Individual provider Active NPI

Robert Peter Wunderlich, D.P.M.

  • Foot Surgery Podiatrist
  • San Antonio, TX
National Provider Identifier
1417951385
Registry record updated Oct 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
1395 Issued in TX
Practice address
1123 N Main Ave
# 201
San Antonio, TX 78212-4740
Phone
(210) 281-9200
Fax
(210) 281-9734
NPI assigned
Jun 9, 2005
Last updated
Oct 12, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 1395 TX Primary

Addresses

Primary practice location

1123 N Main Ave
# 201
San Antonio, TX 78212-4740

Mailing address

PO Box 12092
San Antonio, TX 78212-0092
Phone (210) 281-9200

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1395TXMDFoot Surgery Podiatrist

Organizations & group practices 1

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192147200000",
    "number": "1417951385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12092",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782120092",
            "telephone_number": "210-281-9200",
            "fax_number": "210-281-9734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 N MAIN AVE",
            "address_2": "# 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124740",
            "telephone_number": "210-281-9200",
            "fax_number": "210-281-9734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUNDERLICH",
        "first_name": "ROBERT",
        "middle_name": "PETER",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2007-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "TX",
            "license": "1395",
            "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 Oct 12, 2007; 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.