Individual provider Active NPI

Jose Reynaldo Carcamo Jr.

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1124629522
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1018465 Issued in TX
Practice address
8055 West Ave Ste 101
San Antonio, TX 78213-1842
Phone
(210) 542-3069
NPI assigned
Nov 3, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 1018465 TX Primary

Addresses

Primary practice location

8055 West Ave Ste 101
San Antonio, TX 78213-1842

Mailing address

1544 W Mistletoe Ave
San Antonio, TX 78201-5445
Phone (210) 542-3069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1018465TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hill Country ENT Multi-Specialty CurrentSince May 25, 2021 Accepting new patients
Mercy Wellness Clinic Alamo Ranch PLLC Multi-Specialty CurrentSince Nov 8, 2025 Accepting new patients

Locations

18568 Forty Six Pkwy
Ste 1001
Spring Branch, TX 78070
Phone (830) 438-9300

18568 Forty Six Pkwy
Ste 3001
Spring Branch, TX 78070
Phone (830) 438-9300

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1124629522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1544 W MISTLETOE AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782015445",
            "telephone_number": "210-542-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8055 WEST AVE STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131842",
            "telephone_number": "210-542-3069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARCAMO",
        "first_name": "JOSE",
        "middle_name": "REYNALDO",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-03",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "1018465",
            "primary": true
        }
    ],
    "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 Dec 4, 2025; 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.