Organization Active NPI

J R Holcomb MD PA

  • Pulmonary Disease Physician
  • San Antonio, TX
National Provider Identifier
1467631135
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
E4159 Issued in TX
Legal business name
J R HOLCOMB MD PA
Practice address
4410 Medical Dr Ste 360
San Antonio, TX 78229-3749
Phone
(210) 614-2100
Fax
(210) 692-1999
NPI assigned
Oct 30, 2007
Last updated
Jul 25, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Authorized official

Name
Claire Clark
Title
Credentialing
Phone
(210) 614-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X E4159 TX Primary

Addresses

Primary practice location

4410 Medical Dr Ste 360
San Antonio, TX 78229-3749

Mailing address

4410 Medical Dr Ste 360
San Antonio, TX 78229-3749
Phone (210) 614-2100

Other identifiers 3

IdentifierTypeStateIssuer
DN3722OtherTXRAILROAD MEDICARE
201540601MedicaidTX
0054RFOtherTXBLUE CROSS

National Provider Directory

National Provider Directory

Locations

1110 N Sarah Dewitt Dr
#A
Gonzales, TX 78629

4242 Medical Dr
Ste 7275
San Antonio, TX 78229
Phone (210) 614-7474

4410 Medical Dr
Ste 360
San Antonio, TX 78229
Phone (210) 614-2100

8026 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-8110

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564012800000",
    "number": "1467631135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 MEDICAL DR STE 360",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293749",
            "telephone_number": "210-614-2100",
            "fax_number": "210-692-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 MEDICAL DR STE 360",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293749",
            "telephone_number": "210-614-2100",
            "fax_number": "210-692-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J R HOLCOMB MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-30",
        "last_updated": "2019-07-25",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CLAIRE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "210-614-2100"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "E4159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DN3722",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201540601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0054RF",
            "state": "TX"
        }
    ],
    "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 Jul 25, 2019; 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.