Active NPI
Conviva Medical Center Management of Texas, PLLC
Doing business as Conviva Care Center
- Family Medicine Physician
- San Antonio, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- CONVIVA MEDICAL CENTER MANAGEMENT OF TEXAS, PLLC
- Doing business as
- Conviva Care Center
- Practice address
- 18414 US Highway 281 N Ste 104
San Antonio, TX 78259 - Phone
- (210) 495-0222
- Fax
- (210) 495-5914
- NPI assigned
- Jan 31, 2013
- Organization subpart
- Yes
- Parent organization
- CONVIVA MEDICAL CENTER MANAGEMENT OF TEXAS, PLLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gioany Bacon-Williams
- Title
- Director, Provider Contracting
- Phone
- (210) 608-2110
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary | ||
| General Practice Physician | 208D00000X |
Addresses
Primary practice location
18414 US Highway 281 N Ste 104
San Antonio, TX 78259
Mailing address
6101 Blue Lagoon Dr Ste 400
Miami, FL 33126-2051
Phone (305) 500-2000
Other practice location 1
4254 S Alameda St
Corpus Christi, TX 78412-2469
Phone (361) 853-4191
Other practice location 2
9727 Poteet Jourdanton Fwy Ste 108
San Antonio, TX 78211-4575
Phone (210) 923-4372
Other practice location 3
1314 Guadalupe St Ste 105
San Antonio, TX 78207-5582
Phone (210) 225-4810
Other practice location 4
1209 Highway 35 N
Rockport, TX 78382-3117
Phone (361) 729-9811
Other practice location 5
10435 Vista Del Sol Dr
El Paso, TX 79925-7920
Phone (915) 591-6229
Other practice location 6
917 S Port Ave
Corpus Christi, TX 78405-2301
Phone (361) 887-0584
Other practice location 7
1211B E Cliff Dr
El Paso, TX 79902-4734
Phone (915) 591-6226
Other practice location 8
1911 Rogers Rd
San Antonio, TX 78251-4614
Phone (210) 523-9933
Other names 1
- Conviva Care Center
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D0502882 | Conviva Medical Center Management of Texas PA | Certificate of waiver | May 10, 2028 |
| 45D0509418 | Conviva Medical Center Management of | Certificate of waiver | May 10, 2028 |
| 45D1023179 | Conviva Medical Center Management of Texas PA | Certificate of waiver | Mar 8, 2028 |
| 45D2062228 | Conviva Medical Center Management of Texas PA | Certificate of waiver | Jul 11, 2027 |
| 45D2070575 | Conviva Medical Center Management of Texas, PA | Certificate of waiver | Dec 18, 2027 |
National Provider Directory
National Provider Directory- Part of
- McCi of TX Primary Care GRP
Locations
10435 Vista del Sol Dr
El Paso, TX 79925
Phone (915) 591-6227
9727 Poteet Jourdanton Fwy
San Antonio, TX 78211
Phone (210) 881-0643
9727 Poteet Jourdanton Fwy
Ste 108
San Antonio, TX 78211
Phone (210) 733-5072
7430 Barlite Blvd
San Antonio, TX 78224
Phone (210) 923-5581
9727 Poteet Jourdanton Fwy
Ste 1
San Antonio, TX 78211
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- San Antonio, TX
- NPI 1003528498
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359590400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1747699200000",
"number": "1972842664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6101 BLUE LAGOON DR STE 400",
"city": "MIAMI",
"state": "FL",
"postal_code": "331262051",
"telephone_number": "305-500-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18414 US HIGHWAY 281 N STE 104",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78259",
"telephone_number": "210-495-0222",
"fax_number": "210-495-5914"
}
],
"practiceLocations": [
{
"address_1": "4254 S Alameda St",
"address_purpose": "LOCATION",
"city": "Corpus Christi",
"state": "TX",
"postal_code": "784122469",
"country_code": "US",
"telephone_number": "361-853-4191",
"fax_number": "361-853-8768",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9727 Poteet Jourdanton Fwy Ste 108",
"address_purpose": "LOCATION",
"city": "San Antonio",
"state": "TX",
"postal_code": "782114575",
"country_code": "US",
"telephone_number": "210-923-4372",
"fax_number": "210-923-5581",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1314 Guadalupe St Ste 105",
"address_purpose": "LOCATION",
"city": "San Antonio",
"state": "TX",
"postal_code": "782075582",
"country_code": "US",
"telephone_number": "210-225-4810",
"fax_number": "210-686-3835",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1209 Highway 35 N",
"address_purpose": "LOCATION",
"city": "Rockport",
"state": "TX",
"postal_code": "783823117",
"country_code": "US",
"telephone_number": "361-729-9811",
"fax_number": "361-729-9819",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "10435 Vista Del Sol Dr",
"address_purpose": "LOCATION",
"city": "El Paso",
"state": "TX",
"postal_code": "799257920",
"country_code": "US",
"telephone_number": "915-591-6229",
"fax_number": "915-206-6385",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "917 S Port Ave",
"address_purpose": "LOCATION",
"city": "Corpus Christi",
"state": "TX",
"postal_code": "784052301",
"country_code": "US",
"telephone_number": "361-887-0584",
"fax_number": "361-887-0586",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1211B E Cliff Dr",
"address_purpose": "LOCATION",
"city": "El Paso",
"state": "TX",
"postal_code": "799024734",
"country_code": "US",
"telephone_number": "915-591-6226",
"fax_number": "915-308-9433",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1911 Rogers Rd",
"address_purpose": "LOCATION",
"city": "San Antonio",
"state": "TX",
"postal_code": "782514614",
"country_code": "US",
"telephone_number": "210-523-9933",
"fax_number": "210-647-0242",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "CONVIVA MEDICAL CENTER MANAGEMENT OF TEXAS, PLLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "CONVIVA MEDICAL CENTER MANAGEMENT OF TEXAS, PLLC",
"enumeration_date": "2013-01-31",
"last_updated": "2025-05-20",
"certification_date": "2025-05-20",
"status": "A",
"authorized_official_last_name": "BACON-WILLIAMS",
"authorized_official_first_name": "GIOANY",
"authorized_official_title_or_position": "DIRECTOR, PROVIDER CONTRACTING",
"authorized_official_telephone_number": "210-608-2110"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Conviva Care Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.