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SA-LTP PA NPI 1619167921


NPI Information

NPI: 1619167921
Provider Name: SA-LTP PA

Doing Business As: LITTLE TEXANS PEDIATRICS

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 45D0951425

Address:
20306 ENCINO LEDGE
SUITE 101
SAN ANTONIO, TX
ZIP 78259
Phone: (210) 402-0138
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SA-LTP PA is a pediatrics in San Antonio, TX. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. SA-LTP PA NPI is 1619167921. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Little Texans Pediatrics.

The provider's business location address is:

20306 ENCINO LEDGE
SUITE 101
SAN ANTONIO, TX
ZIP 78259
Phone: (210) 402-0138
Fax: (210) 402-0051

The provider's authorized official is Teresa M Rochabrun .
The authorized official title is Manager and has the following contact phone number (210) 402-0138.

The CLIA number assigned to this NPI record is 45D0951425 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/1/2007 and was last updated on 9/25/2012.


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
1208000000XPediatricsK3632TEXASYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10075CLOTHERTEXASBLUE CROSS BLUE SHIELD
2=========OTHERTEXASTRICARE
3092309601MEDICAIDTEXAS
4=========OTHERTEXASHUMANA
5=========OTHERTEXASPACIFICARE
6=========OTHERTEXASGEHA
7=========OTHERTEXASVALERO
8092309602MEDICAIDTEXAS
9=========OTHERTEXASBENEFIT CONCEPT
10=========OTHERTEXASCIGNA
11=========OTHERTEXASAETNA
12=========OTHERTEXASCOMUNITY FIRST
13=========OTHERTEXASUNICARE
14=========OTHERTEXASBENEFIT PLANNERS
15=========OTHERTEXASUNITED HEALTHCARE
16=========OTHERTEXASCCN
17=========OTHERTEXASCPS/HARRINGTON
18=========OTHERTEXASPHCS
19=========OTHERTEXASBEECHSTREET

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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