Prime Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

Q6091 Issued in TX

Legal business name

PRIME PEDIATRICS

Practice address

2005 E Griffin Pkwy
193
Mission, TX 78572-3222

Phone

(956) 271-8050

NPI assigned

Jan 13, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Mohan Babu Rayala, M.D.

Title

Pediatrician

Phone

(956) 271-8050

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458172800000",
    "number": "1861858367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 E GRIFFIN PKWY",
            "address_2": "193",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785723222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 E GRIFFIN PKWY",
            "address_2": "193",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785723222",
            "telephone_number": "956-271-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-13",
        "last_updated": "2016-03-17",
        "status": "A",
        "authorized_official_last_name": "RAYALA",
        "authorized_official_first_name": "MOHAN",
        "authorized_official_middle_name": "BABU",
        "authorized_official_title_or_position": "PEDIATRICIAN",
        "authorized_official_telephone_number": "956-271-8050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q6091",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "Q6091",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Mission, TX
• Providers in Mission, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2016; 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.