 531968
Harlingen, TX 78553-1968

Other identifiers 1

IdentifierTypeStateIssuer
338892805MedicaidTX

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200210001463 TX Practitioner - Pediatric Medicine 1153757265 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Rio Grande Valley Pediatrics Current Accepting new patients
The University of Texas Rio Grande Valley CurrentSince Mar 2, 2020 Accepting new patients
Columbia Valley Healthcare System, L.P. Past Accepting new patients
VHS Brownsville Hospital Company LLC Past Accepting new patients
University of Texas Rio Grande Valley Past Accepting new patients

Locations

4150 Crosspoint Blvd
Edinburg, TX 78539
Phone (956) 296-1960

2102 Treasure Hills Blvd
Harlingen, TX 78550
Phone (956) 296-1437

2101 Pease St
Harlingen, TX 78550
Phone (956) 369-1100

2810 W Expressway 83
Mercedes, TX 78570
Phone (956) 296-1831

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1629323118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 531968",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785531968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 CROSSPOINT BLVD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785391803",
            "telephone_number": "956-296-1960",
            "fax_number": "956-381-5397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIERRA",
        "first_name": "TARA",
        "middle_name": "PHILLIPP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-20",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P9274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "338892805",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

Verify at the official NPI Registry.