Individual provider Active NPI

Clayton Louis Pullin, M.D.

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1952309114
Registry record updated Feb 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J8726 Issued in TX
Practice address
7913 Bandera Rd
San Antonio, TX 78250-6511
Phone
(210) 680-9393
Fax
(210) 681-7906
NPI assigned
Jul 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X J8726 TX Primary
Sports Medicine (Family Medicine) Physician 207QS0010X J8726 TX

Addresses

Primary practice location

7913 Bandera Rd
San Antonio, TX 78250-6511

Mailing address

PO Box 680819
San Antonio, TX 78268-0819
Phone (210) 680-9393

Other identifiers 4

IdentifierTypeStateIssuer
080187389OtherMEDICARE RAILROAD
0076EGOtherTXBCBS
0088MCOtherTXBCBS GROUP ID
J8726OtherTXSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090129000082 TX Practitioner - Family Practice 7911061452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at Houston, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TMC Provider Group PLLCGroup PAC ID 6305149121, 213 clinicians

Practice addresses (Care Compare)

13722 Embassy Row
San Antonio, TX 78216-2000
Phone (726) 207-3656

23611W Interstate 10
San Antonio, TX 78257-1694
Phone (210) 698-6617

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
J8726TXMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TMC Provider Group PLLC Current Accepting new patients
TMC Provider Group PLLC CurrentSince Jan 1, 2016 Accepting new patients
TMC Provider Group PLLC Family Medicine CurrentSince Jan 1, 2016 Accepting new patients

Locations

9900 S Interstate 35
Austin, TX 78748
Phone (512) 291-5577

13722 Embassy Row
San Antonio, TX 78216
Phone (210) 349-5577

23611 W Interstate 10
San Antonio, TX 78257
Phone (210) 698-6617

23611 Ih 10 W
Ste 101
San Antonio, TX 78257
Phone (210) 698-6617

11811 Blanco Rd
San Antonio, TX 78216
Phone (210) 341-5588

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234742400000",
    "number": "1952309114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 680819",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782680819",
            "telephone_number": "210-680-9393",
            "fax_number": "210-681-7906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7913 BANDERA RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782506511",
            "telephone_number": "210-680-9393",
            "fax_number": "210-681-7906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLIN",
        "first_name": "CLAYTON",
        "middle_name": "LOUIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2009-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J8726",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TX",
            "license": "J8726",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "080187389",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0076EG",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP ID",
            "identifier": "0088MC",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "J8726",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.