Organization Active NPI

Surgery Center - Shavano Park

Doing business as Premier Surgical Center at Shavano

  • Ambulatory Surgical Clinic/Center
  • San Antonio, TX
National Provider Identifier
1417810805
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SURGERY CENTER - SHAVANO PARK
Doing business as
Premier Surgical Center at Shavano
Practice address
14603 Huebner Rd BLDG 41
San Antonio, TX 78230-5505
Phone
(210) 468-5426
NPI assigned
Dec 3, 2025
Last updated
Mar 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Authorized official

Name
Jose E Barrera, MDNPI 1619966686
Title
Chief of Staff
Phone
(210) 468-5426

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

14603 Huebner Rd BLDG 41
San Antonio, TX 78230-5505

Mailing address

14603 Huebner Rd BLDG 41
San Antonio, TX 78230-5505

Other names 1

  • Premier Surgical Center at Shavano Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2339032Premier Surgical Center at Shavano Park14603 Huebner Rd BLDG 41, San Antonio, TX 78230Certificate of waiverFeb 22, 2028

National Provider Directory

National Provider Directory

Locations

14603 Huebner Rd
Bldg 41
San Antonio, TX 78230
Phone (210) 468-5426

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1764720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773705600000",
    "number": "1417810805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14603 HUEBNER RD BLDG 41",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782305505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14603 HUEBNER RD BLDG 41",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782305505",
            "telephone_number": "210-468-5426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY CENTER - SHAVANO PARK",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-03",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A",
        "authorized_official_last_name": "BARRERA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF OF STAFF",
        "authorized_official_telephone_number": "210-468-5426",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Surgical Center at Shavano",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.