PLASTIC, RECONSTRUCTIVE & MICROSURGICAL ASSOCIATES OF SOUTH TEXAS PLLC
NPI 1063405504
Surgery - Plastic and Reconstructive Surgery in San Antonio, TX

Q: What is Plastic, Reconstructive & Microsurgical Associates Of South Texas PLLC's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Active since August 30, 2005CLIA Certified · 2 labs

9635 HUEBNER RD, SAN ANTONIO, TX 78240(210) 692-1181(210) 692-7584 Get Directions Write a Review

NPPES record last updated: February 22, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Plastic, Reconstructive & Microsurgical Associates Of South Texas Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PLASTIC, RECONSTRUCTIVE & MICROSURGICAL ASSOCIATES OF SOUTH TEXAS PLLC (NPI 1063405504) is a healthcare organization registered as a plastic and reconstructive surgery in San Antonio, Texas and active in the NPI registry since August 2005. The organization holds 2 active CLIA laboratory certificates, maintains a secondary practice location in San Antonio, and lists Peter Robert Ledoux, President, as its authorized official.

NPPES Registry Identity

NPI1063405504

Entity TypeOrganization

Primary Taxonomy2086S0122X

Legal Business NamePLASTIC, RECONSTRUCTIVE & MICROSURGICAL ASSOCIATES OF SOUTH TEXAS PLLC

Location Address9635 HUEBNER RDSan Antonio, TX 78240-1512

Mailing Address9635 Huebner RdSan Antonio, TX 78240-1512 · (210) 692-1181 · Fax (210) 692-7584

Phone(210) 692-1181

Fax(210) 692-7584

Organization SubpartNo

Authorized OfficialPeter Robert LedouxPresident · (210) 692-1181

Enumeration DateAugust 30, 2005

Last NPPES UpdateFebruary 22, 2023

NPPES CertifiedFebruary 22, 2023

✔ NPI 1063405504 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code2086S0122X

Definition

A surgeon who specializes in plastic and reconstructive surgery.

9635 HUEBNER RD, San Antonio, TX 78240

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Secondary Practice Location 1

Location 1502 Madison Oak Dr Ste 220San Antonio, TX 78258-4192 · Phone (210) 692-1181

Other Identifiers 1

Medicaid084224701TX

Group Practice 1

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

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2056051

Plastic Reconstructive & Microsurgical Associates South Texas PLLC · San Antonio, TX

Active · expires Mar 20, 2027

CLIA Number45D2056051

Laboratory TypePhysician Office

Certificate Effective DateMarch 21, 2025

Certificate Expiration DateMarch 20, 2027

Laboratory DirectorPeter R. Ledoux

Laboratory Phone(210) 692-1181

Laboratory LocationPlastic Reconstructive & Microsurgical Associates South Texas PLLC9635 Huebner Road, San Antonio, TX 78240

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 45D2073732

Plastic Reconstructive & Microsurgical Associates Of South Texas PLLC · San Antonio, TX

Active · expires Feb 23, 2028

CLIA Number45D2073732

Laboratory TypePhysician Office

Certificate Effective DateFebruary 24, 2026

Certificate Expiration DateFebruary 23, 2028

Laboratory DirectorPeter R. Ledoux

Laboratory Phone(210) 692-1181

Laboratory LocationPlastic Reconstructive & Microsurgical Associates Of South Texas PLLC540 Madison Oak Drive Suite 600, San Antonio, TX 78258

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GARY I. ARISHITA M.D.

Surgery (Plastic and Reconstructive Surgery)