Active NPI
Roberto Corral, PA
- Medical Physician Assistant
- San Antonio, TX
National Provider Identifier
1528065224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA00380
- Practice address
- 1831 S General McMullen Dr
San Antonio, TX 78226-1190 - Phone
- (210) 434-1400
- Fax
- (210) 431-7472
- NPI assigned
- Jul 7, 2005
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA00380 | TX | Primary |
Addresses
Primary practice location
1831 S General McMullen Dr
San Antonio, TX 78226-1190
Mailing address
1831 S General McMullen Dr
San Antonio, TX 78226-1190
Phone (210) 434-1400
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA00380 | TX | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340582400000",
"number": "1528065224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1831 S GENERAL MCMULLEN DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782261190",
"telephone_number": "210-434-1400",
"fax_number": "210-431-7472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1831 S GENERAL MCMULLEN DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782261190",
"telephone_number": "210-434-1400",
"fax_number": "210-431-7472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORRAL",
"first_name": "ROBERTO",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-07",
"last_updated": "2012-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TX",
"license": "PA00380",
"primary": true
}
],
"identifiers": [],
"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 Jun 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.