NPIMap

Organization Active NPI

South Alamo Medical Group, P.a.

  • Pediatrics Physician
  • San Antonio, TX
National Provider Identifier
1316023773
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SOUTH ALAMO MEDICAL GROUP, P.A.
Practice address
4203 E Southcross Blvd
San Antonio, TX 78222-3722
Phone
(210) 222-0333
Fax
(210) 928-4837
NPI assigned
Oct 28, 2006
Last updated
Oct 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

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

Authorized official

Name
Dr. Miguel Ayala, MDNPI 1174510507
Title
MD
Phone
(210) 222-0333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Pediatrics Physician 208000000X NU Primary
Case Management Agency 251B00000X NU

Addresses

Primary practice location

4203 E Southcross Blvd
San Antonio, TX 78222-3722

Mailing address

740 South Alamo Street
San Antonio, TX 78205-3437
Phone (210) 222-0333

Other identifiers 1

IdentifierTypeStateIssuer
080083101MedicaidTX

National Provider Directory

National Provider Directory

Locations

7355 Barlite Blvd
Ste 301
San Antonio, TX 78224

7355 Barlite Blvd
Ste 401
San Antonio, TX 78224
Phone (210) 921-2011

740 S Alamo St
San Antonio, TX 78205
Phone (210) 224-7688

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1161993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634601600000",
    "number": "1316023773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 SOUTH ALAMO STREET",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782053437",
            "telephone_number": "210-222-0333",
            "fax_number": "210-928-4837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4203 E SOUTHCROSS BLVD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782223722",
            "telephone_number": "210-222-0333",
            "fax_number": "210-928-4837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ALAMO MEDICAL GROUP, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-28",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A",
        "authorized_official_last_name": "AYALA",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "210-222-0333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080083101",
            "state": "TX"
        }
    ],
    "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 Oct 19, 2021; 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.