NPIMap

Organization Active NPI

San Antonio Internal Medicine Physicians, PLLC

  • Internal Medicine Physician
  • San Antonio, TX
National Provider Identifier
1548550528
Registry record updated Jul 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SAN ANTONIO INTERNAL MEDICINE PHYSICIANS, PLLC
Practice address
255 E Sonterra Blvd
Suite 100
San Antonio, TX 78258-4075
Phone
(210) 404-0000
Fax
(210) 404-2813
NPI assigned
Apr 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2011

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

Authorized official

Name
Roberta S. Cloud
Title
Vice President
Phone
(210) 575-8501

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X

Addresses

Primary practice location

255 E Sonterra Blvd
Suite 100
San Antonio, TX 78258-4075

Mailing address

8109 Fredericksburg Rd
Physician Practice Services
San Antonio, TX 78229-3311
Phone (210) 575-8501

Other identifiers 2

IdentifierTypeStateIssuer
0097WMOtherTXBCBS
2167660-01MedicaidTX

Other names 1

  • IMED Healthcare Associates Doing business as

National Provider Directory

National Provider Directory

Locations

255 E Sonterra Blvd
Ste 100
San Antonio, TX 78258
Phone (210) 404-0000

NPI Registry JSON

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

{
    "created_epoch": "1302566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311724800000",
    "number": "1548550528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8109 FREDERICKSBURG RD",
            "address_2": "PHYSICIAN PRACTICE SERVICES",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293311",
            "telephone_number": "210-575-8501",
            "fax_number": "210-575-0167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 E SONTERRA BLVD",
            "address_2": "SUITE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584075",
            "telephone_number": "210-404-0000",
            "fax_number": "210-404-2813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANTONIO INTERNAL MEDICINE PHYSICIANS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-12",
        "last_updated": "2011-07-27",
        "status": "A",
        "authorized_official_last_name": "CLOUD",
        "authorized_official_first_name": "ROBERTA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "210-575-8501"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0097WM",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2167660-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMED Healthcare Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 27, 2011; 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.