Individual provider Active NPI

Grace Theresa Bebeau, FNP

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1437693801
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP132249 Issued in TX
Practice address
4502 Medical Dr
San Antonio, TX 78229-4402
Phone
(210) 358-2078
Fax
(210) 702-6274
NPI assigned
Dec 5, 2016
Last updated
May 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP132249 TX
Family Nurse Practitioner 363LF0000X AP132249 TX Primary

Addresses

Primary practice location

4502 Medical Dr
San Antonio, TX 78229-4402

Mailing address

4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-2078

Other practice location 1

6335 Camp Bullis Rd
suite B-38
San Antonio, TX 78257-9720
Phone (210) 286-3593

Other identifiers 2

IdentifierTypeStateIssuer
375646202OtherTXCSHCN
375646201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170918000516 TX Practitioner - Nurse Practitioner 0143594911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7703 Floyd Curl Dr
San Antonio, TX 78229-3901
Phone (210) 450-9000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Health Science Center at San Antonio CurrentSince Sep 15, 2017 Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Sep 15, 2017 Accepting new patients
University of Texas Health Science Center at San Antonio Current Accepting new patients
San Antonio Ketamine Specialists PLLC Past Accepting new patients

Locations

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1480896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1437693801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-2078",
            "fax_number": "210-702-6274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-2078",
            "fax_number": "210-702-6274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6335 Camp Bullis Rd",
            "address_2": "suite B-38",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782579720",
            "country_code": "US",
            "telephone_number": "210-286-3593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEBEAU",
        "first_name": "GRACE",
        "middle_name": "THERESA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-05",
        "last_updated": "2024-05-02",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP132249",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP132249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "375646202",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375646201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.