Active NPI
Leticia a Poret MD PA
- Internal Medicine Physician
- San Antonio, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- H9289
- 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, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Leticia Ann Poret, MD
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0009QF | Other | TX | BC BS |
| 00182U | Other | TX | MEDICARE |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Internal Medicine Physician
- San Antonio, TX
- NPI 1578763462
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.