EMERGENCY PEDIATRIC PHYSICIAN MGMT LLC NPI 1508814385

NPI Information

  • NPI: 1508814385
  • Provider Name: EMERGENCY PEDIATRIC PHYSICIAN MGMT LLC
  • Classification: Emergency Medicine - 207PP0204X
  • Specialization: Pediatric Emergency Medicine
  • Entity Type: Organization
  • Address: 520 MADISON OAK
    PEDS - EMERGENCY ROOM
    SAN ANTONIO, TX
    ZIP 78258
  • Phone: (210) 297-4050

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NPI Details

EMERGENCY PEDIATRIC PHYSICIAN MGMT LLC is a pediatric emergency medicine emergency medicine in San Antonio, TX. The provider is pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department. EMERGENCY PEDIATRIC PHYSICIAN MGMT LLC NPI is 1508814385. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

520 MADISON OAK
PEDS - EMERGENCY ROOM
SAN ANTONIO, TX
ZIP 78258-913
Phone: (210) 297-4050

The provider's authorized official is James S. Potyka .
The authorized official title is General Partner and has the following contact phone number (210) 495-9860.

The enumeration date for this NPI number is 5/4/2006 and was last updated on 6/13/2008.

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
1207PP0204XEmergency MedicinePediatric Emergency MedicineYes

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
10030MSOTHERTEXASBCBSTX
2174511901MEDICAIDTEXAS
300911YMEDICARE PINTEXAS

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: 11/21/2025

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