Organization Active NPI

Saint Raphael Family Focused Medicine PA

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1447430608
Registry record updated Nov 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L5014 Issued in TX
Legal business name
SAINT RAPHAEL FAMILY FOCUSED MEDICINE PA
Practice address
10350 Bandera Rd
Suite 300
San Antonio, TX 78250-5615
Phone
(210) 383-6861
NPI assigned
Nov 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2007

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

Authorized official

Name
Dr. James Manning Lackey, MDNPI 1730255050
Title
President
Phone
(210) 383-6861

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X L5014 TX Primary

Addresses

Primary practice location

10350 Bandera Rd
Suite 300
San Antonio, TX 78250-5615

Mailing address

10350 Bandera Rd
Suite 300
San Antonio, TX 78250-5615
Phone (210) 383-6861

National Provider Directory

National Provider Directory

Locations

10350 Bandera Rd
Ste 300
San Antonio, TX 78250
Phone (210) 380-7679

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194220800000",
    "number": "1447430608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 BANDERA RD",
            "address_2": "SUITE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782505615",
            "telephone_number": "210-383-6861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10350 BANDERA RD",
            "address_2": "SUITE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782505615",
            "telephone_number": "210-383-6861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT RAPHAEL FAMILY FOCUSED MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-05",
        "last_updated": "2007-11-05",
        "status": "A",
        "authorized_official_last_name": "LACKEY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "MANNING",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-383-6861",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L5014",
            "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 5, 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.