Pmpa PLLC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

M1395 Issued in TX

Legal business name

PMPA PLLC

Practice address

9502 Huebner Rd
Suite 101
San Antonio, TX 78240-1649

Phone

(210) 767-2258

Fax

(210) 767-2259

NPI assigned

Sep 18, 2015

Organization subpart

No

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

Authorized official

Name

Christne Vidouria, DO

Title

Owner

Phone

(210) 767-2258

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1442534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442534400000",
    "number": "1699144881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9502 HUEBNER RD",
            "address_2": "SUITE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401649",
            "telephone_number": "210-767-2258",
            "fax_number": "210-767-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9502 HUEBNER RD",
            "address_2": "SUITE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401649",
            "telephone_number": "210-767-2258",
            "fax_number": "210-767-2259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PMPA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-18",
        "last_updated": "2015-09-18",
        "status": "A",
        "authorized_official_last_name": "VIDOURIA",
        "authorized_official_first_name": "CHRISTNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-767-2258",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "TX",
            "license": "M1395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine (Physical Medicine & Rehabilitation) Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2015; 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.