Active NPI
Utmb Faculty Group Practice
- Obstetrics & Gynecology Physician
- Nacogdoches, TX
National Provider Identifier
1760423974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- Legal business name
- UTMB FACULTY GROUP PRACTICE
- Practice address
- 206 Mimms Ave
Nacogdoches, TX 75961-5028 - Phone
- (936) 560-0515
- Fax
- (936) 560-1636
- NPI assigned
- Jun 9, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Cynthia L. Smith
- Title
- Director
- Phone
- (409) 772-2222
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | |||
| Dermatology Physician | 207N00000X | |||
| Emergency Medicine Physician | 207P00000X | |||
| Family Medicine Physician | 207Q00000X | |||
| Internal Medicine Physician | 207R00000X | |||
| Obstetrics & Gynecology Physician | 207V00000X | Primary | ||
| Ophthalmology Physician | 207W00000X | |||
| Otolaryngology Physician | 207Y00000X | |||
| Anatomic Pathology Physician | 207ZP0101X | |||
| Pediatrics Physician | 208000000X | |||
| Neurology Physician | 2084N0400X | |||
| Psychiatry Physician | 2084P0800X | |||
| Radiation Oncology Physician | 2085R0001X | |||
| Diagnostic Radiology Physician | 2085R0202X | |||
| Surgery Physician | 208600000X |
Addresses
Primary practice location
206 Mimms Ave
Nacogdoches, TX 75961-5028
Mailing address
P O Box 4797-710
Houston, TX 77210-4797
Phone (409) 772-2222
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 109372602 | Medicaid | TX |
National Provider Directory
National Provider Directory- Tax ID family
- University of Texas Medical Branch at Galveston
Other organizations with this tax ID 8
Organizations that report the same tax identification number in the National Provider Directory.
-
- Multi-Specialty Clinic/Center
- Galveston, TX
- NPI 1295119493
-
- Women's Hospital
- Dickinson, TX
- NPI 1962871699
-
- Optician
- Texas City, TX
- NPI 1124401716
-
- Primary Care Clinic/Center
- Galveston, TX
- NPI 1083703433
-
- Multi-Specialty Clinic/Center
- Austin, TX
- NPI 1114968294
-
- Obstetrics & Gynecology Physician
- Pasadena, TX
- NPI 1154362382
-
- Obstetrics & Gynecology Physician
- Pearland, TX
- NPI 1629019823
-
- Multi-Specialty Clinic/Center
- Beaumont, TX
- NPI 1821039058
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Angleton, TX
- NPI 1992867121
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1253577600000",
"number": "1760423974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P O BOX 4797-710",
"city": "HOUSTON",
"state": "TX",
"postal_code": "772104797",
"telephone_number": "409-772-2222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 MIMMS AVE",
"city": "NACOGDOCHES",
"state": "TX",
"postal_code": "759615028",
"telephone_number": "936-560-0515",
"fax_number": "936-560-1636"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UTMB FACULTY GROUP PRACTICE",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-09",
"last_updated": "2009-09-22",
"status": "A",
"authorized_official_last_name": "SMITH",
"authorized_official_first_name": "CYNTHIA",
"authorized_official_middle_name": "L.",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "409-772-2222",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dermatology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": null,
"license": null,
"primary": true
},
{
"code": "207W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Otolaryngology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207ZP0101X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pathology, Anatomic Pathology",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Neurology",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": false
},
{
"code": "2085R0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Radiology, Radiation Oncology",
"state": null,
"license": null,
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "109372602",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nacogdoches, TX
- Leslie Ann Tyndall, L.P.C.
- Ally Kirsten Tywater
- University Drive Health Center, P.a.
- Urgent Health Solutions Nacogdoches
- Usad
- Utmb Regional and Maternal Child Health Program
- Utmb Regional Maternal and Child Health Program
- Utmb Regional Maternal and Child Health Program
- Yuliana Valadez-Maya, RDA
- Roger Ivan Van Horn, DDS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.