Active NPI
Susan Homan, MD
- Pediatrics Physician
- San Antonio, TX
National Provider Identifier
1841307907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- H4960
- Practice address
- 3030 Nacogdoches Rd
Suite 101
San Antonio, TX 78217-4540 - Phone
- (210) 826-9599
- NPI assigned
- Aug 24, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | H4960 | TX | Primary |
Addresses
Primary practice location
3030 Nacogdoches Rd
Suite 101
San Antonio, TX 78217-4540
Mailing address
3030 Nacogdoches Rd
Suite 101
San Antonio, TX 78217-4540
Phone (210) 826-9599
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1211468-08 | Medicaid | TX | |
| 121146805 | Medicaid | TX |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317772800000",
"number": "1841307907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3030 NACOGDOCHES RD",
"address_2": "SUITE 101",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782174540",
"telephone_number": "210-826-9599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3030 NACOGDOCHES RD",
"address_2": "SUITE 101",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782174540",
"telephone_number": "210-826-9599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOMAN",
"first_name": "SUSAN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-24",
"last_updated": "2011-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "H4960",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1211468-08",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "121146805",
"state": "TX"
}
],
"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 Oct 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.