Active NPI
Affiong Udoiwod
- Licensed Practical Nurse
- San Antonio, TX
National Provider Identifier
1306642962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 201761
- Practice address
- 7400 Merton Minter St
San Antonio, TX 78229-4404 - Phone
- (210) 617-5300
- NPI assigned
- Feb 24, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 201761 | TX | Primary |
Addresses
Primary practice location
7400 Merton Minter St
San Antonio, TX 78229-4404
Mailing address
5610 James Trace Dr
San Antonio, TX 78253-7498
Phone (706) 951-3453
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201761 | TX | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740355200000",
"number": "1306642962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5610 JAMES TRACE DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782537498",
"telephone_number": "706-951-3453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7400 MERTON MINTER ST",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782294404",
"telephone_number": "210-617-5300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UDOIWOD",
"first_name": "AFFIONG",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-02-24",
"last_updated": "2025-02-24",
"certification_date": "2025-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "TX",
"license": "201761",
"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 Feb 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.