Active NPI
Iris Well Child Physicals
- Pediatric Clinical Nurse Specialist
- Elsa, TX
National Provider Identifier
1881834539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Clinical Nurse Specialist
- License
- 533197
- Legal business name
- IRIS WELL CHILD PHYSICALS
- Practice address
- 200 W. Edinburg Hwy 107
Suite B
Elsa, TX 78543-1274 - Phone
- (956) 262-9805
- Fax
- (956) 262-9233
- NPI assigned
- Feb 20, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Iris Garcia, R.N., PNP
- Title
- Owner
- Phone
- (956) 262-9805
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Clinical Nurse Specialist | 364SP0200X | 533197 | TX | Primary |
Addresses
Primary practice location
200 W. Edinburg Hwy 107
Suite B
Elsa, TX 78543-1274
Mailing address
PO Box 1274
Elsa, TX 78543-1274
Phone (956) 262-9805
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 121084102 | Other | TX | MEDICAID-EPSDT |
| 121392 | Other | TX | SUPERIOR HEALTHPLAN NETWORK |
| 8N8564 | Other | TX | BLUE CROSS BLUE SHIELD OF TEXAS |
| 121084101 | Medicaid | TX |
National Provider Directory
National Provider DirectoryLocations
200 W Edinburg Ave
Ste B
Elsa, TX 78543
Phone (956) 262-9805
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235088000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1235088000000",
"number": "1881834539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1274",
"city": "ELSA",
"state": "TX",
"postal_code": "785431274",
"telephone_number": "956-262-9805",
"fax_number": "956-262-9233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 W. EDINBURG HWY 107",
"address_2": "SUITE B",
"city": "ELSA",
"state": "TX",
"postal_code": "785431274",
"telephone_number": "956-262-9805",
"fax_number": "956-262-9233"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IRIS WELL CHILD PHYSICALS",
"organizational_subpart": "NO",
"enumeration_date": "2009-02-20",
"last_updated": "2009-02-20",
"status": "A",
"authorized_official_last_name": "GARCIA",
"authorized_official_first_name": "IRIS",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "956-262-9805",
"authorized_official_credential": "R.N., PNP"
},
"taxonomies": [
{
"code": "364SP0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Clinical Nurse Specialist, Pediatrics",
"state": "TX",
"license": "533197",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID-EPSDT",
"identifier": "121084102",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUPERIOR HEALTHPLAN NETWORK",
"identifier": "121392",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD OF TEXAS",
"identifier": "8N8564",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "121084101",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elsa, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.