David Fuentes MD PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

J3309

Legal business name

DAVID FUENTES MD PA

Practice address

109 Falls CT Ste 100
Boerne, TX 78006-2978

Phone

(830) 249-0633

Fax

(830) 249-0622

NPI assigned

Oct 24, 2007

Organization subpart

No

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

Authorized official

Name

Jane Shepard

Title

Practice Manager

Phone

(830) 249-0633

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Allergy & Asthma Center of Boerne Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Fuentes, MD

  • Allergy Physician
  • Boerne, TX
  • NPI 1013911544
  Medicare reassignment NPD

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340064000000",
    "number": "1265611420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 FALLS CT STE 100",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780062978",
            "telephone_number": "830-249-0633",
            "fax_number": "830-249-0622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 FALLS CT STE 100",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780062978",
            "telephone_number": "830-249-0633",
            "fax_number": "830-249-0622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID FUENTES MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2012-06-19",
        "status": "A",
        "authorized_official_last_name": "SHEPARD",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "830-249-0633"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": "J3309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159054901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allergy & Asthma Center of Boerne",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Abiola Dairo
• Desiree Daniel, LPC
• Felicia Mae Danner
• Aditya Dave
• Peggy Davenport-Mendoza
• David J Katrana DDS,MD,PA
• Delana Rondrici Davis, LCSW
• Rachel Davis
• Eric Randell Day, A.T.C., L.A.T.
• Morgan Lee Day

• Specialist in Boerne, TX
• Providers in Boerne, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.