Organization Active NPI

West Kirk Medical Practice, PA

  • Primary Care Clinic/Center
  • San Antonio, TX
National Provider Identifier
1508054842
Registry record updated Sep 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
E7516 Issued in TX
Legal business name
WEST KIRK MEDICAL PRACTICE, PA
Practice address
711 Kirk PL
San Antonio, TX 78226-1416
Phone
(210) 227-9408
NPI assigned
Oct 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2014

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

Authorized official

Name
Leonel Tano
Title
M.D.
Phone
(210) 227-9408

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X E7516 TX Primary

Addresses

Primary practice location

711 Kirk PL
San Antonio, TX 78226-1416

Mailing address

711 Kirk PL
San Antonio, TX 78226-1416
Phone (210) 227-9408

Other identifiers 7

IdentifierTypeStateIssuer
168296501MedicaidTX
112094102MedicaidTX
5903OtherTXAETNA
112094104MedicaidTX
112094101MedicaidTX
8K1570OtherTXBCBS
112094103MedicaidTX

National Provider Directory

National Provider Directory

Locations

711 Kirk Pl
San Antonio, TX 78226
Phone (210) 227-9408

NPI Registry JSON

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410825600000",
    "number": "1508054842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 KIRK PL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782261416",
            "telephone_number": "210-227-9408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 KIRK PL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782261416",
            "telephone_number": "210-227-9408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST KIRK MEDICAL PRACTICE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-11",
        "last_updated": "2014-09-16",
        "status": "A",
        "authorized_official_last_name": "TANO",
        "authorized_official_first_name": "LEONEL",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "210-227-9408"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "E7516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168296501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112094102",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5903",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112094104",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112094101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8K1570",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112094103",
            "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 Sep 16, 2014; 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.