Conviva Medical Center Management Of Texas, P.A.

LBN: Conviva Medical Center Management Of Texas, P.A.
Conviva Medical Center Management Of Texas, P.A. is an health care organization with primary practice located at 12602 Toepperwein Rd Ste 100 , Live Oak TX 78233-3204. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / General Practice, Ambulatory Health Care Facilities / Primary Care. Allopathic & Osteopathic Physicians / Internal Medicine is the primary health care specialty. Conviva Medical Center Management Of Texas, P.A. can be contacted via phone (210) 654-0030, or through Bonetti, Jessica via phone (786) 507-8556.

Contact Information

Primary practice address
12602 Toepperwein Rd Ste 100 Live Oak TX 78233-3204
Phone: (210) 654-0030
Fax: (855) 278-4550
Website:
Map and Directions
Authorized official contact:
Name: Bonetti, Jessica
Phone: (786) 507-8556

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X
Allopathic & Osteopathic Physicians / General Practice 208D00000X
Ambulatory Health Care Facilities / Primary Care 261QP2300X

Profile Details

NPI number 1770988990
LBN Legal business name Conviva Medical Center Management Of Texas, P.A.
DBA Doing business as
Authorized official Bonetti, Jessica
Entity Organization
Organization subpart 1 No
Enumeration date Oct 30th, 2014
Last updated Jun 21st, 2024 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770988990 NPPES
Texas MEDICAID 350315301

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