PEDIATRIC INPATIENT CRITICAL CARE SERVICES PA (NPI# 1104219781) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104219781 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC INPATIENT CRITICAL CARE SERVICES PA |
| Practice Address |
520 Madison Oak Dr San Antonio TX 78258-3913 |
| Mailing Address |
Po Box 4346 Dept 409 Houston TX 77210-4346 |
| Practice Telephone | 2102974000 |
| Mailing Telephone | 2105586288 |
| Mailing Fax Number | 2105586289 |
| Enumeration Date | 2015-03-06 |
| Last Update Date | 2015-08-12 |
| Authorized Official Name | HUGO CARVAJAL (PRESIDENT) |
| Authorized Official Telephone | 2105586288 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
520 MADISON OAK DR |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78258-3913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033182977 | Sandra R Aviles | Pediatrics | 520 Madison Oak Dr, San Antonio, TX 78258-3913 | 2006-02-10 |
| 1073134151 | Farahnaz Shafiey | Anesthesiologist Assistant | 520 Madison Oak Dr, San Antonio, TX 78258-3913 | 2020-04-30 |
| 1316401326 | Russell Aaron Bryan | Nurse Practitioner | 520 Madison Oak Dr, San Antonio, TX 78258-3912 | 2019-01-23 |
| 1861977464 | Jennifer Kay Nagel | Registered Nurse | 520 Madison Oak Dr, San Antonio, TX 78258-3912 | 2018-09-28 |
| 1538676838 | Omurkan Mira Finley | Nurse Practitioner | 520 Madison Oak Dr, San Antonio, TX 78258-3913 | 2018-01-08 |
| 1548631690 | Bve Group Pllc | Anesthesiology | 520 Madison Oak Dr, San Antonio, TX 78258-3913 | 2015-10-15 |
| 1972816692 | River City Pediatric Emergency Physicians, Pllc | Emergency Medicine | 520 Madison Oak Dr, San Antonio, TX 78258-3913 | 2010-07-22 |
| 1629203195 | Esmeralda Lugo | Internal Medicine | 520 Madison Oak Dr, San Antonio, TX 78258-3913 | 2009-05-27 |
| 1831341189 | Suneetha Muthyala | Internal Medicine | 520 Madison Oak Dr, North Central Baptist Hospital, San Antonio, TX 78258-3913 | 2008-10-17 |
| 1386802833 | Arsen M Zacharian | Internal Medicine | 520 Madison Oak Dr, San Antonio, TX 78258-3913 | 2008-05-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356980163 | Jeffrey M. Martinez, M.d., P.a. | Surgery | 525 Centre Oak Drive, Suite 140, San Antonio, TX 78258 | 2019-12-26 |
| 1588226211 | New Life Brace and Limb, LLC | Prosthetist | 300 E. Sonterra Blvd., Suite 220, San Antonio, TX 78258 | 2019-07-02 |
| 1720649080 | Miguel Ibarra | Pharmacist | 18866 Stone Oak Pkwy., St.101, San Antonio, TX 78258 | 2019-06-26 |
| 1528538113 | Kevin Scott Farnsworth | Dentist | 1130 E. Sonterra Blvd Suite 100, San Antonio, TX 78258 | 2018-11-27 |
| 1891262176 | Dentists of Stone Oak, PC | Dentist | 23714 Hardy Oak Blvd, Suite 110, San Antonio, TX 78258 | 2018-10-25 |
| 1003399437 | Jesus Alcala | Physical Therapist | 20821 Us Hwy 281 N, Ste 110, San Antonio, TX 78258 | 2018-09-11 |
| 1184106544 | Marissa Kaye Bruton | Occupational Therapist | 505 Madison Oak, San Antonio, TX 78258 | 2018-09-02 |
| 1508346933 | Desiree Carroll | Occupational Therapy Assistant | 18803 Hardy Oak Drive, San Antonio, TX 78258 | 2018-08-15 |
| 1700376456 | Conner Jay Mcnabb | Optometrist | 810 Knights Cross Dr Ste 101, San Antonio, TX 78258 | 2018-05-17 |
| 1982191516 | Freehand Solutions LLC | Chiropractor | Nec Stone Oak Parkway & Loop 1604, San Antonio, TX 78258 | 2018-04-19 |
| Find all providers in zip 78258 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619934098 | Candace Campos Kenton | Pediatrics | 302 W Lynwood Ave, San Antonio, TX 78212-2592 | 2006-04-28 |
| 1831156595 | Samuel L. Zuckerman | Pediatrics | 315 N San Saba Ste 1135, San Antonio, TX 78207-3255 | 2006-04-27 |
| 1386601888 | Najmul H. Salman | Pediatrics | 11019 Culebra Rd Ste 155, San Antonio, TX 78253-4519 | 2006-04-27 |
| 1487061321 | Niveditha Balakumar | Pediatrics | 333 N Santa Rosa St, San Antonio, TX 78207-3108 | 2014-07-11 |
| 1720408578 | Kirstin Henley | Pediatrics | 333 N Santa Rosa St, San Antonio, TX 78207-3108 | 2014-04-21 |
| 1871850487 | Magdelenis Gongora | Pediatrics | 4502 Medical Dr, San Antonio, TX 78229 | 2012-04-19 |
| 1255604104 | Utpal S Bhalala | Pediatrics | 315 N San Saba, Suite 1135, San Antonio, TX 78207-3154 | 2012-02-22 |
| 1528395985 | Mohammed Salameh | Pediatrics | 333 N Santa Rosa St, San Antonio, TX 78207-3108 | 2009-11-05 |
| 1598921223 | Childrens Critical Care Specialists Pllc | Pediatrics | 7700 Floyd Curl Dr, San Antonio, TX 78229-3902 | 2008-08-01 |
| 1588821797 | Thomas Jacob Lee Jr. | Pediatrics | Brooke Army Medical Center, 3551 Roger Brooke Dr, San Antonio, TX 78234 | 2008-05-16 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78258 |
Please comment or provide details below to improve the information on PEDIATRIC INPATIENT CRITICAL CARE SERVICES PA.
| 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.