| Hendrick Provider Network | |
|
1904 Pine St Suite 200 Abilene TX 79601-2344 | |
| (325) 670-4220 | |
| Not Available |
| Full Name | Hendrick Provider Network |
|---|---|
| Speciality | Internal Medicine |
| Location | 1904 Pine St, Abilene, Texas |
| Authorized Official Name and Position | Joe Pearson (VP REGIONAL SERVICES) |
| Authorized Official Contact | 3256707106 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hendrick Provider Network Po Box 1198 Abilene TX 79604-1198 Ph: (325) 670-4220 | Hendrick Provider Network 1904 Pine St Suite 200 Abilene TX 79601-2344 Ph: (325) 670-4220 |
| NPI Number | 1396961322 |
|---|---|
| Provider Enumeration Date | 04/18/2007 |
| Last Update Date | 03/12/2013 |
| Medicare PECOS PAC ID | 9739162181 |
|---|---|
| Medicare Enrollment ID | O20040609001047 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396961322 | NPI | - | NPPES |
| 080866901 | Medicaid | TX | |
| 0060AE | Other | TX | BLUE CROSS BLUE SHIELD |
| Provider Name | Gary D Wright |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811098411 PECOS PAC ID: 6103730338 Enrollment ID: I20031113000054 |
| Provider Name | Sridhar P Reddy |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1134123938 PECOS PAC ID: 8325951718 Enrollment ID: I20031117000242 |
| Provider Name | Tamara M Cox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558359976 PECOS PAC ID: 2466357298 Enrollment ID: I20031204000399 |
| Provider Name | Nikunjkumar Patel |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1740388396 PECOS PAC ID: 3779489810 Enrollment ID: I20040308000761 |
| Provider Name | Dwan M Turner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679669865 PECOS PAC ID: 1759374028 Enrollment ID: I20040405000675 |
| Provider Name | Baochong B Chang |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1790851525 PECOS PAC ID: 8325021652 Enrollment ID: I20040609000363 |
| Provider Name | Yamini H Kalla |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1568420693 PECOS PAC ID: 9638153182 Enrollment ID: I20040614001346 |
| Provider Name | Victor John Hirsch |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1720089931 PECOS PAC ID: 1759376320 Enrollment ID: I20040621001007 |
| Provider Name | Boyd S Fenton |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1174564694 PECOS PAC ID: 2466430871 Enrollment ID: I20040712001215 |
| Provider Name | David M Stark |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1730115908 PECOS PAC ID: 0648259804 Enrollment ID: I20040720000579 |
| Provider Name | Shannon E Cooke |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1811923063 PECOS PAC ID: 1052391513 Enrollment ID: I20040726000317 |
| Provider Name | James Bradley Nicholls |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1215946942 PECOS PAC ID: 8123008422 Enrollment ID: I20040726000399 |
| Provider Name | Amir Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205824810 PECOS PAC ID: 0244210151 Enrollment ID: I20040730000829 |
| Provider Name | George T Williams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730275041 PECOS PAC ID: 4981675931 Enrollment ID: I20040803001203 |
| Provider Name | Sandip V Mathur |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1972549632 PECOS PAC ID: 6507837861 Enrollment ID: I20040804000252 |
| Provider Name | John C Mcclish |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1427019249 PECOS PAC ID: 5991776593 Enrollment ID: I20040805000969 |
| Provider Name | Violeta Stevens Baddour |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1134123037 PECOS PAC ID: 3779554217 Enrollment ID: I20040806000440 |
| Provider Name | Paul W Watts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285600684 PECOS PAC ID: 5092789230 Enrollment ID: I20040823001439 |
| Provider Name | James T Cammack |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1417191875 PECOS PAC ID: 0042289852 Enrollment ID: I20040929000045 |
| Provider Name | Muhammad Naeem |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1043201668 PECOS PAC ID: 7810966355 Enrollment ID: I20040930000654 |
| Provider Name | David Peres Hernandez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1033168323 PECOS PAC ID: 2466445762 Enrollment ID: I20041004001180 |
| Provider Name | Jeremy B Britten |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1306881065 PECOS PAC ID: 5294795902 Enrollment ID: I20041018000316 |
| Provider Name | Julia R Kellcy |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1265540793 PECOS PAC ID: 6305829748 Enrollment ID: I20050113000493 |
| Provider Name | Kristen E Segall |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073593166 PECOS PAC ID: 6305881954 Enrollment ID: I20050623000524 |
| Provider Name | Karen R Little |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720061856 PECOS PAC ID: 9739116914 Enrollment ID: I20050719001127 |
| Provider Name | Whitney Mascorro |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1033106042 PECOS PAC ID: 4082647441 Enrollment ID: I20050915000667 |
| Provider Name | James G Bass |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992725956 PECOS PAC ID: 6800829995 Enrollment ID: I20050919000488 |
| Provider Name | Jose A Suarez |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1669470332 PECOS PAC ID: 5991773863 Enrollment ID: I20050922000757 |
| Provider Name | Randy C Daniell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1528063005 PECOS PAC ID: 7012932536 Enrollment ID: I20051013000141 |
| Provider Name | Tommie W Farrell |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1053303131 PECOS PAC ID: 9931125473 Enrollment ID: I20051024000402 |
| 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 | Sarah B Ferguson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366489908 PECOS PAC ID: 8426021379 Enrollment ID: I20060112000721 |
| Provider Name | Allan W Cass |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1609889203 PECOS PAC ID: 3678587441 Enrollment ID: I20060131000890 |
| Provider Name | Eugene Victor Hudman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093718793 PECOS PAC ID: 8820989189 Enrollment ID: I20060407000506 |
| Provider Name | Albert J Wood |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1962406462 PECOS PAC ID: 7810895109 Enrollment ID: I20060816000349 |
| Provider Name | Gary W Binkley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093756801 PECOS PAC ID: 3870597958 Enrollment ID: I20060901000083 |
| Provider Name | Daniel M Altstatt |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1982634424 PECOS PAC ID: 7517961287 Enrollment ID: I20060912000185 |
| Provider Name | Ranjana N Nigalye |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477541886 PECOS PAC ID: 5890799407 Enrollment ID: I20060914000616 |
| Provider Name | Narendra L Nigalye |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659369056 PECOS PAC ID: 8022904580 Enrollment ID: I20060914000637 |
