Diabetes and Glandular Disease Clinic Certified Diabetes Education Cen

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

DIABETES AND GLANDULAR DISEASE CLINIC CERTIFIED DIABETES EDUCATION CEN

Practice address

5107 Medical Dr
San Antonio, TX 78229-4801

Phone

(210) 614-8612

Fax

(210) 615-1666

NPI assigned

Mar 2, 2010

Last updated

Aug 24, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Joseph Bagwell, MT

Title

Director of Clinic Operations

Phone

(210) 615-5541

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Diabetes and Glandular Disease Clinic Certified Diabetes Education Cen2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Diabetes and Glandular Disease Clinic PA

  • Endocrinology, Diabetes & Metabolism Physician
  • San Antonio, TX
  • NPI 1427166305
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vanessa Tamez, RDN LD CDE

  • Registered Dietitian
  • Cibolo, TX
  • NPI 1548736325
  NPD (past)

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

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692835200000",
    "number": "1629391842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5107 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294801",
            "telephone_number": "210-614-8612",
            "fax_number": "210-615-1666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5107 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294801",
            "telephone_number": "210-614-8612",
            "fax_number": "210-615-1666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETES AND GLANDULAR DISEASE CLINIC CERTIFIED DIABETES EDUCATION CEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-02",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A",
        "authorized_official_last_name": "BAGWELL",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "DIRECTOR OF CLINIC OPERATIONS",
        "authorized_official_telephone_number": "210-615-5541",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MT"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121762202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul Anthony Di Leo
• Sara Di Stefano, LMT, MTI, CEP
• Dia Health PLLC
• Diabetes & Endocrinology Consultants, Inc.
• Diabetes America
• Diabetes and Glandular Disease Clinic PA
• Diabetes Education and Management Clinic
• Diabetes Specialty Supply LLC
• Diabetex of Texas, LLC.
• Diabetic Testing Supply LLC

• Medical Specialty Clinic/Center in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Medical Specialty Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.