Active NPI
David Fuentes, MD
- Allergy Physician
- Boerne, TX
National Provider Identifier
1013911544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy Physician
- License
- J3309
- Practice address
- 1420 River Rd Ste 300
Boerne, TX 78006-1995 - Phone
- (830) 249-0633
- Fax
- (830) 249-0622
- NPI assigned
- Jun 13, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy Physician | 207KA0200X | J3309 | TX | Primary |
Addresses
Primary practice location
1420 River Rd Ste 300
Boerne, TX 78006-1995
Mailing address
1420 River Rd Ste 300
Boerne, TX 78006-1995
Phone (830) 249-0633
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 042756902 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041222000630 | TX | Practitioner - Allergy/Immunology | 2860459245 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Allergy/Immunology
- Education
- University of Texas Medical School at San Antonio, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1420 River Rd
Suite 300
Boerne, TX 78006-1995
Phone (830) 249-0633
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| J3309 | TX | MD | Allergy Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David Fuentes MD PA | Current | Accepting new patients | |
| Allergy and Immunology Specialists of Corpus Christi, PA | Past | Accepting new patients |
Locations
109 Falls Ct
Ste 100
Boerne, TX 78006
Phone (210) 495-5771
1420 River Rd
Ste 300
Boerne, TX 78006
Phone (830) 249-0633
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Medical Specialty Clinic/Center
- Corpus Christi, TX
- NPI 1013947720
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759104000000",
"number": "1013911544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1420 RIVER RD STE 300",
"city": "BOERNE",
"state": "TX",
"postal_code": "780061995",
"telephone_number": "830-249-0633",
"fax_number": "830-249-0622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1420 RIVER RD STE 300",
"city": "BOERNE",
"state": "TX",
"postal_code": "780061995",
"telephone_number": "830-249-0633",
"fax_number": "830-249-0622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUENTES",
"first_name": "DAVID",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-13",
"last_updated": "2025-09-29",
"certification_date": "2025-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "207KA0200X",
"taxonomy_group": "",
"desc": "Allergy & Immunology, Allergy",
"state": "TX",
"license": "J3309",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "042756902",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Boerne, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.