Individual provider Active NPI

Clay F Istre, PA-C

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1811214521
Registry record updated Jun 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA09534 Issued in TX
Practice address
16755 Huebner Rd
San Antonio, TX 78248-2342
Phone
(210) 493-4357
Fax
(210) 493-4355
NPI assigned
Apr 21, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA09534 TX Primary

Addresses

Primary practice location

16755 Huebner Rd
San Antonio, TX 78248-2342

Mailing address

2550 N Thunderbird Cir
Suite 303
Mesa, AZ 85215-1214
Phone (480) 455-4932

Other identifiers 3

IdentifierTypeStateIssuer
343919203MedicaidTX
343919201MedicaidTX
343919202MedicaidTX

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150106001274 TX Practitioner - Physician Assistant 4385870609 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ucp Physicians of Central Texas, PLLC CurrentSince Dec 5, 2014 Accepting new patients
St. David's Carenow Urgent Care PLLC Past Accepting new patients
Methodist Health Centers Past Accepting new patients

Locations

2550 N Thunderbird Cir
Ste 303
Mesa, AZ 85215
Phone (480) 289-7890

2145 E Baseline Rd
Ste 101
Tempe, AZ 85283
Phone (480) 498-4058

6001 W William Cannon Dr
Ste 302
Austin, TX 78749
Phone (512) 288-3627

1331 Northpark Dr
Kingwood, TX 77339
Phone (281) 359-5330

1240 E Palm Valley Blvd
Round Rock, TX 78664
Phone (512) 733-9100

16755 Huebner Rd
San Antonio, TX 78248
Phone (210) 493-4357

5400 Crosslake Pkwy
Ste 300
Waco, TX 76712
Phone (254) 420-2336

Organizations & group practices 7

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": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435276800000",
    "number": "1811214521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 N THUNDERBIRD CIR",
            "address_2": "SUITE 303",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852151214",
            "telephone_number": "480-455-4932",
            "fax_number": "480-776-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16755 HUEBNER RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782482342",
            "telephone_number": "210-493-4357",
            "fax_number": "210-493-4355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISTRE",
        "first_name": "CLAY",
        "middle_name": "F",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-21",
        "last_updated": "2015-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "343919203",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "343919201",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "343919202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.