| Heart Of Texas Community Health Center Inc | |
|
1610 Providence Dr Waco TX 76707-2261 | |
| (254) 313-4200 | |
| (254) 313-4549 |
| Full Name | Heart Of Texas Community Health Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1610 Providence Dr, Waco, Texas |
| Authorized Official Name and Position | Matthew Polk (COO) |
| Authorized Official Contact | 2543134412 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heart Of Texas Community Health Center Inc 1600 Providence Dr Waco TX 76707-2261 Ph: (254) 313-4200 | Heart Of Texas Community Health Center Inc 1610 Providence Dr Waco TX 76707-2261 Ph: (254) 313-4200 |
| NPI Number | 1568191492 |
|---|---|
| Provider Enumeration Date | 06/07/2022 |
| Last Update Date | 06/07/2022 |
| Medicare PECOS PAC ID | 1153370242 |
|---|---|
| Medicare Enrollment ID | O20050114000813 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568191492 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Stacy Lynn Lessman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821095316 PECOS PAC ID: 5395734578 Enrollment ID: I20040525001505 |
| Provider Name | Manish P Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922056357 PECOS PAC ID: 7517948383 Enrollment ID: I20040527000232 |
| Provider Name | Nicholas Schwedock |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598742124 PECOS PAC ID: 0749262723 Enrollment ID: I20040603000472 |
| Provider Name | John H Gill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578540183 PECOS PAC ID: 3274516166 Enrollment ID: I20040610001793 |
| Provider Name | Kelley M Reynolds |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528045846 PECOS PAC ID: 2769434554 Enrollment ID: I20050221000526 |
| Provider Name | Randall Lynn York |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740261395 PECOS PAC ID: 4688601016 Enrollment ID: I20050718000811 |
| Provider Name | Michael J Borucki |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194713230 PECOS PAC ID: 6103858402 Enrollment ID: I20050907001234 |
| Provider Name | Matthew R Porter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023095676 PECOS PAC ID: 3072530716 Enrollment ID: I20051101000441 |
| Provider Name | Jackson O Griggs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861479818 PECOS PAC ID: 9830117571 Enrollment ID: I20051110000592 |
| Provider Name | Terriawkia A Woods-campbell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861479180 PECOS PAC ID: 0345263729 Enrollment ID: I20060111001104 |
| Provider Name | Jenny Snow Carl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396712691 PECOS PAC ID: 1850315391 Enrollment ID: I20060123000952 |
| Provider Name | Wesley C Marshall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194702126 PECOS PAC ID: 4486668696 Enrollment ID: I20060126000739 |
| Provider Name | Martin R Pritchett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861425969 PECOS PAC ID: 7719994565 Enrollment ID: I20060320000359 |
| Provider Name | Rita L Haws |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043297005 PECOS PAC ID: 8820009624 Enrollment ID: I20060508000842 |
| Provider Name | Kevin Steele |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245268929 PECOS PAC ID: 5698786390 Enrollment ID: I20060509000822 |
| Provider Name | Floyd C Watson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447268164 PECOS PAC ID: 5890799795 Enrollment ID: I20060907000449 |
| Provider Name | Hayley S Voige |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598961963 PECOS PAC ID: 9335240951 Enrollment ID: I20070726000697 |
| Provider Name | Chia Lien Wang |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1689641656 PECOS PAC ID: 7214029644 Enrollment ID: I20070815000473 |
| Provider Name | Robert C Rainey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871781302 PECOS PAC ID: 8426131145 Enrollment ID: I20080218000646 |
| Provider Name | Karen M Patterson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629086954 PECOS PAC ID: 4183700404 Enrollment ID: I20080327000367 |
| Provider Name | Burritt W Hess |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902866569 PECOS PAC ID: 4284713215 Enrollment ID: I20080502000075 |
| Provider Name | Susan Laura Rhodes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144497637 PECOS PAC ID: 0446325898 Enrollment ID: I20080819000570 |
| Provider Name | Keith Boles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710946561 PECOS PAC ID: 6709951890 Enrollment ID: I20080825000620 |
| Provider Name | Donald M Hardin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083877054 PECOS PAC ID: 0941361869 Enrollment ID: I20081210000154 |
| Provider Name | Latrisha Spain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336399625 PECOS PAC ID: 7113080888 Enrollment ID: I20090107000508 |
| Provider Name | Rebecca D Mahan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255582607 PECOS PAC ID: 9133283997 Enrollment ID: I20090123000194 |
| Provider Name | Joel B Mahan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720239106 PECOS PAC ID: 8426112764 Enrollment ID: I20090130000387 |
