MR. ISRAEL D. CUSTODIO PA-C
NPI 1366570087
Physician Assistant - Medical in San Antonio, TX

Q: What is Israel Custodio's NPI number?

The NPI number for Israel Custodio is 1366570087. It was assigned to this individual provider in the NPPES registry on March 2, 2007.

Q: What is Israel Custodio's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Israel Custodio was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 02, 2007

4805 FREDERICKSBURG RD, SAN ANTONIO, TX 78229(210) 979-7999(210) 798-2457 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mr. Israel D. Custodio Pa-c NPPES

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

MR. ISRAEL D. CUSTODIO PA-C (NPI 1366570087) is an individual medical provider in San Antonio, Texas, licensed in Texas (PA01549) and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1366570087

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameMR. ISRAEL D. CUSTODIOCredential: PA-C

Location Address4805 FREDERICKSBURG RDSan Antonio, TX 78229-3627

Mailing Address4805 Fredericksburg RdSan Antonio, TX 78229-3627 · (210) 979-7999 · Fax (210) 798-2457

Phone(210) 979-7999

Fax(210) 798-2457

Sole ProprietorNo

Enumeration DateMarch 2, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1366570087 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in TX · PA01549

4805 FREDERICKSBURG RD, San Antonio, TX 78229

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Israel Custodio's NPI number?

The NPI number for Israel Custodio is 1366570087. It was assigned to this individual provider in the NPPES registry on March 2, 2007.

Where is Israel Custodio located?

Israel Custodio practices at 4805 Fredericksburg Rd, San Antonio, TX 78229. The listed phone number is (210) 979-7999.

What is Israel Custodio's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Israel Custodio was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.