SHAYLON DWAYNE RETTIG M.D. NPI 1679595045

NPI Information

NPI: 1679595045
Provider Name: SHAYLON DWAYNE RETTIG, M.D.
Classification: Pediatrics - 2080P0204X
Entity Type: Individual

Specialization: Pediatric Emergency Medicine

PECOS Registration: Yes

Address:
333 N SANTA ROSA ST
SAN ANTONIO, TX
ZIP 78207
Phone: (210) 704-4708
Get Directions

Shaylon Dwayne Rettig, M.D. is a pediatric emergency medicine pediatrics in San Antonio, TX. The provider is a pediatrician who has special qualifications to manage emergencies in infants and children. Shaylon Dwayne Rettig, M.D. NPI is 1679595045. 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:

333 N SANTA ROSA ST
SAN ANTONIO, TX
ZIP 78207-108
Phone: (210) 704-4708

The NPI 1679595045 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/24/2006 and was last updated on 6/17/2021.

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	174400000X	Specialist		L9869	TEXAS	No
2	2080P0204X	Pediatrics	Pediatric Emergency Medicine	L9869	TEXAS	Yes
3	2080S0010X	Pediatrics	Sports Medicine	L9869	TEXAS	No

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	184276701	OTHER	TEXAS	GROUP
2	174284303	MEDICAID	TEXAS
3	PO#174284301	MEDICAID	TEXAS

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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