Organization Active NPI

Leticia a Poret MD PA

  • Internal Medicine Physician
  • San Antonio, TX
National Provider Identifier
1114024478
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
H9289 Issued in TX
Legal business name
LETICIA A PORET MD PA
Practice address
4522 Fredericksburg Rd
Suite a 14
San Antonio, TX 78201-6521
Phone
(210) 733-3005
NPI assigned
Sep 20, 2006
Last updated
Jan 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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

Authorized official

Name
Dr. Leticia Ann Poret, MDNPI 1578763462
Title
Physician
Phone
(210) 733-3005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X H9289 TX Primary

Addresses

Primary practice location

4522 Fredericksburg Rd
Suite a 14
San Antonio, TX 78201-6521

Mailing address

12627 Stonehenge Dr
San Antonio, TX 78230-1941
Phone (210) 733-3005

Other identifiers 2

IdentifierTypeStateIssuer
0009QFOtherTXBC BS
00182UOtherTXMEDICARE

National Provider Directory

National Provider Directory

Locations

4522 Fredericksburg Rd
Ste A14
San Antonio, TX 78201
Phone (210) 733-3005

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200355200000",
    "number": "1114024478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12627 STONEHENGE DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782301941",
            "telephone_number": "210-733-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4522 FREDERICKSBURG RD",
            "address_2": "SUITE A 14",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782016521",
            "telephone_number": "210-733-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LETICIA A PORET MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-01-15",
        "status": "A",
        "authorized_official_last_name": "PORET",
        "authorized_official_first_name": "LETICIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "210-733-3005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "H9289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "0009QF",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "00182U",
            "state": "TX"
        }
    ],
    "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 Jan 15, 2008; 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.