Individual provider Active NPI

Stephanie Eyestone, MD

  • General Practice Physician
  • San Antonio, TX
National Provider Identifier
1184007833
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
R4835 Issued in TX
Practice address
6711 S New Braunfels Ave
San Antonio, TX 78223-3005
Phone
(210) 860-2208
NPI assigned
Jun 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X R4835 TX Primary

Addresses

Primary practice location

6711 S New Braunfels Ave
San Antonio, TX 78223-3005

Mailing address

6711 S New Braunfels Ave Ste 500
San Antonio, TX 78223-3004
Phone (210) 860-2208

Other identifiers 1

IdentifierTypeStateIssuer
3821316-01MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180213000234 TX Practitioner - General Practice 9638483860 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Health and Human Services Commission General Practice Current Accepting new patients
United Medical Centers General Practice CurrentSince Jan 8, 2018 Accepting new patients
Health and Human Services Commission CurrentSince Nov 12, 2020 Accepting new patients
United Medical Centers CurrentSince Jan 8, 2018 Accepting new patients
Health and Human Services Commission CurrentSince Nov 12, 2020 Accepting new patients

Locations

2501 Maple St
Abilene, TX 79602
Phone (325) 692-4053

4001 Highway 36 S
Brenham, TX 77833
Phone (979) 277-1327

913 S Main St
Del Rio, TX 78840
Phone (830) 774-5534

2525 N Veterans Blvd
Eagle Pass, TX 78852
Phone (830) 773-5358

6711 S New Braunfels Ave
Ste 500
San Antonio, TX 78223
Phone (210) 531-3743

Organizations & group practices 5

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": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1184007833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6711 S NEW BRAUNFELS AVE STE 500",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782233004",
            "telephone_number": "210-860-2208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6711 S NEW BRAUNFELS AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782233005",
            "telephone_number": "210-860-2208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EYESTONE",
        "first_name": "STEPHANIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-30",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "R4835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3821316-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.