Organization Active NPI

Firefly Pediatrics, PLLC

  • Pediatrics Physician
  • San Antonio, TX
National Provider Identifier
1952727109
Registry record updated Dec 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
P3769 Issued in TX
Legal business name
FIREFLY PEDIATRICS, PLLC
Practice address
2148 Jackson Keller Rd
San Antonio, TX 78213-2722
Phone
(210) 501-0703
Fax
(210) 526-0334
NPI assigned
Mar 12, 2014
Last updated
Dec 9, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2014

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

Authorized official

Name
Michael Lee Segura, MBA
Title
Administrator
Phone
(512) 940-1027

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X P3769 TX Primary
Pediatric Adolescent Medicine Physician 2080A0000X P3769 TX

Addresses

Primary practice location

2148 Jackson Keller Rd
San Antonio, TX 78213-2722

Mailing address

2148 Jackson Keller Rd
San Antonio, TX 78213-2722
Phone (210) 501-0703

Other identifiers 1

IdentifierTypeStateIssuer
336517301MedicaidTX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2087701Firefly Pediatrics2148 Jackson Keller Road, San Antonio, TX 78213Certificate of waiverDec 1, 2026

National Provider Directory

National Provider Directory

Locations

2148 Jackson Keller Rd
San Antonio, TX 78213
Phone (210) 501-0703

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1394582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418083200000",
    "number": "1952727109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2148 JACKSON KELLER RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782132722",
            "telephone_number": "210-501-0703",
            "fax_number": "210-526-0334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2148 JACKSON KELLER RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782132722",
            "telephone_number": "210-501-0703",
            "fax_number": "210-526-0334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIREFLY PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-12",
        "last_updated": "2014-12-09",
        "status": "A",
        "authorized_official_last_name": "SEGURA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "512-940-1027",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P3769",
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "TX",
            "license": "P3769",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "336517301",
            "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 Dec 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.