Individual provider Active NPI

Luis Sevilla Escobedo

  • Internal Medicine Physician
  • Kingwood, TX
National Provider Identifier
1891256970
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
T8048 Issued in TX
Practice address
22999 Highway 59 N Ste 204
Kingwood, TX 77339-4439
Phone
(713) 852-1763
NPI assigned
Mar 29, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X T8048 TX Primary

Addresses

Primary practice location

22999 Highway 59 N Ste 204
Kingwood, TX 77339-4439

Mailing address

22999 Highway 59 N Ste 204
Kingwood, TX 77339-4439
Phone (713) 852-1763

Other practice location 1

22999 Highway 59 N Ste 204
Kingwood, TX 77339-4439
Phone (713) 852-1763

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221014001024 TX Practitioner - Internal Medicine 5193108884 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmed Networks, Inc.Group PAC ID 6002091261, 116 clinicians

Practice addresses (Care Compare)

4330 Medical Dr
Suite 500
San Antonio, TX 78229-3318
Phone (210) 558-0122

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Networks, Inc. CurrentSince Aug 1, 2022 Accepting new patients
Lonestar Hospital Medicine Associates, PA Internal Medicine CurrentSince Nov 7, 2023 Accepting new patients

Locations

5950 Saratoga Blvd
Corpus Christi, TX 78414
Phone (321) 917-9263

600 Elizabeth St
Corpus Christi, TX 78404
Phone (361) 325-2511

22999 Highway 59 N
Kingwood, TX 77339
Phone (281) 348-3322

22999 Highway 59 N
Ste 204
Kingwood, TX 77339
Phone (281) 312-6313

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

4330 Medical Dr
Ste 500
San Antonio, TX 78229
Phone (210) 558-0122

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1891256970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22999 HIGHWAY 59 N STE 204",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773394439",
            "telephone_number": "713-852-1763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22999 HIGHWAY 59 N STE 204",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773394439",
            "telephone_number": "713-852-1763"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22999 Highway 59 N Ste 204",
            "address_purpose": "LOCATION",
            "city": "Kingwood",
            "state": "TX",
            "postal_code": "773394439",
            "country_code": "US",
            "telephone_number": "713-852-1763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEVILLA ESCOBEDO",
        "first_name": "LUIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-29",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T8048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, TX

Sources for this page

Verify at the official NPI Registry.