Organization Active NPI

Mark M. Casillas, M.D., P.a.

Doing business as Foot and Ankle Center of South Texas

  • Orthopaedic Surgery Physician
  • San Antonio, TX
National Provider Identifier
1174772461
Registry record updated Dec 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
J1917 Issued in TX
Legal business name
MARK M. CASILLAS, M.D., P.A.
Doing business as
Foot and Ankle Center of South Texas
Practice address
414 Navarro St
Suite 1616
San Antonio, TX 78205-2516
Phone
(210) 224-2655
Fax
(866) 644-0889
NPI assigned
Sep 11, 2008
Last updated
Dec 2, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2009

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

Authorized official

Name
Ms. Michelle Fleming
Title
Office Manager
Phone
(210) 224-2655

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X J1917 TX Primary

Addresses

Primary practice location

414 Navarro St
Suite 1616
San Antonio, TX 78205-2516

Mailing address

414 Navarro St
Suite 1616
San Antonio, TX 78205-2516
Phone (210) 224-2655

Other identifiers 1

IdentifierTypeStateIssuer
1999781MedicaidTX

Other names 1

  • Foot and Ankle Center of South Texas Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

414 Navarro St
Ste 1616
San Antonio, TX 78205
Phone (210) 224-2655

Practitioners & affiliated clinicians

Practitioners 2

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": "1221091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259712000000",
    "number": "1174772461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 NAVARRO ST",
            "address_2": "SUITE 1616",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782052516",
            "telephone_number": "210-224-2655",
            "fax_number": "866-644-0889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 NAVARRO ST",
            "address_2": "SUITE 1616",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782052516",
            "telephone_number": "210-224-2655",
            "fax_number": "866-644-0889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK M. CASILLAS, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-11",
        "last_updated": "2009-12-02",
        "status": "A",
        "authorized_official_last_name": "FLEMING",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "210-224-2655",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "J1917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1999781",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foot and Ankle Center of South Texas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 2, 2009; 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.