Organization Active NPI

Stone Oak South Texas Center for Pediatric Care

  • Pediatrics Physician
  • San Antonio, TX
National Provider Identifier
1396797874
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
STONE OAK SOUTH TEXAS CENTER FOR PEDIATRIC CARE
Practice address
1954 E Houston St
Suite 104
San Antonio, TX 78202-2951
Phone
(210) 576-0533
Fax
(210) 226-4676
NPI assigned
May 16, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Lisa Michelle Daluz
Title
Credentialing Manager
Phone
(210) 576-0533

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

1954 E Houston St
Suite 104
San Antonio, TX 78202-2951

Mailing address

525 Oak Centre
Suite 100
San Antonio, TX 78258
Phone (210) 576-0533

National Provider Directory

National Provider Directory
Tax ID family
Stone Oak South Texas Center for Pediatric Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396797874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 OAK CENTRE",
            "address_2": "SUITE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78258",
            "telephone_number": "210-576-0533",
            "fax_number": "210-226-4676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1954 E HOUSTON ST",
            "address_2": "SUITE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782022951",
            "telephone_number": "210-576-0533",
            "fax_number": "210-226-4676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONE OAK SOUTH TEXAS CENTER FOR PEDIATRIC CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DALUZ",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "210-576-0533"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "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 Aug 22, 2020; 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.