Organization Active NPI

Ana T Sauceda MD PLLC

  • Dermatology Physician
  • San Antonio, TX
National Provider Identifier
1578897203
Registry record updated Aug 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
M2077 Issued in TX
Legal business name
ANA T SAUCEDA MD PLLC
Practice address
2829 Babcock Rd Ste 636
San Antonio, TX 78229-6014
Phone
(210) 615-8460
Fax
(210) 615-0406
NPI assigned
Sep 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2016

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

Authorized official

Name
Ana Trevino Sauceda, M.D.NPI 1497764302
Title
Sole Member
Phone
(210) 615-8460

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X M2077 TX Primary

Addresses

Primary practice location

2829 Babcock Rd Ste 636
San Antonio, TX 78229-6014

Mailing address

2829 Babcock Rd Ste 636
San Antonio, TX 78229-6014
Phone (210) 615-8460

Other identifiers 1

IdentifierTypeStateIssuer
357166301MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091022000614 TX Part B Supplier - Clinic/Group Practice 0648317792 Receives reassigned benefits from 7 practitioners
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Locations

2829 Babcock Rd
Ste 629
San Antonio, TX 78229
Phone (210) 615-8460

2829 Babcock Rd
Ste 410
San Antonio, TX 78229

2833 Babcock Rd
Ste 410
San Antonio, TX 78229
Phone (210) 615-8460

1005 N US Highway 83
Zapata, TX 78076

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471910400000",
    "number": "1578897203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 BABCOCK RD STE 636",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782296014",
            "telephone_number": "210-615-8460",
            "fax_number": "210-615-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2829 BABCOCK RD STE 636",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782296014",
            "telephone_number": "210-615-8460",
            "fax_number": "210-615-0406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANA T SAUCEDA MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-29",
        "last_updated": "2016-08-23",
        "status": "A",
        "authorized_official_last_name": "SAUCEDA",
        "authorized_official_first_name": "ANA",
        "authorized_official_middle_name": "TREVINO",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "210-615-8460",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "TX",
            "license": "M2077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "357166301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Aug 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.