Texas Institute of Pediatrics PLLC

Key facts

NPI

1669633848

Entity type

Organization (NPI type 2)

Primary specialty

Pediatrics Physician 208000000X

Legal business name

TEXAS INSTITUTE OF PEDIATRICS PLLC

Practice address

4410 Medical Drive
Suite 540
San Antonio, TX 78229-3755

Phone

(210) 575-6240

Fax

(210) 575-6280

NPI assigned

Jun 20, 2008

Organization subpart

No

Authorized official

Name

Mrs. Roberta S Cloud

Title

Vice President of Managing Member

Phone

(210) 575-8500

Practitioners 14

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

• Catherine Louise Brigman, M.D. Pediatric Gastroenterology Physician · San Antonio, TX · NPI 1295889400
  NPD (past)
• Ka Wah Chan, M.D. Pediatric Hematology & Oncology Physician · San Antonio, TX · NPI 1134186034
  NPD (past) PEDIATRICS
• Rosemaria Gennuso, MD Pediatric Surgery Physician · San Antonio, TX · NPI 1093771297
  NPD (past) NEUROLOGICAL SURGERY
• Veronica Hernandez Jude, M.D. Pediatric Hematology & Oncology Physician · San Antonio, TX · NPI 1275715856
  NPD (past) PEDIATRICS
• John Paul Kupferschmid, M.D. Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · San Antonio, TX · NPI 1861459729
  NPD (past) PEDIATRIC SURGERY
• Julie Lee Luke, RN, C-PNP Nurse Practitioner · San Antonio, TX · NPI 1861685448
  NPD (past) PEDIATRICS
• Lisa Rene McDonald, DNP, APRN, CPNP Allergy & Immunology Physician · San Antonio, TX · NPI 1447331277
  NPD (past) PEDIATRICS
• Hatem Salah Megahed, M.D. Neurological Surgery Physician · San Antonio, TX · NPI 1154374502
  NPD (past) NEUROLOGICAL SURGERY
• Martha Ruth Morse, MD, FAAP Pediatric Pulmonology Physician · San Antonio, TX · NPI 1831191071
  NPD (past) PEDIATRICS
• Gerardo Quezada, MD Pediatric Hematology & Oncology Physician · San Antonio, TX · NPI 1427227602
  NPD (past) PEDIATRICS
• Mahesh S Sharma, MD Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · San Antonio, TX · NPI 1891998183
  NPD (past) PEDIATRICS
• Nelia P Soares, RN, CPNP-AC/PC Pediatric Nurse Practitioner · Dallas, TX · NPI 1215083761
  NPD (past) PEDIATRICS
• Lesley L Vernor, C-PNP Pediatric Nurse Practitioner · San Antonio, TX · NPI 1659419349
  NPD (past) PEDIATRICS
• Michael Sean Grimley, M.D. Pediatric Hematology & Oncology Physician · Cincinnati, OH · NPI 1780641555
  NPD (past) PEDIATRIC HEMATOLOGY-ONCOLOGY

National Provider Directory

Locations

Specialties & licenses

Addresses

Other identifiers

Other names

• Pediatric Specialists of Texas Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 2, 2009.

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243900800000",
    "number": "1669633848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7711 LOUIS PASTEUR",
            "address_2": "STE 705",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293415",
            "telephone_number": "210-575-7828",
            "fax_number": "866-741-3697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 MEDICAL DRIVE",
            "address_2": "SUITE 540",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293755",
            "telephone_number": "210-575-6240",
            "fax_number": "210-575-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS INSTITUTE OF PEDIATRICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-20",
        "last_updated": "2009-06-02",
        "status": "A",
        "authorized_official_last_name": "CLOUD",
        "authorized_official_first_name": "ROBERTA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "VICE PRESIDENT OF MANAGING MEMBER",
        "authorized_official_telephone_number": "210-575-8500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Pediatric Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0A3121",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197834803",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "197834804",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Specialists of Texas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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