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DIRECT MEDICAL PLLC NPI 1689104846


NPI Information

NPI: 1689104846
Provider Name: DIRECT MEDICAL PLLC

Doing Business As: DIRECT MED CLINIC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 45D2136592

Address:
1010 NW LOOP 410 STE 100A
SAN ANTONIO, TX
ZIP 78213
Phone: (210) 886-8031
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DIRECT MEDICAL PLLC is a family medicine in San Antonio, TX. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DIRECT MEDICAL PLLC NPI is 1689104846. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Direct Med Clinic.

The provider's business location address is:

1010 NW LOOP 410 STE 100A
SAN ANTONIO, TX
ZIP 78213-220
Phone: (210) 886-8031
Fax: (210) 886-8059

The provider's authorized official is Roger Moczygemba .
The authorized official title is Owner and has the following contact phone number (210) 264-5500.

The CLIA number assigned to this NPI record is 45D2136592 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/19/2017 and was last updated on 1/17/2019.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

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

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