San Antonio Internal Medicine Physicians, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SAN ANTONIO INTERNAL MEDICINE PHYSICIANS, PLLC

Practice address

12702 Ih 35 N
San Antonio, TX 78233-2609

Phone

(210) 650-9669

Fax

(210) 650-0750

NPI assigned

Apr 13, 2011

Organization subpart

No

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

Authorized official

Name

Roberta S Cloud

Title

Vice President

Phone

(210) 575-8501

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Northeast Internal Medical Associates Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1302652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311724800000",
    "number": "1245520089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8109 FREDERICKSBURG RD",
            "address_2": "PHYSICIAN PRACTICE SERVICES",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293311",
            "telephone_number": "210-575-8501",
            "fax_number": "210-575-0167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12702 IH 35 N",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782332609",
            "telephone_number": "210-650-9669",
            "fax_number": "210-650-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANTONIO INTERNAL MEDICINE PHYSICIANS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-13",
        "last_updated": "2011-07-27",
        "status": "A",
        "authorized_official_last_name": "CLOUD",
        "authorized_official_first_name": "ROBERTA",
        "authorized_official_middle_name": "S",
        "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": "0098WM",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2167660-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northeast Internal Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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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 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.