Pearl Family Practice PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

K8276 Issued in TX

Legal business name

PEARL FAMILY PRACTICE PA

Practice address

950 W University Ave
Building 1, Suite 104
Georgetown, TX 78626-6505

Phone

(512) 869-8500

Fax

(512) 869-5052

NPI assigned

Aug 25, 2008

Organization subpart

No

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

Authorized official

Name

Raju Kurunthottical, D.O.NPI 1184602393

Title

President/Owner

Phone

(512) 869-8500

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raju Z Kurunthottical, D.O.

  • Family Medicine Physician
  • Round Rock, TX
  • NPI 1184602393
  NPD (past) Authorized official

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

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246924800000",
    "number": "1992952634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 W UNIVERSITY AVE",
            "address_2": "BUILDING 1, SUITE 104",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786266505",
            "telephone_number": "512-869-8500",
            "fax_number": "512-869-5052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 W UNIVERSITY AVE",
            "address_2": "BUILDING 1, SUITE 104",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786266505",
            "telephone_number": "512-869-8500",
            "fax_number": "512-869-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARL FAMILY PRACTICE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-25",
        "last_updated": "2009-07-07",
        "status": "A",
        "authorized_official_last_name": "KURUNTHOTTICAL",
        "authorized_official_first_name": "RAJU",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "512-869-8500",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K8276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198021101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP #",
            "identifier": "0009RT",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Griselda Onofre Pattillo, LCSW
• Scott Thomas Pattison, DPM
• Kimberly Sue Patton, FNP-C
• Lorena Paulino Brito
• Richard Wiley Pearce, MD
• Devin Peck, M.D.
• Pediatric Associates of Georgetown, PA
• Kelly Pedrozo, CD
• Peds Center of Round Rock PA
• Samuel B Pegram, MD

• Family Medicine Physician in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2009; 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.