Individual provider Active NPI

Patricia Kelley Deforest, DO

  • Pediatrics Physician
  • San Antonio, TX
National Provider Identifier
1386030526
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R7197 Issued in TX
Practice address
5430 Fredericksburg Rd Ste 508
San Antonio, TX 78229-3561
Phone
(210) 541-8281
Fax
(210) 541-9123
NPI assigned
Apr 14, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X R7197 TX Primary

Addresses

Primary practice location

5430 Fredericksburg Rd Ste 508
San Antonio, TX 78229-3561

Mailing address

2020 Babcock Rd
San Antonio, TX 78229-4443
Phone (210) 761-9001

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
I20190613002969 TX Practitioner - Pediatric Medicine 5294025953 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medicine Associates Pediatrics CurrentSince Jul 16, 2019 Accepting new patients
RH Center LLC Pediatrics CurrentSince Apr 24, 2026 Accepting new patients
Renew Health Centers PLLC Pediatrics CurrentSince Apr 24, 2026 Accepting new patients
University of Texas Health Science Center at San Antonio Pediatrics CurrentSince Jul 16, 2019 Accepting new patients
Creative Care Pediatric Health & Wellness PLLC Pediatrics Current Accepting new patients
The University of Texas Health Science Center at San Antonio CurrentSince Jul 16, 2019 Accepting new patients
Pain Management Specialists PastSince Feb 7, 2021 Accepting new patients
Shaun S. Varghese, M.D., PLLC Past Accepting new patients

Locations

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

903 W Martin St
#492
San Antonio, TX 78207
Phone (210) 358-3441

2020 Babcock Rd
Ste 19
San Antonio, TX 78229
Phone (210) 614-5000

903 W Martin St
#B
San Antonio, TX 78207
Phone (210) 358-3441

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

903 W Martin St
San Antonio, TX 78207
Phone (210) 358-3400

88 Briggs St
Ste 120
San Antonio, TX 78224
Phone (210) 224-2026

Organizations & group practices 8

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": "1428969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1386030526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 BABCOCK RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294443",
            "telephone_number": "210-761-9001",
            "fax_number": "800-852-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5430 FREDERICKSBURG RD STE 508",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293561",
            "telephone_number": "210-541-8281",
            "fax_number": "210-541-9123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFOREST",
        "first_name": "PATRICIA",
        "middle_name": "KELLEY",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-14",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "R7197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.