Individual provider Active NPI

Eradio Arredondo, M.D.

  • Specialist
  • San Antonio, TX
National Provider Identifier
1861431256
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD8137 Issued in TX
Practice address
730 N Main Ave
Suite 110
San Antonio, TX 78205-1152
Phone
(210) 226-9311
Fax
(210) 225-6270
NPI assigned
Jun 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD8137 TX Primary

Addresses

Primary practice location

730 N Main Ave
Suite 110
San Antonio, TX 78205-1152

Mailing address

8100 Donore PL
San Antonio, TX 78229-2620
Phone (210) 349-3050

Other identifiers 2

IdentifierTypeStateIssuer
40016344OtherDPS NUMBER
26664OtherECFMG NUMBER

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

State licenses

LicenseStateTypeSpecialty
MD8137TXMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1861431256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 DONORE PL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782292620",
            "telephone_number": "210-349-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 N MAIN AVE",
            "address_2": "SUITE 110",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782051152",
            "telephone_number": "210-226-9311",
            "fax_number": "210-225-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARREDONDO",
        "first_name": "ERADIO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "MD8137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPS NUMBER",
            "identifier": "40016344",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ECFMG NUMBER",
            "identifier": "26664",
            "state": null
        }
    ],
    "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 Mar 7, 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.

Verify at the official NPI Registry.