Plastic Surgery of Northeast San Antonio

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

K7278 Issued in TX

Legal business name

PLASTIC SURGERY OF NORTHEAST SAN ANTONIO

Practice address

19315 Nacogdoches Rd
Ste. 305
San Antonio, TX 78266-2516

Phone

(210) 656-4216

Fax

(210) 656-4217

NPI assigned

Aug 12, 2010

Organization subpart

Yes

Parent organization

KENZER J DIRKSON MDAs reported in NPPES

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

Authorized official

Name

Mrs. Mary E Flores

Title

Dr.'S Assistant/ Billing Personel

Phone

(210) 656-4216

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Methodist Medical GRP

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

{
    "created_epoch": "1281571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281571200000",
    "number": "1548575707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19315 NACOGDOCHES RD",
            "address_2": "STE. 305",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782662516",
            "telephone_number": "210-656-4216",
            "fax_number": "210-656-4217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19315 NACOGDOCHES RD",
            "address_2": "STE. 305",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782662516",
            "telephone_number": "210-656-4216",
            "fax_number": "210-656-4217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGERY OF NORTHEAST SAN ANTONIO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KENZER J DIRKSON MD",
        "enumeration_date": "2010-08-12",
        "last_updated": "2010-08-12",
        "status": "A",
        "authorized_official_last_name": "FLORES",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DR.'S ASSISTANT/ BILLING PERSONEL",
        "authorized_official_telephone_number": "210-656-4216",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "TX",
            "license": "K7278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127561201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Planned Parenthood South Texas Surgical Center
• Planned Parenthood South Texas Surgical Center
• Barbara Plasencia
• Catherine Plasencia, OT
• Jamie Plaster, LVN
• Plastic, Reconstructive & Microsurgical Associates of South Texas PLLC
• Kristen Allison Plastino, M.D.
• Brenna Ayana Plata-Robles
• Elyssa Plata
• Plate of Wellness Group LLC

• Exclusive Provider Organization in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Exclusive Provider Organization in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; 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.