Clinica Nuevo Leon, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

CLINICA NUEVO LEON, LLC

Practice address

3601 Tom Gill Rd
Penitas, TX 78576-7352

Phone

(956) 778-4598

NPI assigned

Feb 20, 2020

Last updated

Dec 1, 2020By 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

Miguel A Mata, FNP-C

Title

Family Nurse Practitioner/Provider

Phone

(956) 778-4598

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606780800000",
    "number": "1871126599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 TOM GILL RD",
            "city": "PENITAS",
            "state": "TX",
            "postal_code": "785767352",
            "telephone_number": "956-778-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 TOM GILL RD",
            "city": "PENITAS",
            "state": "TX",
            "postal_code": "785767352",
            "telephone_number": "956-778-4598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA NUEVO LEON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-20",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A",
        "authorized_official_last_name": "MATA",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER/PROVIDER",
        "authorized_official_telephone_number": "956-778-4598",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "clinicanuevoleon@gmail.com",
            "affiliation": "N",
            "endpointDescription": "google business email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3601 Tom Gill Rd",
            "city": "Penitas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785767352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Family Nurse Practitioner in Penitas, TX
• Providers in Penitas, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.