Individual provider Active NPI

Paul Sundberg, MD

  • General Practice Physician
  • San Antonio, TX
National Provider Identifier
1346669124
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
R8996 Issued in TX
Practice address
1102 Barclay St
San Antonio, TX 78207
Phone
(210) 233-7000
Fax
(210) 228-0065
NPI assigned
Apr 9, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X BP10054932 TX
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Physician 208D00000X R8996 TX Primary

Addresses

Primary practice location

1102 Barclay St
San Antonio, TX 78207

Mailing address

3066 E Commerce St
San Antonio, TX 78220-1013
Phone (210) 233-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180712000839 TX Practitioner - General PracticePractitioner - Obstetrics/Gynecology 8729378286 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
BP10054932TXMDObstetrics & Gynecology Physician
R8996TXMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Jun 27, 2018 Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Jun 27, 2018 Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. Current Accepting new patients

Locations

1102 Barclay St
San Antonio, TX 78207
Phone (210) 434-0513

3066 E Commerce St
San Antonio, TX 78220
Phone (210) 233-7062

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1346669124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3066 E COMMERCE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782201013",
            "telephone_number": "210-233-7000",
            "fax_number": "210-228-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 BARCLAY ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78207",
            "telephone_number": "210-233-7000",
            "fax_number": "210-228-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDBERG",
        "first_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-09",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "BP10054932",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "R8996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.