| Provider Name | Jeremiah B Seely |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073753448 PECOS PAC ID: 2466519749 Enrollment ID: I20090401000341 |
| Provider Name | Josephine E Watson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699915066 PECOS PAC ID: 0446307979 Enrollment ID: I20090420000447 |
| Provider Name | Kenneth W Koeritz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881784775 PECOS PAC ID: 5890844468 Enrollment ID: I20090617000582 |
| Provider Name | Kimberly L Micus |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235199753 PECOS PAC ID: 6103970629 Enrollment ID: I20090819000043 |
| Provider Name | Claudia G Bachofen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982663886 PECOS PAC ID: 6507910031 Enrollment ID: I20090819000126 |
| Provider Name | Carl A Dunn |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1013977834 PECOS PAC ID: 6305990649 Enrollment ID: I20090820000422 |
| Provider Name | Mark A Beaird |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861452088 PECOS PAC ID: 6002960374 Enrollment ID: I20090820000655 |
| Provider Name | Matthew B Bierwirth |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750340568 PECOS PAC ID: 3577602986 Enrollment ID: I20091124000529 |
| Provider Name | Lauren G Barron |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245217058 PECOS PAC ID: 3870634645 Enrollment ID: I20091231000178 |
| Provider Name | Courtney Blair Parker-hudson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285611806 PECOS PAC ID: 4082747506 Enrollment ID: I20100804001192 |
| Provider Name | William Michael Chop |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639156425 PECOS PAC ID: 5698808012 Enrollment ID: I20100804001245 |
| Provider Name | James Earhart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700852183 PECOS PAC ID: 3678658770 Enrollment ID: I20100819000787 |
| Provider Name | Jason Bauerschlag |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275509838 PECOS PAC ID: 5496830598 Enrollment ID: I20100819000851 |
| Provider Name | Christopher W Teague |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821064486 PECOS PAC ID: 6305921404 Enrollment ID: I20100819000930 |
| Provider Name | Sally P Weaver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457338733 PECOS PAC ID: 1254524291 Enrollment ID: I20101021001284 |
| Provider Name | Floyd L Barry |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649257429 PECOS PAC ID: 8426245242 Enrollment ID: I20101206001199 |
| Provider Name | Michael L Jahrmarkt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598742108 PECOS PAC ID: 9830386598 Enrollment ID: I20101207000502 |
| Provider Name | Donald R Koester |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275510968 PECOS PAC ID: 6608063250 Enrollment ID: I20101208000289 |
| Provider Name | Stephanie E Claus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659673036 PECOS PAC ID: 0648454157 Enrollment ID: I20110407000426 |
| Provider Name | Jenny Lee Brakovec |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1689834863 PECOS PAC ID: 4183892169 Enrollment ID: I20110718000542 |
| Provider Name | Megan K Lemley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922394279 PECOS PAC ID: 7113197906 Enrollment ID: I20110906000253 |
| Provider Name | Pamela K Mckown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417244369 PECOS PAC ID: 7214104777 Enrollment ID: I20120124000619 |
| Provider Name | Lacy Coker Kessler |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629239579 PECOS PAC ID: 2062678592 Enrollment ID: I20120726000722 |
| Provider Name | Juanita Castillo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750554093 PECOS PAC ID: 3870740293 Enrollment ID: I20120820000997 |
| Provider Name | Julie K Bellah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528098167 PECOS PAC ID: 7113163890 Enrollment ID: I20130425000159 |
| Provider Name | Jesse Cover |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366730301 PECOS PAC ID: 8123266764 Enrollment ID: I20130521000417 |
| Provider Name | Janet R Ellor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114212800 PECOS PAC ID: 3072752070 Enrollment ID: I20130625000039 |
| Provider Name | Jeremy G Korteweg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073801015 PECOS PAC ID: 4880836725 Enrollment ID: I20130806000577 |
| Provider Name | Carena L Chai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063579704 PECOS PAC ID: 0648364067 Enrollment ID: I20130819000687 |
| Provider Name | Tiffany K Remsing |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881851863 PECOS PAC ID: 9234364019 Enrollment ID: I20131102000213 |
| Provider Name | Rebekkah L Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861780819 PECOS PAC ID: 2668601444 Enrollment ID: I20140128001305 |
| Provider Name | Benjamin Alan Wilson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992091003 PECOS PAC ID: 2466673264 Enrollment ID: I20141020002509 |
| Provider Name | Robert Ward |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720131618 PECOS PAC ID: 7810219490 Enrollment ID: I20141210001108 |
| Provider Name | Anna Hoffman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386044329 PECOS PAC ID: 6406179647 Enrollment ID: I20141219001389 |
| Provider Name | Lance Patrick Kelley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598069767 PECOS PAC ID: 5092038067 Enrollment ID: I20141223001414 |
| Provider Name | Ryan David Laschober |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861831034 PECOS PAC ID: 0749507499 Enrollment ID: I20150318000892 |
| Provider Name | Callie Carruth-harper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114319464 PECOS PAC ID: 5890013676 Enrollment ID: I20150407000360 |
| Provider Name | Thomas James Webb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588003867 PECOS PAC ID: 8224356639 Enrollment ID: I20150415001609 |
| Provider Name | Brandon Haney |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083908073 PECOS PAC ID: 4587979182 Enrollment ID: I20150811005340 |
| Provider Name | Rachel Harrington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710329859 PECOS PAC ID: 3779701313 Enrollment ID: I20151020002369 |
| Provider Name | Jacqueline Orler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811364466 PECOS PAC ID: 1850691163 Enrollment ID: I20151118000938 |
| Provider Name | Kelly Stanley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992177968 PECOS PAC ID: 0446551311 Enrollment ID: I20151217002136 |
| Provider Name | Becky Scott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770948010 PECOS PAC ID: 4880998632 Enrollment ID: I20160215002295 |
| Provider Name | Jennifer Seale |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407295785 PECOS PAC ID: 1254636707 Enrollment ID: I20160222002484 |
| Provider Name | Joshua Wesley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942612783 PECOS PAC ID: 9739486028 Enrollment ID: I20160331002104 |
| Provider Name | Deborah Simcox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396298410 PECOS PAC ID: 6305131095 Enrollment ID: I20160819000543 |
| Provider Name | Christopher Vera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760863153 PECOS PAC ID: 3577851757 Enrollment ID: I20161004002926 |
| Provider Name | Jonathan Seale |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255714739 PECOS PAC ID: 7618255464 Enrollment ID: I20161028000976 |
| Provider Name | Kimberly A Thornhill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396032686 PECOS PAC ID: 0143492298 Enrollment ID: I20161104001918 |
| Provider Name | Rebeka R Calhoun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992104871 PECOS PAC ID: 1456570779 Enrollment ID: I20161107001656 |
| Provider Name | Grace M Hecker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043659337 PECOS PAC ID: 7315227667 Enrollment ID: I20161203000204 |
| Provider Name | Iliana Neumann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508075185 PECOS PAC ID: 5496845893 Enrollment ID: I20161216000299 |
| Provider Name | Shannon C Mcdermitt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841736774 PECOS PAC ID: 4486937265 Enrollment ID: I20170202001211 |
| Provider Name | Natalie Fjellanger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851830376 PECOS PAC ID: 3173807831 Enrollment ID: I20170227000186 |
| Provider Name | Calvin Bradley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780096578 PECOS PAC ID: 0547545451 Enrollment ID: I20170315002238 |
| Provider Name | Raquel C Salinas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255869749 PECOS PAC ID: 5597035790 Enrollment ID: I20170720002535 |
| Provider Name | Marcela C Castillo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841516192 PECOS PAC ID: 3375761315 Enrollment ID: I20171002002848 |
| Provider Name | Stephen Mccall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578975389 PECOS PAC ID: 8123394368 Enrollment ID: I20171016002884 |
| Provider Name | Amanda Gayle Ibanez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326569666 PECOS PAC ID: 4789950270 Enrollment ID: I20171027002508 |
| Provider Name | Kayla Lammert |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1225457633 PECOS PAC ID: 2264799378 Enrollment ID: I20171128001825 |
| Provider Name | Horacio Sosa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831545938 PECOS PAC ID: 8820357486 Enrollment ID: I20180108000168 |
| Provider Name | Megan Abigail Arboleda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225484553 PECOS PAC ID: 0446519292 Enrollment ID: I20180124000975 |
| Provider Name | Ashley M Pitts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154838357 PECOS PAC ID: 3274893854 Enrollment ID: I20180130000546 |
| Provider Name | Morgan Estes |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1063916989 PECOS PAC ID: 1355604406 Enrollment ID: I20180424001860 |
