Pediatric Ear, Nose & Throat Institute of South Texas

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

PEDIATRIC EAR, NOSE & THROAT INSTITUTE OF SOUTH TEXAS

Practice address

16723 Huebner Rd
San Antonio, TX 78248-2342

Phone

(210) 733-4368

Fax

(210) 402-3417

NPI assigned

Jun 2, 2005

Last updated

May 9, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Benjamin Salazar

Title

Office Administrator

Phone

(210) 733-4268

Specialties & licenses 1

Addresses

Other identifiers 3

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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 Arturo Bonilla, M.D.

  • Specialist
  • San Antonio, TX
  • NPI 1255331781
  NPD (past)
• Juan Alfredo Bonilla, M.D.

  • Pediatric Otolaryngology Physician
  • San Antonio, TX
  • NPI 1548260078

  Specialist

  NPD (past)
• Scott Duhaime, PA-C

  • Physician Assistant
  • San Antonio, TX
  • NPI 1386720951
  NPD (past)
• Roderick Donald Moe Jr., MD

  • Pediatric Otolaryngology Physician
  • San Antonio, TX
  • NPI 1982636742
  NPD (past)

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

{
    "created_epoch": "1117670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304899200000",
    "number": "1093719379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29749",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782290749",
            "telephone_number": "210-733-4368",
            "fax_number": "210-402-3417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16723 HUEBNER RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782482342",
            "telephone_number": "210-733-4368",
            "fax_number": "210-402-3417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC EAR, NOSE & THROAT INSTITUTE OF SOUTH TEXAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-02",
        "last_updated": "2011-05-09",
        "status": "A",
        "authorized_official_last_name": "SALAZAR",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "210-733-4268"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIDC GROUP",
            "identifier": "095065102",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "095065103",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID TIP #",
            "identifier": "095065101",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pedi Place at Westover Hills
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• Pediatric Anesthesia Consultants of San Antonio PLLC
• Pediatric Dentistry of San Antonio
• Pediatric Health Therapy, Inc
• Pediatric Heroes Primary Care Clinic, PLLC
• Pediatric Home Healthcare, LLC
• Pediatric Hospital Care Associates
• Pediatric Infectious Diseases Associates PA

• Specialist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.

Verify at the official NPI Registry.