| Michael Shawn Lively, MD | |
|
710 Water St, Kerrville, TX 78028-5329 | |
| (830) 258-7747 | |
| Not Available |
| Full Name | Michael Shawn Lively |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 710 Water St, Kerrville, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962460303 | NPI | - | NPPES |
| 8M6794 | Other | TX | BCBS |
| 180018702 | Other | TX | CSHCN |
| 180018701 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | M3632 (Texas) | Primary |
| Entity Name | Legacy Urgent Care Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568622272 PECOS PAC ID: 3072679828 Enrollment ID: O20090304000140 |
| Entity Name | Premier Physicians - Ii Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801204656 PECOS PAC ID: 9234416744 Enrollment ID: O20170511000584 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Shawn Lively, MD 1845 Foothills Dr, Kerrville, TX 78028-3873 Ph: (717) 246-9097 | Michael Shawn Lively, MD 710 Water St, Kerrville, TX 78028-5329 Ph: (830) 258-7747 |
Richard Mason, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 710 Water St, Kerrville, TX 78028 Phone: 830-258-7747 | |
Benjamin Travis Halloran, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: Peterson Regional Medical Center, 551 Hill Country Drive, Kerrville, TX 78028 Phone: 830-896-4200 | |
Benjamin Lucas Harper, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 130 W Main St, Kerrville, TX 78028 Phone: 830-258-7769 | |
Dr. Rondalea Ann Rhoades, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 551 Hill Country Dr, Peterson Regional Medical Center, Kerrville, TX 78028 Phone: 830-896-4200 | |
Alan D Moy, D.O. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 551 Hill Country Dr, Kerrville, TX 78028 Phone: 310-488-0669 | |
Alfred Carl Roschmann, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 218 Quinlan St # 372, Kerrville, TX 78028 Phone: 775-241-8553 Fax: 775-852-6902 | |
Eileen Marie Toloza-thompson, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 551 Hill Country Dr, Kerrville, TX 78028 Phone: 830-896-4200 |