Individual provider Active NPI

Juan Marin

  • Licensed Vocational Nurse
  • San Antonio, TX
National Provider Identifier
1417425133
Registry record updated Nov 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
346068 Issued in TX
Practice address
9130 Dublin SPG
San Antonio, TX 78254-5446
Phone
(951) 746-8595
NPI assigned
Nov 12, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 346068 TX Primary

Addresses

Primary practice location

9130 Dublin SPG
San Antonio, TX 78254-5446

Mailing address

9130 Dublin SPG
San Antonio, TX 78254-5446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
346068TXMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1541980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1417425133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9130 DUBLIN SPG",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782545446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9130 DUBLIN SPG",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782545446",
            "telephone_number": "951-746-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIN",
        "first_name": "JUAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-12",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "346068",
            "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 Nov 12, 2018; 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.