KENNEDY MICHAEL TLASECA (NPI# 1639604069) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639604069 |
| Entity Type | Individual |
| Full Name | KENNEDY MICHAEL TLASECA |
| Credential | MD |
| Practice Address |
1055 Ada St San Antonio TX 78223-1703 |
| Mailing Address |
Po Box 734812 Dallas TX 75373-4812 |
| Practice Telephone | 2103585515 |
| Practice Fax Number | 2103585530 |
| Mailing Telephone | 2103589500 |
| Mailing Fax Number | 2103589183 |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2020-08-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | S6963 | TX | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1055 ADA ST |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78223-1703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417947326 | Marco Xavier Garcia | Internal Medicine | 1055 Ada St, San Antonio, TX 78223-1703 | 2005-10-24 |
| 1124509625 | Bridget Sedano Haggerty | Nurse Practitioner | 1055 Ada St, San Antonio, TX 78223-1703 | 2018-08-23 |
| 1821501347 | Daniel R. Flores | Pharmacist | 1055 Ada St, San Antonio, TX 78223-1703 | 2017-11-06 |
| 1740715671 | Hao Shen | Family Medicine | 1055 Ada St, San Antonio, TX 78223-1703 | 2017-04-28 |
| 1104370543 | Justine Lee Hudson | Physician Assistant | 1055 Ada St, San Antonio, TX 78223-1703 | 2016-08-13 |
| 1891149381 | Albert Bararwandika | Family Medicine | 1055 Ada St, San Antonio, TX 78223-1703 | 2016-04-20 |
| 1689033722 | Stephanie Kaiser | Physician Assistant | 1055 Ada St, San Antonio, TX 78223-1703 | 2016-02-17 |
| 1477936219 | Deborah Dergan | Family Medicine | 1055 Ada St, San Antonio, TX 78223-1703 | 2015-06-29 |
| 1821476649 | Kathryn Wolters | Physical Therapist | 1055 Ada St, San Antonio, TX 78223-1703 | 2015-05-13 |
| 1639575053 | Tinesha Rios | Nurse Practitioner | 1055 Ada St, San Antonio, TX 78223-1703 | 2014-11-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598310344 | Celebraces Se Military Pllc | Dentist | 3611 Se Military Drive, Suite B101, San Antonio, TX 78223 | 2019-08-08 |
| 1295204410 | All Discountz Mobile Phlebotomy Services | Contractor | 6639 South New Braunfels, #19101, San Antonio, TEXAS 78223 | 2018-11-16 |
| 1588131585 | Ad Mobile Phlebotomy Services | Technician, Pathology | 6639 South New Braunfels Avenue, #19101, San Antonio, TEXAS 78223 | 2018-10-28 |
| 1437626694 | Valerie Brown | Technician, Pathology | C/o 6639 South New Braunfels Avenue, #19101, San Antonio, TEXAS 78223 | 2018-10-25 |
| 1285135574 | Allan Socrates Mamaril Angeles | Registered Nurse | 535 Hot Wells Blvd, Apt 301, San Antonio, TX 78223 | 2018-02-22 |
| 1356799845 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 3502 Se Military Drive, San Antonio, TX 78223 | 2016-05-25 |
| 1467810325 | Dsi Southeast San Antonio, LLC | Clinic/Center | 2635 S.e. Military Drive, San Antonio, TX 78223 | 2016-02-08 |
| 1477832293 | Jg-surgical Assistant's,llc | Specialist/Technologist, Other | 5311 Cynthia Linn, San Antonio, TX 78223 | 2011-08-10 |
| 1841580826 | Kiddo Denal Pa | Dentist | 3520 S. New Braunfels Ste 100, Kiddo Dental, San Antonio, TX 78223 | 2011-04-12 |
| 1770885162 | Primavera Primary Home Care, Inc | Custodial Care Facility | 1007 Fair, San Antonio, TX 78223 | 2010-11-17 |
| Find all providers in zip 78223 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356951735 | Central Texas Diabetes & Wellness Institute | Pediatrics | 8428 Bandera Rd Ste 2, San Antonio, TX 78250-2514 | 2020-07-31 |
| 1306455530 | Z-pediatrics Pllc | Pediatrics | 5886 Dezavala Rd Suite 101 #510, San Antonio, TX 78249 | 2020-07-23 |
| 1821606062 | Alamo City Healthy Kids and Families, Pllc | Pediatrics | 1919 Oakwell Farms Pkwy Ste 125, San Antonio, TX 78218-1720 | 2020-07-14 |
| 1508403585 | Michelle Ann Portis | Pediatrics | 502 Madison Oak Dr Ste 245, San Antonio, TX 78258-4086 | 2019-12-09 |
| 1144782970 | Kelly L Thomas | Pediatrics | 10011 Ink Wells Dr, San Antonio, TX 78250-7011 | 2019-04-01 |
| 1407384605 | Whitney Taylor | Pediatrics | 8606 Village Dr Unit A, San Antonio, TX 78217-5506 | 2017-06-01 |
| 1811428147 | Karen Lee Garay | Pediatrics | 13750 San Pedro Ave Ste 150, San Antonio, TX 78232-4382 | 2017-03-27 |
| 1538510664 | Suzanna Elizabeth Maupin | Pediatrics | 7355 Barlite Blvd Ste 201, San Antonio, TX 78224-1340 | 2016-06-30 |
| 1366804866 | Allison Wells Morales | Pediatrics | 11085 Bandera Rd # 102, San Antonio, TX 78250-6814 | 2016-03-23 |
| 1275995771 | Pedro Zavala | Pediatrics | 11503 Nw Military Hwy Ste 113, San Antonio, TX 78231-1998 | 2016-03-23 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78223 |
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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.