Sou – Nephrology Physician, NPI 1275503393
Nephrology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Sou
PO BOX 504152
SAINT LOUIS, MO 631504152
Phone: (210) 212-8622
Fax: (210) 212-9197
Type: Mailing
12011 State Highway 151 Ste 202
San Antonio, TX 782511233
Phone: (210) 265-8155
Fax: (210) 212-9197
Type: Location
205 22nd St
Hondo, TX 788612520
Phone: (210) 614-7900
Fax: (210) 615-1211
Type: Location
19910 Interstate 35 S Ste 102
Lytle, TX 780523547
Phone: (210) 614-7900
Fax: (210) 615-1211
Type: Location
2011 E Houston St Ste 101A
San Antonio, TX 782022916
Phone: (210) 226-1717
Fax: (210) 212-9197
Type: Location
3307 Bob Rogers Dr Ste B
Eagle Pass, TX 788526979
Phone: (830) 212-4786
Fax: (210) 212-9197
Type: Location
1595 S Main St Ste 107
Boerne, TX 780063329
Phone: (210) 614-7900
Fax: (210) 615-1211
Type: Location
215 N San Saba Ste 206
San Antonio, TX 782073120
Phone: (210) 615-6626
Fax: (210) 477-0279
Type: Location
11212 State Highway 151 Ste 320
San Antonio, TX 782514502
Phone: (210) 265-8155
Fax: (210) 477-2750
Type: Location
137 Palo Alto Rd
San Antonio, TX 782113736
Phone: (210) 572-5330
Fax: (210) 368-2816
Type: Location
8115 Datapoint Dr Ste 200
San Antonio, TX 782293745
Phone: (210) 614-7900
Fax: (210) 615-1211
Type: Location
12970 Toepperwein Rd
Live Oak, TX 782334767
Phone: (210) 664-0717
Fax: (210) 664-0719
Type: Location
215 N SAN SABA STE 301
SAN ANTONIO, TX 782073164
Phone: (210) 212-8622
Fax: (210) 212-9197
Type: Location
PO BOX 650002
DEPT 8286
DALLAS, TX 75265
Phone: (210) 212-8622
Fax: (210) 212-9197
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-08-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040823000238 | O | Clinic/Group Practice | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 63150)
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Reviews
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