Roy Derek Balderas

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2007977 Issued in TX

Practice address

5757 N Knoll
San Antonio, TX 78240-2239

Phone

(210) 699-8535

Fax

(210) 699-8674

NPI assigned

Aug 30, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1700368370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6023 WOOD PASS",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782491922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 N KNOLL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782402239",
            "telephone_number": "210-699-8535",
            "fax_number": "210-699-8674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDERAS",
        "first_name": "ROY",
        "middle_name": "DEREK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-30",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2007977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Balderas
• Grace Glenda Balderas, A.P.R.N. B.C.
• Jorge Balderas
• Odilia Balderas
• Ricky Balderas
• Teresita G Balderas, M.D.
• Vidal Garza Balderas, DDS
• Benjamin Balderman, MD
• Cristina Irene Balderrama-McInnis, OT
• Paula Balderston, LCSW

• Physical Therapy Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; 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.