San Marcos Diagnostics PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SAN MARCOS DIAGNOSTICS PA

Practice address

1305 Wonder World Dr Ste 206
San Marcos, TX 78666-7540

Phone

(512) 396-1525

NPI assigned

Oct 5, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Grayson Keith Smith, M.D.

Title

President

Phone

(512) 396-1525

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447718400000",
    "number": "1235327073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 WONDER WORLD DR STE 206",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 WONDER WORLD DR STE 206",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667540",
            "telephone_number": "512-396-1525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN MARCOS DIAGNOSTICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2015-11-17",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "GRAYSON",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-396-1525",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0032MD",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170927101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• San Marcos Anesthesiology, LLP
• San Marcos ASC LLC
• San Marcos Cisd
• San Marcos Cisd
• San Marcos Dental and Braces PLLC
• San Marcos DSG PLLC
• San Marcos Ear Nose & Throat Association
• San Marcos Family Medicine
• San Marcos Gentle Dental, PLLC
• San Marcos Medical Imaging PLLC

• Internal Medicine Physician in San Marcos, TX
• Providers in San Marcos, 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 Nov 17, 2015; 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.