Organization Active NPI

Bertha Laura R Medina MD PA

  • Family Medicine Physician
  • McAllen, TX
National Provider Identifier
1750349700
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G-7102 Issued in TX
Legal business name
BERTHA LAURA R MEDINA MD PA
Practice address
721 Savannah Ave
McAllen, TX 78503-3006
Phone
(956) 630-5585
Fax
(956) 631-1372
NPI assigned
May 1, 2006
Last updated
May 26, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Authorized official

Name
Bertha Laura Rodriguez-Medina
Title
Owner
Phone
(956) 630-5585

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X G-7102 TX Primary

Addresses

Primary practice location

721 Savannah Ave
McAllen, TX 78503-3006

Mailing address

721 Savannah Ave
McAllen, TX 78503-3006
Phone (956) 630-5585

Other identifiers 1

IdentifierTypeStateIssuer
0805541-01MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120515000627 TX Part B Supplier - Clinic/Group Practice 1951564715 Receives reassigned benefits from 2 practitioners
Practice locations: McAllen, TX

National Provider Directory

National Provider Directory

Locations

721 Savannah Ave
McAllen, TX 78503
Phone (956) 630-5585

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779753600000",
    "number": "1750349700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 SAVANNAH AVE",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785033006",
            "telephone_number": "956-630-5585",
            "fax_number": "956-631-1372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 SAVANNAH AVE",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785033006",
            "telephone_number": "956-630-5585",
            "fax_number": "956-631-1372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERTHA LAURA R MEDINA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ-MEDINA",
        "authorized_official_first_name": "BERTHA",
        "authorized_official_middle_name": "LAURA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "956-630-5585"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G-7102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0805541-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McAllen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.