Organization Active NPI

South Texas Orthopedic Specialty Group, PLLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • San Antonio, TX
National Provider Identifier
1114290624
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
Legal business name
SOUTH TEXAS ORTHOPEDIC SPECIALTY GROUP, PLLC
Practice address
10010 Rogers Xing Ste 308
San Antonio, TX 78251-4776
Phone
(210) 598-5605
Fax
(210) 598-5620
NPI assigned
Feb 14, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Authorized official

Name
Dr. Dmitry Tuder, M.D.
Title
Authorized Official
Phone
(210) 598-5605

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0106X
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0005X Primary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

10010 Rogers Xing Ste 308
San Antonio, TX 78251-4776

Mailing address

10010 Rogers Xing Ste 308
San Antonio, TX 78251-4776
Phone (210) 598-5605

National Provider Directory

National Provider Directory

Locations

7500 Barlite Blvd
Ste 311
San Antonio, TX 78224
Phone (210) 598-5605

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1329177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641340800000",
    "number": "1114290624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10010 ROGERS XING STE 308",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782514776",
            "telephone_number": "210-598-5605",
            "fax_number": "210-598-5620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 ROGERS XING STE 308",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782514776",
            "telephone_number": "210-598-5605",
            "fax_number": "210-598-5620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH TEXAS ORTHOPEDIC SPECIALTY GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-14",
        "last_updated": "2022-01-05",
        "certification_date": "2021-09-07",
        "status": "A",
        "authorized_official_last_name": "TUDER",
        "authorized_official_first_name": "DMITRY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "210-598-5605",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 5, 2022; 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.