Advanced Concpets in Plastic Surgery PA
Organization Active NPI Specialist · San Antonio, TX
NPI 1891907424 · NPPES record last updated Nov 1, 2011
Key facts
- NPI
- 1891907424
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- K0874 (TX)
- Legal business name
- ADVANCED CONCPETS IN PLASTIC SURGERY PA
- Practice address
- 423 Treeline Park
Suite 300
San Antonio, TX 78209 - Phone
- (210) 499-5900
- Fax
- (210) 333-4975
- NPI assigned
- May 4, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Suresh Koneru, MD
- Title
- Physician
- Phone
- (210) 499-5900
Member organizations 1
Practitioners 1
-
Suresh Koneru, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060206000801 | TX | Part B Supplier - Clinic/Group Practice | 2961416342 |
Receives reassigned benefits from 1 practitioner Practice locations: San Antonio, TX |
National Provider Directory
Locations
423 Treeline Park
Ste 300
San Antonio, TX 78209
Phone (210) 359-6644
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | K0874 | TX | Yes |
Addresses
Primary practice location
423 Treeline Park
Suite 300
San Antonio, TX 78209
Mailing address
423 Treeline Park
Suite 300
San Antonio, TX 78209
Phone (210) 499-5900
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 029455502 | Medicaid | TX |
Other names
- DR. SURESH KONERU
Other providers in San Antonio, TX
- Advanced Behavioral Intervention Therapies, Inc
- Advanced Behavioral Interventions
- Advanced Cardiac Imaging Solutions, PLLC
- Advanced Clinician Specialty Group PLLC
- Advanced Clinician, Multispecialty Clinical Consultant Services, PLLC
- Advanced Counseling
- Advanced Counseling Services Inc
- Advanced Dental Arts, LLC
- Advanced Dental Associates PLLC
- Advanced Diagnostic Laboratory
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.