Medical Envision,Inc.

Primary specialty

Home Health Clinical Nurse SpecialistTaxonomy code 364SH0200X

License

G0869 Issued in TX

Legal business name

MEDICAL ENVISION,INC.

Practice address

5001 Williford Rd
Sachse, TX 75048

Phone

(972) 495-6929

NPI assigned

Jul 16, 2018

Last updated

Jul 16, 2018By 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

Dr. Elizabeth Pascual Srivastava, MD

Title

Medical Director

Phone

(972) 495-6929

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531699200000",
    "number": "1649756420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 WILLIFORD RD",
            "city": "SACHSE",
            "state": "TX",
            "postal_code": "750483378",
            "telephone_number": "214-934-0768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 WILLIFORD RD",
            "city": "SACHSE",
            "state": "TX",
            "postal_code": "75048",
            "telephone_number": "972-495-6929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ENVISION,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-16",
        "last_updated": "2018-07-16",
        "status": "A",
        "authorized_official_last_name": "SRIVASTAVA",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "PASCUAL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "972-495-6929",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "364SH0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Home Health",
            "state": "TX",
            "license": "G0869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G0869",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2018; 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.