Pegasus Pediatrics PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

M9015 Issued in TX

Legal business name

PEGASUS PEDIATRICS PA

Practice address

6406 N New Braunfels Ave
San Antonio, TX 78209-3827

Phone

(215) 584-5780

Fax

(516) 214-8751

NPI assigned

Jan 23, 2010

Last updated

Jan 23, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Benjamin Lightfoot Smith, MDNPI 1376739631

Title

President

Phone

(215) 584-5780

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Benjamin Lightfoot Smith, MD

  • Pediatrics Physician
  • San Antonio, TX
  • NPI 1376739631
  NPD (past) Authorized official

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

{
    "created_epoch": "1264204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264204800000",
    "number": "1215268776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 THOUSAND OAKS DR",
            "address_2": "#165",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782324108",
            "telephone_number": "210-912-8395",
            "fax_number": "516-214-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6406 N NEW BRAUNFELS AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782093827",
            "telephone_number": "215-584-5780",
            "fax_number": "516-214-8751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEGASUS PEDIATRICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-23",
        "last_updated": "2010-01-23",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "LIGHTFOOT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-584-5780",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M9015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanna Kay Peelgren, LSA
• Amy B Peeples, LCSW
• Lane Allen Peery, MD
• Travis Wayne Peery, MD
• Alan L Peet, DDS
• Pegha Karimi DDS PC
• Kiara Pegues
• Collin Eugene Pehde, D.P.M.
• Charles Andrew Peirce, M.D.
• Hamid Pejman, D.C.

• Pediatrics Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2010; 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.