NPIMap

Organization Active NPI

Soba Texas LLC

  • Substance Abuse Rehabilitation Facility
  • San Antonio, TX
National Provider Identifier
1831520360
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
SOBA TEXAS LLC
Practice address
1401 Dezarae Lot 3
San Antonio, TX 78253-5986
Phone
(210) 530-4167
Fax
(310) 919-0319
NPI assigned
Dec 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Authorized official

Name
Mrs. Audrey Graham
Title
Cfo
Phone
(310) 457-5250

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0802X
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

1401 Dezarae Lot 3
San Antonio, TX 78253-5986

Mailing address

1401 Dezarae Lot 3
San Antonio, TX 78253-5986
Phone (310) 457-2730

Other identifiers 1

IdentifierTypeStateIssuer
45D2067229OtherTXCMS CLIA

Other names 1

  • Soba Recovery Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Soba Recovery Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757980800000",
    "number": "1831520360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 DEZARAE LOT 3",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782535986",
            "telephone_number": "310-457-2730",
            "fax_number": "310-919-0319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 DEZARAE LOT 3",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782535986",
            "telephone_number": "210-530-4167",
            "fax_number": "310-919-0319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOBA TEXAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-10",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "310-457-5250",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS CLIA",
            "identifier": "45D2067229",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Soba Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 16, 2025; 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.