Individual provider Active NPI

Elkin Suescun, MD

  • Internal Medicine Physician
  • San Antonio, TX
National Provider Identifier
1033349097
Registry record updated Jul 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D9682 Issued in TX
Practice address
2620 McCullough Ave
San Antonio, TX 78212
Phone
(210) 738-0800
Fax
(210) 737-9307
NPI assigned
Jul 23, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D9682 TX Primary

Addresses

Primary practice location

2620 McCullough Ave
San Antonio, TX 78212

Mailing address

2620 McCullough Ave
San Antonio, TX 78212
Phone (210) 738-0800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D9682TXMDInternal Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248307200000",
    "number": "1033349097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 MCCULLOUGH AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78212",
            "telephone_number": "210-738-0800",
            "fax_number": "210-737-9307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 MCCULLOUGH AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78212",
            "telephone_number": "210-738-0800",
            "fax_number": "210-737-9307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUESCUN",
        "first_name": "ELKIN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-23",
        "last_updated": "2009-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "D9682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.