Individual provider Active NPI

Robert Anthony Tavera, MD

  • Internal Medicine Physician
  • San Antonio, TX
National Provider Identifier
1730155458
Registry record updated Feb 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
F7219 Issued in TX
Practice address
1200 Brooklyn Ave
Ste 240
San Antonio, TX 78212-4830
Phone
(210) 225-4511
Fax
(210) 225-4514
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X F7219 TX Primary

Addresses

Primary practice location

1200 Brooklyn Ave
Ste 240
San Antonio, TX 78212-4830

Mailing address

2961 Mossrock
San Antonio, TX 78230-5119
Phone (210) 731-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423440000000",
    "number": "1730155458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2961 MOSSROCK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782305119",
            "telephone_number": "210-731-4800",
            "fax_number": "210-731-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 BROOKLYN AVE",
            "address_2": "STE 240",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124830",
            "telephone_number": "210-225-4511",
            "fax_number": "210-225-4514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVERA",
        "first_name": "ROBERT",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2015-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "F7219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.