| Provider Name | Allan L Haynes |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1548258130 PECOS PAC ID: 1456345362 Enrollment ID: I20061019000626 |
| Provider Name | Thomas Nelius |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1033120100 PECOS PAC ID: 9537164736 Enrollment ID: I20061102000369 |
| Provider Name | James Gregory Yost |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659443208 PECOS PAC ID: 6507868668 Enrollment ID: I20070202000430 |
| Provider Name | Julio E Williams |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1588761001 PECOS PAC ID: 7517969454 Enrollment ID: I20070206000668 |
| Provider Name | Melanie A Faglie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962589606 PECOS PAC ID: 0941302756 Enrollment ID: I20070226000439 |
| Provider Name | Ren Zhang |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1114909181 PECOS PAC ID: 6507968922 Enrollment ID: I20070302000304 |
| Provider Name | Michael Blanc |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1932139953 PECOS PAC ID: 5496762270 Enrollment ID: I20070305000475 |
| Provider Name | Randall M Barron |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538206305 PECOS PAC ID: 2365546082 Enrollment ID: I20070404000538 |
| Provider Name | Ginger F Wood |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255351227 PECOS PAC ID: 8325144900 Enrollment ID: I20070517000361 |
| Provider Name | Tammy P Mccullough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316974082 PECOS PAC ID: 9638279755 Enrollment ID: I20070702000656 |
| Provider Name | John F Cole |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992846950 PECOS PAC ID: 8123129574 Enrollment ID: I20070730000166 |
| Provider Name | Theodore C Dyer |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1821042391 PECOS PAC ID: 6406947498 Enrollment ID: I20070806000358 |
| Provider Name | Douglas Randolph Turgeon |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1861431793 PECOS PAC ID: 3375635147 Enrollment ID: I20070824000080 |
| Provider Name | Stephen D Scoggin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1043201247 PECOS PAC ID: 3870482102 Enrollment ID: I20070828001070 |
| Provider Name | Nicholas E Lux |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922000710 PECOS PAC ID: 0648340380 Enrollment ID: I20080610000501 |
| Provider Name | Christopher A Vaughan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548441967 PECOS PAC ID: 6507800075 Enrollment ID: I20080619000394 |
| Provider Name | Taylor R Tidmore |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1699879874 PECOS PAC ID: 4587736459 Enrollment ID: I20080709000540 |
| Provider Name | Neeraja Dasari |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1306884853 PECOS PAC ID: 5092880591 Enrollment ID: I20080819000068 |
| Provider Name | Derek T Padon |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1881852689 PECOS PAC ID: 3274608591 Enrollment ID: I20080821000423 |
| Provider Name | Rufus James Mark |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1992786628 PECOS PAC ID: 0244273571 Enrollment ID: I20080909000070 |
| Provider Name | Robert L Striegler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790864528 PECOS PAC ID: 4587728894 Enrollment ID: I20090202000288 |
| Provider Name | Joji J Varghese |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1053479683 PECOS PAC ID: 2466453204 Enrollment ID: I20090220000402 |
| Provider Name | Min Gao |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134155005 PECOS PAC ID: 7214084359 Enrollment ID: I20090407000530 |
| Provider Name | Michael R Crone |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1205875556 PECOS PAC ID: 2567519408 Enrollment ID: I20090413000282 |
| Provider Name | Laura L Ceballos |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275724841 PECOS PAC ID: 2264580109 Enrollment ID: I20090501000312 |
| Provider Name | Elpidia H Balbastro |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1386614345 PECOS PAC ID: 0547261083 Enrollment ID: I20090514000097 |
| Provider Name | Werner T De Riese |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1861478240 PECOS PAC ID: 2668524489 Enrollment ID: I20090708000785 |
| Provider Name | Harvinder Singh Arora |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1891922134 PECOS PAC ID: 6709939432 Enrollment ID: I20090729000010 |
| Provider Name | Cornelia S De Riese |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841280716 PECOS PAC ID: 3971656109 Enrollment ID: I20090805000163 |
| Provider Name | Ivanoe J Vega Dulanto |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1992913461 PECOS PAC ID: 5991858995 Enrollment ID: I20090807000279 |
| Provider Name | Shona S Preston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184614539 PECOS PAC ID: 7012061484 Enrollment ID: I20090819000551 |
| Provider Name | Elango P Vinjirayer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093975278 PECOS PAC ID: 4385790708 Enrollment ID: I20090925000301 |
| Provider Name | Scott H Crocker |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1073505889 PECOS PAC ID: 7214914399 Enrollment ID: I20091116000246 |
| Provider Name | David E Carlson |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1194717652 PECOS PAC ID: 5496732570 Enrollment ID: I20091116000298 |
| Provider Name | Luis G Echeverri |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1457351777 PECOS PAC ID: 8527108273 Enrollment ID: I20091210000711 |
| Provider Name | Lisa S Fowler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265478408 PECOS PAC ID: 0446250856 Enrollment ID: I20091216000639 |
| Provider Name | David G Morales |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265468326 PECOS PAC ID: 7911907324 Enrollment ID: I20091217000093 |
| Provider Name | Amy Tindol |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205872900 PECOS PAC ID: 8820098239 Enrollment ID: I20091221000038 |
| Provider Name | Richard D Stanley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1427167329 PECOS PAC ID: 2466537972 Enrollment ID: I20100212000451 |
| Provider Name | Mark E Lawrence |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1255392494 PECOS PAC ID: 9638213630 Enrollment ID: I20100215000098 |
| Provider Name | Thaddeus Rex Tolleson |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1912992082 PECOS PAC ID: 2264516525 Enrollment ID: I20100330001150 |
| Provider Name | Jeffrey M Braaten |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1508819590 PECOS PAC ID: 0840266193 Enrollment ID: I20100427000256 |
| Provider Name | Gorman M Thorp |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1184722753 PECOS PAC ID: 9739217118 Enrollment ID: I20100505000485 |
| Provider Name | Preston Leigh Pate |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1144211368 PECOS PAC ID: 0244323749 Enrollment ID: I20100506000890 |
| Provider Name | Michelle R Olson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1710200217 PECOS PAC ID: 9638207533 Enrollment ID: I20100513001058 |
