Endormir Surgical PLLC

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

N3480 Issued in TX

Legal business name

ENDORMIR SURGICAL PLLC

Practice address

555 E Basse Rd
Suite 201
San Antonio, TX 78209-8353

Phone

(210) 468-5426

Fax

(210) 468-3282

NPI assigned

Apr 21, 2014

Organization subpart

No

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

Authorized official

Name

Jose Barrera, MDNPI 1619966686

Title

President

Phone

(210) 468-5426

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Tax ID family

Endormir Surgical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Endormir Surgical, PLLC

  • General Acute Care Hospital
  • Humble, TX
  • NPI 1003183039
  NPD tax ID

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jose Enrique Barrera, M.D., F.A.C.S.

  • Facial Plastic Surgery Physician
  • San Antonio, TX
  • NPI 1619966686

  Single Specialty

  Medicare reassignment NPD Authorized official
• Nici Eddy Bothwell, MD

  • Sleep Medicine (Otolaryngology) Physician
  • San Antonio, TX
  • NPI 1033195417
  Medicare reassignment NPD
• Jeanie Sozansky Lujan, M.D.

  • Otolaryngology Physician
  • San Antonio, TX
  • NPI 1962896977

  Facial Plastic Surgery

  Medicare reassignment NPD
• Derrick Cripps Gale, M.D.

  • Otolaryngology Physician
  • Riverton, UT
  • NPI 1548695729
  NPD (past)

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398038400000",
    "number": "1083034862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 E BASSE RD",
            "address_2": "SUITE 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782098353",
            "telephone_number": "210-468-5426",
            "fax_number": "210-468-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 E BASSE RD",
            "address_2": "SUITE 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782098353",
            "telephone_number": "210-468-5426",
            "fax_number": "210-468-3282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDORMIR SURGICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-21",
        "last_updated": "2014-04-21",
        "status": "A",
        "authorized_official_last_name": "BARRERA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-468-5426",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207YS0012X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "TX",
            "license": "N3480",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "TX",
            "license": "N3480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Facial Plastic Surgery Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Facial Plastic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.