Kimberly Sue Lasswell, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA03758 Issued in TX

Practice address

4360 Greco Dr
San Antonio, TX 78222-2725

Phone

(210) 648-8200

Fax

(855) 392-7988

NPI assigned

Aug 17, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1250467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479427200000",
    "number": "1306078886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 CENTRAL PKWY N",
            "address_2": "SUITE #200",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782325085",
            "telephone_number": "210-533-9591",
            "fax_number": "904-425-2949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4360 GRECO DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782222725",
            "telephone_number": "210-648-8200",
            "fax_number": "855-392-7988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASSWELL",
        "first_name": "KIMBERLY",
        "middle_name": "SUE",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-17",
        "last_updated": "2016-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA03758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01430297",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "320249102",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX LICENSE",
            "identifier": "PA03758",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David J Lasho, DDS
• Lasik and Cataract San Antonio
• Keith G. Lassandro, PTA
• Lisa Michelle Lassen, LCSW
• Matthew Lassiter, LSA
• Shannon Brookes Lasswell, MA, CCC-SLP
• Manuel Ray Lastra-Cruz
• Mier Sun Lastra, PHYSICAL THERAPIST
• Stephen McAlpine Laswell
• Asmabanu Lat, PHARMD

• Medical Physician Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; 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.