Individual provider Active NPI

David K Tharakan, M.D.

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1386732527
Registry record updated Jan 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L0646 Issued in TX
Practice address
2838 N Loop 1604 E
Suite 104
San Antonio, TX 78232-1711
Phone
(210) 495-2117
Fax
(888) 893-4363
NPI assigned
Oct 11, 2006
Last updated
Jan 11, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L0646 TX Primary

Addresses

Primary practice location

2838 N Loop 1604 E
Suite 104
San Antonio, TX 78232-1711

Mailing address

2838 N Loop 1604 E
Ste 104
San Antonio, TX 78232-1712
Phone (210) 495-2117

Other names 1

  • David K. Tharakan Professional name

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
I20040615001791 TX Practitioner - Family Practice 8729061395 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L0646TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Rogers Medical Group PA. CurrentSince Apr 15, 2014 Accepting new patients
David Tharakan M.D. PA Family Medicine PastSince Nov 19, 2003 Accepting new patients
Alamo City Medical Group, PLLC Family Medicine PastSince Apr 1, 2013 Accepting new patients

Locations

2838 N Loop 1604 E
Ste 104
San Antonio, TX 78232
Phone (210) 495-2117

5539 W Loop 1604 N
Ste 10
San Antonio, TX 78253
Phone (210) 403-9400

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IAFGBD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484092800000",
    "number": "1386732527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2838 N LOOP 1604 E",
            "address_2": "STE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321712",
            "telephone_number": "210-495-2117",
            "fax_number": "888-893-4363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2838 N LOOP 1604 E",
            "address_2": "SUITE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321711",
            "telephone_number": "210-495-2117",
            "fax_number": "888-893-4363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THARAKAN",
        "first_name": "DAVID",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2017-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L0646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "THARAKAN",
            "middle_name": "K.",
            "credential": "M.D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.