Texas Federal Wellness Center of Laredo

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

TEXAS FEDERAL WELLNESS CENTER OF LAREDO

Practice address

8607 McPherson Rd Ste 101
Laredo, TX 78045-6383

Phone

(956) 568-3583

NPI assigned

Jun 26, 2018

Organization subpart

No

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

Authorized official

Name

Candice Zimmer

Title

Credentialing

Phone

(512) 800-3659

Specialties & licenses 5

Addresses

Other names 1

• Texas Federal Wellness Center of Laredo Doing business as

Locations

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529971200000",
    "number": "1972098630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8607 MCPHERSON RD STE 101",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780456383",
            "telephone_number": "956-568-3583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8607 MCPHERSON RD STE 101",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780456383",
            "telephone_number": "956-568-3583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS FEDERAL WELLNESS CENTER OF LAREDO",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-26",
        "last_updated": "2018-06-26",
        "status": "A",
        "authorized_official_last_name": "ZIMMER",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "512-800-3659"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Texas Federal Wellness Center of Laredo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Physician in Laredo, TX
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; 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.