| Children's Health Medical Group | |
|
1935 Medical District Dr Dallas TX 75235-7701 | |
| (214) 456-7000 | |
| Not Available |
| Full Name | Children's Health Medical Group |
|---|---|
| Speciality | Pediatrics |
| Location | 1935 Medical District Dr, Dallas, Texas |
| Authorized Official Name and Position | Adam Melton (SVP PHYSICIAN ORGANIZATION) |
| Authorized Official Contact | 2144560039 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Health Medical Group 1935 Medical District Dr Dallas TX 75235-7701 Ph: (214) 456-7000 | Children's Health Medical Group 1935 Medical District Dr Dallas TX 75235-7701 Ph: (214) 456-7000 |
| NPI Number | 1194153650 |
|---|---|
| Provider Enumeration Date | 10/21/2013 |
| Last Update Date | 08/03/2023 |
| Medicare PECOS PAC ID | 1759607906 |
|---|---|
| Medicare Enrollment ID | O20150305000673 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194153650 | NPI | - | NPPES |
| 554199 | Other | TX | MEDICARE |
| 393968 | Other | TX | MEDICARE |
| 404548 | Other | TX | MEDICARE |
| Provider Name | Galit Kastner-ungar |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1912090002 PECOS PAC ID: 3870585011 Enrollment ID: I20040330001575 |
| Provider Name | Matthew J Miller |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1235182551 PECOS PAC ID: 2769475722 Enrollment ID: I20040406000364 |
| Provider Name | David Bui |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1881647964 PECOS PAC ID: 6800877093 Enrollment ID: I20040525000680 |
| Provider Name | Alan Cooke Farrow Gillespie |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1407809817 PECOS PAC ID: 6002890340 Enrollment ID: I20040615001109 |
| Provider Name | William R Strand |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1134166127 PECOS PAC ID: 8820072168 Enrollment ID: I20040615001111 |
| Provider Name | Hadi Sakhai |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1962440024 PECOS PAC ID: 3274595780 Enrollment ID: I20041027001040 |
| Provider Name | Steven C Copenhaver |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396784518 PECOS PAC ID: 5294797346 Enrollment ID: I20041103001278 |
| Provider Name | Andrew Gordon Lashus |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1366535452 PECOS PAC ID: 4981668613 Enrollment ID: I20041112000912 |
| Provider Name | Nicole Leah Lanman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063413201 PECOS PAC ID: 2365406980 Enrollment ID: I20041115000189 |
| Provider Name | Rachel A Dreiling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518057835 PECOS PAC ID: 6507821345 Enrollment ID: I20041122000460 |
| Provider Name | Piper Merrill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811901994 PECOS PAC ID: 7012972664 Enrollment ID: I20041123000840 |
| Provider Name | John T Connor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477758688 PECOS PAC ID: 8022076512 Enrollment ID: I20041230000233 |
| Provider Name | Joyce Faye Henry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164534442 PECOS PAC ID: 4789632134 Enrollment ID: I20050112000341 |
| Provider Name | John Zhong |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1043281538 PECOS PAC ID: 8123088366 Enrollment ID: I20050527000159 |
| Provider Name | Nancy R Kelly |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033171996 PECOS PAC ID: 3375570047 Enrollment ID: I20050725000586 |
| Provider Name | David Ewalt |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1043257686 PECOS PAC ID: 4688633258 Enrollment ID: I20050923000083 |
| Provider Name | Thomas Spain |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1053355321 PECOS PAC ID: 3072530526 Enrollment ID: I20051025000262 |
| Provider Name | Stephen Hoang |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1073566493 PECOS PAC ID: 2769400720 Enrollment ID: I20051108000648 |
| Provider Name | Matthew G Meyer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467499459 PECOS PAC ID: 4486663812 Enrollment ID: I20060413000147 |
| Provider Name | Linda K Phan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235245895 PECOS PAC ID: 2860493210 Enrollment ID: I20070126000619 |
| Provider Name | Peter Szmuk |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1023107620 PECOS PAC ID: 5890796296 Enrollment ID: I20070129000213 |
| Provider Name | Stormee R Williams |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881628238 PECOS PAC ID: 2860599289 Enrollment ID: I20070521000061 |
| Provider Name | Brian Kravitz |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1811099773 PECOS PAC ID: 2365539418 Enrollment ID: I20071106000476 |
| Provider Name | Shannon L Ternan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1598969602 PECOS PAC ID: 9537256680 Enrollment ID: I20071106000485 |
| Provider Name | Jennifer B Walsh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205057205 PECOS PAC ID: 4082796321 Enrollment ID: I20080125000477 |
| Provider Name | Kelly C Huffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669578001 PECOS PAC ID: 4981781820 Enrollment ID: I20080402000916 |
| Provider Name | Amy J Hogge |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1427124437 PECOS PAC ID: 4082792296 Enrollment ID: I20080428000600 |
| Provider Name | William H Jones |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1285666875 PECOS PAC ID: 8224107701 Enrollment ID: I20080523000367 |
| Provider Name | Erin E Wallace |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396952263 PECOS PAC ID: 0941376990 Enrollment ID: I20080827000697 |
| Provider Name | Yolande M Pengetnze |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952574055 PECOS PAC ID: 0244306462 Enrollment ID: I20080911000313 |
| Provider Name | Lauren P Ortega |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134336530 PECOS PAC ID: 7719073196 Enrollment ID: I20081017000545 |
