Concussive and Cognitive Diagnostics PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CONCUSSIVE AND COGNITIVE DIAGNOSTICS PLLC

Practice address

10300 Heritage St Ste 140
San Antonio, TX 78216-3924

Phone

(210) 441-2557

Fax

(210) 349-7876

NPI assigned

Jun 21, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Laidee Hanika Francia, NP

Title

Owner/NP

Phone

(210) 332-9100

Specialties & licenses 1

Addresses

Other names 1

• Alta Vita Medical Group Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 6

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

• Brian Michael Kanatzar, D.O.

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1093033243
  Medicare reassignment NPD
• Laidee Hanika Nguyen, NP

  • Nurse Practitioner
  • San Antonio, TX
  • NPI 1669872214
  Medicare reassignment NPD
• Victor M Romo, M.D.

  • Emergency Medicine Physician
  • San Antonio, TX
  • NPI 1043471469

  Internal Medicine

  Medicare reassignment NPD
• Steven Temerlin, MD

  • Emergency Medicine Physician
  • Bulverde, TX
  • NPI 1871569012
  Medicare reassignment NPD
• Michael Christian Glassinger, MD

  • Emergency Medicine Physician
  • Mandeville, LA
  • NPI 1023113792

  TX

  Medicare reassignment NPD
• Marlischa Jackson

  • Nurse Practitioner
  • San Antonio, TX
  • NPI 1801399019
  Medicare reassignment

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652918400000",
    "number": "1689243156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10218 DESERT SANDS ST APT 5A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782163910",
            "telephone_number": "210-341-1012",
            "fax_number": "210-349-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 HERITAGE ST STE 140",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782163924",
            "telephone_number": "210-441-2557",
            "fax_number": "210-349-7876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCUSSIVE AND COGNITIVE DIAGNOSTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-21",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A",
        "authorized_official_last_name": "FRANCIA",
        "authorized_official_first_name": "LAIDEE",
        "authorized_official_middle_name": "HANIKA",
        "authorized_official_title_or_position": "OWNER/NP",
        "authorized_official_telephone_number": "210-332-9100",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alta Vita Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Alejandro Conde, MD
• Alfredo Emilio Conde, M.D.
• Camila Mercedes Conde, MD
• Michelle Conde, MD
• Sara Maria Conde, MD

• Internal Medicine Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.