Individual provider Active NPI

Gabriela Ivonne Vazquez Santos, M.D.

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1184065815
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
Q8176 Issued in TX
Practice address
2833 Babcock Rd Ste 203
San Antonio, TX 78229-4894
Phone
(210) 705-5100
NPI assigned
Jul 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Q8176 TX Primary

Addresses

Primary practice location

2833 Babcock Rd Ste 203
San Antonio, TX 78229-4894

Mailing address

919 Hidden RDG
Irving, TX 75038-3813
Phone (469) 282-2711

Other practice location 1

4640 9th Ave Ste 100
Port Arthur, TX 77642-5820
Phone (409) 982-6461

Other identifiers 3

IdentifierTypeStateIssuer
P02601737OtherTXMCRR
363041001MedicaidTX
636041003MedicaidTX

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
I20160820000129 TX Practitioner - Family Practice 5698060358 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
C H Wilkinson Physician Network Family Medicine CurrentSince Mar 3, 2018 Accepting new patients
C H Wilkinson Physician Network CurrentSince Mar 3, 2018 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jan 1, 2021 Accepting new patients
Christus Trinity Clinic Texas Family Medicine CurrentSince Jan 1, 2021 Accepting new patients

Locations

3030 North St
Ste 420
Beaumont, TX 77702
Phone (409) 835-2900

5875 N Major Dr
Beaumont, TX 77713
Phone (409) 892-2262

919 Hidden Rdg
Irving, TX 75038

1276 S Peachtree St
Jasper, TX 75951
Phone (409) 384-5701

4640 9th Ave
Ste 100
Port Arthur, TX 77642
Phone (409) 982-6461

2833 Babcock Rd
Ste 203
San Antonio, TX 78229
Phone (210) 267-1709

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: gvazquezsantos242841@christushealth.direct-ci.net
  • FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4

Organizations & group practices 4

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": "1373414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1184065815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 HIDDEN RDG",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750383813",
            "telephone_number": "469-282-2711",
            "fax_number": "469-282-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2833 BABCOCK RD STE 203",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294894",
            "telephone_number": "210-705-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4640 9th Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Port Arthur",
            "state": "TX",
            "postal_code": "776425820",
            "country_code": "US",
            "telephone_number": "409-982-6461",
            "fax_number": "409-983-7461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAZQUEZ SANTOS",
        "first_name": "GABRIELA",
        "middle_name": "IVONNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-10",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q8176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCRR",
            "identifier": "P02601737",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363041001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "636041003",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.