Active NPI
Phillip Lodico, DO
- Family Medicine Physician
- San Antonio, TX
National Provider Identifier
1730609082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- T6949
- Practice address
- 4301 Broadway St
San Antonio, TX 78209-6318 - Phone
- (210) 283-6304
- NPI assigned
- Jun 27, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | T6949 | TX | Primary |
Addresses
Primary practice location
4301 Broadway St
San Antonio, TX 78209-6318
Mailing address
4301 Broadway St
San Antonio, TX 78209-6318
Phone (210) 283-6304
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T6949 | TX | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718582400000",
"number": "1730609082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4301 BROADWAY ST",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782096318",
"telephone_number": "210-283-6304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4301 BROADWAY ST",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782096318",
"telephone_number": "210-283-6304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LODICO",
"first_name": "PHILLIP",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-27",
"last_updated": "2024-06-17",
"certification_date": "2024-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "T6949",
"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 Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.