Lois Archer Killewich, MD | |
4502 Medical Dr, 3rd Floor, San Antonio, TX 78229-4402 | |
(210) 358-2074 | |
(210) 358-4779 |
Full Name | Lois Archer Killewich |
---|---|
Gender | Female |
Speciality | Surgery - Vascular Surgery |
Location | 4502 Medical Dr, San Antonio, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1316058274 | NPI | - | NPPES |
100476404 | Other | TX | MEDICAID CSHCN |
100476403 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2086S0129X | Surgery - Vascular Surgery | L9764 (Texas) | Primary |
208600000X | Surgery | L9764 (Texas) | Secondary |
2086S0102X | