Healthcare Provider Details

I. General information

NPI: 1003225848
Provider Name (Legal Business Name): SAPNA RAGHUNATHAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2014
Last Update Date: 10/21/2022
Certification Date: 10/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 FLOYD CURL DR
SAN ANTONIO TX
78229-3931
US

IV. Provider business mailing address

8300 FLOYD CURL DR
SAN ANTONIO TX
78229-3931
US

V. Phone/Fax

Practice location:
  • Phone: 210-450-9490
  • Fax: 210-450-6065
Mailing address:
  • Phone: 210-450-9490
  • Fax: 210-450-6065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberT5006
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207RB0002X
TaxonomyObesity Medicine (Internal Medicine) Physician
License NumberT5006
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD468932
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberT5006
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: