Space Center Ipa PA

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

SPACE CENTER IPA PA

Practice address

12902 Cloud Dr
Santa Fe, TX 77510-9345

Phone

(409) 316-1928

Fax

(713) 344-9421

NPI assigned

May 11, 2007

Organization subpart

No

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

Authorized official

Name

Joe E Pouzar, MD

Title

President

Phone

(409) 316-1928

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891900981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 525",
            "city": "SANTA FE",
            "state": "TX",
            "postal_code": "775100525",
            "telephone_number": "409-316-1928",
            "fax_number": "713-344-9421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12902 CLOUD DR",
            "city": "SANTA FE",
            "state": "TX",
            "postal_code": "775109345",
            "telephone_number": "409-316-1928",
            "fax_number": "713-344-9421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPACE CENTER IPA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POUZAR",
        "authorized_official_first_name": "JOE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "409-316-1928",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Renee Saylor
• Amy Sckittone
• Heather Ann Sheely, MS, LPC
• Ashlee Skabla, NP
• Solara Home Health LLC
• John Sullivan Stafford, M.D.
• Stanley a. Higgs, D.D.S., Inc.
• Stepping Stones Community Church of the Desert
• Texas Professional Healthcare Alliance, Inc.
• Texas State Optical of Santa Fe, P.a.

• General Practice Physician in Santa Fe, TX
• Providers in Santa Fe, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.