SD- 4315FREDERICK PC (NPI# 1174074496) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174074496 |
| Entity Type | Organization |
| Organization Name | SD- 4315FREDERICK PC |
| Practice Address |
4522 Fredericksburg Rd A28 San Antonio TX 78201-6547 |
| Mailing Address |
10901 Garland Rd Dallas TX 75218-2613 |
| Practice Telephone | 2105308841 |
| Practice Fax Number | 2105308738 |
| Mailing Telephone | 2144661400 |
| Mailing Fax Number | 2143675896 |
| Enumeration Date | 2016-10-21 |
| Last Update Date | 2020-04-27 |
| Authorized Official Name | DR. LYNHTHY THY PHAM (PRESIDENT) |
| Authorized Official Telephone | 2144661400 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
19887 | TX | Dental Providers |
| Street Address |
4522 FREDERICKSBURG RD A28 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78201-6547 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336674696 | Jessica Martin | Counselor | 4522 Fredericksburg Rd, San Antonio, TX 78201-6521 | 2017-04-25 |
| 1073063335 | Martha Anne Combs | Psychologist | 4522 Fredericksburg Rd, Suites A-10 and A-88, San Antonio, TX 78201-6521 | 2016-10-11 |
| 1497124150 | Marc Garza | Pharmacist | 4522 Fredericksburg Rd, San Antonio, TX 78201-6521 | 2015-09-23 |
| 1902205768 | Adam Tyler Barnes, Dds of Texas II, Pllc | Dentist | 4522 Fredericksburg Rd, #a-29, San Antonio, TX 78201-6521 | 2014-08-18 |
| 1003224049 | San Antonio Vamc | Clinic/Center | 4522 Fredericksburg Rd, Suites A-10 and A-88, San Antonio, TX 78201-6521 | 2014-07-22 |
| 1710317789 | Angela De Los Santos | Pharmacist | 4522 Fredericksburg Rd, San Antonio, TX 78201-6521 | 2013-11-12 |
| 1659713659 | Aljon Family Counseling Pllc | Community/Behavioral Health | 4522 Fredericksburg Rd, Suite A-45, San Antonio, TX 78201-6521 | 2013-07-19 |
| 1588932628 | Pedro A Cuba | Optometrist | 4522 Fredericksburg Rd, Ste B36, San Antonio, TX 78201-6530 | 2011-12-04 |
| 1609164714 | Rebecca Marie Williams | Optometrist | 4522 Fredericksburg Rd, Bldg 2434, San Antonio, TX 78201-6521 | 2011-07-11 |
| 1225322498 | Mylestones Pediatric Therapy, Pllc | Occupational Therapist | 4522 Fredericksburg Rd, Ste. A-45, San Antonio, TX 78201-6521 | 2011-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043864648 | Woodlawn Lake Dental Partners Pllc | Dentist | 1707 Williams, San Antonio, TX 78201 | 2019-07-31 |
| 1912559840 | Tara Devi Nath | Dentist | 1770 Williams, San Antonio, TX 78201 | 2019-07-11 |
| 1205329042 | Louis A Gonzalez | Registered Nurse | 2362 W Gramercy Pl, San Antonio, TX 78201 | 2018-06-06 |
| 1194212860 | Zarzamora Healthcare LLC | Pharmacy | 6800 W Ih 10 # 200a, San Antonio, TX 78201 | 2018-04-18 |
| 1891211926 | Jessica Ann Salazar | Specialist/Technologist | 511 Crestview Dr, San Antonio, TX 78201 | 2017-08-21 |
| 1093262172 | Access Dental of Fredericksburg Pa | Dentist | 4315 Fredericksburg Balcones Height, 100a, San Antonio, TX 78201 | 2016-09-06 |
| 1144664962 | Raymond Evan Skunda | Orthopaedic Surgery | 6800 W Ih 10 Ste 250, San Antonio, TX 78201 | 2013-04-23 |
| 1114289477 | Shaun D Perryman | Dentist | 4522 Fredericksbug Rd., Ste A28, San Antonio, TX 78201 | 2012-06-13 |
| 1871872093 | Jose Miguel Urencio Marcue | Surgery | 6800 W Ih 10 Ste 200, San Antonio, TX 78201 | 2011-08-04 |
| 1962719658 | Julio C Mata | Specialist/Technologist, Other | 426 Concord Pl, San Antonio, TX 78201 | 2010-09-02 |
| Find all providers in zip 78201 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306452354 | Cesar Oscar Gonzalez | Dentist | 20122 Stone Oak Pkwy Ste 101, San Antonio, TX 78258-7041 | 2020-09-16 |
| 1760093397 | Grace Jie Zhang | Dentist | 11535 West Ave # A, San Antonio, TX 78213-1343 | 2020-08-17 |
| 1104436831 | Tian Meng | Dentist | 8110 W Loop 1604 N, San Antonio, TX 78254-2104 | 2020-08-07 |
| 1780217976 | Tovar Dental, Pllc | Dentist | 11840 Alamo Ranch Parkway, #90, San Antonio, TX 78253 | 2020-02-17 |
| 1972133767 | Evodent Dental Pllc | Dentist | 18838 Stone Oak Pkwy Ste 102, San Antonio, TX 78258-4179 | 2020-01-21 |
| 1659901502 | Dental Care of San Antonio, Pllc | Dentist | 115 N Loop 1604 E Ste 1104, San Antonio, TX 78232-1399 | 2020-01-20 |
| 1437792041 | Precision Smile Structure Culebra Pllc | Dentist | 6626 W Loop 1604 N Ste 216, San Antonio, TX 78254-6602 | 2019-10-26 |
| 1013558998 | Great White Dental Pllc | Dentist | 238 Sw Military Dr Ste 104, San Antonio, TX 78221-1657 | 2019-10-02 |
| 1376192443 | Deborah R. Keepers Dds Pa | Dentist | 11309 Bandera Rd Ste 101, San Antonio, TX 78250-2602 | 2019-09-10 |
| 1487202750 | Western Dental Care | Dentist | 2347 Nw Military Hwy Ste 101, San Antonio, TX 78231-2502 | 2019-08-29 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78201 |
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| 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.