CONVIVA MEDICAL CENTER MANAGEMENT OF TEXAS, PLLC
NPI 1972842664
Family Medicine in San Antonio, TX

NPI Status: Active since January 31, 2013

Contact Information

18414 US HIGHWAY 281 N STE 104
SAN ANTONIO, TX
ZIP 78259
Phone: (210) 495-0222
Fax: (210) 495-5914

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Group Taxonomy
Secondary Locations
Authorized Official
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Family Medicine
CLIA Number: 45D0509418
CLIA Cert. Type: Physician Office
CLIA Exp. Date: 05-10-2026

About CONVIVA MEDICAL CENTER MANAGEMENT OF TEXAS, PLLC

This page provides the complete NPI Profile along with additional information for Conviva Medical Center Management Of Texas, Pllc, a primary care provider established in San Antonio, Texas operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1972842664 assigned on January 2013. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated May 2025. Conviva Medical Center Management Of Texas, Pllc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's . The authorized official of this NPI record is Gioany Bacon-williams (Director, Provider Contracting)

NPI: 1972842664
Provider Legal Name: CONVIVA MEDICAL CENTER MANAGEMENT OF TEXAS, PLLC
Other Organization Name
Other Name Type: (6)
Entity Type: Organization
Location Address: 18414 US HIGHWAY 281 N STE 104 SAN ANTONIO, TX 78259
Location Phone: (210) 495-0222
Location Fax: (210) 495-5914
Mailing Address: 6101 BLUE LAGOON DR STE 400 MIAMI, FL 33126
Mailing Phone: (305) 500-2000
Is Sole Proprietor?: No
Is Organization Subpart?: Yes
Enumeration Date: 01-31-2013
Last Update Date: 05-20-2025
Code Navigator

A primary care provider (PCP) like Conviva Medical Center Management Of Texas, Pllc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Secondary Locations

917 S Port Ave
Corpus Christi, TX 78405
(361) 887-0584
1211B E Cliff Dr
El Paso, TX 79902
(915) 591-6226
10435 Vista Del Sol Dr
El Paso, TX 79925
(915) 591-6229
1314 Guadalupe St Ste 105
San Antonio, TX 78207
(210) 225-4810
9727 Poteet Jourdanton Fwy Ste 108
San Antonio, TX 78211
(210) 923-4372
4254 S Alameda St
Corpus Christi, TX 78412
(361) 853-4191
1209 Highway 35 N
Rockport, TX 78382
(361) 729-9811
1911 Rogers Rd
San Antonio, TX 78251
(210) 523-9933

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Family Medicine
Taxonomy Code: 207Q00000X
Type: Allopathic & Osteopathic Physicians
Taxonomy Description: 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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	208D00000X	Allopathic & Osteopathic Physicians	General Practice

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: GIOANY BACON-WILLIAMS
Authorized Official Title: DIRECTOR, PROVIDER CONTRACTING
Authorized Official Phone: (210) 608-2110

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number: 45D0509418
Facility Type: Physician Office
Certificate Effective Date: May 11, 2024
Certificate Expiration Date: May 10, 2026
Laboratory Director: CLYDE CLYBOURNE
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to Conviva Medical Center Management Of Texas, Pllc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	9	7	2	8	4	2	6	6	4
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	9	14	2	16	4	4	6	12
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 1 + 4 + 2 + 1 + 6 + 4 + 4 + 6 + 1 + 2 + 24 = 66
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 66 = 4									4

The NPI number 1972842664 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.