| Family Medical Home, Pllc | |
|
9179 Grissom Rd Ste 101 San Antonio TX 78251-2810 | |
| (210) 680-8081 | |
| (210) 680-3133 |
| Full Name | Family Medical Home, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 9179 Grissom Rd Ste 101, San Antonio, Texas |
| Authorized Official Name and Position | Jesus Alejandro Rodriguez (MANAGER) |
| Authorized Official Contact | 2106808081 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medical Home, Pllc 9179 Grissom Rd Ste 101 San Antonio TX 78251-2810 Ph: (210) 680-8081 | Family Medical Home, Pllc 9179 Grissom Rd Ste 101 San Antonio TX 78251-2810 Ph: (210) 680-8081 |
| NPI Number | 1841557642 |
|---|---|
| Provider Enumeration Date | 04/18/2012 |
| Last Update Date | 04/18/2012 |
| Medicare PECOS PAC ID | 3274780127 |
|---|---|
| Medicare Enrollment ID | O20120828000324 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841557642 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M8960 (Texas) | Primary |
| Provider Name | Jesus A Rodriguez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447383187 PECOS PAC ID: 6406923903 Enrollment ID: I20080925000310 |
| Provider Name | Pedro A Calzada |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043343064 PECOS PAC ID: 5193874998 Enrollment ID: I20090528000128 |
| Provider Name | Alessandro Valverde |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821400805 PECOS PAC ID: 1254656341 Enrollment ID: I20170823002583 |
| Provider Name | Sheila Renee Pinkston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386057883 PECOS PAC ID: 4486979556 Enrollment ID: I20170824002028 |
| Provider Name | Clint Kelley Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588012447 PECOS PAC ID: 8628369931 Enrollment ID: I20190708002805 |
| Provider Name | Sai-han Ackerman Yu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831656081 PECOS PAC ID: 2264860006 Enrollment ID: I20200310001587 |
| Provider Name | Susan Sankey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427662949 PECOS PAC ID: 9234559204 Enrollment ID: I20201013000354 |
| Provider Name | Jonathan Sidle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750996534 PECOS PAC ID: 4183038961 Enrollment ID: I20210208001212 |
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