Provider Demographics
NPI:1154499077
Name:THE SAN ANTONIO ORTHOPAEDIC GROUP, LLP
Entity Type:Organization
Organization Name:THE SAN ANTONIO ORTHOPAEDIC GROUP, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:CHLOE
Authorized Official - Middle Name:B
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-804-5416
Mailing Address - Street 1:3327 RESEARCH PLAZA DRIVE
Mailing Address - Street 2:SUITE 404
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78235-5159
Mailing Address - Country:US
Mailing Address - Phone:210-804-5400
Mailing Address - Fax:210-678-4142
Practice Address - Street 1:3327 RESEARCH PLAZA DRIVE
Practice Address - Street 2:SUITE 404
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78235-5159
Practice Address - Country:US
Practice Address - Phone:210-804-5400
Practice Address - Fax:210-678-4142
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE SAN ANTONIO ORTHOPAEDIC GROUP, LLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-30
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle SurgeryGroup - Multi-Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145160102Medicaid
TX164381902OtherMEDICAID DME
TX0005GWOtherBC GROUP #
CJ3104OtherRAILROAD MEDICARE
TX145160102Medicaid
CJ3104OtherRAILROAD MEDICARE