Individual provider Active NPI

Jaime Ildebrando Barillas, MD, LSA

  • Surgical Physician Assistant
  • Houston, TX
National Provider Identifier
1922126598
Registry record updated Jul 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
SA00196 Issued in TX
Practice address
8203 Willow Place Dr S
419
Houston, TX 77070-5655
Phone
(832) 237-5656
Fax
(832) 237-5655
NPI assigned
Mar 26, 2007
Last updated
Jul 26, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X SA00196 TX Primary

Addresses

Primary practice location

8203 Willow Place Dr S
419
Houston, TX 77070-5655

Mailing address

PO Box 691789
Houston, TX 77269-1789
Phone (832) 237-5656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
SA00196TXMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Houston Surgical Assistant Services Surgical Past Accepting new patients
Houston Surgical Assistant Services, Inc. Surgical Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501027200000",
    "number": "1922126598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 691789",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772691789",
            "telephone_number": "832-237-5656",
            "fax_number": "832-237-5655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8203 WILLOW PLACE DR S",
            "address_2": "419",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770705655",
            "telephone_number": "832-237-5656",
            "fax_number": "832-237-5655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARILLAS",
        "first_name": "JAIME",
        "middle_name": "ILDEBRANDO",
        "credential": "MD, LSA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2017-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "SA00196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2017; 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.