GASTROENTEROLOGY CLINIC OF SAN ANTONIO, P.A. NPI 1053490631

Internal Medicine (Gastroenterology) in San Antonio, TX

NPI 1053490631 Organization Internal Medicine Gastroenterology CLIA Number 45D0710307 CLIA Certificate of Accreditation

About GASTROENTEROLOGY CLINIC OF SAN ANTONIO, P.A.

Gastroenterology Clinic Of San Antonio, P.a. is an internal medicine provider established in San Antonio, Texas specializing in internal medicine (gastroenterology) . The NPI number of Gastroenterology Clinic Of San Antonio, P.a. is 1053490631 and was assigned on November 2006. The practitioner's primary taxonomy code is 207RG0100X. The provider is registered as an organization and their NPI record was last updated 6 years ago. Gastroenterology Clinic Of San Antonio, P.a. operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Russell Havranek Md (Ceo)

An internist like Gastroenterology Clinic Of San Antonio, P.a. is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

The CLIA number of Gastroenterology Clinic Of San Antonio, P.a. is 45D0710307 registered as a "physician office" facility with a CLIA Certificate of Accreditation. This is a CLIA certificate is issued to Gastroenterology Clinic Of San Antonio, P.a. on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.

NPI

1053490631

Provider NameGASTROENTEROLOGY CLINIC OF SAN ANTONIO, P.A.
Provider Location Address8550 DATAPOINT DR SUITE 200 SAN ANTONIO, TX 78229
Provider Mailing Address8550 DATAPOINT DR SUITE 200 SAN ANTONIO, TX 78229
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date11-03-2006
Last Update Date10-29-2015


Primary Taxonomy

Taxonomy Code207RG0100X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
SpecializationGastroenterology
Taxonomy DescriptionAn internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

Business Address

GASTROENTEROLOGY CLINIC OF SAN ANTONIO, P.A.
8550 DATAPOINT DR
SUITE 200
SAN ANTONIO, TX
ZIP 78229
Phone: (210) 615-8308
Fax: (210) 615-8313

Get Directions


Mailing Address

GASTROENTEROLOGY CLINIC OF SAN ANTONIO, P.A.
8550 DATAPOINT DR
SUITE 200
SAN ANTONIO, TX
ZIP 78229
Phone: (210) 615-8308
Fax: (210) 615-8313



Authorized Official

Authorized Official Name RUSSELL HAVRANEK MD
Authorized Official TitleCEO
Authorized Official Phone(210) 615-8308

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1053490631 is:

CLIA Number45D0710307
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Accreditation

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
00BL45OTHER (01)TX
044080201MEDICAID (05)TX

Other Providers at the same location


The following 12 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1811042096HAND AND MICROSURGERY
Organization
Surgery (Surgery of the Hand)8550 DATAPOINT DR SUITE 110
SAN ANTONIO, TX 78229
(210) 615-5350
1285896613MS. CYNTHIA DIANE ALEXANDER OT,MS,CHT,CLT
Individual
Occupational Therapist (Hand)8550 DATAPOINT DR SUITE 110
SAN ANTONIO, TX 78229
(210) 615-5350
1124091079DR. GARY SCOTT GOSSEN M.D.
Individual
Internal Medicine (Gastroenterology)8550 DATAPOINT DR SUITE 200
SAN ANTONIO, TX 78229
(210) 615-8308
1154374742DR. BASSEM MAZLOUM M.D.
Individual
Specialist8550 DATAPOINT DR SUITE 200
SAN ANTONIO, TX 78229
(210) 615-8308
1164535191 JORGE MUNOZ M.D.
Individual
Specialist8550 DATAPOINT DR SUITE 200
SAN ANTONIO, TX 78229
(210) 615-8308
1871672519 RUSSELL DEAN HAVRANEK MD
Individual
Internal Medicine (Gastroenterology)8550 DATAPOINT DR SUITE 200
SAN ANTONIO, TX 78229
(210) 615-8308
1760561492 DAVID L STUMP MD
Individual
Internal Medicine (Gastroenterology)8550 DATAPOINT DR SUITE 200
SAN ANTONIO, TX 78229
(210) 615-8308
1245319995 VICTOR FRANZ ZURITA MD
Individual
Internal Medicine (Gastroenterology)8550 DATAPOINT DR SUITE 200
SAN ANTONIO, TX 78229
(210) 615-8308
1295814952 CHARLES W RANDALL MD
Individual
Internal Medicine (Gastroenterology)8550 DATAPOINT DR SUITE 200
SAN ANTONIO, TX 78229
(210) 615-8308
1174843726DR. NICHOLAS PEREZ MARTINEZ M.D.
Individual
Internal Medicine (Gastroenterology)8550 DATAPOINT DR SUITE 200
SAN ANTONIO, TX 78229
(210) 615-8308
1023301488UAP SAN ANTONIO ENDO, LLC
Organization
Nurse Anesthetist, Certified Registered8550 DATAPOINT DR SUITE 100
SAN ANTONIO, TX 78229
(972) 763-3893
1093271546 DEANNA MAY
Individual
Nurse Practitioner (Family)8550 DATAPOINT DR
SAN ANTONIO, TX 78229
(210) 615-8308

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.