Individual provider Active NPI

Omar A Zantua, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Houston, TX
National Provider Identifier
1083675359
Registry record updated Apr 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
M0614 Issued in TX
Practice address
8511 S Sam Houston Pkwy E
101
Houston, TX 77075-4857
Phone
(713) 343-2301
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X M0614 TX Primary

Addresses

Primary practice location

8511 S Sam Houston Pkwy E
101
Houston, TX 77075-4857

Mailing address

8511 S Sam Houston Pkwy E
101
Houston, TX 77075-4857
Phone (713) 343-2301

Other identifiers 1

IdentifierTypeStateIssuer
173870002MedicaidTX

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
I20050120000567 TX Practitioner - Geriatric MedicinePractitioner - Internal Medicine 8820047459 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CS Pacs 3 Southwest, LLCGroup PAC ID 1254879620, 23 clinicians

Practice addresses (Care Compare)

310 E Lawrence St
Dayton, TX 77535-1805
Phone (936) 258-7227

Hospital & facility affiliations

  • Wurzbach Nursing and Rehabilitation Nursing home, San Antonio, TX, CCN 455824
  • Mystic Park Nursing and Rehabilitation Center Nursing home, San Antonio, TX, CCN 676012
  • Silver Creek Nursing and Rehabilitation Nursing home, San Antonio, TX, CCN 455652
  • Patriot Heights Health Care Center Nursing home, San Antonio, TX, CCN 455969
  • Huebner Creek Health & Rehabilitation Center Nursing home, San Antonio, TX, CCN 676136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Pac Healthcare Services of Texas PLLC CurrentSince Sep 1, 2016 Accepting new patients
NV Pacs 2 LLC CurrentSince Jul 1, 2021 Accepting new patients
Lonestar Hospital Medicine Associates, PA CurrentSince Jun 1, 2016 Accepting new patients
CS Pacs 3 Southwest, LLC CurrentSince Sep 9, 2024 Accepting new patients
Medina County Hospital District Past Accepting new patients
West Wharton County Hospital District Past Accepting new patients
Geriatric Associates of America-Texas, PLLC Past Accepting new patients
Uvalde County Hospital Authority Past Accepting new patients
Caraday Wurzbach LLC Past Accepting new patients
West Wharton County Hospital District Past Accepting new patients

Locations

999 Raintree Cir
Allen, TX 75013
Phone (972) 390-8088

5800 W Baker Rd
Baytown, TX 77520
Phone (281) 424-4541

310 E Lawrence St
Dayton, TX 77535
Phone (936) 258-7227

5400 Clearfork Main St
Fort Worth, TX 76109
Phone (817) 433-7000

201 Sycamore School Rd
#R
Fort Worth, TX 76134
Phone (817) 293-7610

6301 Oakmont Blvd
Ft Worth, TX 76132
Phone (682) 250-4055

415 Indian Oaks Dr
Harker Hts, TX 76548
Phone (254) 699-5051

721 W Mulberry St
Holiday Lakes, TX 77515
Phone (979) 848-0279

2101 W Northgate Dr
Irving, TX 75062
Phone (972) 255-4460

208 S Utah St
La Porte, TX 77571
Phone (281) 471-1810

811 Garner Rd
Pasadena, TX 77502
Phone (713) 473-0687

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

6211 S New Braunfels Ave
#T
San Antonio, TX 78223
Phone (210) 531-0569

8300 Wurzbach Rd
San Antonio, TX 78229
Phone (210) 614-1040

4949 Ravenswood Dr
San Antonio, TX 78227
Phone (210) 568-5061

8026 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-8110

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

424 Tarpey Rd
#C
Texas City, TX 77591
Phone (409) 938-8431

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mystic Park Nursing and Rehabilitation CenterSan Antonio, TX, CCN 676012 Skilled nursing facility Operational/Managerial Control
Managing Control - Governing Body
Adp of the SNF
Jan 18, 2023
Jan 18, 2023
Jan 18, 2023
Wurzbach Nursing and RehabilitationSan Antonio, TX, CCN 455824 Skilled nursing facility Adp of the SNF Jan 1, 2006

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 10

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396569600000",
    "number": "1083675359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8511 S SAM HOUSTON PKWY E",
            "address_2": "101",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770754857",
            "telephone_number": "713-343-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8511 S SAM HOUSTON PKWY E",
            "address_2": "101",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770754857",
            "telephone_number": "713-343-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZANTUA",
        "first_name": "OMAR",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2014-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "M0614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173870002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.