Active NPI
Jose Carlos Interiano, M.D.
- Pediatrics Physician
- Houston, TX
National Provider Identifier
1790778470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- H7434
- Practice address
- 1631 North Loop W
#440
Houston, TX 77008-1500 - Phone
- (713) 861-8113
- Fax
- (713) 861-6010
- NPI assigned
- Aug 26, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | H7434 | TX | Primary |
Addresses
Primary practice location
1631 North Loop W
#440
Houston, TX 77008-1500
Mailing address
1631 North Loop W
#440
Houston, TX 77008-1500
Phone (713) 861-8113
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10014841 | Other | TX | AMERIGROUP MEDICAID |
| 00F74B | Other | TX | BLUE CROSS BLUE SHIELD |
| 10014840 | Other | TX | AMERIGROUP CHIP PROGRAM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H7434 | TX | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1790778470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1631 NORTH LOOP W",
"address_2": "#440",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770081500",
"telephone_number": "713-861-8113",
"fax_number": "713-861-6010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1631 NORTH LOOP W",
"address_2": "#440",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770081500",
"telephone_number": "713-861-8113",
"fax_number": "713-861-6010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INTERIANO",
"first_name": "JOSE",
"middle_name": "CARLOS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-26",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "H7434",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP MEDICAID",
"identifier": "10014841",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "00F74B",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP CHIP PROGRAM",
"identifier": "10014840",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
- Interface-Samaritan Counseling Centers
- Interfaith Carepartners, Inc.
- Interfaith Ministries for Greater Houston
- Alvaro Interiano, M.ED, LPC-INTERN
- Benjamin Interiano, M.D.
- Intermountain Surgical PA
- Internal Directions Inc
- Internal Medicine Specialists, P.a.
- International Center for Neuroscience
- International Center for Surgical Science
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.