Active NPI
Noble Isac
- Perfusionist
- San Antonio, TX
National Provider Identifier
1821875956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Perfusionist
- License
- FPF02000268
- Practice address
- 3463 Magic Dr Ste T21
San Antonio, TX 78229-3621 - Phone
- (210) 614-8101
- NPI assigned
- Sep 12, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Perfusionist | 242T00000X | FPF02000268 | TX | Primary |
Addresses
Primary practice location
3463 Magic Dr Ste T21
San Antonio, TX 78229-3621
Mailing address
658 Emerald Forest Cir
Lawrenceville, GA 30044-5849
Phone (980) 263-1795
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| FPF02000268 | TX | MD | Perfusionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694476800000",
"number": "1821875956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "658 EMERALD FOREST CIR",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300445849",
"telephone_number": "980-263-1795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3463 MAGIC DR STE T21",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782293621",
"telephone_number": "210-614-8101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISAC",
"first_name": "NOBLE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-09-12",
"last_updated": "2023-09-12",
"certification_date": "2023-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "242T00000X",
"taxonomy_group": "",
"desc": "Perfusionist",
"state": "TX",
"license": "FPF02000268",
"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 Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.