| Provider Name | Huy Do |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1568486330 PECOS PAC ID: 6800957127 Enrollment ID: I20081205000057 |
| Provider Name | Deryk L Walsh |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1982828505 PECOS PAC ID: 8426119744 Enrollment ID: I20081205000079 |
| Provider Name | Osama Aboul-fettouh |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1376634741 PECOS PAC ID: 7911930870 Enrollment ID: I20081211000358 |
| Provider Name | Wei Wei Boone |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1063469021 PECOS PAC ID: 7416010368 Enrollment ID: I20090120000543 |
| Provider Name | Nicholas Strittmatter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215194667 PECOS PAC ID: 7810045929 Enrollment ID: I20090429000474 |
| Provider Name | Shahid Hussain |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1659461127 PECOS PAC ID: 1355336355 Enrollment ID: I20090430000274 |
| Provider Name | Shannon E Blalock |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1285825505 PECOS PAC ID: 5395899736 Enrollment ID: I20090819000330 |
| Provider Name | Otto R Velasquez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144302605 PECOS PAC ID: 2466507348 Enrollment ID: I20090827000867 |
| Provider Name | Nathan M Nolte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558514075 PECOS PAC ID: 6507911336 Enrollment ID: I20090831000656 |
| Provider Name | Kathleen E Vandiver |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487845988 PECOS PAC ID: 4981759651 Enrollment ID: I20090901000458 |
| Provider Name | Kristin J Royal |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1275710105 PECOS PAC ID: 7315013604 Enrollment ID: I20091008000428 |
| Provider Name | Julie Steele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194934158 PECOS PAC ID: 5890833198 Enrollment ID: I20091106000121 |
| Provider Name | Kristen M Ogg |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1144431644 PECOS PAC ID: 4486792710 Enrollment ID: I20091106000336 |
| Provider Name | Katherine L Moorehead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235183120 PECOS PAC ID: 3779621883 Enrollment ID: I20091110000688 |
| Provider Name | Heather L Grein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770680316 PECOS PAC ID: 9739227844 Enrollment ID: I20091110000727 |
| Provider Name | Bonita W Conley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871663419 PECOS PAC ID: 9537207436 Enrollment ID: I20091113000361 |
| Provider Name | Michael C Lee |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043270945 PECOS PAC ID: 5193867695 Enrollment ID: I20100121000591 |
| Provider Name | Peter N Schochet |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1578593190 PECOS PAC ID: 4789728700 Enrollment ID: I20100215000375 |
| Provider Name | Angela P Mihalic |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073575122 PECOS PAC ID: 9931243714 Enrollment ID: I20100217000293 |
| Provider Name | Dorothy M Sendelbach |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558321711 PECOS PAC ID: 8729113642 Enrollment ID: I20100317000858 |
| Provider Name | Umar H Khan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1194739391 PECOS PAC ID: 9830289313 Enrollment ID: I20100507000734 |
| Provider Name | Cynthia Gonzales |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1073559787 PECOS PAC ID: 7618981614 Enrollment ID: I20110131000981 |
| Provider Name | Lyndsey A Grover |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1144366717 PECOS PAC ID: 6800076738 Enrollment ID: I20110210000422 |
| Provider Name | Preethy Susan Varghese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821305624 PECOS PAC ID: 3173705035 Enrollment ID: I20110314000724 |
| Provider Name | Andrea M Newman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912208687 PECOS PAC ID: 2961685110 Enrollment ID: I20110324000761 |
| Provider Name | Lee M Clintsman |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1538468756 PECOS PAC ID: 1759565005 Enrollment ID: I20110411000496 |
| Provider Name | Merin M Abraham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033431408 PECOS PAC ID: 8022295112 Enrollment ID: I20110526000337 |
| Provider Name | Jennifer Lauren Pittmon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871809244 PECOS PAC ID: 1658558903 Enrollment ID: I20110614000277 |
| Provider Name | Kevin M Rivera Vazquez |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1205011103 PECOS PAC ID: 0749458974 Enrollment ID: I20110714000196 |
| Provider Name | Adolfo Gonzalez |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1013163633 PECOS PAC ID: 0941368799 Enrollment ID: I20110718000615 |
| Provider Name | Luis Zabala |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1982794459 PECOS PAC ID: 5799774147 Enrollment ID: I20110808000023 |
| Provider Name | Jana J Mcalister |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1346400454 PECOS PAC ID: 0446429575 Enrollment ID: I20110808000197 |
| Provider Name | Carol Leigh Newman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952689820 PECOS PAC ID: 8729259031 Enrollment ID: I20110919000083 |
| Provider Name | Tracy H Laird |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1518955335 PECOS PAC ID: 7810158573 Enrollment ID: I20120405000696 |
| Provider Name | William Pennock Laird |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1306834023 PECOS PAC ID: 5496916173 Enrollment ID: I20120406000115 |
| Provider Name | Jeena Jacob |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073893731 PECOS PAC ID: 0143481630 Enrollment ID: I20120410000314 |
| Provider Name | Gregory T Mccain |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528130192 PECOS PAC ID: 0042471344 Enrollment ID: I20120413000116 |
| Provider Name | Suma G Putcha |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255600813 PECOS PAC ID: 2466615893 Enrollment ID: I20120523000315 |
