Individual provider Active NPI

Robert Derek Watson, DO

  • Child & Adolescent Psychiatry Physician
  • San Antonio, TX
National Provider Identifier
1679004386
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
T2288 Issued in TX
Practice address
17720 Corporate Woods Dr
San Antonio, TX 78259-3500
Phone
(210) 491-9400
NPI assigned
Mar 23, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X T2288 TX
Student in an Organized Health Care Education/Training Program 390200000X TX
Child & Adolescent Psychiatry Physician 2084P0804X T2288 TX Primary

Addresses

Primary practice location

17720 Corporate Woods Dr
San Antonio, TX 78259-3500

Mailing address

5804 B Abcock Rd
#299
San Antonio, TX 78240
Phone (210) 300-4666

Other practice location 1

7703 Floyd Curl Dr
San Antonio, TX 78229-3901
Phone (210) 567-7000

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
I20220616003064 TX Practitioner - Psychiatry 7719264720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
78.35 of 100Reported as group
Quality
50.62
Promoting interoperability
95
Improvement activities
20
Cost
73.04

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McAllen Hospitalist Group, PLLC Psychiatry CurrentSince Aug 1, 2022 Accepting new patients
Texas Laurel Ridge Hospital LP Past Accepting new patients

Locations

1102 W Trenton Rd
Edinburg, TX 78539
Phone (956) 388-6500

17720 Corporate Woods Dr
San Antonio, TX 78259
Phone (210) 491-9400

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1679004386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5804 B ABCOCK RD",
            "address_2": "#299",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78240",
            "telephone_number": "210-300-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17720 CORPORATE WOODS DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782593500",
            "telephone_number": "210-491-9400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7703 Floyd Curl Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293901",
            "country_code": "US",
            "telephone_number": "210-567-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "ROBERT",
        "middle_name": "DEREK",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-23",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "T2288",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "T2288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.