Individual provider Active NPI

Clemente Govea, SURGICAL ASSISTANT

  • Surgical Technologist
  • Brownsville, TX
National Provider Identifier
1710104393
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical TechnologistTaxonomy code 246ZS0410X
License
SA00175 Issued in TX
Practice address
5300Wilderness LN.
Brownsville, TX 78526
Phone
(956) 544-1486
NPI assigned
Apr 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Technologist 246ZS0410X SA00175 TX Primary

Addresses

Primary practice location

5300Wilderness LN.
Brownsville, TX 78526

Mailing address

5300 Wilderness LN
Brownsville, TX 78526-3832
Phone (956) 541-6939

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

LicenseStateTypeSpecialty
SA00175TXMDSurgical Technologist

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710104393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 WILDERNESS LN",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785263832",
            "telephone_number": "956-541-6939",
            "fax_number": "956-541-5282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300WILDERNESS LN.",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "78526",
            "telephone_number": "956-544-1486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOVEA",
        "first_name": "CLEMENTE",
        "name_prefix": "Mr.",
        "credential": "SURGICAL ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "TX",
            "license": "SA00175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, 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.

Verify at the official NPI Registry.