Individual provider Active NPI

Sowmya Kalathuru, DO

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1568085397
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
T3797 Issued in TX
Practice address
4438 Centerview
San Antonio, TX 78228-1440
Phone
(210) 280-0040
Fax
(210) 280-0060
NPI assigned
May 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X T3797 TX
Family Medicine Physician 207Q00000X T3797 TX Primary

Addresses

Primary practice location

4438 Centerview
San Antonio, TX 78228-1440

Mailing address

4438 Centerview
San Antonio, TX 78228-1440
Phone (210) 280-0040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220609002337 TX Practitioner - Family PracticePractitioner - General Practice 5193103745

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
T3797TXMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1568085397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4438 CENTERVIEW",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281440",
            "telephone_number": "210-280-0040",
            "fax_number": "210-280-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4438 CENTERVIEW",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281440",
            "telephone_number": "210-280-0040",
            "fax_number": "210-280-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALATHURU",
        "first_name": "SOWMYA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-27",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "T3797",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T3797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.