Pecan Medical Center LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

PECAN MEDICAL CENTER LLC

Practice address

110 Pecan Blvd
McAllen, TX 78501-9557

Phone

(956) 661-0040

Fax

(956) 661-0042

NPI assigned

May 26, 2006

Last updated

Jun 10, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Gloria M Ibanez, PA-C

Title

Member

Phone

(956) 661-0040

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1649226762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 PECAN BLVD",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785019557",
            "telephone_number": "956-661-0040",
            "fax_number": "956-661-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PECAN BLVD",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785019557",
            "telephone_number": "956-661-0040",
            "fax_number": "956-661-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECAN MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "IBANEZ",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "956-661-0040",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181534201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in McAllen, TX
• Providers in McAllen, TX by specialty
• Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.