=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073045977
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CALZADA MEDICAL ASSOCIATES PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/30/2017
-----------------------------------------------------
Last Update Date | 10/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 147 W SUNSET RD STE 200
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78209-2080
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-826-1215
-----------------------------------------------------
Fax | 210-826-1241
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 147 W SUNSET RD STE 217
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78209-2676
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-826-1215
-----------------------------------------------------
Fax | 210-826-1241
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | PEDRO A. CALZADA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 210-826-1215
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WW0000X
-----------------------------------------------------
Taxonomy Name | Wound Care Registered Nurse
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | N2976
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------