Active NPI
Fabian Leon Bedoya
- Addiction (Substance Use Disorder) Counselor
- San Antonio, TX
National Provider Identifier
1477126746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 38935
- Practice address
- 9216 Dublin GRN
San Antonio, TX 78254-5432 - Phone
- (210) 792-9942
- NPI assigned
- Jul 23, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 38935 | TX | Primary |
Addresses
Primary practice location
9216 Dublin GRN
San Antonio, TX 78254-5432
Mailing address
9216 Dublin GRN
San Antonio, TX 78254-5432
Phone (210) 792-9942
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14799577 | Other | TX | DRIVER LICENSE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38935 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626998400000",
"number": "1477126746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9216 DUBLIN GRN",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782545432",
"telephone_number": "210-792-9942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9216 DUBLIN GRN",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782545432",
"telephone_number": "210-792-9942"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEDOYA",
"first_name": "FABIAN",
"middle_name": "LEON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-23",
"last_updated": "2021-07-23",
"certification_date": "2021-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "38935",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER LICENSE",
"identifier": "14799577",
"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 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.