Individual provider Active NPI

Jacqueline Ann Pugh, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • San Antonio, TX
National Provider Identifier
1235233842
Registry record updated Mar 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
F9981 Issued in TX
Practice address
7863 Callaghan Rd
Suite 206
San Antonio, TX 78229-2453
Phone
(832) 237-3500
Fax
(832) 237-0200
NPI assigned
Sep 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X F9981 TX
Endocrinology, Diabetes & Metabolism Physician 207RE0101X F9981 TX Primary

Addresses

Primary practice location

7863 Callaghan Rd
Suite 206
San Antonio, TX 78229-2453

Mailing address

11321 Fallbrook Dr
Houston, TX 77065-4232
Phone (832) 237-3500

Other identifiers 1

IdentifierTypeStateIssuer
044130502MedicaidTX

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
I20141031002191 TX Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4688751738

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F9981TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dcoa Physician Associates PA Endocrinology, Diabetes & Metabolism Past Accepting new patients
Dcoa Physicians PA Endocrinology, Diabetes & Metabolism Past Accepting new patients

Organizations & group practices 2

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": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238371200000",
    "number": "1235233842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11321 FALLBROOK DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770654232",
            "telephone_number": "832-237-3500",
            "fax_number": "832-237-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7863 CALLAGHAN RD",
            "address_2": "SUITE 206",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782292453",
            "telephone_number": "832-237-3500",
            "fax_number": "832-237-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGH",
        "first_name": "JACQUELINE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-12",
        "last_updated": "2009-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "F9981",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TX",
            "license": "F9981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044130502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.