Individual provider Active NPI

Sandra L Nieto, M.D.

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1467580191
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K4173 Issued in TX
Practice address
10607 Liberty Field
Suite 103
San Antonio, TX 78254
Phone
(210) 999-5586
Fax
(210) 999-5605
NPI assigned
Mar 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K4173 TX Primary

Addresses

Primary practice location

10607 Liberty Field
Suite 103
San Antonio, TX 78254

Mailing address

PO Box 1714
Helotes, TX 78023-1714
Phone (210) 999-5586

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
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Tandi Medical Center PA Family Medicine Current Accepting new patients

Locations

10607 Liberty Fld
Ste 103
San Antonio, TX 78254
Phone (210) 999-5586

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1467580191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1714",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780231714",
            "telephone_number": "210-999-5586",
            "fax_number": "210-999-5605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10607 LIBERTY FIELD",
            "address_2": "SUITE 103",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78254",
            "telephone_number": "210-999-5586",
            "fax_number": "210-999-5605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIETO",
        "first_name": "SANDRA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K4173",
            "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 Jun 14, 2016; 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.