Pediatric Institute of Southwest Texas,P.a.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PEDIATRIC INSTITUTE OF SOUTHWEST TEXAS,P.A.

Practice address

5255 Prue Rd
Suite #105
San Antonio, TX 78240-1335

Phone

(210) 877-9966

Fax

(210) 877-1162

NPI assigned

Jun 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Kassia Loueva Kubena, M.D.,

Title

Owner/Physician

Phone

(210) 877-9966

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Kubena Pediatrics Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263254400000",
    "number": "1497790703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5255 PRUE RD",
            "address_2": "SUITE #105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401335",
            "telephone_number": "210-877-9966",
            "fax_number": "210-877-1162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 PRUE RD",
            "address_2": "SUITE #105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401335",
            "telephone_number": "210-877-9966",
            "fax_number": "210-877-1162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC INSTITUTE OF SOUTHWEST TEXAS,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2010-01-12",
        "status": "A",
        "authorized_official_last_name": "KUBENA",
        "authorized_official_first_name": "KASSIA",
        "authorized_official_middle_name": "LOUEVA",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "210-877-9966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D.,"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "169084401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS ID NUMBER",
            "identifier": "0051LZ",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kubena Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatrics Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.