Active NPI
Alejandro Botello I
- Contractor
- Marshall, TX
National Provider Identifier
1689717290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 3-20083-3144-2
- Practice address
- 114 Fairview St
Marshall, TX 75672-7757 - Phone
- (903) 938-8209
- Fax
- (903) 938-8461
- NPI assigned
- Feb 14, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 3-20083-3144-2 | TX | Primary |
Addresses
Primary practice location
114 Fairview St
Marshall, TX 75672-7757
Mailing address
114 Fairview St
Marshall, TX 75672-7757
Phone (903) 938-8209
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3-20083-3144-2 | TX | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689717290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 FAIRVIEW ST",
"city": "MARSHALL",
"state": "TX",
"postal_code": "756727757",
"telephone_number": "903-938-8209",
"fax_number": "903-938-8461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 FAIRVIEW ST",
"city": "MARSHALL",
"state": "TX",
"postal_code": "756727757",
"telephone_number": "903-938-8209",
"fax_number": "903-938-8461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOTELLO",
"first_name": "ALEJANDRO",
"name_prefix": "Mr.",
"name_suffix": "I",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "TX",
"license": "3-20083-3144-2",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marshall, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.