Individual provider Active NPI

Nicholas Paulos Zablan Estioko, PA-C

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1992465058
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA15115 Issued in TX
Practice address
23119 W Interstate 10 BLDG 7
San Antonio, TX 78257-1767
Phone
(210) 994-6336
NPI assigned
Dec 29, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X PA15115 TX Primary

Addresses

Primary practice location

23119 W Interstate 10 BLDG 7
San Antonio, TX 78257-1767

Mailing address

130 Impala Trce
San Antonio, TX 78258-4853
Phone (619) 569-6603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PA15115TXMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1640736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1992465058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 IMPALA TRCE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584853",
            "telephone_number": "619-569-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23119 W INTERSTATE 10 BLDG 7",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782571767",
            "telephone_number": "210-994-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTIOKO",
        "first_name": "NICHOLAS PAULOS",
        "middle_name": "ZABLAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-29",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA15115",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.