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JACINTO MEDICAL GROUP P A NPI 1265474597


NPI Information

NPI: 1265474597
Provider Name: JACINTO MEDICAL GROUP P A
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 45D2003121

Address:
2800 GARTH RD
BAYTOWN, TX
ZIP 77521
Phone: (281) 425-3800
Get Directions

JACINTO MEDICAL GROUP P A is a family medicine in Baytown, TX. The provider is 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. JACINTO MEDICAL GROUP P A NPI is 1265474597. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2800 GARTH RD
BAYTOWN, TX
ZIP 77521-947
Phone: (281) 425-3800
Fax: (281) 425-3992

The provider's authorized official is Maggie Khan .
The authorized official title is Credentialing Coordinator and has the following contact phone number (281) 425-3844.

The CLIA number assigned to this NPI record is 45D2003121 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/12/2006 and was last updated on 2/13/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RG0100XInternal MedicineGastroenterology816738-03TEXASNo
2207R00000XInternal Medicine816738-03TEXASNo
3207Q00000XFamily Medicine816738-03TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100U80BOTHERTEXASBCBS
2U80BMEDICARE ID-TYPE UNSPECIFIEDTEXAS
36624010001MEDICARE NSCTEXAS
4085781501MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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