Individual provider Active NPI

David Fuentes, MD

  • Allergy Physician
  • Boerne, TX
National Provider Identifier
1013911544
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
J3309 Issued in TX
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

Updated by the provider on Sep 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
042756902MedicaidTX

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041222000630 TX Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 2860459245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Pediatric Medicine
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

LicenseStateTypeSpecialty
J3309TXMDAllergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
David Fuentes MD PA CurrentSince May 4, 2003 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.

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

Verify at the official NPI Registry.