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

Q: What is the provider's specialty?

The provider's specialty is Surgery with taxonomy code 2086S0122X and a focus in Plastic and Reconstructive Surgery.

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: July 19, 2026.

Table of Contents

NPI Profile Information
Primary Taxonomy
Group Taxonomy
Insurance Plans Accepted
Secondary Locations
Authorized Official
CLIA Information
Other Providers Same Location
Frequently Asked Questions

Organization
Surgery
Plastic and Reconstructive Surgery
CLIA Number: 45D2073732
CLIA Cert. Type: Physician Office
CLIA Exp. Date: 02-23-2028

About PLASTIC, RECONSTRUCTIVE & MICROSURGICAL ASSOCIATES OF SOUTH TEXAS PLLC

This page provides the complete NPI Profile along with additional information for Plastic, Reconstructive & Microsurgical Associates Of South Texas Pllc, a provider established in San Antonio, Texas operating as a Surgery, focusing in plastic and reconstructive surgery . The healthcare provider is registered in the NPI registry with number 1063405504 assigned on August 2005. The practitioner's primary taxonomy code is 2086S0122X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Peter Robert Ledoux Md (President)

NPI: 1063405504 Verify this NPI
Provider Name: PLASTIC, RECONSTRUCTIVE & MICROSURGICAL ASSOCIATES OF SOUTH TEXAS PLLC
Entity Type: Organization
Location Address: 9635 HUEBNER RD SAN ANTONIO, TX 78240
Location Phone: (210) 692-1181
Location Fax: (210) 692-7584
Mailing Address: 9635 HUEBNER RD SAN ANTONIO, TX 78240
Mailing Phone: (210) 692-1181
Mailing Fax: (210) 692-7584
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 08-30-2005
Last Update Date: 02-22-2023
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Location Map

Secondary Locations

502 Madison Oak Dr Ste 220
San Antonio, TX 78258
(210) 692-1181

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Surgery Plastic and Reconstructive Surgery
Taxonomy Code: 2086S0122X
Type: Allopathic & Osteopathic Physicians
Taxonomy Description: A surgeon who specializes in plastic and reconstructive surgery.

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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: PETER ROBERT LEDOUX MD
Authorized Official Title: PRESIDENT
Authorized Official Phone: (210) 692-1181

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
084224701	MEDICAID (05)	TX

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 this NPI number is:

CLIA Number: 45D2073732
Facility Type: Physician Office
Certificate Effective Date: February 24, 2026
Certificate Expiration Date: February 23, 2028
Laboratory Director: PETER R. LEDOUX
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to Plastic, Reconstructive & Microsurgical Associates Of South Texas Pllc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.