Georgetown Family & Geriatric Medicine PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

GEORGETOWN FAMILY & GERIATRIC MEDICINE PLLC

Practice address

103 Thousand Oaks Blvd
Georgetown, TX 78628-8757

Phone

(512) 869-4800

Fax

(512) 869-4807

NPI assigned

Jan 16, 2009

Last updated

Jan 18, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rogelio Trevino, M.D.NPI 1477682938

Title

Owner/President

Phone

(512) 869-4800

Specialties & licenses 2

Addresses

Other identifiers 2

Practitioners 1

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.

• Rogelio Trevino, MD

  • Family Medicine Physician
  • Georgetown, TX
  • NPI 1477682938
  Authorized official Same address or phone

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

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263772800000",
    "number": "1851538565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 THOUSAND OAKS BLVD",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786288757",
            "telephone_number": "512-869-4800",
            "fax_number": "512-869-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 THOUSAND OAKS BLVD",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786288757",
            "telephone_number": "512-869-4800",
            "fax_number": "512-869-4807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGETOWN FAMILY & GERIATRIC MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-16",
        "last_updated": "2010-01-18",
        "status": "A",
        "authorized_official_last_name": "TREVINO",
        "authorized_official_first_name": "ROGELIO",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "512-869-4800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX GROUP #",
            "identifier": "0010SA",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201407801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Georgetown DME LLC
• Georgetown Durable Medical Equipment, L.P.
• Georgetown Ear, Nose and Throat Center, PA
• Georgetown Elite Dental
• Georgetown Emergency Physicians PLLC
• Georgetown Family and Cosmetic Dentistry
• Georgetown Family Dental PLLC (Aesthetic Dentistry of Georgetown)
• Georgetown Family Emergency Center, LLC
• Georgetown Healthcare System Inc (Georgetown Home Health)
• Georgetown Integrated Medical PLLC

• Family Medicine Physician in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2010; 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.