Organization Active NPI

Gary M. Songco PA

  • Specialist
  • San Antonio, TX
National Provider Identifier
1912213398
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
H2183 Issued in TX
Legal business name
GARY M. SONGCO PA
Practice address
61 Longsford
San Antonio, TX 78209-1820
Phone
(210) 226-5933
Fax
(210) 226-6433
NPI assigned
Aug 24, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Authorized official

Name
Gary M Songco, M.D.NPI 1538107503
Title
Owner
Phone
(210) 226-5933

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X H2183 TX Primary

Addresses

Primary practice location

61 Longsford
San Antonio, TX 78209-1820

Mailing address

61 Longsford
San Antonio, TX 78209-1820
Phone (210) 226-5933

Other identifiers 1

IdentifierTypeStateIssuer
097514601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101025001245 TX Part B Supplier - Clinic/Group Practice 5294928073 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Locations

125 W Sunset Rd
#202
San Antonio, TX 78209
Phone (210) 226-5933

1711 Citadel Plz
#100
San Antonio, TX 78209
Phone (210) 226-5933

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1282608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712620800000",
    "number": "1912213398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 LONGSFORD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782091820",
            "telephone_number": "210-226-5933",
            "fax_number": "210-226-6433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 LONGSFORD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782091820",
            "telephone_number": "210-226-5933",
            "fax_number": "210-226-6433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY M. SONGCO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-24",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A",
        "authorized_official_last_name": "SONGCO",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-226-5933",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "H2183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "097514601",
            "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 Apr 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.