Octavio A De la Pena, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

K3150 Issued in TX

Practice address

4401 Coit Rd
Site 201
Frisco, TX 75035-0500

Phone

(972) 335-7306

Fax

(972) 335-7468

NPI assigned

Mar 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274832000000",
    "number": "1780643692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7610 STEMMONS FWY",
            "address_2": "SUITE 500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474231",
            "telephone_number": "214-689-5960",
            "fax_number": "214-630-7293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 COIT RD",
            "address_2": "SITE 201",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750350500",
            "telephone_number": "972-335-7306",
            "fax_number": "972-335-7468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA PENA",
        "first_name": "OCTAVIO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2010-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "K3150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142704901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8B4310",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102131303",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ajzhane Ravon Dawn
• Richard Taylor Dawson, MSM, PA-C
• Ashlyn Day
• DC View Imaging, LLC
• Heidi Katheryn De Diego, PMHNP-BC
• Briana De la Rocha
• Denise Esperanza De Leon
• Isabella De Leon
• Carrie E De Moor, MD
• Ernest De Paoli, D.D.S.

• Gastroenterology Physician in Frisco, TX
• Providers in Frisco, TX by specialty
• Gastroenterology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.