| Provider Name | Elizabeth Vallejo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679896856 PECOS PAC ID: 4486782182 Enrollment ID: I20100517000196 |
| Provider Name | Amber M Ervin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811139371 PECOS PAC ID: 8325178221 Enrollment ID: I20100618000383 |
| Provider Name | Justin Wayne Powell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487663191 PECOS PAC ID: 2264446939 Enrollment ID: I20100706000335 |
| Provider Name | Larry Lin |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1972600823 PECOS PAC ID: 8224160080 Enrollment ID: I20100715000049 |
| Provider Name | Udaya S Swarna |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1306944962 PECOS PAC ID: 7214069533 Enrollment ID: I20100721000611 |
| Provider Name | Charles Albert Shoultz |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1780680496 PECOS PAC ID: 0941383681 Enrollment ID: I20100726000459 |
| Provider Name | Nageswari Daggubati |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1518065135 PECOS PAC ID: 6608909700 Enrollment ID: I20100726000726 |
| Provider Name | David E Wiley |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1841271376 PECOS PAC ID: 4688563919 Enrollment ID: I20100802000626 |
| Provider Name | Kumarapillai Narendran |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1366438566 PECOS PAC ID: 2961427422 Enrollment ID: I20100817000540 |
| Provider Name | Cesar Jorge Tula |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487630885 PECOS PAC ID: 1658325634 Enrollment ID: I20100826001106 |
| Provider Name | Sommer M Ellis |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1730400722 PECOS PAC ID: 7618093733 Enrollment ID: I20100927000843 |
| Provider Name | David Randell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932198611 PECOS PAC ID: 1153395520 Enrollment ID: I20101006000892 |
| Provider Name | Narasimharao Vemula |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1912966391 PECOS PAC ID: 4385644137 Enrollment ID: I20101101000128 |
| Provider Name | Rafael G Sanchez |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1871504795 PECOS PAC ID: 6103010442 Enrollment ID: I20101101001052 |
| Provider Name | Robert L Dickey |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1982689790 PECOS PAC ID: 1759287410 Enrollment ID: I20101206000825 |
| Provider Name | Charlotte Akor |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1457314387 PECOS PAC ID: 0840233607 Enrollment ID: I20101207000673 |
| Provider Name | David B Mccain |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1912978800 PECOS PAC ID: 0345429536 Enrollment ID: I20110119001365 |
| Provider Name | Michael Neel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114925401 PECOS PAC ID: 3678752243 Enrollment ID: I20110127001192 |
| Provider Name | Ousama Moammar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699981431 PECOS PAC ID: 1658462908 Enrollment ID: I20110211000028 |
| Provider Name | Courtnee Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578872206 PECOS PAC ID: 3577744655 Enrollment ID: I20110222001183 |
| Provider Name | Marifi Calamlam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710211230 PECOS PAC ID: 9234314816 Enrollment ID: I20110425000741 |
| Provider Name | Katherine D Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962702779 PECOS PAC ID: 8628253267 Enrollment ID: I20110426000586 |
| Provider Name | Joseph Leonard Tadvick |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205832524 PECOS PAC ID: 5991784852 Enrollment ID: I20110523000842 |
| Provider Name | Jason C Bell |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1033376983 PECOS PAC ID: 8527237411 Enrollment ID: I20110810000442 |
| Provider Name | Jack Needham |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1770782369 PECOS PAC ID: 9335321835 Enrollment ID: I20110830000754 |
| Provider Name | Sina Haeri |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730357039 PECOS PAC ID: 2668544487 Enrollment ID: I20111007000224 |
| Provider Name | Alexandria Jill Hill |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598956591 PECOS PAC ID: 8325211394 Enrollment ID: I20111108000405 |
| Provider Name | Tanja Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043587124 PECOS PAC ID: 0446427249 Enrollment ID: I20120119000297 |
| Provider Name | Millie K Goetz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114295185 PECOS PAC ID: 2769641554 Enrollment ID: I20120314000603 |
| Provider Name | Ameeta Kapu |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023024742 PECOS PAC ID: 7214957778 Enrollment ID: I20120410000044 |
| Provider Name | Harry P Froeschke |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1710975560 PECOS PAC ID: 8628006251 Enrollment ID: I20120412000317 |
| Provider Name | Douglas A Lampkin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831105675 PECOS PAC ID: 9436310398 Enrollment ID: I20120419000790 |
| Provider Name | Neelima Ryali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508874918 PECOS PAC ID: 7416943295 Enrollment ID: I20120517000242 |
| Provider Name | Kelly Hyde |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1336394154 PECOS PAC ID: 5991977621 Enrollment ID: I20120625000643 |
| Provider Name | Swapna Koduru |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1124262209 PECOS PAC ID: 6204013246 Enrollment ID: I20120625000666 |
| Provider Name | Rhett K Lohman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942469283 PECOS PAC ID: 4587820147 Enrollment ID: I20120725001005 |
| Provider Name | Wendy Beth Artho |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1942471438 PECOS PAC ID: 7911046933 Enrollment ID: I20120726000297 |
| Provider Name | Krystal Lovelady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285901967 PECOS PAC ID: 4981860475 Enrollment ID: I20120727000605 |
| Provider Name | Samantha H Goodman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154558781 PECOS PAC ID: 8527214782 Enrollment ID: I20120803000779 |
| Provider Name | Henry Fosah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992935456 PECOS PAC ID: 0749436483 Enrollment ID: I20120810000710 |
| Provider Name | Mark A Tomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942539986 PECOS PAC ID: 7911154299 Enrollment ID: I20120821000630 |
| Provider Name | Ralphie Alberto Rosario Feliciano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013005875 PECOS PAC ID: 0446339063 Enrollment ID: I20130308000255 |
| Provider Name | Olivia Renee Graham-williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104160167 PECOS PAC ID: 1759536063 Enrollment ID: I20130312000209 |
| Provider Name | Guangquan Zhao |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1710197314 PECOS PAC ID: 8224288451 Enrollment ID: I20130516000233 |
| Provider Name | Elizabeth M Bement |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033422431 PECOS PAC ID: 5496994204 Enrollment ID: I20130626000524 |
