NPIMap

Individual provider Active NPI

Austin Eagleton, M.D.

  • Surgery Physician
  • San Antonio, TX
National Provider Identifier
1568753291
Registry record updated Jul 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
Q7862 Issued in TX
Practice address
4502 Medical Dr
San Antonio, TX 78229-4402
Phone
(210) 358-2082
Fax
(210) 358-1972
NPI assigned
Apr 28, 2011
Last updated
Jul 22, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Q7862 TX Primary

Addresses

Primary practice location

4502 Medical Dr
San Antonio, TX 78229-4402

Mailing address

7703 Floyd Curl Dr
San Antonio, TX 78229-3901
Phone (210) 358-2082

Other identifiers 2

IdentifierTypeStateIssuer
358457501MedicaidTX
358457502OtherTXCSHCN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160627000380 TX Practitioner - General Surgery 3577861004 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Texas Medical School at San Antonio, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

1020 E Idel St
Tyler, TX 75701-2024
Phone (903) 535-2902

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at Tyler-Facility-Physician CurrentSince Jun 1, 2019 Accepting new patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2018 Accepting new patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2018 Accepting new patients
University of Texas Health Science Center at Tyler-Facilty-Physician CurrentSince Jun 1, 2019 Accepting new patients
Starks Medical Past Accepting new patients
Tyler Regional Hospital LLC Past Accepting new patients

Locations

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

102 W Henderson St
Overton, TX 75684
Phone (903) 834-0201

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

1020 E Idel St
Tyler, TX 75701
Phone (903) 535-2902

11937 US Highway 271
Tyler, TX 75708
Phone (903) 877-3451

Interoperability endpoints

  • Direct secure messaging: aeagleton355006@ahs.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1303948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469145600000",
    "number": "1568753291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7703 FLOYD CURL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293901",
            "telephone_number": "210-358-2082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-2082",
            "fax_number": "210-358-1972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAGLETON",
        "first_name": "AUSTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-28",
        "last_updated": "2016-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "Q7862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "358457501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "358457502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.