Individual provider Active NPI

Juan Ricardo Saucedo, FNP

  • Family Nurse Practitioner
  • Mission, TX
National Provider Identifier
1962064881
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP142042 Issued in TX
Practice address
2121 E Griffin Pkwy Ste 12
Mission, TX 78572-3072
Phone
(956) 271-6203
Fax
(956) 529-5009
NPI assigned
Jul 1, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X AP142042 TX
Family Nurse Practitioner 363LF0000X AP142042 TX Primary

Addresses

Primary practice location

2121 E Griffin Pkwy Ste 12
Mission, TX 78572-3072

Mailing address

1704 Sebastian St
Mission, TX 78572-6066
Phone (830) 513-2230

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200402001739 TX Practitioner - Nurse Practitioner 3072942671 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP142042TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saucedo Family Clinic PLLC CurrentSince Jun 19, 2025 Accepting new patients
G Athansi Orfanos MD PA Past Accepting new patients

Locations

2121 E Griffin Pkwy
Ste 12
Mission, TX 78572
Phone (956) 581-0303

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1962064881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 SEBASTIAN ST",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785726066",
            "telephone_number": "830-513-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 E GRIFFIN PKWY STE 12",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785723072",
            "telephone_number": "956-271-6203",
            "fax_number": "956-529-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUCEDO",
        "first_name": "JUAN",
        "middle_name": "RICARDO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-01",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP142042",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP142042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission, TX

Sources for this page

Verify at the official NPI Registry.