Individual provider Active NPI

Wesley William Krueger, M.D., F.A.C.S.

  • Otology & Neurotology Physician
  • San Antonio, TX
National Provider Identifier
1740211192
Registry record updated Apr 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otology & Neurotology PhysicianTaxonomy code 207YX0901X
License
E4463 Issued in TX
Practice address
2632 Broadway St
Suite 201-202 South Building
San Antonio, TX 78215-1021
Phone
(210) 697-0880
Fax
(210) 697-0888
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otology & Neurotology Physician 207YX0901X E4463 TX Primary

Addresses

Primary practice location

2632 Broadway St
Suite 201-202 South Building
San Antonio, TX 78215-1021

Mailing address

2101 S Cynthia St
McAllen, TX 78503-1294
Phone (956) 687-7896

Other identifiers 1

IdentifierTypeStateIssuer
134986201MedicaidTX

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ears of Texas Hearing Instrument Clinic, P.a. Past Accepting new patients
Ears of Texas, P.a. PastSince Feb 14, 2007 Accepting new patients
Clinical Associates, Inc Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398816000000",
    "number": "1740211192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 S CYNTHIA ST",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785031294",
            "telephone_number": "956-687-7896",
            "fax_number": "956-994-9694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2632 BROADWAY ST",
            "address_2": "SUITE 201-202 SOUTH BUILDING",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782151021",
            "telephone_number": "210-697-0880",
            "fax_number": "210-697-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "WESLEY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D., F.A.C.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2014-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "TX",
            "license": "E4463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134986201",
            "state": "TX"
        }
    ],
    "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 Apr 30, 2014; 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.