PEDIATRIC UROLOGY OF SAN ANTONIO PLLC (NPI# 1033652425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033652425 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC UROLOGY OF SAN ANTONIO PLLC |
| Practice Address |
12446 West Ave Ste 200 San Antonio TX 78216-2517 |
| Practice Telephone | 2105251668 |
| Practice Fax Number | 2105251669 |
| Mailing Telephone | 2105251668 |
| Mailing Fax Number | 2105251669 |
| Enumeration Date | 2016-12-02 |
| Last Update Date | 2016-12-02 |
| Authorized Official Name | JUAN PRIETO (PARTNER) |
| Authorized Official Telephone | 2105251668 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2088P0231X |
Urology Specialization: Pediatric Urology |
Allopathic & Osteopathic Physicians |
| Street Address |
12446 WEST AVE STE 200 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78216-2517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265431415 | Samuel R Neeley | Neuromusculoskeletal Medicine & OMM | 12446 West Ave, Suite 200, San Antonio, TX 78216-2517 | 2005-07-19 |
| 1568824209 | James B Ellis Mdpa | Internal Medicine | 12446 West Ave, Ste 200, San Antonio, TX 78216-2517 | 2016-03-22 |
| 1881077857 | Charles Thomas Md Pa | Psychiatry & Neurology | 12446 West Ave, Ste 200, San Antonio, TX 78216-2517 | 2015-07-08 |
| 1548668411 | Neurology Associates of San Antonio Pllc | Psychiatry & Neurology | 12446 West Ave, Ste 200, San Antonio, TX 78216-2517 | 2014-12-09 |
| 1235360009 | Christina Ann Keane | Specialist/Technologist, Other | 12446 West Ave, Ste 200, San Antonio, TX 78216-2517 | 2009-07-28 |
| 1376749564 | Jerry I. Koch | Chiropractor | 12446 West Ave, Ste 100, San Antonio, TX 78216-2517 | 2007-06-25 |
| 1508061482 | Rose Medical Group, P.a. | Anesthesiology | 12446 West Ave, Suite 100, San Antonio, TX 78216-2517 | 2007-06-19 |
| 1649391632 | Samuel R Neeley Md Pa | Clinic/Center | 12446 West Ave, Suite 200, San Antonio, TX 78216-2517 | 2007-04-03 |
| 1801869268 | James Brant Ellis | Internal Medicine | 12446 West Ave, Ste 200, San Antonio, TX 78216-2517 | 2006-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376179820 | Damiana Lea Mcmahan | Speech-Language Pathologist | 12 Inter Park Blvd, #105, San Antonio, TX 78216 | 2020-03-17 |
| 1811530967 | Hacienda Hospice, Ltd | Hospice Care, Community Based | 101 W Silver Sands Dr, San Antonio, TX 78216 | 2019-10-22 |
| 1437792876 | Eddy Sidra | Optometrist | 7400 San Pedro Avenue, Suite 486, San Antonio, TX 78216 | 2019-10-17 |
| 1083256796 | Tiffany Michelle Goericke | Physical Therapist | 502 East Ramsey, San Antonio, TX 78216 | 2019-10-14 |
| 1780246942 | Esperanza Eating Disorders Center, Pllc | Clinic/Center | 403 E. Ramsey, Suite 204, San Antonio, TX 78216 | 2019-07-08 |
| 1568938314 | Lyric Lea Lewis | Licensed Vocational Nurse | 85 Ne Interstate 410 Loop #500, San Antonio, TX 78216 | 2018-10-19 |
| 1912488206 | Rebecca Anna Poppe | Licensed Vocational Nurse | 1514 Vista Del Norte, San Antonio, TX 78216 | 2018-08-24 |
| 1205338779 | Bailee Hannah Mokry | Behavioral Analyst | 11306 Sir Winston, San Antonio, TX 78216 | 2018-03-01 |
| 1487155677 | Ojer Corbie | Behavior Technician | 11310 Sir Winston At Bld D, San Antonio, TX 78216 | 2018-02-23 |
| 1366943631 | Briana Nicole Rodriguez | Behavior Technician | 14235 Blanco Road, San Antonio, TX 78216 | 2018-02-22 |
| Find all providers in zip 78216 | ||||
| Taxonomy Code | 2088P0231X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| Specialization | Pediatric Urology |
| Surgeons who can diagnose, treat, and manage children’s urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele). |
| Notes: Source: American Academy of Pediatrics [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679702377 | Andrew John Marks | Urology | 4499 Medical Dr Ste 360, San Antonio, TX 78229-3857 | 2009-07-02 |
| 1154641546 | Gaayana Raju | Urology | 4499 Medical Dr Ste 360, San Antonio, TX 78229-3857 | 2010-06-08 |
| 1720131022 | Alamo Urology Assoc.,p.a. | Urology | 3338 Oakwell Court, Suite 216, San Antonio, TX 78218 | 2007-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932543246 | Dung Pham | Urology | 1200 Binz St Ste 690, Houston, TX 77004-6943 | 2013-04-18 |
| 1780719997 | Mohammad A Sami | Urology | 26019 Juniper Stone Ln, Katy, TX 77494-2615 | 2007-02-21 |
| 1659455616 | Lawrence J. Cisek | Urology | 6410 Fannin St Ste 950, Houston, TX 77030-5204 | 2006-10-25 |
| 1366411803 | Warren Thomas Snodgrass | Urology | 5680 Frisco Square Blvd Ste 2300, Frisco, TX 75034 | 2006-03-16 |
| 1871589978 | Jeff L Pugach | Urology | 750 8th Ave Fl 6, Fort Worth, TX 76104-2515 | 2005-09-23 |
| 1063044881 | Crescent Medical Institute Pllc | Urology | 1200 Binz St Ste 690, Houston, TX 77004-6943 | 2020-02-10 |
| 1619383650 | Pediatric and Adult Reconstructive Center for Urology, Pllc | Urology | 5680 Frisco Square Blvd, Suite 2300, Frisco, TX 75034-3308 | 2014-07-10 |
| 1326337874 | Matthew David Timberlake | Urology | 3601 4th St Stop 7260, Lubbock, TX 79430-0816 | 2011-04-06 |
| 1821327404 | Houston Pediatric Urology P A | Urology | 7900 Fannin St, Suite 3700, Houston, TX 77054-2934 | 2009-12-10 |
| 1700048964 | Jonathan David Kaye | Urology | 750 8th Ave Fl 6, Fort Worth, TX 76104-2515 | 2008-06-30 |
| Find all providers with the same taxonomy | ||||
| City | SAN ANTONIO |
| Zip Code | 78216 |
Please comment or provide details below to improve the information on PEDIATRIC UROLOGY OF SAN ANTONIO PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.