Individual provider Active NPI

Antonio Carvalho Braga, MD

  • Pediatrics Physician
  • Victoria, TX
National Provider Identifier
1922040138
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
Q7327 Issued in TX
Practice address
4304 N Laurent St
Victoria, TX 77901-2741
Phone
(361) 573-4313
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Q7327 TX Primary

Addresses

Primary practice location

4304 N Laurent St
Victoria, TX 77901-2741

Mailing address

115 Medical Dr
Suite 208
Victoria, TX 77904-3102

Other practice location 1

115 Medical Dr
Suite 208
Victoria, TX 77904-3102
Phone (361) 579-0043

Other practice location 2

501 E Colorado St
Victoria, TX 77901-6025
Phone (361) 579-8300

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
I20160509001174 TX Practitioner - Pediatric Medicine 7315953379 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q7327TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Employee Assistance Program Inc CurrentSince May 1, 2016 Accepting new patients
Regional Employee Assistance Program Inc Pediatrics Current Accepting new patients
Regional Employee Assistance Program Inc CurrentSince May 1, 2016 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients
Antonio C. Braga M.D., P.a. Pediatrics Past Accepting new patients

Locations

1602 E Houston St
Ste C
Beeville, TX 78102
Phone (361) 354-2900

501 E Colorado St
Victoria, TX 77901
Phone (361) 571-5283

115 Medical Dr
Ste 208
Victoria, TX 77904
Phone (361) 573-7900

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FBEDAD/Endpoint/FBEDAD

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1922040138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MEDICAL DR",
            "address_2": "SUITE 208",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779043102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4304 N LAURENT ST",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779012741",
            "telephone_number": "361-573-4313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Medical Dr",
            "address_2": "Suite 208",
            "address_purpose": "LOCATION",
            "city": "Victoria",
            "state": "TX",
            "postal_code": "779043102",
            "country_code": "US",
            "telephone_number": "361-579-0043",
            "fax_number": "361-576-9861",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 E Colorado St",
            "address_purpose": "LOCATION",
            "city": "Victoria",
            "state": "TX",
            "postal_code": "779016025",
            "country_code": "US",
            "telephone_number": "361-579-8300",
            "fax_number": "361-579-8303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAGA",
        "first_name": "ANTONIO",
        "middle_name": "CARVALHO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q7327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

Verify at the official NPI Registry.