San Antonio Internal Medicine Physicians, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SAN ANTONIO INTERNAL MEDICINE PHYSICIANS, PLLC

Practice address

1303 McCullough Ave
Suite #560
San Antonio, TX 78212-5609

Phone

(210) 223-9617

Fax

(210) 568-1910

NPI assigned

Jun 21, 2010

Organization subpart

No

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

Authorized official

Name

Roberta Cloud

Title

Vice President

Phone

(210) 575-8501

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311206400000",
    "number": "1184945446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 MCCULLOUGH AVE",
            "address_2": "SUITE #560",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782125609",
            "telephone_number": "210-223-9617",
            "fax_number": "210-568-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 MCCULLOUGH AVE",
            "address_2": "SUITE #560",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782125609",
            "telephone_number": "210-223-9617",
            "fax_number": "210-568-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANTONIO INTERNAL MEDICINE PHYSICIANS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-21",
        "last_updated": "2011-07-21",
        "status": "A",
        "authorized_official_last_name": "CLOUD",
        "authorized_official_first_name": "ROBERTA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "210-575-8501"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0033TQ",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2167660-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2011; 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.