| Provider Name | Katherine Holden Rinard |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1225299795 PECOS PAC ID: 0547401630 Enrollment ID: I20130801000584 |
| Provider Name | Benton L. Brown |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1144482605 PECOS PAC ID: 8527200898 Enrollment ID: I20130815000772 |
| Provider Name | Jarmara Laurette Darcey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063649838 PECOS PAC ID: 1759524648 Enrollment ID: I20130824000117 |
| Provider Name | Christina Daniel Grubbs |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1548494040 PECOS PAC ID: 9931342615 Enrollment ID: I20130828000292 |
| Provider Name | Mariela Agosto-rivera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578876736 PECOS PAC ID: 1658514211 Enrollment ID: I20130829000305 |
| Provider Name | Elliott Richard Vann |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1972586584 PECOS PAC ID: 3577758143 Enrollment ID: I20130904000923 |
| Provider Name | Kirtan S Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144517269 PECOS PAC ID: 5799677449 Enrollment ID: I20131121001651 |
| Provider Name | Tina Schuster |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1396868253 PECOS PAC ID: 6800963927 Enrollment ID: I20131204001420 |
| Provider Name | Lauren Templeton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912132911 PECOS PAC ID: 7618104811 Enrollment ID: I20131214000004 |
| Provider Name | Joshua B Reed |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1902127988 PECOS PAC ID: 0446488167 Enrollment ID: I20131231002005 |
| Provider Name | Cassidy Kay Hodges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811324817 PECOS PAC ID: 0143459354 Enrollment ID: I20140211001226 |
| Provider Name | Sunnie J Thiberville |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841628385 PECOS PAC ID: 9931339314 Enrollment ID: I20140304001297 |
| Provider Name | Brent Paul Mahoney |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1689882680 PECOS PAC ID: 7618040940 Enrollment ID: I20140415000503 |
| Provider Name | Antao Du |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396916037 PECOS PAC ID: 6507034832 Enrollment ID: I20140708000563 |
| Provider Name | Kelly Stewart Taylor |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1760511281 PECOS PAC ID: 9638395528 Enrollment ID: I20140730000835 |
| Provider Name | April Enard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558654087 PECOS PAC ID: 5193942407 Enrollment ID: I20140811001291 |
| Provider Name | Bonnie H Hayashi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164741674 PECOS PAC ID: 6901023720 Enrollment ID: I20140818002393 |
| Provider Name | Nancy L Burleson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1528124336 PECOS PAC ID: 9234118423 Enrollment ID: I20140826002512 |
| Provider Name | Daniel Canario |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1972638583 PECOS PAC ID: 0547213498 Enrollment ID: I20140904001915 |
| Provider Name | Amanda G Duke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346596624 PECOS PAC ID: 8729208103 Enrollment ID: I20141007001217 |
| Provider Name | Amanda Horton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730131509 PECOS PAC ID: 4880606235 Enrollment ID: I20141030002421 |
| Provider Name | Jeffrey Edwards |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801152152 PECOS PAC ID: 6709008212 Enrollment ID: I20141118002277 |
| Provider Name | Gibel S Cedeno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730301615 PECOS PAC ID: 3577629542 Enrollment ID: I20141202001501 |
| Provider Name | Amanda M Ramos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114315371 PECOS PAC ID: 5294059994 Enrollment ID: I20150129001718 |
| Provider Name | Shamail Butt |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1043531981 PECOS PAC ID: 5496871907 Enrollment ID: I20150212000046 |
| Provider Name | Jessica G Castillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578991477 PECOS PAC ID: 3971823618 Enrollment ID: I20150521000262 |
| Provider Name | Praveen Sampath |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1023348299 PECOS PAC ID: 9335327576 Enrollment ID: I20150609001266 |
| Provider Name | Ishmeet Walia |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1174840862 PECOS PAC ID: 9133430895 Enrollment ID: I20150622001736 |
| Provider Name | Christopher Ross Thompson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1447570619 PECOS PAC ID: 3375855240 Enrollment ID: I20150707000440 |
| Provider Name | Leslie M Hutchins |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1023278660 PECOS PAC ID: 2769622737 Enrollment ID: I20150710001373 |
| Provider Name | Michael Justin Adames |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275947533 PECOS PAC ID: 1052624517 Enrollment ID: I20150714000054 |
| Provider Name | James P Hosler |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1437110699 PECOS PAC ID: 5395058317 Enrollment ID: I20150721000372 |
| Provider Name | Amie Keawmanee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669841300 PECOS PAC ID: 7618286345 Enrollment ID: I20151021000501 |
| Provider Name | Christina Wells |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699144303 PECOS PAC ID: 6002118411 Enrollment ID: I20151231000498 |
| Provider Name | Kathleen Phillipp |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1750484069 PECOS PAC ID: 4789988536 Enrollment ID: I20160215002328 |
| Provider Name | Wendi Rice |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1558728782 PECOS PAC ID: 0840596599 Enrollment ID: I20160307002554 |
| Provider Name | Shannon L Young Delacruz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164893889 PECOS PAC ID: 9537467345 Enrollment ID: I20160412001031 |
| Provider Name | Evan Hardegree |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1699096354 PECOS PAC ID: 2769653864 Enrollment ID: I20160512002125 |
| Provider Name | Kevin Alan Bridge |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1679735393 PECOS PAC ID: 2961636899 Enrollment ID: I20160615000234 |
| Provider Name | Ke Ning |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1073802674 PECOS PAC ID: 2860706934 Enrollment ID: I20160628000054 |
| Provider Name | Joseph Stafford |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1962847947 PECOS PAC ID: 5991098527 Enrollment ID: I20160720000716 |
| Provider Name | Charles L Cecil |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1457646697 PECOS PAC ID: 1254624760 Enrollment ID: I20160721000471 |
| Provider Name | Kelsey Nicole Walker May |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1437501095 PECOS PAC ID: 1557654712 Enrollment ID: I20160726000416 |
| Provider Name | Erin Marie Woller |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1427285659 PECOS PAC ID: 7416246442 Enrollment ID: I20160823001087 |
