CONVIVA MEDICAL CENTER MANAGEMENT OF TEXAS, P.A. – NPI #1770988990
Internal Medicine

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CONVIVA MEDICAL CENTER MANAGEMENT OF TEXAS, P.A. is a provider located in LIVE OAK, TX. NPPES has assigned the NPI number 1770988990 to CONVIVA MEDICAL CENTER MANAGEMENT OF TEXAS, P.A. on October 30, 2014. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207R00000X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine.

The NPI profile was last updated on Jun 21, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CONVIVA MEDICAL CENTER MANAGEMENT OF TEXAS, P.A. below.

NPI Profile for
CONVIVA MEDICAL CENTER MANAGEMENT OF TEXAS, P.A.

NPI Number
1770988990
Enumeration Date

(more than 11 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CONVIVA MEDICAL CENTER MANAGEMENT OF TEXAS, P.A.
Primary location
12602 TOEPPERWEIN RD STE 100
LIVE OAK, TX 78233-3204
Phone: (210) 654-0030 Fax: (855) 278-4550
1 Other location(s):
12602 Toepperwein Rd Ste 100
Live Oak, TX 78233-3204
Phone: (210) 654-0030
Fax: (855) 278-4550
Mailing address
6101 BLUE LAGOON DR STE 200
MIAMI, FL 33126-3168
Phone: (305) 500-2000 Fax:
Organization Subpart
No
Authorized Official
JESSICA BONETTI
ASSOCIATE DIRECTOR
Phone: (786) 507-8556
Updated
Certification Date
Jun 21, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for CONVIVA MEDICAL CENTER MANAGEMENT OF TEXAS, P.A.

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidTX350315301
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207R00000X
- Internal Medicine (Primary)
261QP2300X
- Clinic/Center / Primary Care
208D00000X
- General Practice
207Q00000X
- Family Medicine

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.