Individual provider Active NPI

Myriam Soraya Barragan, M.D.

  • Pediatric Gastroenterology Physician
  • San Antonio, TX
National Provider Identifier
1205062189
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
Q4363 Issued in TX
Practice address
903 W Martin St
San Antonio, TX 78207
Phone
(210) 358-5467
NPI assigned
Jun 4, 2009
Last updated
Nov 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X Q4363 TX Primary
Pediatric Gastroenterology Physician 2080P0206X ME136162 FL

Addresses

Primary practice location

903 W Martin St
San Antonio, TX 78207

Mailing address

903 W Martin St
San Antonio, TX 78207-0903
Phone (210) 358-5467

Other practice location 1

8331 N Davis Hwy
Pensacola, FL 32514
Phone (850) 505-4700

Other practice location 2

1 Baylor Plz
Houston, TX 77030-3411
Phone (832) 824-1000

Other identifiers 1

IdentifierTypeStateIssuer
346875303MedicaidTX

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
I20190925000858 TX Practitioner - GastroenterologyPractitioner - Pediatric Medicine 6608122346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Pediatric Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

903 W Martin St
San Antonio, TX 78207-0903
Phone (210) 358-3400

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME136162FLMDPediatric Gastroenterology Physician
Q4363TXMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Health Science Center at San Antonio CurrentSince Nov 1, 2019 Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Nov 1, 2019 Accepting new patients
The Nemours Foundation Past Accepting new patients
Bexar County Hospital District Past Accepting new patients

Locations

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

903 W Martin St
San Antonio, TX 78207
Phone (210) 358-3400

Interoperability endpoints

  • Direct secure messaging: mbarragan30233@direct.utmsa.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1205062189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 W MARTIN ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782070903",
            "telephone_number": "210-358-5467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 W MARTIN ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78207",
            "telephone_number": "210-358-5467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8331 N Davis Hwy",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "32514",
            "country_code": "US",
            "telephone_number": "850-505-4700",
            "fax_number": "850-505-4711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Baylor Plz",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770303411",
            "country_code": "US",
            "telephone_number": "832-824-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARRAGAN",
        "first_name": "MYRIAM",
        "middle_name": "SORAYA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-04",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "TX",
            "license": "Q4363",
            "primary": true
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "FL",
            "license": "ME136162",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "346875303",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.