San Antonio Gastroenterology Associates, PA

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

SAN ANTONIO GASTROENTEROLOGY ASSOCIATES, PA

Practice address

520 E Euclid Ave
San Antonio, TX 78212-4414

Phone

(210) 242-0020

Fax

(210) 475-9806

NPI assigned

Sep 1, 2006

Reactivated

Sep 11, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Kimberly Freehauf

Title

Administrator

Phone

(210) 242-0020

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536624000000",
    "number": "1427150697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E EUCLID AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124414",
            "telephone_number": "210-242-0020",
            "fax_number": "210-475-9806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E EUCLID AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124414",
            "telephone_number": "210-242-0020",
            "fax_number": "210-475-9806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANTONIO GASTROENTEROLOGY ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2018-09-11",
        "deactivation_date": "2018-07-23",
        "reactivation_date": "2018-09-11",
        "status": "A",
        "authorized_official_last_name": "FREEHAUF",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "210-242-0020",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00RM40",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "095002402",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "45D0707595",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CP8292",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Gastroenterology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.