| Provider Name | Katy Wesley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487066270 PECOS PAC ID: 0345521407 Enrollment ID: I20180806000647 |
| Provider Name | Melissa Ann Altamirano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760834808 PECOS PAC ID: 2769778463 Enrollment ID: I20180827000042 |
| Provider Name | Audrey N Patterson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1871085837 PECOS PAC ID: 6204186752 Enrollment ID: I20180905001163 |
| Provider Name | Katie Carranza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508293705 PECOS PAC ID: 1052539954 Enrollment ID: I20180906001285 |
| Provider Name | Bonnie Sue Nichols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861943268 PECOS PAC ID: 8123307022 Enrollment ID: I20180907000838 |
| Provider Name | Leslie Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003101718 PECOS PAC ID: 9931329646 Enrollment ID: I20180917000673 |
| Provider Name | Starla Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871872069 PECOS PAC ID: 3678702933 Enrollment ID: I20180919001473 |
| Provider Name | Teresa Randall-wong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568757268 PECOS PAC ID: 7214155183 Enrollment ID: I20180920000761 |
| Provider Name | Aaron Christian Blackwelder |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1629296553 PECOS PAC ID: 8426306382 Enrollment ID: I20180925001540 |
| Provider Name | Janet Huggard |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1013039510 PECOS PAC ID: 0143519603 Enrollment ID: I20180925002394 |
| Provider Name | Claudia I Raimondo |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1275510380 PECOS PAC ID: 8224389341 Enrollment ID: I20180927003147 |
| Provider Name | Michelle Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649729989 PECOS PAC ID: 3274812748 Enrollment ID: I20180928000024 |
| Provider Name | Julia Anne Riley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588140354 PECOS PAC ID: 2668723792 Enrollment ID: I20180928000440 |
| Provider Name | John Mccue |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1497732465 PECOS PAC ID: 8426348202 Enrollment ID: I20180928002070 |
| Provider Name | Taylor Gehring |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1538484571 PECOS PAC ID: 9931490489 Enrollment ID: I20181003000303 |
| Provider Name | Asana Mohamad |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1801101407 PECOS PAC ID: 6406145648 Enrollment ID: I20181004002423 |
| Provider Name | Wendi Weaver |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1114101821 PECOS PAC ID: 7012207426 Enrollment ID: I20181008000764 |
| Provider Name | Jason D Doel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811424815 PECOS PAC ID: 0143573782 Enrollment ID: I20181029000314 |
| Provider Name | Zachary Sartor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336595669 PECOS PAC ID: 2264785708 Enrollment ID: I20181030001399 |
| Provider Name | John Coleman Snider |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124474465 PECOS PAC ID: 3476806910 Enrollment ID: I20181030001800 |
| Provider Name | Steven Christopher Liebing |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770010787 PECOS PAC ID: 1355694852 Enrollment ID: I20181031000904 |
| Provider Name | Amy V Coker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699241844 PECOS PAC ID: 7911251715 Enrollment ID: I20181114001563 |
| Provider Name | Kimberly Trippodo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629544176 PECOS PAC ID: 8325384803 Enrollment ID: I20190104001920 |
| Provider Name | Jose Carlos Sepulveda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194252106 PECOS PAC ID: 5193063790 Enrollment ID: I20190206001026 |
| Provider Name | Andrew Pham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841646171 PECOS PAC ID: 5799023206 Enrollment ID: I20190207002443 |
| Provider Name | Crystal Steed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730616749 PECOS PAC ID: 3274871322 Enrollment ID: I20190214001750 |
| Provider Name | Kelsey Elaine Richardson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558717876 PECOS PAC ID: 9335487354 Enrollment ID: I20190215001756 |
| Provider Name | Rachel N Rube |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992151229 PECOS PAC ID: 0941548705 Enrollment ID: I20190220003309 |
| Provider Name | Brock Niceler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164608113 PECOS PAC ID: 8527195528 Enrollment ID: I20190227000327 |
| Provider Name | Morgan Nicole Dickerson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295262293 PECOS PAC ID: 9133468333 Enrollment ID: I20190306001137 |
| Provider Name | Lauren Elise Repa Dickman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093371809 PECOS PAC ID: 7517293350 Enrollment ID: I20190731002323 |
| Provider Name | Alexandra M Jones Adesina |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255722179 PECOS PAC ID: 8426340993 Enrollment ID: I20190829000918 |
| Provider Name | Sara Cooley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346882594 PECOS PAC ID: 5496187445 Enrollment ID: I20191113003174 |
