MAURICIO ANTONIO CENTENO LSA NPI 1679865265

NPI Information

NPI: 1679865265
Provider Name: MAURICIO ANTONIO CENTENO, LSA
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Address:
19026 STONE OAK PKWY STE 210B
SAN ANTONIO, TX
ZIP 78258
Phone: (210) 606-8213
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Mauricio Antonio Centeno, LSA is a surgical physician assistant in San Antonio, TX. Mauricio Antonio Centeno, LSA NPI is 1679865265. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

19026 STONE OAK PKWY STE 210B
SAN ANTONIO, TX
ZIP 78258-229
Phone: (210) 606-8213
Fax: (210) 491-1349

The enumeration date for this NPI number is 5/14/2011 and was last updated on 2/1/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	SA00481	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	12678899	OTHER	TEXAS	CAQH
2	SA00481	OTHER	TEXAS	SURGICAL ASSISTANT LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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