NPIMap

Organization Active NPI

Spi Clinic, PLLC

  • Internal Medicine Physician
  • South Padre Island, TX
National Provider Identifier
1699087650
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SPI CLINIC, PLLC
Doing business as
SPI Clinic, PLLC
Practice address
3808 Padre Blvd
South Padre Island, TX 78597
Phone
(956) 761-3996
Fax
(956) 791-6635
NPI assigned
Jul 7, 2010
Organization subpart
Yes
Parent organization
MEDICAL ASSOCIATES OF BROWNSVILLE PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

Authorized official

Name
Chris Tryka, CPC, CPMA
Title
Practice Manager
Phone
(956) 546-3116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3808 Padre Blvd
South Padre Island, TX 78597

Mailing address

425 E Los Ebanos Blvd
Suite 100
Brownsville, TX 78520-8481
Phone (956) 546-3116

Other identifiers 1

IdentifierTypeStateIssuer
080669701MedicaidTX

Other names 1

  • SPI Clinic, PLLC Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2021576Spi Clinic3808 Padre Blvd, South Padre Island, TX 78597Certificate of waiverMar 15, 2027

National Provider Directory

National Provider Directory
Tax ID family
Spi Clinic PLLC3 organizations share this tax ID, including this one
Part of
Spi Clinic PLLC

Other organizations with this tax ID 2

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 5

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": "1278460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592784000000",
    "number": "1699087650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 E LOS EBANOS BLVD",
            "address_2": "SUITE 100",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785208481",
            "telephone_number": "956-546-3116",
            "fax_number": "956-546-8793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3808 PADRE BLVD",
            "city": "SOUTH PADRE ISLAND",
            "state": "TX",
            "postal_code": "78597",
            "telephone_number": "956-761-3996",
            "fax_number": "956-791-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPI CLINIC, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDICAL ASSOCIATES OF BROWNSVILLE PA",
        "enumeration_date": "2010-07-07",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A",
        "authorized_official_last_name": "TRYKA",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "956-546-3116",
        "authorized_official_credential": "CPC, CPMA"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080669701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPI Clinic, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Padre Island, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.