WAVERLY PRIMARY CARE, PLLC
NPI 1215557715
Nurse Practitioner - Family in New Waverly, TX
About Waverly Primary Care, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WAVERLY PRIMARY CARE, PLLC (NPI 1215557715) is a healthcare organization registered as a family in New Waverly, Texas and active in the NPI registry since April 2020. The organization holds a CLIA Waiver certificate valid through July 21, 2028 and lists Kristina Mata, Owner, Authorized Official, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
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 45D2188789
Waverly Primary Care, PLLC · New Waverly, TXFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Waverly Primary Care, PLLC's NPI number?
The NPI number for Waverly Primary Care, PLLC is 1215557715. It was assigned to this organization in the NPPES registry on April 24, 2020.
Where is Waverly Primary Care, PLLC located?
Waverly Primary Care, PLLC is located at 9329 State Hwy 75, New Waverly, TX 77358. The listed phone number is (936) 284-2055.
What is Waverly Primary Care, PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Does Waverly Primary Care, PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 45D2188789) is associated with this NPI, valid through July 21, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Waverly Primary Care, PLLC accept?
Health plans from Blue Cross and Blue Shield of Texas list Waverly Primary Care, PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Waverly Primary Care, PLLC was last updated on April 24, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Waverly Primary Care, Pllc · NPI 1215557715
Family organization in New Waverly, Texas. Organization record, active in the CMS NPPES registry since April 24, 2020.
## Identity
- **NPI:** 1215557715 (Entity type: Organization)
- **Enumerated:** April 24, 2020
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Kristina Mata, OWNER, AUTHORIZED OFFICIAL
## Practice location
- **Address:** 9329 STATE HWY 75, New Waverly, TX 77358
- **Phone:** (936) 284-2055
## Record status
- **NPPES last updated:** April 24, 2020
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1215557715) · Data from the CMS NPPES public registry.