Leticia A Poret, MD PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

H9289 Issued in TX

Practice address

4522 Fredericksburg Rd Ste A14
San Antonio, TX 78201-6595

Phone

(210) 733-3005

NPI assigned

Jul 19, 2007

Last updated

Jan 7, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Dr. Leticia A Poret Professional name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

Practice roles

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.

• Leticia a Poret MD PA

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1114024478
  Authorized official Same address or phone
• HMG Medical Group, P.a.

  • Adult Medicine Physician
  • San Antonio, TX
  • NPI 1720298367
  NPD (past)

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199664000000",
    "number": "1578763462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12627 STONEHENGE DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782301941",
            "telephone_number": "210-733-3005",
            "fax_number": "210-733-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4522 FREDERICKSBURG RD STE A14",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782016595",
            "telephone_number": "210-733-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORET",
        "first_name": "LETICIA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-19",
        "last_updated": "2008-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "H9289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "8AJ423",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "8755B9",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157488101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LETICIA",
            "last_name": "PORET",
            "middle_name": "A",
            "prefix": "DR.",
            "credential": "MD PA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Por Vida Academy Charter High School
• Anton Hiram Poral
• Erin Porche, LPC
• Lea Porche, M.D.
• Gina Poree
• Mary Elizabeth Porisch, M.D.
• Jennifer Rehm Porr, M.D.
• Jessica Janet Porras
• Ginny V Porrata
• Rocio A Portales, M.S., LPC

• Internal Medicine Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.