| Provider Name | David Stevenson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1982880282 PECOS PAC ID: 2567546633 Enrollment ID: I20120629000373 |
| Provider Name | Anu A Cherian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417216706 PECOS PAC ID: 6709032998 Enrollment ID: I20120802000698 |
| Provider Name | Jenna B Cavazos |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1255612701 PECOS PAC ID: 3779739578 Enrollment ID: I20120810000082 |
| Provider Name | Courtney Kowalczyk Derderian |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1699978346 PECOS PAC ID: 9830346154 Enrollment ID: I20120821000978 |
| Provider Name | Naveed Ahmad |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992934533 PECOS PAC ID: 6406003946 Enrollment ID: I20120905000827 |
| Provider Name | Edgar E Kiss |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1194917591 PECOS PAC ID: 7113175639 Enrollment ID: I20120907000086 |
| Provider Name | Christopher T Setiawan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1487801858 PECOS PAC ID: 6204951114 Enrollment ID: I20120907000387 |
| Provider Name | Sana Ullah |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1356431829 PECOS PAC ID: 0840351292 Enrollment ID: I20121016000011 |
| Provider Name | Cassi R Glandon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164786901 PECOS PAC ID: 3274785829 Enrollment ID: I20121206000473 |
| Provider Name | Victoria Yang |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821312794 PECOS PAC ID: 6800038746 Enrollment ID: I20130806000551 |
| Provider Name | Giselle V Escalona |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740313907 PECOS PAC ID: 8325280696 Enrollment ID: I20130815000800 |
| Provider Name | Jami M Eidem |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1750538823 PECOS PAC ID: 6406099100 Enrollment ID: I20130828000537 |
| Provider Name | Jennifer L Hill |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790096923 PECOS PAC ID: 8325281900 Enrollment ID: I20130829000502 |
| Provider Name | Dawn D Johnson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588624431 PECOS PAC ID: 9537394630 Enrollment ID: I20131025001425 |
| Provider Name | Peter H Le |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1215375605 PECOS PAC ID: 5193951341 Enrollment ID: I20131119000543 |
| Provider Name | Gary R Turner |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1871665703 PECOS PAC ID: 9638339864 Enrollment ID: I20131206000678 |
| Provider Name | Aditee P Ambardekar |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1184784761 PECOS PAC ID: 4385797109 Enrollment ID: I20140221000456 |
| Provider Name | Saad Hussain |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1801062062 PECOS PAC ID: 9537316781 Enrollment ID: I20140305001084 |
| Provider Name | Erika Maria Ondrasek |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487974846 PECOS PAC ID: 7113162058 Enrollment ID: I20140826000937 |
| Provider Name | Israel P Nosnik |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1962660019 PECOS PAC ID: 0345468500 Enrollment ID: I20140829000870 |
| Provider Name | Long Ngoc Van |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1477967800 PECOS PAC ID: 8628296795 Enrollment ID: I20140903000235 |
| Provider Name | Sharon Koruthu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033524020 PECOS PAC ID: 6305066010 Enrollment ID: I20141001000570 |
| Provider Name | Ashkan Shawn Sharifi |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1083034433 PECOS PAC ID: 7517187123 Enrollment ID: I20141002001827 |
| Provider Name | Carmelita M Pearson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114272242 PECOS PAC ID: 5698995710 Enrollment ID: I20141013000452 |
| Provider Name | Jason R Newman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528173507 PECOS PAC ID: 5698772762 Enrollment ID: I20141104000580 |
| Provider Name | Renesha Christine Butler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033403522 PECOS PAC ID: 1052556388 Enrollment ID: I20141120000403 |
| Provider Name | Tally Goldfarb |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1952531675 PECOS PAC ID: 5698097194 Enrollment ID: I20141212000875 |
| Provider Name | Amy R Keefover-hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841506730 PECOS PAC ID: 1355664921 Enrollment ID: I20150107000416 |
| Provider Name | Gwen N Hughes |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1417346024 PECOS PAC ID: 9537487061 Enrollment ID: I20150414001307 |
| Provider Name | Dustin Michael Loveland |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1578797940 PECOS PAC ID: 2466679832 Enrollment ID: I20150528002436 |
| Provider Name | John D Roaten |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1760619878 PECOS PAC ID: 8325266794 Enrollment ID: I20150709001898 |
| Provider Name | Ashley D Bocanegra |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1407173420 PECOS PAC ID: 9931413069 Enrollment ID: I20150804003660 |
| Provider Name | Deepa A Mohan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336537083 PECOS PAC ID: 7416263116 Enrollment ID: I20150826000184 |
| Provider Name | Christopher Nicol Redman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1699065748 PECOS PAC ID: 6103133954 Enrollment ID: I20150911000757 |
| Provider Name | Kathryn Leigh Bauer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1942462346 PECOS PAC ID: 1456593979 Enrollment ID: I20150926000114 |
| Provider Name | Megha Patel |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1710111604 PECOS PAC ID: 0446491096 Enrollment ID: I20150930000462 |
| Provider Name | Kingsley C Okonkwo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982732178 PECOS PAC ID: 2860518578 Enrollment ID: I20151118001200 |
| Provider Name | Mohammed I Ahmed |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1578510863 PECOS PAC ID: 8426210063 Enrollment ID: I20151211002254 |
