LYTLE FAMILY PRACTICE PA
NPI 1790870327
Family Medicine in Lytle, TX
About Lytle Family Practice Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LYTLE FAMILY PRACTICE PA (NPI 1790870327) is a healthcare organization registered as a family medicine in Lytle, Texas and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through October 28, 2027 and lists Glendon Saldivar Hack, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Lytle Family Practice Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Lytle Family Practice PA, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 45D0992887
Lytle Family Practice · Lytle, 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 Lytle Family Practice PA's NPI number?
The NPI number for Lytle Family Practice PA is 1790870327. It was assigned to this organization in the NPPES registry on October 3, 2006.
Where is Lytle Family Practice PA located?
Lytle Family Practice PA is located at 19432 Davis St, Lytle, TX 78052. The listed phone number is (830) 709-9960.
What is Lytle Family Practice PA's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Lytle Family Practice PA enrolled in Medicare?
Yes. Lytle Family Practice PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Lytle Family Practice PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Lytle Family Practice PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Lytle Family Practice PA hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 45D0992887) is associated with this NPI, valid through October 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Lytle Family Practice PA was last updated on August 22, 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.
# Lytle Family Practice Pa · NPI 1790870327
Family Medicine organization in Lytle, Texas. Organization record, active in the CMS NPPES registry since October 3, 2006.
## Identity
- **NPI:** 1790870327 (Entity type: Organization)
- **Enumerated:** October 3, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Glendon Hack, PRESIDENT
## Practice location
- **Address:** 19432 DAVIS ST, Lytle, TX 78052-1601
- **Phone:** (830) 709-9960
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 22, 2020
- **Other identifiers:** Other 0057NC (TX)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1790870327) · Data from the CMS NPPES public registry.