| Provider Name | Jose R Pena |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407346927 PECOS PAC ID: 9133554116 Enrollment ID: I20200122000314 |
| Provider Name | Ashleigh Grace Holden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821624628 PECOS PAC ID: 6103256607 Enrollment ID: I20200424000641 |
| Provider Name | Malinda Villegas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912543208 PECOS PAC ID: 5294166120 Enrollment ID: I20200511000192 |
| Provider Name | James Huddleston |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144670480 PECOS PAC ID: 6204117484 Enrollment ID: I20200708003720 |
| Provider Name | Casey A Leamon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811487333 PECOS PAC ID: 4789002197 Enrollment ID: I20200917000708 |
| Provider Name | Joy R Burrell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104316603 PECOS PAC ID: 6002234325 Enrollment ID: I20200917001710 |
| Provider Name | Katherine Elizabeth Horton Altahif |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346777356 PECOS PAC ID: 4789002809 Enrollment ID: I20200922000405 |
| Provider Name | Callie Ann Leamon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679063184 PECOS PAC ID: 3476972282 Enrollment ID: I20200929000261 |
| Provider Name | Magen Terese Lesak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447740964 PECOS PAC ID: 1254751902 Enrollment ID: I20201019000497 |
| Provider Name | Suzanne Sarah Jacob |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255867057 PECOS PAC ID: 7911317987 Enrollment ID: I20201103000036 |
| Provider Name | Hilda Ana Deen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538778543 PECOS PAC ID: 5294145652 Enrollment ID: I20201113001681 |
| Provider Name | Margaret Rudyard Durham Bossaller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548741077 PECOS PAC ID: 4587078167 Enrollment ID: I20210121001841 |
| Provider Name | Hannah Kathryn Ermon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144753187 PECOS PAC ID: 7810398807 Enrollment ID: I20210629000018 |
| Provider Name | Joanne E Pritchard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215427687 PECOS PAC ID: 8820490089 Enrollment ID: I20210709001941 |
| Provider Name | Elizabeth Jane Keller Lolley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174059620 PECOS PAC ID: 4082018429 Enrollment ID: I20210809000545 |
| Provider Name | Jeremiah Lee Moen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578238929 PECOS PAC ID: 5597160499 Enrollment ID: I20210816001483 |
| Provider Name | Devon Nicole Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245813534 PECOS PAC ID: 2365833522 Enrollment ID: I20211222001500 |
| Provider Name | Kenneth Minor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982366621 PECOS PAC ID: 2264823152 Enrollment ID: I20220104001362 |
| Provider Name | Stefan R Huber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023633716 PECOS PAC ID: 8729472600 Enrollment ID: I20220221000332 |
| Provider Name | Susan A Dornbusch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265185961 PECOS PAC ID: 4688068265 Enrollment ID: I20220224001046 |
| Provider Name | Lisa Seibert |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1720748981 PECOS PAC ID: 0648657775 Enrollment ID: I20220511001595 |
| Provider Name | Ryan Michael Trantham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477113785 PECOS PAC ID: 5294112199 Enrollment ID: I20220516000658 |
| Provider Name | Alexandra Justine Mitchell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205496510 PECOS PAC ID: 0143607887 Enrollment ID: I20220518000711 |
| Provider Name | Ann Elizabeth Erickstad |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720571060 PECOS PAC ID: 8628457397 Enrollment ID: I20220627002075 |
| Provider Name | Mercedes V Charles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477047462 PECOS PAC ID: 7214358902 Enrollment ID: I20220707000033 |
| Provider Name | Girlinda L Robinson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1245967603 PECOS PAC ID: 5597149443 Enrollment ID: I20220826001596 |
| Provider Name | Katharine Raedy Matli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710569066 PECOS PAC ID: 7214311901 Enrollment ID: I20220830000736 |
| Provider Name | Keara Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659024222 PECOS PAC ID: 8628454592 Enrollment ID: I20220929001461 |
| Provider Name | Alexandra Elizabeth Chapman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609491398 PECOS PAC ID: 7113303777 Enrollment ID: I20221005000723 |
| Provider Name | Benjamin Craig Harstine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649852997 PECOS PAC ID: 7911383393 Enrollment ID: I20221010000006 |
| Provider Name | Kathryn Leah Kline |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821613514 PECOS PAC ID: 4486020856 Enrollment ID: I20221026002732 |
| Provider Name | Corey Holt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306461090 PECOS PAC ID: 8921475385 Enrollment ID: I20221028000119 |
