Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Conviva Medical Center Management of Texas, PA

Organization Family Medicine Physician · NPI 1770988990

Conviva Medical Center Management of Texas, PA is a Family Medicine Physician in Live Oak, Texas. Works from 2 locations. Registered with an NPI since 2014.

In the registry since
2014
Specialties on file
4
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12602 Toepperwein Rd Ste 100
Live Oak, TX 78233-3204
Phone: (210) 654-0030
Fax: (855) 278-4550
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 12602 Toepperwein Rd Ste 100, Live Oak, TX 78233-3204 — (210) 654-0030

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Family Medicine Physician Taxonomy 207Q00000X
General Practice Physician Taxonomy 208D00000X
Primary Care Clinic/Center Taxonomy 261QP2300X

Record details

NPI number1770988990
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jessica Bonetti — Associate Director · (786) 507-8556
NPI enumeratedOctober 30, 2014
Last updated in NPPESJune 21, 2024
Certification dateJune 21, 2024
Mailing address6101 Blue Lagoon Dr Ste 200, Miami, FL 33126-3168

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