Live Oak Pediatrics, PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

LIVE OAK PEDIATRICS, PA

Practice address

12702 Toepperwein Rd
Ste 132
Live Oak, TX 78233-3278

Phone

(210) 599-6251

Fax

(210) 599-6254

NPI assigned

Jul 23, 2007

Last updated

Jul 23, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jesus Luis Rodriguez III, MDNPI 1558430884

Title

Director, Live Oak Pediatrics

Phone

(210) 599-6251

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jesus Luis Rodriguez III, MD

  • Pediatrics Physician
  • Live Oak, TX
  • NPI 1558430884
  NPD (past) Authorized official

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185148800000",
    "number": "1992905525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12702 TOEPPERWEIN RD",
            "address_2": "STE 132",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333278",
            "telephone_number": "210-599-6251",
            "fax_number": "210-599-6254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12702 TOEPPERWEIN RD",
            "address_2": "STE 132",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333278",
            "telephone_number": "210-599-6251",
            "fax_number": "210-599-6254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE OAK PEDIATRICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-23",
        "last_updated": "2007-07-23",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "JESUS",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "DIRECTOR, LIVE OAK PEDIATRICS",
        "authorized_official_telephone_number": "210-599-6251",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "I15074",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Linam
• David Liu, MD
• Nadine Liu, D.O.
• Live Oak Allergy & Asthma Clinic; PA
• Live Oak Pediatric Dentistry (Olympia Hills Junior Pediatric Dental)
• Kenneth Omer Livingston Jr., D.D.S.
• Samantha Ann Logue, MSN, APRN, FNP-C
• Lone Star State Dermatology Clinic PLLC
• Elizabeth Kay Long, FNP
• Joao Lopes, PT

• Primary Care Clinic/Center in Live Oak, TX
• Providers in Live Oak, TX by specialty
• Primary Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; 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.