| Provider Name | Stuart Allen Martin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023423779 PECOS PAC ID: 1850686361 Enrollment ID: I20160823002095 |
| Provider Name | Pranav Sharma |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1174758965 PECOS PAC ID: 2860624715 Enrollment ID: I20160908002284 |
| Provider Name | Steven J Hamlett |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1710433164 PECOS PAC ID: 2961790803 Enrollment ID: I20161010001779 |
| Provider Name | Imran Sheikh |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1982848750 PECOS PAC ID: 1254593015 Enrollment ID: I20161102002734 |
| Provider Name | David Allen Brown |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1730269341 PECOS PAC ID: 0648448654 Enrollment ID: I20161116000478 |
| Provider Name | Jessica Ann Ortolano |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1124283387 PECOS PAC ID: 8022336783 Enrollment ID: I20161213002359 |
| Provider Name | Alfonso Joel Cavazos |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1619235868 PECOS PAC ID: 7113207994 Enrollment ID: I20161213002655 |
| Provider Name | Indira Cassandra Maharaj-mikiel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891056164 PECOS PAC ID: 4789803743 Enrollment ID: I20161216000120 |
| Provider Name | Elizabeth M Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932654142 PECOS PAC ID: 1557642790 Enrollment ID: I20170103000447 |
| Provider Name | Rohan Patankar |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1699041608 PECOS PAC ID: 9032490768 Enrollment ID: I20170111001807 |
| Provider Name | Atam Mehdiratta |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1700828050 PECOS PAC ID: 7810892171 Enrollment ID: I20170220000232 |
| Provider Name | Eric Areiter |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1427496264 PECOS PAC ID: 8426343740 Enrollment ID: I20170517002577 |
| Provider Name | Clayton A Stevens |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1992145361 PECOS PAC ID: 0345536306 Enrollment ID: I20170518000182 |
| Provider Name | Cari Kathryn Sorrell |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1255623138 PECOS PAC ID: 6800186966 Enrollment ID: I20170531001355 |
| Provider Name | Leigh Collins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538571963 PECOS PAC ID: 9436377819 Enrollment ID: I20170606001087 |
| Provider Name | Gibbs Wilson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1649658592 PECOS PAC ID: 9133400385 Enrollment ID: I20170621002955 |
| Provider Name | Joshua Lowell Gray |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952728040 PECOS PAC ID: 3173828365 Enrollment ID: I20170622000883 |
| Provider Name | Ted Samuel Ritchie |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1033476551 PECOS PAC ID: 9335465889 Enrollment ID: I20170623000156 |
| Provider Name | Jessica R Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801206560 PECOS PAC ID: 1850699000 Enrollment ID: I20170710002528 |
| Provider Name | Jorge Javier Figueroa Flores |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1548499098 PECOS PAC ID: 6103197546 Enrollment ID: I20170803002609 |
| Provider Name | Ana Maria Argumaniz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013442516 PECOS PAC ID: 2264703560 Enrollment ID: I20170804001382 |
| Provider Name | Sterlynn Chelz Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578086682 PECOS PAC ID: 9931471448 Enrollment ID: I20170817003696 |
| Provider Name | Todd Pitts |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1780979575 PECOS PAC ID: 7810282407 Enrollment ID: I20170818001279 |
| Provider Name | Brandi Gray Jacob |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952509978 PECOS PAC ID: 2365714300 Enrollment ID: I20170825000212 |
| Provider Name | Charles G Cox |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1760467443 PECOS PAC ID: 5092888685 Enrollment ID: I20171003004665 |
| Provider Name | Roberta L Vickery |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1619297348 PECOS PAC ID: 0446376552 Enrollment ID: I20171017001295 |
| Provider Name | Ashley Oladunni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366801326 PECOS PAC ID: 9335415660 Enrollment ID: I20171031003236 |
| Provider Name | Jonathan Urbanczyk |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1366898744 PECOS PAC ID: 4880975770 Enrollment ID: I20171121003256 |
| Provider Name | Jennifer Leigh Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821501826 PECOS PAC ID: 1759648439 Enrollment ID: I20171205002584 |
| Provider Name | Obinna Charles Ukabam |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1528354545 PECOS PAC ID: 0345489696 Enrollment ID: I20171211000211 |
| Provider Name | Neil Craig White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558874198 PECOS PAC ID: 0749557023 Enrollment ID: I20171229001630 |
| Provider Name | Olakumbi B Otulana |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1760769699 PECOS PAC ID: 7911286554 Enrollment ID: I20180108001934 |
| Provider Name | Mustapha Ali Khalife |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1013127836 PECOS PAC ID: 5193973071 Enrollment ID: I20180201002023 |
| Provider Name | Rebecca D'layne Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497268023 PECOS PAC ID: 0143580514 Enrollment ID: I20180220002332 |
| Provider Name | Kelsey Lauren Dow |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1184122715 PECOS PAC ID: 4486916004 Enrollment ID: I20180320000805 |
| Provider Name | Kristy Lyn Booth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639670243 PECOS PAC ID: 7315209723 Enrollment ID: I20180323000760 |
| Provider Name | Latifa Akande Fakoya |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1215199971 PECOS PAC ID: 4688846496 Enrollment ID: I20180410000607 |
| Provider Name | Ugochukwu Ada Odo |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1215282694 PECOS PAC ID: 9931454956 Enrollment ID: I20180615000572 |
| Provider Name | Jacqueline Zimmerman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417369349 PECOS PAC ID: 7517248727 Enrollment ID: I20180620002946 |
| Provider Name | Prejith P Rajendran |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1255758298 PECOS PAC ID: 3173879335 Enrollment ID: I20180702002761 |
| Provider Name | Victor S Reis |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1841586484 PECOS PAC ID: 9537306436 Enrollment ID: I20180718003563 |
| Provider Name | Roy Tom Byrd |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275920712 PECOS PAC ID: 3476852534 Enrollment ID: I20180906000724 |
| Provider Name | Trey Durdin |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1003295320 PECOS PAC ID: 8022399609 Enrollment ID: I20180914001740 |
| Provider Name | Cassi Richelle Crouch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578043956 PECOS PAC ID: 0749531853 Enrollment ID: I20180927002897 |
| Provider Name | Megan Dianne Stephenson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417439001 PECOS PAC ID: 5092066100 Enrollment ID: I20180927002999 |
