Victor Bravo MHT LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

H2258 Issued in TX

Legal business name

VICTOR BRAVO MHT LLC

Practice address

1215 S Coulter St
Suite 100
Amarillo, TX 79106-1758

Phone

(972) 616-4702

NPI assigned

Jul 18, 2014

Organization subpart

No

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

Authorized official

Name

Victor Bravo, MD

Title

Owner

Phone

(800) 359-4701

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1405641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405641600000",
    "number": "1922415272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 HERITAGE DRIVE",
            "address_2": "SUITE 110",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750693379",
            "telephone_number": "972-616-4702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 S COULTER ST",
            "address_2": "SUITE 100",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061758",
            "telephone_number": "972-616-4702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTOR BRAVO MHT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-18",
        "last_updated": "2014-07-18",
        "status": "A",
        "authorized_official_last_name": "BRAVO",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "800-359-4701",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H2258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2014; 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.