Organization Active NPI

Sonterra Dermatology PLLC

  • Specialist
  • San Antonio, TX
National Provider Identifier
1285925966
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
N5065 Issued in TX
Legal business name
SONTERRA DERMATOLOGY PLLC
Practice address
1314 E Sonterra Blvd Ste 2201
San Antonio, TX 78258-4287
Phone
(210) 496-5792
Fax
(210) 496-5792
NPI assigned
Apr 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Annabelle L Garcia, M.D.NPI 1013181916
Title
President
Phone
(210) 496-5792

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X N5065 TX Primary

Addresses

Primary practice location

1314 E Sonterra Blvd Ste 2201
San Antonio, TX 78258-4287

Mailing address

1314 E Sonterra Blvd Ste 2201
San Antonio, TX 78258-4287
Phone (210) 496-5792

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120831000104 TX Part B Supplier - Clinic/Group Practice 5193972859 Receives reassigned benefits from 9 practitioners
Practice locations: Laredo, TX; San Antonio, TX

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2181242Sonterra Dermatology PLLC1314 E Sonterra Blvd, Ste 2201, San Antonio, TX 78258ComplianceJun 18, 2027

National Provider Directory

National Provider Directory

Locations

2632 Broadway St
Ste 201
San Antonio, TX 78215
Phone (210) 854-2931

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1303948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1285925966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 E SONTERRA BLVD STE 2201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584287",
            "telephone_number": "210-496-5792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 E SONTERRA BLVD STE 2201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584287",
            "telephone_number": "210-496-5792",
            "fax_number": "210-496-5792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONTERRA DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-28",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "ANNABELLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-496-5792",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "N5065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.