| Provider Name | Chukwuemeka Charles Ezeoke |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1548522675 PECOS PAC ID: 3870883218 Enrollment ID: I20181002002821 |
| Provider Name | Tamara Nicole Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902381270 PECOS PAC ID: 0840543435 Enrollment ID: I20181029002250 |
| Provider Name | Lauren Brooke Terrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013482496 PECOS PAC ID: 4385997832 Enrollment ID: I20181030002330 |
| Provider Name | Lindsey Madden Crowe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366918609 PECOS PAC ID: 5092068452 Enrollment ID: I20181101000378 |
| Provider Name | Marcus Samuel Davis |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1780114504 PECOS PAC ID: 6507136009 Enrollment ID: I20181109002699 |
| Provider Name | Michael Barris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386671204 PECOS PAC ID: 9032203559 Enrollment ID: I20181127001556 |
| Provider Name | Harold Coulter Salmon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710455811 PECOS PAC ID: 0143565309 Enrollment ID: I20181218000097 |
| Provider Name | Marcela Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154899037 PECOS PAC ID: 5597000752 Enrollment ID: I20181218000149 |
| Provider Name | Holley H Forester |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609345156 PECOS PAC ID: 7416295142 Enrollment ID: I20190205001697 |
| Provider Name | Jessica Lyn Perini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760954572 PECOS PAC ID: 4183962483 Enrollment ID: I20190212001880 |
| Provider Name | Robert Johnston |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1003194853 PECOS PAC ID: 5890006696 Enrollment ID: I20190218003000 |
| Provider Name | Shannon Ferrill Hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548738032 PECOS PAC ID: 3274872890 Enrollment ID: I20190226002516 |
| Provider Name | Ramez S Nairooz |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1750710810 PECOS PAC ID: 9032411095 Enrollment ID: I20190404000287 |
| Provider Name | Prabhu Deepak Kumar Udayakumar |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1679725923 PECOS PAC ID: 6507036852 Enrollment ID: I20190529001947 |
| Provider Name | Adlene Jenita Jebakumar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427311679 PECOS PAC ID: 0143508119 Enrollment ID: I20190531000194 |
| Provider Name | Delena Marie Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851957591 PECOS PAC ID: 5799019451 Enrollment ID: I20190628002567 |
| Provider Name | Lauren Jade Crawford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891356879 PECOS PAC ID: 3678808235 Enrollment ID: I20190718001699 |
| Provider Name | Paul Glen Morrison |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1093154064 PECOS PAC ID: 9133362981 Enrollment ID: I20190729000558 |
| Provider Name | Amanda Jean Sherley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386106615 PECOS PAC ID: 7810224565 Enrollment ID: I20190805000285 |
| Provider Name | John Patrick Masterson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1033180922 PECOS PAC ID: 1052205960 Enrollment ID: I20190814000691 |
| Provider Name | James Hunter Deal |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1982019683 PECOS PAC ID: 4385972694 Enrollment ID: I20190824000604 |
| Provider Name | Sheetal Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255693529 PECOS PAC ID: 5395073225 Enrollment ID: I20190829003508 |
| Provider Name | Tania Oyola Rosario |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679925127 PECOS PAC ID: 8729317235 Enrollment ID: I20190909003517 |
| Provider Name | Farley Berry Graden Neasman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1023373545 PECOS PAC ID: 6002167756 Enrollment ID: I20190921000005 |
| Provider Name | Addison Lavon Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962050567 PECOS PAC ID: 7911237276 Enrollment ID: I20190930001187 |
| Provider Name | Shirley Sue Connell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538713565 PECOS PAC ID: 2961733852 Enrollment ID: I20191007003452 |
| Provider Name | Mauricio La Rosa De Los Rios |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235488719 PECOS PAC ID: 1759643018 Enrollment ID: I20191010000339 |
| Provider Name | Joel Seth Hoover |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1992354997 PECOS PAC ID: 3173854387 Enrollment ID: I20191018000762 |
| Provider Name | Oyewole Jacob Olanrewaju |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740609593 PECOS PAC ID: 5698040525 Enrollment ID: I20191021002492 |
| Provider Name | Jennifer Salazar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447801055 PECOS PAC ID: 3173855327 Enrollment ID: I20191022000235 |
| Provider Name | Rachel Elise Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275184939 PECOS PAC ID: 5698007797 Enrollment ID: I20191022002850 |
| Provider Name | Jeffrey B Manley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700016961 PECOS PAC ID: 8426207416 Enrollment ID: I20191204000493 |
| Provider Name | Allison Kristine Shekhawat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053951780 PECOS PAC ID: 4486089281 Enrollment ID: I20200125000087 |
| Provider Name | Scott William Beauchamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386278521 PECOS PAC ID: 7416385018 Enrollment ID: I20200313001091 |
| Provider Name | Christian A Otero |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1316178502 PECOS PAC ID: 6103184775 Enrollment ID: I20200319002373 |
| Provider Name | Rafael L Rocha |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1750380903 PECOS PAC ID: 3779683198 Enrollment ID: I20200325001688 |
| Provider Name | Skye D Altieri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821635475 PECOS PAC ID: 3779914262 Enrollment ID: I20200518001292 |
| Provider Name | Megan Shepherd |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538556402 PECOS PAC ID: 2264735281 Enrollment ID: I20200519001223 |
| Provider Name | James Adam Sweet |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1851778591 PECOS PAC ID: 1254752561 Enrollment ID: I20200521002484 |
| Provider Name | Heather Elizabeth Hermoso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235776055 PECOS PAC ID: 9032530126 Enrollment ID: I20200527002646 |
| Provider Name | Grant Jameson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1780066878 PECOS PAC ID: 7012204993 Enrollment ID: I20200529002018 |
| Provider Name | Christopher C Hardegree |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104350800 PECOS PAC ID: 4688943863 Enrollment ID: I20200611000887 |
| Provider Name | Jillian Mcangus |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1285011502 PECOS PAC ID: 1153602248 Enrollment ID: I20200612001425 |
| Provider Name | Bradon E Loya |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700377215 PECOS PAC ID: 9638429707 Enrollment ID: I20200615001811 |
