Individual provider Active NPI

Angela Leon Granado

  • Family Nurse Practitioner
  • Corpus Christi, TX
National Provider Identifier
1932873445
Registry record updated Jun 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1060102 Issued in TX
Practice address
1620 S Padre Island Dr Ste 180
Corpus Christi, TX 78416-1361
Phone
(361) 221-1905
Fax
(361) 201-5540
NPI assigned
Aug 7, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1060102 TX Primary

Addresses

Primary practice location

1620 S Padre Island Dr Ste 180
Corpus Christi, TX 78416-1361

Mailing address

1620 S Padre Island Dr Ste 180
Corpus Christi, TX 78416-1361
Phone (361) 221-1905

Other identifiers 1

IdentifierTypeStateIssuer
1060102OtherTXNP LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210901001706 FL Practitioner - Nurse Practitioner 7113323056 Reassigns benefits to 1 organization
I20220824002332 TX Practitioner - Nurse Practitioner 7113323056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1620 S Padre Island Dr
Suite 180
Corpus Christi, TX 78416-1361
Phone (361) 221-1905

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1060102TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
San Rafael Medical Center LLC CurrentSince May 11, 2022 Accepting new patients
Victor Lopez de Mendoza, MD PLLC CurrentSince Aug 10, 2021 Accepting new patients
Texas Spine and Orthopedic Solutions PastSince May 11, 2022 Accepting new patients

Locations

3661 S Miami Ave
Ste 901
Miami, FL 33133
Phone (305) 856-5057

7031 SW 62nd Ave
South Miami, FL 33143
Phone (305) 284-7585

1620 S Padre Island Dr
Ste 180
Corpus Christi, TX 78416
Phone (210) 401-1515

Organizations & group practices 3

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": "1628294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1932873445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 S PADRE ISLAND DR STE 180",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784161361",
            "telephone_number": "361-221-1905",
            "fax_number": "361-201-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 S PADRE ISLAND DR STE 180",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784161361",
            "telephone_number": "361-221-1905",
            "fax_number": "361-201-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON GRANADO",
        "first_name": "ANGELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-07",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1060102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE",
            "identifier": "1060102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.