Md1961 LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

MD1961 LLC

Practice address

4201 Garth Rd Ste 301
Baytown, TX 77521-3156

Phone

(281) 422-9811

Fax

(281) 420-1262

NPI assigned

Oct 16, 2018

Organization subpart

No

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

Authorized official

Name

Carla Pina

Title

Owner

Phone

(281) 422-9811

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539648000000",
    "number": "1780150995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 GARTH RD STE 301",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775213156",
            "telephone_number": "281-422-9811",
            "fax_number": "281-420-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 GARTH RD STE 301",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775213156",
            "telephone_number": "281-422-9811",
            "fax_number": "281-420-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD1961 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-16",
        "last_updated": "2018-10-16",
        "status": "A",
        "authorized_official_last_name": "PINA",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-422-9811"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacquelyn McGreggor, LPC
• Molly McHale, PA-C
• Kendra McKee
• McKinney Podiatric Associates PA
• MD Pharmacy
• Chad Michael Meadows, FNP-C
• Pamela Louisa Medellin, MD
• Medquip DME LLC
• Vanessa Marie Medrano
• Alphonse E Mehany, DO

• Surgery Physician in Baytown, TX
• Providers in Baytown, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; 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.