| Provider Name | Zachariah Mark Gibson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689256927 PECOS PAC ID: 8426425265 Enrollment ID: I20221107003241 |
| Provider Name | William Casey Dean |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134744824 PECOS PAC ID: 4880062017 Enrollment ID: I20221121000191 |
| Provider Name | Kayla Anne Filan Mcenery |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750941068 PECOS PAC ID: 5597134668 Enrollment ID: I20221212002417 |
| Provider Name | Vanessa Cressy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235847252 PECOS PAC ID: 6507237252 Enrollment ID: I20230117002632 |
| Provider Name | Kelly Nieves |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922392059 PECOS PAC ID: 5092129742 Enrollment ID: I20230301000154 |
| Provider Name | Michael Thomas Boone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346865037 PECOS PAC ID: 5092180802 Enrollment ID: I20230410001502 |
| Provider Name | Emily Cunningham |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982694139 PECOS PAC ID: 1456436120 Enrollment ID: I20230425001162 |
| Provider Name | Miriam Hernandez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144925504 PECOS PAC ID: 0749645471 Enrollment ID: I20230502000382 |
| Provider Name | Sunny Gilliam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043947278 PECOS PAC ID: 7214393032 Enrollment ID: I20230522001992 |
| Provider Name | Melissa Sue Perschke |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1275026288 PECOS PAC ID: 5698132132 Enrollment ID: I20230529000037 |
| Provider Name | Kelsey Thompson |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1194100016 PECOS PAC ID: 1658676804 Enrollment ID: I20230601000648 |
| Provider Name | Catana Villarreal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912582610 PECOS PAC ID: 4880053024 Enrollment ID: I20230706000053 |
| Provider Name | Julie Foster |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1033518451 PECOS PAC ID: 3375844145 Enrollment ID: I20230720003461 |
| Provider Name | Carlos Emmanuel Cano-gutierrez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679253785 PECOS PAC ID: 8123481165 Enrollment ID: I20230824000382 |
| Provider Name | Chad M Thompson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912384850 PECOS PAC ID: 9537463799 Enrollment ID: I20230907001452 |
| Provider Name | Melody Fillmore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467148585 PECOS PAC ID: 3375997257 Enrollment ID: I20230926002868 |
| Provider Name | Clifton Martin |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1215033725 PECOS PAC ID: 1052601804 Enrollment ID: I20231030003764 |
| Provider Name | Emily Ann Humphrey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851793459 PECOS PAC ID: 2163746223 Enrollment ID: I20240205003573 |
| Provider Name | Samantha Rae Sophie Stough |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033988167 PECOS PAC ID: 8022451764 Enrollment ID: I20240208004542 |
| Provider Name | Bethany Dawn Putz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740581917 PECOS PAC ID: 6103261417 Enrollment ID: I20240227000548 |
| Provider Name | Jennifer Anne Wallace |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942927090 PECOS PAC ID: 1456796440 Enrollment ID: I20240229001981 |
| Provider Name | Sharon Ruth Rollins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497808398 PECOS PAC ID: 4880039734 Enrollment ID: I20240229004569 |
| Provider Name | Meredith Holub |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912671066 PECOS PAC ID: 5496190225 Enrollment ID: I20240301003158 |
| Provider Name | Jada Rene Stanton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295598357 PECOS PAC ID: 4789029521 Enrollment ID: I20240301003475 |
| Provider Name | Gina Prado |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740840057 PECOS PAC ID: 0749625523 Enrollment ID: I20240303000014 |
Waco Infectious Disease Associates P A Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7030 New Sanger Ave, Ste 202, Waco, TX 76712 Phone: 254-741-1860 Fax: 254-741-1249 | |
Waco Regional Cancer Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3420 Pine Ave, Waco, TX 76708 Phone: 254-752-2900 Fax: 254-752-2902 | |
Careconnect Medical Group P.l.l.c Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1600 Lake Shore Dr Apt 121, Waco, TX 76708 Phone: 254-498-6671 | |
Medico Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1437 S. Valley Mills Drive, Waco, TX 76711 Phone: 254-221-1901 Fax: 254-221-1909 | |
Slsp Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 611 W Hwy 6, Suite 108, Waco, TX 76710 Phone: 254-776-5900 Fax: 254-776-5921 | |
Waco Functional Medicine, Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 318 Richland West Cir Ste B, Waco, TX 76712 Phone: 254-776-8009 | |
Brazos Pulmonary & Sleep Associates Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2911 Herring Ave, Suite 212, Waco, TX 76708 Phone: 254-756-5600 Fax: 254-756-5601 |