NPIMap

Organization Active NPI

Mario Cervantes, M.D., PA

Doing business as Clinica Angeles

  • General Practice Physician
  • Bellaire, TX
National Provider Identifier
1891931457
Registry record updated Nov 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
H7953 Issued in TX
Legal business name
MARIO CERVANTES, M.D., PA
Doing business as
Clinica Angeles
Practice address
4922 Locust St
Bellaire, TX 77401-4040
Phone
(832) 638-6072
Fax
(888) 327-1505
NPI assigned
Dec 31, 2008
Last updated
Nov 19, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2013

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

Authorized official

Name
Dr. Mario Cervantes, M.D.
Title
President
Phone
(832) 638-6072

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Pathology) Physician 207ZH0000X H7953 TX
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X H7953 TX
General Practice Physician 208D00000X H7953 TX Primary

Addresses

Primary practice location

4922 Locust St
Bellaire, TX 77401-4040

Mailing address

5210 Maple St
Bellaire, TX 77401
Phone (832) 638-6072

Other identifiers 2

IdentifierTypeStateIssuer
200034101MedicaidTX
45D2028678OtherTXCLIA

Other names 1

  • CLINICA ANGELES Doing business as

National Provider Directory

National Provider Directory

Locations

4922 Locust St
Bellaire, TX 77401
Phone (832) 638-6072

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1230681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384819200000",
    "number": "1891931457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5210 MAPLE ST",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "77401",
            "telephone_number": "832-638-6072",
            "fax_number": "888-327-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4922 LOCUST ST",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774014040",
            "telephone_number": "832-638-6072",
            "fax_number": "888-327-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIO CERVANTES, M.D., PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-31",
        "last_updated": "2013-11-19",
        "status": "A",
        "authorized_official_last_name": "CERVANTES",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "832-638-6072",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "TX",
            "license": "H7953",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "H7953",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "H7953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200034101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "45D2028678",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLINICA ANGELES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bellaire, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2013; 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.