Individual provider Active NPI

Laura Miramontes Perez, MD

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1790782464
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L4573 Issued in TX
Practice address
4243 E Southcross Blvd
Suite 205
San Antonio, TX 78222-3727
Phone
(210) 304-3500
Fax
(210) 337-2909
NPI assigned
Jul 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L4573 TX Primary

Addresses

Primary practice location

4243 E Southcross Blvd
Suite 205
San Antonio, TX 78222-3727

Mailing address

8637 Fredericksburg Rd
#360
San Antonio, TX 78240-1285
Phone (210) 949-4179

Other names 1

  • Laura Miramontes Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050124000180 TX Practitioner - Family Practice 2466402995 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical Branch at Galveston, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TMC Provider Group PLLCGroup PAC ID 6305149121, 213 clinicians

Practice addresses (Care Compare)

13722 Embassy Row
San Antonio, TX 78216-2000
Phone (726) 207-3656

23611W Interstate 10
San Antonio, TX 78257-1694
Phone (210) 698-6617

958N Interstate 35
New Braunfels, TX 78130-3731
Phone (830) 606-5533

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L4573TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TMC Provider Group PLLC Family Medicine CurrentSince Jan 1, 2016 Accepting new patients
TMC Provider Group PLLC Current Accepting new patients
TMC Provider Group PLLC CurrentSince Jan 1, 2016 Accepting new patients

Locations

9900 S Interstate 35
Austin, TX 78748
Phone (512) 291-5577

13722 Embassy Row
San Antonio, TX 78216
Phone (210) 349-5577

23611 W Interstate 10
San Antonio, TX 78257
Phone (210) 698-6617

23611 Ih 10 W
Ste 101
San Antonio, TX 78257
Phone (210) 698-6617

11811 Blanco Rd
San Antonio, TX 78216
Phone (210) 341-5588

Organizations & group practices 4

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1790782464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8637 FREDERICKSBURG RD",
            "address_2": "#360",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401285",
            "telephone_number": "210-949-4179",
            "fax_number": "210-617-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4243 E SOUTHCROSS BLVD",
            "address_2": "SUITE 205",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782223727",
            "telephone_number": "210-304-3500",
            "fax_number": "210-337-2909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "LAURA",
        "middle_name": "MIRAMONTES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L4573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "MIRAMONTES",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.