| Provider Name | Tiffany A Douglas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982959904 PECOS PAC ID: 2466753082 Enrollment ID: I20151223001112 |
| Provider Name | Itzel A Zambrano |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1558718569 PECOS PAC ID: 9436449998 Enrollment ID: I20160613000940 |
| Provider Name | Christine H Wang |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1649627639 PECOS PAC ID: 2365733722 Enrollment ID: I20160615002389 |
| Provider Name | Rushi R Parikh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568801926 PECOS PAC ID: 9638460942 Enrollment ID: I20160616001374 |
| Provider Name | Katherine G Maddox |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023350857 PECOS PAC ID: 2567753320 Enrollment ID: I20160624001856 |
| Provider Name | Rita Saynhalath |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1205127933 PECOS PAC ID: 3779875216 Enrollment ID: I20160701001428 |
| Provider Name | Patrice Suzanne Wilson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1114213550 PECOS PAC ID: 5092963306 Enrollment ID: I20160812001040 |
| Provider Name | Katie Amy Liu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1376833582 PECOS PAC ID: 3870887714 Enrollment ID: I20160816000354 |
| Provider Name | Alissa D Z Doll |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1154612414 PECOS PAC ID: 1759676661 Enrollment ID: I20160817000118 |
| Provider Name | Gijo A Alex |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1265675110 PECOS PAC ID: 0941420848 Enrollment ID: I20160914000626 |
| Provider Name | Christopher Ryan Powers |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1730637141 PECOS PAC ID: 0941588743 Enrollment ID: I20161029000203 |
| Provider Name | Loren M Glasser |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1538387865 PECOS PAC ID: 9234186040 Enrollment ID: I20170112003222 |
| Provider Name | James Demasi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568542645 PECOS PAC ID: 9133116585 Enrollment ID: I20170223001590 |
| Provider Name | Neethu Kumar Chandran |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1639468374 PECOS PAC ID: 1850675166 Enrollment ID: I20170306002013 |
| Provider Name | Wansheng Wang |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790970796 PECOS PAC ID: 7517243868 Enrollment ID: I20170421000032 |
| Provider Name | Pravin K Sah |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609014851 PECOS PAC ID: 4880962299 Enrollment ID: I20170607001907 |
| Provider Name | Stephen J Kimatian |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1407807555 PECOS PAC ID: 9638226863 Enrollment ID: I20170721002530 |
| Provider Name | Jessica N Sabers |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1467981092 PECOS PAC ID: 3476824053 Enrollment ID: I20170731002386 |
| Provider Name | Jacqueline M Abraham |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1407378433 PECOS PAC ID: 0941571053 Enrollment ID: I20170808003503 |
| Provider Name | Shayla L Derousseau |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1275891988 PECOS PAC ID: 1456624071 Enrollment ID: I20170901002499 |
| Provider Name | Elizabeth Aviles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881147155 PECOS PAC ID: 9234405218 Enrollment ID: I20171018002068 |
| Provider Name | Katherine Venta |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437246113 PECOS PAC ID: 6002172210 Enrollment ID: I20171103001179 |
| Provider Name | Simi Pulikkiel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316497498 PECOS PAC ID: 8022374248 Enrollment ID: I20171103001574 |
| Provider Name | Phyllis Kane |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477939486 PECOS PAC ID: 7315205572 Enrollment ID: I20171215000619 |
| Provider Name | Kimberly H Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205348240 PECOS PAC ID: 3476812900 Enrollment ID: I20180109000836 |
| Provider Name | Jason R Buttles |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417991126 PECOS PAC ID: 5294748182 Enrollment ID: I20180124001918 |
| Provider Name | Ruth Osei Fordjour |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003072695 PECOS PAC ID: 5193859189 Enrollment ID: I20180208000033 |
| Provider Name | Danielle Duhon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619492741 PECOS PAC ID: 8921368085 Enrollment ID: I20180209000773 |
| Provider Name | Rima H Patel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821274143 PECOS PAC ID: 9436419223 Enrollment ID: I20180216001690 |
| Provider Name | Yu Ting |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932441698 PECOS PAC ID: 7012278799 Enrollment ID: I20180220001479 |
| Provider Name | Jennifer Lauren Styers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396055323 PECOS PAC ID: 3870854714 Enrollment ID: I20180309001559 |
| Provider Name | Kristi Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912407750 PECOS PAC ID: 7315209160 Enrollment ID: I20180315000668 |
| Provider Name | Alan C Sing |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679885727 PECOS PAC ID: 0941562417 Enrollment ID: I20180321000430 |
| Provider Name | Christine A Glasow |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1710156518 PECOS PAC ID: 8325301260 Enrollment ID: I20180406001044 |
| Provider Name | Amit J Verma |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548450216 PECOS PAC ID: 7113280801 Enrollment ID: I20180411000730 |
| Provider Name | Alicia Nicole Harding |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336384528 PECOS PAC ID: 7214290436 Enrollment ID: I20180420000971 |
| Provider Name | Proshad Nemati Efune |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1104056423 PECOS PAC ID: 6002163649 Enrollment ID: I20180727000851 |
