Organization Active NPI

Family Clinics of Laredo PLLC

  • Family Medicine Physician
  • Laredo, TX
National Provider Identifier
1669794657
Registry record updated Aug 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY CLINICS OF LAREDO PLLC
Practice address
3102 Ross St
Loop 20
Laredo, TX 78043-4980
Phone
(956) 727-3547
Fax
(956) 725-8737
NPI assigned
Feb 18, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2010

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

Authorized official

Name
Edgar A Trevino, MD
Title
MD
Phone
(956) 285-7785

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3102 Ross St
Loop 20
Laredo, TX 78043-4980

Mailing address

101 W Village Blvd
Suite B
Laredo, TX 78041-2211
Phone (956) 727-3047

Other identifiers 1

IdentifierTypeStateIssuer
212220201MedicaidTX

National Provider Directory

National Provider Directory

Locations

101 W Village Blvd
Ste B
Laredo, TX 78041
Phone (956) 285-7785

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1266451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281312000000",
    "number": "1669794657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W VILLAGE BLVD",
            "address_2": "SUITE B",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780412211",
            "telephone_number": "956-727-3047",
            "fax_number": "956-717-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 ROSS ST",
            "address_2": "LOOP 20",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780434980",
            "telephone_number": "956-727-3547",
            "fax_number": "956-725-8737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CLINICS OF LAREDO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-18",
        "last_updated": "2010-08-09",
        "status": "A",
        "authorized_official_last_name": "TREVINO",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "956-285-7785",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212220201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2010; 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.