MCCI OF TEXAS PRIMARY CARE GROUP PLLC (NPI# 1013471184) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013471184 |
| Entity Type | Organization |
| Organization Name | MCCI OF TEXAS PRIMARY CARE GROUP PLLC |
| Other Organization Name | MCCITX SA LEGACY |
| Practice Address |
18414 Us Highway 281 N Ste 104 San Antonio TX 78259-7611 |
| Mailing Address |
6101 Blue Lagoon Dr Ste 400 Miami FL 33126-2051 |
| Practice Telephone | 2104950222 |
| Practice Fax Number | 2104955914 |
| Mailing Telephone | 3055002000 |
| Enumeration Date | 2019-01-23 |
| Last Update Date | 2020-01-30 |
| Authorized Official Name | GEMMA ROSELLO (VP) |
| Authorized Official Telephone | 3055002000 |
| Is Organization Subpart | Y |
| Parent Organization Name | MCCI OF TEXAS PRIMARY CARE GROUP PLLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Conviva Care Center | Doing Business As Name - Organization |
| MCCITX SA Legacy | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518431717 | Mcci of Texas Primary Care Group Pllc | Family Medicine | 917 S Port Ave, Corpus Christi, TX 78405-2301 | 2019-01-22 |
| 1881168086 | Mcci of Texas Primary Care Group Pllc | Internal Medicine | 1211b E Cliff Dr, El Paso, TX 79902-4734 | 2019-01-22 |
| 1508330705 | Mcci of Texas Primary Care Group Pllc | Family Medicine | 1314 Guadalupe St Ste 105, San Antonio, TX 78207-5582 | 2019-01-22 |
| 1033683230 | Mcci of Texas Primary Care Group Pllc | Internal Medicine | 9727 Poteet Jourdanton Fwy Ste 108, San Antonio, TX 78211-4575 | 2019-01-22 |
| 1043784242 | Mcci of Texas Primary Care Group Pllc | Family Medicine | 1209 Highway 35 N, Rockport, TX 78382-4808 | 2019-01-22 |
| 1023582228 | Mcci of Texas Primary Care Group Pllc | Internal Medicine | 10435 Vista Del Sol Dr, El Paso, TX 79925-7920 | 2019-01-22 |
| 1972842664 | Mcci of Texas Primary Care Group Pllc | General Practice | 18414 Us Highway 281 N Ste 104, San Antonio, TX 78259 | 2013-01-31 |
| Street Address |
18414 US HIGHWAY 281 N STE 104 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78259-7611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780681510 | Shannon Rebecca Prevette | Family Medicine | 18414 Us Highway 281 N Ste 104, San Antonio, TX 78259-7611 | 2005-07-07 |
| 1639530173 | Vinh-quang Do Nguyen | Internal Medicine | 18414 Us Highway 281 N Ste 104, San Antonio, TX 78259-7611 | 2016-03-11 |
| 1972988632 | David Medrano | Nurse Practitioner | 18414 Us Highway 281 N Ste 104, San Antonio, TX 78259-7611 | 2015-07-23 |
| 1114309176 | Temitayo Odesanya | Internal Medicine | 18414 Us Highway 281 N Ste 104, San Antonio, TX 78259-7611 | 2015-06-25 |
| 1972842664 | Mcci of Texas Primary Care Group Pllc | General Practice | 18414 Us Highway 281 N Ste 104, San Antonio, TX 78259 | 2013-01-31 |
| 1891088159 | Shelly R Nickels | Internal Medicine | 18414 Us Highway 281 N Ste 104, San Antonio, TX 78259-7611 | 2011-05-19 |
| 1871884007 | Siu-han Paola Abate | Specialist | 18414 Us Highway 281 N Ste 104, San Antonio, TX 78259-7611 | 2011-04-21 |
| 1588896922 | Diego Rodrigo Valencia Chavez | Internal Medicine | 18414 Us Highway 281 N Ste 104, San Antonio, TX 78259-7611 | 2009-08-19 |
| 1184887176 | Samiha Jawed | Internal Medicine | 18414 Us Highway 281 N Ste 104, San Antonio, TX 78259-7611 | 2008-07-09 |
| 1669652632 | Felicia A. Armstrong | Internal Medicine | 18414 Us Highway 281 N Ste 104, San Antonio, TX 78259-7611 | 2007-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952893448 | Greater Texas Palliative Care Services Pllc | Internal Medicine | 21806 Barton Woods, San Antonio, TX 78259 | 2018-05-31 |
| 1336639467 | Kriti Juneja | Behavioral Analyst | 21303 Encino Cmns Apt No1707, San Antonio, TX 78259 | 2018-05-14 |
| 1699121871 | Jesse Frank Delacruz | Nurse Practitioner | 21103 Simi Valley Drive, San Antonio, TX 78259 | 2016-05-06 |
| 1194139063 | Summer Ashley Kotson | Chiropractor | 2719 Rancho Mirage, San Antonio, TX 78259 | 2014-06-18 |
| 1194166645 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 2502 Marshall Rd, San Antonio, TX 78259 | 2013-07-12 |
| 1174882369 | John Adams, Md Psychiatry Pllc | Psychiatric Unit | 17720 Corporate Woods Drive, San Antonio, TX 78259 | 2012-05-09 |
| 1508156589 | Kiddo Dental Pa | Dentist | 20306 Encino Ledge Ste 106, Kiddo Dental, San Antonio, TX 78259 | 2011-04-12 |
| 1386824217 | Austin Joseph Garrison | Dentist | 22100 Bulverde Rd, Suite 114, San Antonio, TX 78259 | 2007-11-08 |
| 1568584670 | Michael John Norgard | Internal Medicine | 226 Roseheart, San Antonio, TX 78259 | 2007-04-06 |
| 1225178817 | Texas Midwives Group | Midwife | 2211 Tworivers Dr., San Antonio, TX 78259 | 2007-02-06 |
| Find all providers in zip 78259 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295327 | Courtney L Buchmeier | Family Medicine | 16620 San Pedro Ave, San Antonio, TX 78232-2327 | 2020-11-02 |
| 1255938866 | Bart Knight | Family Medicine | 106 Herweck Dr, San Antonio, TX 78213-3329 | 2020-10-06 |
| 1114530565 | Jacob C Reedy | Family Medicine | 525 Richmond Ave, San Antonio, TX 78215-2008 | 2020-08-26 |
| 1750992277 | Premier Tests LLC | Family Medicine | 410 E Wildwood, San Antonio, TX 78212-1758 | 2020-08-10 |
| 1770104457 | Bryanna Bermea Cantu | Family Medicine | 2318 San Pedro Ave Ste 12, San Antonio, TX 78212-1901 | 2020-05-04 |
| 1447886544 | Lets Look At Your Labs LLC | Family Medicine | 1603 Babcock Rd Ste 238-5, San Antonio, TX 78229-4708 | 2020-03-20 |
| 1609414937 | Lonestar Visiting Physicians LLC | Family Medicine | 406 Halliday Ave, San Antonio, TX 78210-4057 | 2019-12-17 |
| 1679126817 | Sarah Heather Martinez | Family Medicine | 15106 Oak Loft St, San Antonio, TX 78232-4617 | 2019-07-17 |
| 1659930634 | Villa Family Clinic, PC | Family Medicine | 2000 Se Loop 410 Ste 127a, San Antonio, TX 78220-4933 | 2019-06-12 |
| 1508327859 | South Texas Family Medicine and Urgent Care Center | Family Medicine | 3526 Galveston Trl, San Antonio, TX 78253-6219 | 2019-03-28 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78259 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.