Individual provider Active NPI

Desiree Marie Estrada

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1497217384
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP138988 Issued in TX
Practice address
4800 Fredericksburg Rd Ste 127
San Antonio, TX 78229-3781
Phone
(210) 468-0800
NPI assigned
Apr 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP138988 TX Primary

Addresses

Primary practice location

4800 Fredericksburg Rd Ste 127
San Antonio, TX 78229-3781

Mailing address

1603 Greer St
San Antonio, TX 78210-5504
Phone (210) 630-8980

Other practice location 1

1603 Greer St
San Antonio, TX 78210-5504
Phone (210) 630-8980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP138988TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa of Texas PLLC CurrentSince Jul 1, 2019 Accepting new patients
Vpa of Texas PLLC Current Accepting new patients
Vpa of Texas PLLC CurrentSince Jul 1, 2019 Accepting new patients

Locations

4800 Fredericksburg Rd
Ste 127
San Antonio, TX 78229
Phone (210) 348-5681

5414 Fredericksburg Rd
Ste 100A
San Antonio, TX 78229
Phone (210) 468-0800

Organizations & group practices 3

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": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1497217384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 GREER ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782105504",
            "telephone_number": "210-630-8980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 FREDERICKSBURG RD STE 127",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293781",
            "telephone_number": "210-468-0800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1603 Greer St",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782105504",
            "country_code": "US",
            "telephone_number": "210-630-8980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESTRADA",
        "first_name": "DESIREE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP138988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.