| Provider Name | Erin Reynolds Whitaker Reynolds |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073753554 PECOS PAC ID: 1355596651 Enrollment ID: I20180802001458 |
| Provider Name | Roby Sebastian |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1235306093 PECOS PAC ID: 8820234743 Enrollment ID: I20180816002565 |
| Provider Name | Maria Christian Yates |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1568718211 PECOS PAC ID: 2163766775 Enrollment ID: I20181210001048 |
| Provider Name | Clarisa Ysela Garcia |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093969180 PECOS PAC ID: 8123362670 Enrollment ID: I20181210003433 |
| Provider Name | Randi E Durden |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1316212541 PECOS PAC ID: 3375857105 Enrollment ID: I20181212001870 |
| Provider Name | Holly M Tomlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982925848 PECOS PAC ID: 6406191048 Enrollment ID: I20181231000064 |
| Provider Name | Reana Joyce Abraham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952859696 PECOS PAC ID: 6204175953 Enrollment ID: I20190225002428 |
| Provider Name | Ashley E Hanson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063722999 PECOS PAC ID: 9830439363 Enrollment ID: I20190320002169 |
| Provider Name | Kim Michelle Mchard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417055187 PECOS PAC ID: 6002156023 Enrollment ID: I20190328001699 |
| Provider Name | Melissa Howell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487884151 PECOS PAC ID: 5294076154 Enrollment ID: I20190403001452 |
| Provider Name | Ann Simon Abraham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427315183 PECOS PAC ID: 9335481548 Enrollment ID: I20190508000809 |
| Provider Name | Suji Ann John |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265786271 PECOS PAC ID: 0547502734 Enrollment ID: I20190509001048 |
| Provider Name | Ashley Eunice Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154707909 PECOS PAC ID: 0547503765 Enrollment ID: I20190509002442 |
| Provider Name | Brenda Joyce Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427143320 PECOS PAC ID: 4880937853 Enrollment ID: I20190514001575 |
| Provider Name | Robyn Joy Haynes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821357088 PECOS PAC ID: 1254674252 Enrollment ID: I20190514003018 |
| Provider Name | Heather Lochry Sweeney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295834000 PECOS PAC ID: 2264775147 Enrollment ID: I20190516000272 |
| Provider Name | Jerithea Doronice Tidwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134387558 PECOS PAC ID: 1456694199 Enrollment ID: I20190520002485 |
| Provider Name | Ann H Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699877738 PECOS PAC ID: 1052654530 Enrollment ID: I20190524001544 |
| Provider Name | Esmirna Corona |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528629904 PECOS PAC ID: 9739416066 Enrollment ID: I20190809000880 |
| Provider Name | Sarah E Rebstock |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1205058765 PECOS PAC ID: 1456426477 Enrollment ID: I20190820002123 |
| Provider Name | Elizabeth Thuy-an Hong |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1639737497 PECOS PAC ID: 2567791809 Enrollment ID: I20190911001715 |
| Provider Name | Ranjana Chandramouli |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790769388 PECOS PAC ID: 1456331818 Enrollment ID: I20190923001514 |
| Provider Name | Mevelline Kuon Lim |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679982540 PECOS PAC ID: 8729318308 Enrollment ID: I20190924003264 |
| Provider Name | Amrita Nagra |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740556042 PECOS PAC ID: 4880924463 Enrollment ID: I20190924003492 |
| Provider Name | Jennifer Jeanne Hoover |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891063459 PECOS PAC ID: 2062742471 Enrollment ID: I20190927001807 |
| Provider Name | Adrienne De Ann Odom Hunnicutt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851423487 PECOS PAC ID: 8426388752 Enrollment ID: I20190928000199 |
| Provider Name | Rachel A Courtney |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497141774 PECOS PAC ID: 1850622929 Enrollment ID: I20191004000666 |
| Provider Name | Shelly Ann Ragsdale |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1326459405 PECOS PAC ID: 3274815535 Enrollment ID: I20191004000774 |
| Provider Name | John M Mcgrimley |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1619388071 PECOS PAC ID: 8921330051 Enrollment ID: I20191023000147 |
| Provider Name | Logan Blaze Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124678305 PECOS PAC ID: 9537491162 Enrollment ID: I20191030002602 |
| Provider Name | Elizabeth M Wong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134786288 PECOS PAC ID: 5991137291 Enrollment ID: I20191106003109 |
| Provider Name | Grace Mideva Maina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992105894 PECOS PAC ID: 7618300609 Enrollment ID: I20191205000608 |
| Provider Name | Constance Lee Chen Lin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033518964 PECOS PAC ID: 4082047626 Enrollment ID: I20191212000196 |
| Provider Name | Elizabeth L Iselin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1831392000 PECOS PAC ID: 4486830957 Enrollment ID: I20200228001313 |
| Provider Name | Jaeon Joseph Abraham |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043638885 PECOS PAC ID: 6204263353 Enrollment ID: I20200302001009 |
| Provider Name | Suresh Kumar Rajagopal |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821210311 PECOS PAC ID: 8426145855 Enrollment ID: I20200309001876 |
| Provider Name | Amy Suresh Patel |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1982073375 PECOS PAC ID: 8729389960 Enrollment ID: I20200312000360 |
| Provider Name | Michael Bradford Tate |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1891989349 PECOS PAC ID: 4587092069 Enrollment ID: I20200316001955 |
