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PRIMARY CARE OF EAGLE PASS PLLC
NPI 1043901788
Family Medicine in Eagle Pass, TX

Active since May 15, 2023CLIA 45D2283059 · Waiver
1975 N VETERANS BLVD STE 9, EAGLE PASS, TX 78852(830) 213-8186(830) 213-8157 Get Directions Write a Review

NPPES record last updated: September 26, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 6, 2023, May 15, 2023 (2 updates tracked since 2023).

About Primary Care Of Eagle Pass Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRIMARY CARE OF EAGLE PASS PLLC (NPI 1043901788) is a healthcare organization registered as a family medicine in Eagle Pass, Texas and active in the NPI registry since May 2023. The organization holds a CLIA Waiver certificate valid through May 30, 2027 and lists David W Chisum, Sole Member, as its authorized official.

NPPES Registry Identity

NPI1043901788
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePRIMARY CARE OF EAGLE PASS PLLC
Location Address1975 N VETERANS BLVD STE 9Eagle Pass, TX 78852-4456
Mailing Address1975 N Veterans Blvd Ste 9Eagle Pass, TX 78852-4456 · (830) 213-8186 · Fax (830) 213-8157
Phone(830) 213-8186
Fax(830) 213-8157
Organization SubpartNo
Authorized OfficialDavid W ChisumSole Member · (830) 213-8186
Enumeration DateMay 15, 2023
Last NPPES UpdateSeptember 26, 20232 updates tracked since enumeration
NPPES CertifiedSeptember 26, 2023
✔ NPI 1043901788 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition

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.

1975 N VETERANS BLVD STE 9, Eagle Pass, TX 78852
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2283059

Primary Care Of Eagle Pass PLLC · Eagle Pass, TX
Active · expires May 30, 2027
CLIA Number45D2283059
Laboratory TypePhysician Office
Certificate Effective DateMay 31, 2025
Certificate Expiration DateMay 30, 2027
Laboratory DirectorDavid Chisum
Laboratory Phone(956) 526-6500
Laboratory LocationPrimary Care Of Eagle Pass PLLC2268 El Indio Hwy, Suite E, Eagle Pass, TX 78852
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAVID WESTLY CHISUM MD
Family Medicine
1975 N VETERANS BLVD STE 9
EAGLE PASS, TX 78852
Maverick County (830) 213-8186

Frequently Asked Questions

What is PRIMARY CARE OF EAGLE PASS PLLC's NPI number?

The NPI number assigned to this healthcare provider is 1043901788, enumerated as an "organization" on May 15, 2023.

Where is the provider located?

The provider is located at 1975 N VETERANS BLVD STE 9 EAGLE PASS, TX 78852 and the phone number is (830) 213-8186.

What is the provider's specialty?

Family Medicine with taxonomy code 207Q00000X.