| Provider Name | Mackenzie Malek |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023467693 PECOS PAC ID: 4688955685 Enrollment ID: I20200622002661 |
| Provider Name | Sobie Maduka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043742752 PECOS PAC ID: 6204105265 Enrollment ID: I20200708000084 |
| Provider Name | Alexis Peplinski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417233008 PECOS PAC ID: 8426330242 Enrollment ID: I20200710000990 |
| Provider Name | Eldrid Baez Matos |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1417335951 PECOS PAC ID: 9931415213 Enrollment ID: I20200710001394 |
| Provider Name | Ebenezer Ofori Appah |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1730525213 PECOS PAC ID: 4688955578 Enrollment ID: I20200715000392 |
| Provider Name | Timothy J Hill |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255569455 PECOS PAC ID: 5395961262 Enrollment ID: I20200721001165 |
| Provider Name | Andrea Michelle Levrets |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396370425 PECOS PAC ID: 1456659689 Enrollment ID: I20200728003023 |
| Provider Name | Faith Ighoyivwi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609261148 PECOS PAC ID: 2961704077 Enrollment ID: I20201002001352 |
| Provider Name | Krystal Renee Kent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447866389 PECOS PAC ID: 2961812235 Enrollment ID: I20201028001257 |
| Provider Name | Jared S Folwell |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1619312766 PECOS PAC ID: 2264725449 Enrollment ID: I20201117000220 |
| Provider Name | Narendra Duddyala |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1467680967 PECOS PAC ID: 4880909555 Enrollment ID: I20201119001153 |
| Provider Name | Molly D'ann Sims |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215543483 PECOS PAC ID: 8325459225 Enrollment ID: I20201125001663 |
| Provider Name | Katherine Addie Laws |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205434321 PECOS PAC ID: 2668883448 Enrollment ID: I20201130001968 |
| Provider Name | Himabindu Valluru |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1558672311 PECOS PAC ID: 9436478187 Enrollment ID: I20201211001368 |
| Provider Name | Jason A Murray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972193902 PECOS PAC ID: 0042625907 Enrollment ID: I20210226001726 |
| Provider Name | Jewel Monique Trancoso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003433343 PECOS PAC ID: 8325455843 Enrollment ID: I20210330001723 |
| Provider Name | Karin Mossack |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679743520 PECOS PAC ID: 9335392539 Enrollment ID: I20210413002908 |
| Provider Name | Azarael Titus Dunbar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780175174 PECOS PAC ID: 6709286024 Enrollment ID: I20210608002574 |
| Provider Name | Nathan Boles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952808255 PECOS PAC ID: 5092066878 Enrollment ID: I20210628000082 |
| Provider Name | Anderson Okafor |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1417308271 PECOS PAC ID: 8527392885 Enrollment ID: I20210713002884 |
| Provider Name | Jaxon W Jordan |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1376997957 PECOS PAC ID: 2264725621 Enrollment ID: I20210728002857 |
| Provider Name | Randa Gentry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518631126 PECOS PAC ID: 8729482781 Enrollment ID: I20210812002357 |
| Provider Name | Brenda Chavez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427545474 PECOS PAC ID: 1658622501 Enrollment ID: I20210817002281 |
| Provider Name | Rachelle Eyre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609429307 PECOS PAC ID: 7719218569 Enrollment ID: I20210817003410 |
| Provider Name | Branden C Kret |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942689625 PECOS PAC ID: 3173820636 Enrollment ID: I20210818002544 |
| Provider Name | Nwabundo I Anusim |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1144504408 PECOS PAC ID: 6204067119 Enrollment ID: I20210819001591 |
| Provider Name | Tiffany D. Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578239885 PECOS PAC ID: 6103221494 Enrollment ID: I20210825001144 |
| Provider Name | Brooklyn Paige Gillit |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518639624 PECOS PAC ID: 9436557378 Enrollment ID: I20211007002124 |
| Provider Name | Shannon Sheri Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346902525 PECOS PAC ID: 4981002201 Enrollment ID: I20211018000265 |
| Provider Name | Amy Lovelady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699449538 PECOS PAC ID: 5294123246 Enrollment ID: I20211026000049 |
| Provider Name | Savanah J Reeves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679244305 PECOS PAC ID: 2860880747 Enrollment ID: I20211026001690 |
| Provider Name | Damon Smith |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1760480123 PECOS PAC ID: 4981608171 Enrollment ID: I20211101001070 |
| Provider Name | Maricarmen Martinez Aponte |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427570225 PECOS PAC ID: 4183012610 Enrollment ID: I20211102001422 |
| Provider Name | Susan Stafford |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1982083200 PECOS PAC ID: 1658652623 Enrollment ID: I20211206001910 |
| Provider Name | Matthew J Mccreary |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1043561814 PECOS PAC ID: 5193115780 Enrollment ID: I20211215000108 |
| Provider Name | Dallas A Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538822010 PECOS PAC ID: 0244621613 Enrollment ID: I20211217001643 |
| Provider Name | Mediha Ahmad |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1124447255 PECOS PAC ID: 2264742642 Enrollment ID: I20220112000325 |
| Provider Name | Iheanyichukwu Ogu |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1992093678 PECOS PAC ID: 6709020308 Enrollment ID: I20220124000188 |
| Provider Name | Lauri Cherese Bass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902438559 PECOS PAC ID: 9234522889 Enrollment ID: I20220203001664 |
| Provider Name | Tandy C Reagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629724380 PECOS PAC ID: 2062807993 Enrollment ID: I20220311001054 |
| Provider Name | Rajendra Motwani |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1013950740 PECOS PAC ID: 7810886272 Enrollment ID: I20220312000035 |
| Provider Name | Whitney Sara Kafer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780347302 PECOS PAC ID: 8921485202 Enrollment ID: I20220509000657 |
| Provider Name | Sunhee Kim |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033205083 PECOS PAC ID: 0345248142 Enrollment ID: I20220520001163 |
| Provider Name | Stephen Daugherty |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1114451911 PECOS PAC ID: 2062767197 Enrollment ID: I20220524001043 |
| Provider Name | Kelsey Ann Komechak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831709161 PECOS PAC ID: 1759769631 Enrollment ID: I20220606000678 |