| Provider Name | Rachel Thomas |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992833404 PECOS PAC ID: 2365535564 Enrollment ID: I20200319000197 |
| Provider Name | Aveline Pascual Jerome |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1932529104 PECOS PAC ID: 2466880539 Enrollment ID: I20200324001429 |
| Provider Name | Adam Hamill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821433236 PECOS PAC ID: 4981034816 Enrollment ID: I20200416003954 |
| Provider Name | Lindsey Dickerson Amos |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073732301 PECOS PAC ID: 4082035191 Enrollment ID: I20200528000072 |
| Provider Name | Sierra D Mcfan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578046009 PECOS PAC ID: 0143565747 Enrollment ID: I20200601002359 |
| Provider Name | Heather Kathryn Baumann-laneve |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114459518 PECOS PAC ID: 4688941453 Enrollment ID: I20200610003217 |
| Provider Name | Jillian Beth Halper |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316301625 PECOS PAC ID: 3173813425 Enrollment ID: I20200618001364 |
| Provider Name | Kelly Rose Featherston |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1932738812 PECOS PAC ID: 5991127011 Enrollment ID: I20200618002213 |
| Provider Name | Sachin Hitesh Shah |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1851824510 PECOS PAC ID: 1658794417 Enrollment ID: I20200713000862 |
| Provider Name | Ethan Lance Sanford |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1306112321 PECOS PAC ID: 8729402045 Enrollment ID: I20200721000079 |
| Provider Name | Mikel Salvador Gorbea |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1588071773 PECOS PAC ID: 4183049232 Enrollment ID: I20200806000332 |
| Provider Name | Mihir Parikh |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1346636958 PECOS PAC ID: 1951726017 Enrollment ID: I20200806000929 |
| Provider Name | Clay William Yaklin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740522937 PECOS PAC ID: 1254633571 Enrollment ID: I20200826000549 |
| Provider Name | Luana Oliveira Melo |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1316351059 PECOS PAC ID: 3779901186 Enrollment ID: I20200917000738 |
| Provider Name | Chioma Obianuju Duru |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1588000400 PECOS PAC ID: 7012337090 Enrollment ID: I20201013001039 |
| Provider Name | Danielle Marie Emmett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558851758 PECOS PAC ID: 9335551894 Enrollment ID: I20201208000900 |
| Provider Name | Rhae Ellen Battles |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1447630132 PECOS PAC ID: 3375857584 Enrollment ID: I20201221000747 |
| Provider Name | Katherine Anne Hayes-hammond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104926716 PECOS PAC ID: 2961814561 Enrollment ID: I20201223000209 |
| Provider Name | Robert Humphreys |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164044996 PECOS PAC ID: 6406268002 Enrollment ID: I20201223000274 |
| Provider Name | Omorinsola Oronti |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952714834 PECOS PAC ID: 9032532478 Enrollment ID: I20210105000858 |
| Provider Name | Chaitanya Reddy Konda |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1881088052 PECOS PAC ID: 0042515850 Enrollment ID: I20210218001910 |
| Provider Name | Theresa A Shouse |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467406058 PECOS PAC ID: 8527476712 Enrollment ID: I20210428002020 |
| Provider Name | Benjamin Roshan Abraham |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356736870 PECOS PAC ID: 2567798051 Enrollment ID: I20210617000336 |
| Provider Name | Yingyi Cao |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1891292108 PECOS PAC ID: 6406259191 Enrollment ID: I20210719001499 |
| Provider Name | Brian Spencer Snarr |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1912206178 PECOS PAC ID: 8921401019 Enrollment ID: I20210727002950 |
| Provider Name | Hauw Swan Lie |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1083814248 PECOS PAC ID: 1456755495 Enrollment ID: I20210812001457 |
| Provider Name | James Lee Pace |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1336151232 PECOS PAC ID: 1850583261 Enrollment ID: I20210827000537 |
| Provider Name | Merick Yamada |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073993424 PECOS PAC ID: 5991101826 Enrollment ID: I20210901001394 |
| Provider Name | Preetha Kandaswamy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740787043 PECOS PAC ID: 7012266364 Enrollment ID: I20210914000134 |
| Provider Name | Jacob Allen Sexton |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1558897223 PECOS PAC ID: 5890060735 Enrollment ID: I20210928003798 |
| Provider Name | Arul M. Lingappan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1083885255 PECOS PAC ID: 0143398347 Enrollment ID: I20211018002937 |
| Provider Name | Adolfo Flores |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1659714145 PECOS PAC ID: 6901295138 Enrollment ID: I20211110000275 |
| Provider Name | Leticia Pryor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942641576 PECOS PAC ID: 7315339884 Enrollment ID: I20220112001640 |
| Provider Name | Sheree Mireille Guimont |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467741090 PECOS PAC ID: 7416349204 Enrollment ID: I20220128001600 |
| Provider Name | Hailee Alyssa Scoggins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275292526 PECOS PAC ID: 6709279391 Enrollment ID: I20220202002745 |
| Provider Name | Christina Marie Haefeli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942879077 PECOS PAC ID: 9638562119 Enrollment ID: I20220204000646 |
| Provider Name | Todd Michael Burton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326047671 PECOS PAC ID: 1658764873 Enrollment ID: I20220211001085 |
