MCCI OF TEXAS PRIMARY CARE GROUP, PLLC (NPI# 1891269098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891269098 |
| Entity Type | Organization |
| Organization Name | MCCI OF TEXAS PRIMARY CARE GROUP, PLLC |
| Other Organization Name | CONVIVA CARE CENTER |
| Practice Address |
4254 S Alameda St Corpus Christi TX 78412-2469 |
| Mailing Address |
6101 Blue Lagoon Dr Ste 400 Miami FL 33126-2051 |
| Practice Telephone | 3618534191 |
| Practice Fax Number | 3618538768 |
| Mailing Telephone | 3055002000 |
| Enumeration Date | 2019-01-22 |
| 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 | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Conviva Care Center | Doing Business As Name - Organization |
| Street Address |
4254 S ALAMEDA ST |
| City | CORPUS CHRISTI |
| State | TX |
| Zip Code | 78412-2469 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700885225 | Stephen H. Barth | Family Medicine | 4254 S Alameda St, Corpus Christi, TX 78412-2469 | 2005-07-18 |
| 1962947242 | Dalailah Reyna De La Rosa | Nurse Practitioner | 4254 S Alameda St, Corpus Christi, TX 78412-2469 | 2016-12-22 |
| 1619314879 | Margo L. Gonzalez-hussey | Nurse Practitioner | 4254 S Alameda St, Corpus Christi, TX 78412-2469 | 2013-05-29 |
| 1336438878 | Eric Lee Madarang | Emergency Medicine | 4254 S Alameda St, Corpus Christi, TX 78412 | 2011-04-05 |
| 1174566590 | Veena Kommera Reddy | Internal Medicine | 4254 S Alameda St, Corpus Christi, TX 78412-2469 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063029775 | Cuong Cao | Pharmacist | 1301 Airline Rd, Corpus Christi, Corpus Christi, TX 78412 | 2020-09-26 |
| 1427512995 | Joshni John | Specialist/Technologist | 6500 Ocean Drive, Corpus Christi, TX 78412 | 2019-01-29 |
| 1881193183 | Southside Specialty Surgical Center LLC | Clinic/Center | 6005 Holly Rd, Corpus Christi, TX 78412 | 2018-02-02 |
| 1689181919 | Avacorte Home Health | Home Health | 5206 Mill Wood Dr, Corpus Christi, TX 78412 | 2018-01-09 |
| 1215458245 | Ashley Kerr | Dentist | 6500 S.p.i.d., Ste 12, Corpus Christi, TX 78412 | 2017-06-29 |
| 1285155242 | Adan Lorenzo Narvaez | Physical Therapist | 2033 Airline Rd Ste E7, Corpus Christi, TX 78412 | 2017-06-29 |
| 1467992784 | Harrison Aj Hall | Prevention Professional | 2006 Airline Rd Apt 516, Corpus Christi, TX 78412 | 2017-03-06 |
| 1922468156 | Coastal Er Iv LLC | Clinic/Center | 7750 South Padre Island Drive, Corpus Christi, TX 78412 | 2016-03-01 |
| 1508282823 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 7798 S. Padre Island Drive, Corpus Christi, TX 78412 | 2014-03-11 |
| 1215362553 | Michael Anthony Flores | Nurse Practitioner | 7101 S Pade Island, Corpus Christi, TX 78412 | 2013-09-05 |
| Find all providers in zip 78412 | ||||
| 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 |
|---|---|---|---|---|
| 1134737158 | Christopher Lawrence Dematt | Family Medicine | 14254 S Padre Island Dr, Corpus Christi, TX 78418-6277 | 2020-07-15 |
| 1487216032 | Robert W. Galbreath | Family Medicine | 3515 S Alameda St, Corpus Christi, TX 78411 | 2019-07-03 |
| 1669997953 | Keeps Medical Group, P.a. | Family Medicine | 13715 Hillwood Trl, Corpus Christi, TX 78410-4802 | 2017-08-07 |
| 1407376429 | Jessica L Six | Family Medicine | 1025 Morgan Ave, Corpus Christi, TX 78404-2041 | 2017-06-21 |
| 1568829778 | Salang Health Solutions LLC | Family Medicine | 4833 S Staples St Unit B, Corpus Christi, TX 78411-2609 | 2016-01-19 |
| 1124401088 | Jonathan Dancel | Family Medicine | 7218 S Padre Island Dr, Apt 38c, Corpus Christi, TX 78412-4332 | 2015-07-09 |
| 1114314119 | Shery Malaty | Family Medicine | 2606 Hospital Blvd 5 West, Corpus Christi, TX 78405 | 2015-04-17 |
| 1437400058 | Physicians Express Pllc | Family Medicine | 4929 Burney Dr Ste 120, Corpus Christi, TX 78411-2708 | 2012-09-21 |
| 1740557552 | Myriah Willborn | Family Medicine | 5802 Saratoga Blvd Ste 150, Corpus Christi, TX 78414-4254 | 2011-11-22 |
| 1639408974 | Coastal Bend Primary Care Corp | Family Medicine | 4621 S Staples, Suite A, Corpus Christi, TX 78411-2605 | 2009-12-16 |
| Find all providers in CORPUS CHRISTI | ||||
| City | CORPUS CHRISTI |
| Zip Code | 78412 |
Please comment or provide details below to improve the information on MCCI OF TEXAS PRIMARY CARE GROUP, PLLC.
| 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.