Individual provider Active NPI

Edwin Acevedo Jr., MD, MHA

  • Plastic and Reconstructive Surgery Physician
  • Houston, TX
National Provider Identifier
1609254358
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
V7798 Issued in TX
Practice address
6410 Fannin St Ste 1400
Houston, TX 77030-5389
Phone
(832) 325-7181
Fax
(713) 500-0716
NPI assigned
May 14, 2015
Last updated
Jul 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X MT208318 PA
Plastic and Reconstructive Surgery Physician 2086S0122X V7798 TX Primary

Addresses

Primary practice location

6410 Fannin St Ste 1400
Houston, TX 77030-5389

Mailing address

6410 Fannin St Ste 1400
Houston, TX 77030-5389

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
I20250515002042 TX Practitioner - Plastic and Reconstructive Surgery 7618495417 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Rutgers New Jersey Medical School, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9635 Huebner Rd
San Antonio, TX 78240-1512
Phone (210) 692-1181

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT208318PAMDSurgery Physician
V7798TXMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Plastic, Reconstructive & Microsurgical Associates of South Texas PLLC Plastic and Reconstructive Surgery CurrentSince Aug 1, 2025 Accepting new patients

Locations

540 Madison Oak Dr
Ste 600
San Antonio, TX 78258
Phone (210) 402-1222

9635 Huebner Rd
San Antonio, TX 78240
Phone (210) 692-1181

Interoperability endpoints

  • Direct secure messaging: edwin.acevedomd.p1@direct.prmaplasticsurgery.nextgenshare.com

Organizations & group practices 1

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 4

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": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1609254358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 FANNIN ST STE 1400",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770305389",
            "fax_number": "713-500-0716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 FANNIN ST STE 1400",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770305389",
            "telephone_number": "832-325-7181",
            "fax_number": "713-500-0716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACEVEDO",
        "first_name": "EDWIN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD, MHA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-14",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT208318",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "V7798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.