| Provider Name | Brittney Lanier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376202622 PECOS PAC ID: 0446643506 Enrollment ID: I20220214000339 |
| Provider Name | Kelley D Smith |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396796637 PECOS PAC ID: 8921491093 Enrollment ID: I20220214000634 |
| Provider Name | Angie Marie Osborne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043976491 PECOS PAC ID: 3971996869 Enrollment ID: I20220217001935 |
| Provider Name | Donna Thornley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164857264 PECOS PAC ID: 2769876598 Enrollment ID: I20220222000060 |
| Provider Name | Heather Newby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497401335 PECOS PAC ID: 5193111094 Enrollment ID: I20220401000012 |
| Provider Name | Timothy Charles Shreve |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982344461 PECOS PAC ID: 1658768205 Enrollment ID: I20220428001898 |
| Provider Name | Jacquelynn Antoinette Longshaw |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962463984 PECOS PAC ID: 6204213747 Enrollment ID: I20220523000463 |
| Provider Name | Mia Marshall Best |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700315587 PECOS PAC ID: 5698152098 Enrollment ID: I20220524000345 |
| Provider Name | Mark Douglas Towns |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457312480 PECOS PAC ID: 3375921638 Enrollment ID: I20220528000075 |
| Provider Name | Thomas Walter Deacon |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265493282 PECOS PAC ID: 1052799079 Enrollment ID: I20220603000972 |
| Provider Name | Kenosha F Hobson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568723302 PECOS PAC ID: 1759538887 Enrollment ID: I20220625000222 |
| Provider Name | Angela Kay Shields |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1891216826 PECOS PAC ID: 4385917442 Enrollment ID: I20220629001355 |
| Provider Name | Adijat Olubukola Olanrewaju |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083022297 PECOS PAC ID: 1557666799 Enrollment ID: I20220729002146 |
| Provider Name | Ingrid Moreno Duarte |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1295149128 PECOS PAC ID: 4385942119 Enrollment ID: I20220827000070 |
| Provider Name | Alex Younghoon Chung |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1457715336 PECOS PAC ID: 1355637190 Enrollment ID: I20220905000001 |
| Provider Name | Grace Slater |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942662994 PECOS PAC ID: 1153685524 Enrollment ID: I20220907000089 |
| Provider Name | Hannah Justice |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598227423 PECOS PAC ID: 1658755897 Enrollment ID: I20220907001242 |
| Provider Name | Annette Pearl Ville |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093276123 PECOS PAC ID: 5496130528 Enrollment ID: I20220909002671 |
| Provider Name | Alvin Chi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902330095 PECOS PAC ID: 5193096147 Enrollment ID: I20220928002455 |
| Provider Name | Brittney Shae Letourneau |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790248078 PECOS PAC ID: 1153659453 Enrollment ID: I20220929000912 |
| Provider Name | Fabien C Arous |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255834040 PECOS PAC ID: 4880096114 Enrollment ID: I20220930001017 |
| Provider Name | Judy Kiarie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629661442 PECOS PAC ID: 2567848161 Enrollment ID: I20221005002380 |
| Provider Name | Sapan Jayendra Amin |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1053522755 PECOS PAC ID: 0547316655 Enrollment ID: I20221007002342 |
| Provider Name | Lauren Michelle Williams |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649697665 PECOS PAC ID: 0042696379 Enrollment ID: I20221010002552 |
| Provider Name | Ashley Taylor Wood |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1598487639 PECOS PAC ID: 6507233749 Enrollment ID: I20221101002153 |
| Provider Name | Natasha Patel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013413889 PECOS PAC ID: 0345599445 Enrollment ID: I20221114002028 |
| Provider Name | Grace Elizabeth Woods |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548767312 PECOS PAC ID: 4082962592 Enrollment ID: I20221206001652 |
| Provider Name | Nohea Lauae Ananda Leatherman-arkus |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316444011 PECOS PAC ID: 0143699512 Enrollment ID: I20221206002491 |
| Provider Name | Nazima Zakhidova |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760879381 PECOS PAC ID: 5395037964 Enrollment ID: I20221206002507 |
| Provider Name | Velouette Zavadil |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720052301 PECOS PAC ID: 6608245915 Enrollment ID: I20221208001698 |
| Provider Name | Joanna Lynn Clem |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316106750 PECOS PAC ID: 2365711462 Enrollment ID: I20221209001167 |
| Provider Name | Deepthi Reddy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275899494 PECOS PAC ID: 6901029610 Enrollment ID: I20221215002137 |
| Provider Name | Ashley Varghese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881149284 PECOS PAC ID: 8224391099 Enrollment ID: I20221215003062 |
| Provider Name | Elizabeth Adams |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1407240591 PECOS PAC ID: 5799155891 Enrollment ID: I20230106000878 |
| Provider Name | Cassandra Lynn Stewart |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942578117 PECOS PAC ID: 5698995231 Enrollment ID: I20230107000087 |
| Provider Name | Pooja Desai |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093945172 PECOS PAC ID: 4486966066 Enrollment ID: I20230110002889 |
| Provider Name | Kelly Elisabeth Parsons |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1518429109 PECOS PAC ID: 4486025251 Enrollment ID: I20230116000220 |
