Organization Active NPI

Mainland Infectious Disease Associates, P.a.

  • Infectious Disease Physician
  • Texas City, TX
National Provider Identifier
1710165485
Registry record updated Nov 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
J9932 Issued in TX
Legal business name
MAINLAND INFECTIOUS DISEASE ASSOCIATES, P.A.
Practice address
1125 Highway 3 N Ste 100a
Texas City, TX 77591-4047
Phone
(409) 539-6278
Fax
(409) 419-1108
NPI assigned
Feb 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2011

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

Authorized official

Name
William Scott Warner, M.D.
Title
Owner
Phone
(409) 370-1087

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X J9932 TX Primary

Addresses

Primary practice location

1125 Highway 3 N Ste 100a
Texas City, TX 77591-4047

Mailing address

PO Box 57579
Webster, TX 77598-7579
Phone (409) 370-1087

Other identifiers 2

IdentifierTypeStateIssuer
CH4054OtherTXPALMETTO GBA
209594501MedicaidTX

National Provider Directory

National Provider Directory

Locations

1125 Highway 3 N
Ste 100
Texas City, TX 77591
Phone (409) 539-6278

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": "1202169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320105600000",
    "number": "1710165485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 57579",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775987579",
            "telephone_number": "409-370-1087",
            "fax_number": "409-419-1108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 HIGHWAY 3 N STE 100A",
            "city": "TEXAS CITY",
            "state": "TX",
            "postal_code": "775914047",
            "telephone_number": "409-539-6278",
            "fax_number": "409-419-1108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINLAND INFECTIOUS DISEASE ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-05",
        "last_updated": "2011-11-01",
        "status": "A",
        "authorized_official_last_name": "WARNER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-370-1087",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TX",
            "license": "J9932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "CH4054",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209594501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Texas City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; 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.