NPI age
19 years
Enumerated 2006-08-11
● Active
Type 1 · Individual
Glen A. Medellin, M.D.
Medellin is 1 of 6 pediatrics providers in San Antonio and 1 of 24 in Texas.
Primary specialty
Pediatrics
Plus 1 subspecialty
Licensed in
TX
1 state
Status
Active
No deactivations on record
Last NPPES update
2024-09-19
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 24 active pediatrics providers in Texas.
NPI age
19 years
↑ 6 yr above median (12 yr)
State licenses
1 state
37% of peers hold multiple states
Subspecialties
1
In the 70% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-08Enumerated in NPPES
2006
2026
Where they practice
Practice location
903 W Martin St
San Antonio, TX 782070903
Mailing address
Po Box 87
San Antonio, TX 782910087
Additional practice locations
1 secondary location on file with NPPES.
Location 2
4502 Medical Dr
San Antonio, TX 782294402
Specialties
-
Pediatrics PrimaryA pediatrician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize...
-
PediatricsA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 125095309 | MEDICAID CSHCN |
| 05 (TX) | 125095307 | |
| 05 (TX) | 125095308 | |
| 01 (TX) | 125095307 | CSHCN |
Practice context
Part of a multi-provider practice. 226 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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