| Provider Name | Neethu M Mathew |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447577408 PECOS PAC ID: 5496126021 Enrollment ID: I20230118002962 |
| Provider Name | Betsy B Dehart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689985749 PECOS PAC ID: 9537530092 Enrollment ID: I20230119001183 |
| Provider Name | Maria Guadalupe Ramirez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376275826 PECOS PAC ID: 2668843582 Enrollment ID: I20230131003130 |
| Provider Name | Mai Phuong Tran |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1841635059 PECOS PAC ID: 9638541212 Enrollment ID: I20230207003619 |
| Provider Name | Erika E Flores |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982078093 PECOS PAC ID: 0840662458 Enrollment ID: I20230208001061 |
| Provider Name | Michael Gene Dehart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235455536 PECOS PAC ID: 8325410749 Enrollment ID: I20230214000084 |
| Provider Name | Brian Eugene Wagers |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083821029 PECOS PAC ID: 9133275134 Enrollment ID: I20230405002634 |
| Provider Name | Jill Suzanne Cioffi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093041451 PECOS PAC ID: 7810036993 Enrollment ID: I20230406000200 |
| Provider Name | Philip Alan Bernard |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316966146 PECOS PAC ID: 6103856521 Enrollment ID: I20230406000471 |
| Provider Name | Lindsay Irene Hanno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932664687 PECOS PAC ID: 6002281938 Enrollment ID: I20230406002859 |
| Provider Name | Katherine Elizabeth Lamb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598364291 PECOS PAC ID: 5991118549 Enrollment ID: I20230407001227 |
| Provider Name | Ana Isabel Morales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356964811 PECOS PAC ID: 2860857646 Enrollment ID: I20230501000990 |
| Provider Name | Yomna Farooqi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396242947 PECOS PAC ID: 9133586621 Enrollment ID: I20230526000411 |
| Provider Name | Ally Funkhouser Dye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851814784 PECOS PAC ID: 6800162892 Enrollment ID: I20230705000311 |
| Provider Name | Vivian Chioma Okoye |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194067769 PECOS PAC ID: 9133415581 Enrollment ID: I20230706004056 |
| Provider Name | Bella Xinyi O'malley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265061071 PECOS PAC ID: 1456712264 Enrollment ID: I20230726002120 |
| Provider Name | Samna Rasheed |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114547213 PECOS PAC ID: 9931560612 Enrollment ID: I20230727001531 |
| Provider Name | Gregory Colin Dann |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528453891 PECOS PAC ID: 1254687270 Enrollment ID: I20230727002761 |
| Provider Name | Cody Carnes |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1891322624 PECOS PAC ID: 3476971474 Enrollment ID: I20230731000336 |
| Provider Name | Shreya Reddy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548897382 PECOS PAC ID: 3577987643 Enrollment ID: I20230731002274 |
| Provider Name | Kuan Ju Chen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386178796 PECOS PAC ID: 1153656384 Enrollment ID: I20230802003550 |
| Provider Name | Amelia Chen |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1205531449 PECOS PAC ID: 7315300084 Enrollment ID: I20230828004108 |
| Provider Name | Morgan Coleman Arnold |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679936397 PECOS PAC ID: 6901198381 Enrollment ID: I20230911000284 |
| Provider Name | Selby Chu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528420023 PECOS PAC ID: 6800189531 Enrollment ID: I20230911001668 |
| Provider Name | Madeline Cullins Vernon |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1023515459 PECOS PAC ID: 6800250788 Enrollment ID: I20230911002794 |
| Provider Name | Amanda Motomochi |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1750887998 PECOS PAC ID: 9830553726 Enrollment ID: I20230911003203 |
| Provider Name | Maha Taranish |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255969341 PECOS PAC ID: 0244654838 Enrollment ID: I20230915002953 |
| Provider Name | Sarah Jeanne Boucher |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639547839 PECOS PAC ID: 9537513809 Enrollment ID: I20230921000540 |
| Provider Name | Naveen Zarlish Emmanuel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306406475 PECOS PAC ID: 6800120627 Enrollment ID: I20231002000444 |
| Provider Name | Zhaohui Hu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1396237491 PECOS PAC ID: 4688924400 Enrollment ID: I20231002002534 |
| Provider Name | Sarah Elizabeth Hall |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194401794 PECOS PAC ID: 9931556271 Enrollment ID: I20231108002887 |
| Provider Name | Pauline Karen Wong |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1497282628 PECOS PAC ID: 2163870387 Enrollment ID: I20231129001650 |
| Provider Name | John Stafford Hutton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073717948 PECOS PAC ID: 1254510183 Enrollment ID: I20231206000346 |
| Provider Name | Rafael Zonana Zonana Amkie |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1528597754 PECOS PAC ID: 9931552643 Enrollment ID: I20240130001018 |
| Provider Name | Sean Brunier |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1871524058 PECOS PAC ID: 2365889342 Enrollment ID: I20240326003066 |
| Provider Name | Madeleine Larue Alvin |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1144614199 PECOS PAC ID: 1759693922 Enrollment ID: I20240404002442 |
| Provider Name | Cassidy Eastburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013696939 PECOS PAC ID: 1052753431 Enrollment ID: I20240530002959 |
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