Moreno Medical Clinic West

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA00125 Issued in TX

Legal business name

MORENO MEDICAL CLINIC WEST

Practice address

426 Castroville Rd Ste 4
San Antonio, TX 78207-5169

Phone

(210) 994-6181

NPI assigned

Sep 18, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Roland F Mena, PANPI 1083645964

Title

Physician Assistant

Phone

(210) 994-6181

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Roland F Mena, PA-C

  • Physician Assistant
  • San Antonio, TX
  • NPI 1083645964
  NPD Authorized official

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1770002107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 CASTROVILLE RD STE 4",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782075169",
            "telephone_number": "210-994-6181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 CASTROVILLE RD STE 4",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782075169",
            "telephone_number": "210-994-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORENO MEDICAL CLINIC WEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-18",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MENA",
        "authorized_official_first_name": "ROLAND",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "210-994-6181",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA00125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Jay Moreland, MD MPH
• Jennie Snell Moreland, M.D.
• Eduardo Moreno Beaupuits
• Yamileth Zaitieli Moreno Cano
• Nevia Bernadette Moreno Gonzalez, PRS-RSPS
• Cristiam Moreno Tellez, MD
• Lizette Moreno-Davis, OTR
• Christine Leblanc Moreno-Orta, MD
• Gabriel Moreno-Romo, RN
• Alberto Moreno

• Physician Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.