| Provider Name | Jose Velasco Di Domenico |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1376731968 PECOS PAC ID: 8123250156 Enrollment ID: I20220610001709 |
| Provider Name | Steven Smith |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275982241 PECOS PAC ID: 5991086712 Enrollment ID: I20220622001408 |
| Provider Name | Nikki L Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073072807 PECOS PAC ID: 0749611309 Enrollment ID: I20220705000108 |
| Provider Name | Charles Rotenberry |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1568991552 PECOS PAC ID: 2365713252 Enrollment ID: I20220719003902 |
| Provider Name | Shelby Lynn Beal |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1609506708 PECOS PAC ID: 9436530458 Enrollment ID: I20220721001037 |
| Provider Name | Derek Moore |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1528306511 PECOS PAC ID: 7911278908 Enrollment ID: I20220812002257 |
| Provider Name | Madad Ali |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376564815 PECOS PAC ID: 8325180565 Enrollment ID: I20220825003656 |
| Provider Name | Rachel Marie Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376298315 PECOS PAC ID: 5597152405 Enrollment ID: I20220829003083 |
| Provider Name | Jordan Sims |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952039901 PECOS PAC ID: 3476937707 Enrollment ID: I20220906000029 |
| Provider Name | Whitney Hubbard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356071633 PECOS PAC ID: 5597140095 Enrollment ID: I20220920001831 |
| Provider Name | Cheyenne Musick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073233359 PECOS PAC ID: 8325423510 Enrollment ID: I20220926000020 |
| Provider Name | Norylee Neyoka Hodges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972227387 PECOS PAC ID: 1759757909 Enrollment ID: I20221013001352 |
| Provider Name | Capri Dishman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992428304 PECOS PAC ID: 0840666731 Enrollment ID: I20221018001094 |
| Provider Name | Zoie Walker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679131304 PECOS PAC ID: 6103158068 Enrollment ID: I20221018002658 |
| Provider Name | Bailey Ann Estes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023744141 PECOS PAC ID: 6103292800 Enrollment ID: I20221020003277 |
| Provider Name | Austin Lunney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841827268 PECOS PAC ID: 2860823549 Enrollment ID: I20221101001462 |
| Provider Name | Lesley Ann Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093432973 PECOS PAC ID: 0547637357 Enrollment ID: I20221108002846 |
| Provider Name | Caleb Micha Shannon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871210781 PECOS PAC ID: 5890163281 Enrollment ID: I20221115003256 |
| Provider Name | Kristan Erica Swiney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902521008 PECOS PAC ID: 5092185918 Enrollment ID: I20230110000745 |
| Provider Name | Kevin A West |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1821478603 PECOS PAC ID: 0042519076 Enrollment ID: I20230303001024 |
| Provider Name | Joann M Limones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730804915 PECOS PAC ID: 5597138925 Enrollment ID: I20230306000034 |
| Provider Name | Ross Sage |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1417253428 PECOS PAC ID: 1658503412 Enrollment ID: I20230406000725 |
| Provider Name | Weisi Yan |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1649405028 PECOS PAC ID: 1658596721 Enrollment ID: I20230414001323 |
| Provider Name | Kristopher Lyon |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1194171918 PECOS PAC ID: 2860773439 Enrollment ID: I20230425002533 |
| Provider Name | Bashir Hanif |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1861659310 PECOS PAC ID: 3577928639 Enrollment ID: I20230426000106 |
| Provider Name | Jennifer A Curry |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1235101338 PECOS PAC ID: 8325262439 Enrollment ID: I20230629000760 |
| Provider Name | Clyde Michael Jones |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1477557064 PECOS PAC ID: 0042105066 Enrollment ID: I20230720003125 |
| Provider Name | Michaelia S Sunderland |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1932633401 PECOS PAC ID: 3678935459 Enrollment ID: I20230810001381 |
| Provider Name | Daniel Cognetti |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1891297016 PECOS PAC ID: 9032544606 Enrollment ID: I20230815000899 |
| Provider Name | Lacey Dee West |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154018737 PECOS PAC ID: 1557715802 Enrollment ID: I20230920003994 |
| Provider Name | Jorge Clint De Leon |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1144753633 PECOS PAC ID: 3779850060 Enrollment ID: I20231019000905 |
| Provider Name | Chelsea Uganski |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1093240822 PECOS PAC ID: 8527338730 Enrollment ID: I20231026000520 |
| Provider Name | Sheryl Synetra Rolle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396527115 PECOS PAC ID: 6800242538 Enrollment ID: I20231031003624 |
| Provider Name | Ndidi Chima Okeke |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487187795 PECOS PAC ID: 2567819097 Enrollment ID: I20231106001446 |
| Provider Name | Lauren Stephenson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518738020 PECOS PAC ID: 8426401639 Enrollment ID: I20240124001424 |
| Provider Name | Rizwan Ahmed |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1467728014 PECOS PAC ID: 8123276417 Enrollment ID: I20240215004215 |
| Provider Name | Gilbert P Ancira |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1063875052 PECOS PAC ID: 3870863079 Enrollment ID: I20240216000525 |
| Provider Name | Mark Ono |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1427022144 PECOS PAC ID: 7911932215 Enrollment ID: I20240314004112 |
Agency Of The State Of Texas Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2616 S Clack, Ste 160, Abilene, TX 79606 Phone: 325-690-5131 Fax: 325-690-5228 | |
Stephen M. Osborn, Ph.d., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4601 Buffalo Gap Rd, Suite C-6, Abilene, TX 79606 Phone: 325-695-2232 Fax: 325-695-2233 | |
Regional Employee Assistance Program Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6250 Regional Plz, Suite 1050, Abilene, TX 79606 Phone: 325-428-5740 Fax: 325-428-5749 | |
Big Country Internal Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4716 S 14th St, Abilene, TX 79605 Phone: 325-669-9569 | |
Mikiel Medical Mall, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3347 S 2nd St, Abilene, TX 79605 Phone: 325-208-3274 | |
Sandra J Hazelip, Do, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3202 S Willis St, Abilene, TX 79605 Phone: 325-695-4133 | |
Marshall Turnbull Md, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1900 Pine St, Abilene, TX 79601 Phone: 325-676-4543 Fax: 325-672-9869 |