Organization Active NPI

Khanh Gia DO, MD PA

  • Internal Medicine Physician
  • San Antonio, TX
National Provider Identifier
1972652733
Registry record updated Aug 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
KHANH GIA DO, MD PA
Practice address
1439 SW Military Dr
San Antonio, TX 78221-1539
Phone
(210) 924-6565
Fax
(210) 924-4835
NPI assigned
Jan 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2014

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

Authorized official

Name
Khanh Gia DO, M.D.NPI 1174672927
Title
President
Phone
(210) 924-6565

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1439 SW Military Dr
San Antonio, TX 78221-1539

Mailing address

1439 SW Military Dr
San Antonio, TX 78221-1539
Phone (210) 924-6565

Other identifiers 2

IdentifierTypeStateIssuer
0036LTOtherTXBCBS OF TEXAS
171454501MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040804000742 TX Part B Supplier - Clinic/Group Practice 7618948548 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

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
45D1008145Khanh Gia DO MD PA1439 SW Military Dr, San Antonio, TX 78221Certificate of waiverJan 12, 2027

National Provider Directory

National Provider Directory

Locations

1439 SW Military Dr
San Antonio, TX 78221
Phone (210) 924-6565

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": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407888000000",
    "number": "1972652733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1439 SW MILITARY DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782211539",
            "telephone_number": "210-924-6565",
            "fax_number": "210-924-4835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1439 SW MILITARY DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782211539",
            "telephone_number": "210-924-6565",
            "fax_number": "210-924-4835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHANH GIA DO, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2014-08-13",
        "status": "A",
        "authorized_official_last_name": "DO",
        "authorized_official_first_name": "KHANH",
        "authorized_official_middle_name": "GIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-924-6565",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "0036LT",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171454501",
            "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 Aug 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.