Organization Active NPI

St. Lazarus Family Practice P.a.

  • General Practice Physician
  • San Antonio, TX
National Provider Identifier
1598210411
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
N8176 Issued in TX
Legal business name
ST. LAZARUS FAMILY PRACTICE P.A.
Practice address
14345 Blanco Rd
San Antonio, TX 78216-7723
Phone
(210) 802-7003
Fax
(210) 519-2970
NPI assigned
Aug 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Authorized official

Name
Christine A. Contreras, MDNPI 1619133238
Title
President
Phone
(210) 802-7003

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
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X N8176 TX Primary

Addresses

Primary practice location

14345 Blanco Rd
San Antonio, TX 78216-7723

Mailing address

14345 Blanco Rd
San Antonio, TX 78216-7723
Phone (210) 802-7003

Other practice location 1

7333 Barlite Blvd
Suite 110
San Antonio, TX 78224-1320
Phone (210) 802-7003

Other practice location 2

4143 Gardendale St
San Antonio, TX 78229-3129
Phone (210) 802-7003

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161219001644 TX Part B Supplier - Clinic/Group Practice 1456632058 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2128702St Lazarus Family Practice, PA14345 Blanco Road, San Antonio, TX 78216Certificate of waiverApr 3, 2027

National Provider Directory

National Provider Directory

Locations

7333 Barlite Blvd
Ste 110
San Antonio, TX 78224
Phone (210) 802-7003

Practitioners & affiliated clinicians

Practitioners 1

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": "1471651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689292800000",
    "number": "1598210411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14345 BLANCO RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782167723",
            "telephone_number": "210-802-7003",
            "fax_number": "210-519-2970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14345 BLANCO RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782167723",
            "telephone_number": "210-802-7003",
            "fax_number": "210-519-2970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7333 Barlite Blvd",
            "address_2": "Suite 110",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782241320",
            "country_code": "US",
            "telephone_number": "210-802-7003",
            "fax_number": "210-519-2970",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4143 Gardendale St",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293129",
            "country_code": "US",
            "telephone_number": "210-802-7003",
            "fax_number": "210-519-2970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST. LAZARUS FAMILY PRACTICE P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-20",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A",
        "authorized_official_last_name": "CONTRERAS",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-802-7003",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "TX",
            "license": "N8176",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.