NPIMap

Organization Active NPI

Pediatric Practice Association

  • Physician Assistant
  • Rio Grande City, TX
National Provider Identifier
1639314545
Registry record updated Dec 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA05462 Issued in TX
Legal business name
PEDIATRIC PRACTICE ASSOCIATION
Practice address
5322 E Hwy 83 Ste C4
Rio Grande City, TX 78582-9461
Phone
(956) 488-0330
NPI assigned
Dec 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2008

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

Authorized official

Name
Gloria Gonzalez
Title
Chief Operations Officer
Phone
(956) 488-1200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X PA05462 TX Primary

Addresses

Primary practice location

5322 E Hwy 83 Ste C4
Rio Grande City, TX 78582-9461

Mailing address

201 E 2ND St
Rio Grande City, TX 78582-3803

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Practice Association8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1228435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228435200000",
    "number": "1639314545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E 2ND ST",
            "city": "RIO GRANDE CITY",
            "state": "TX",
            "postal_code": "785823803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5322 E HWY 83 STE C4",
            "city": "RIO GRANDE CITY",
            "state": "TX",
            "postal_code": "785829461",
            "telephone_number": "956-488-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PRACTICE ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-05",
        "last_updated": "2008-12-05",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "956-488-1200"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Grande City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2008; 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.