Active NPI
Pedidocs PLLC
- Pediatrics Physician
- San Antonio, TX
National Provider Identifier
1164445516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- Legal business name
- PEDIDOCS PLLC
- Practice address
- 9838 Westover Hills Blvd
San Antonio, TX 78251 - Phone
- (210) 733-4362
- Fax
- (210) 521-1517
- NPI assigned
- Jul 26, 2006
- 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
- Amanda Gollehon
- Title
- Admin Assistant
- Phone
- (210) 733-4362
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | |||
| Pediatrics Physician | 208000000X | Primary |
Addresses
Primary practice location
9838 Westover Hills Blvd
San Antonio, TX 78251
Mailing address
9838 Westover Hills Blvd
San Antonio, TX 78251
Phone (210) 733-4362
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 182628101 | Medicaid | TX |
National Provider Directory
National Provider DirectoryLocations
9838 Westover Hills Blvd
San Antonio, TX 78251
Phone (210) 495-7334
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pediatrics Physician
- San Antonio, TX
- NPI 1396768743
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1619568000000",
"number": "1164445516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9838 WESTOVER HILLS BLVD",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78251",
"telephone_number": "210-733-4362",
"fax_number": "210-521-1517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9838 WESTOVER HILLS BLVD",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78251",
"telephone_number": "210-733-4362",
"fax_number": "210-521-1517"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEDIDOCS PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-26",
"last_updated": "2021-04-28",
"certification_date": "2021-04-28",
"status": "A",
"authorized_official_last_name": "GOLLEHON",
"authorized_official_first_name": "AMANDA",
"authorized_official_title_or_position": "ADMIN ASSISTANT",
"authorized_official_telephone_number": "210-733-4362"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "182628101",
"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 Apr 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.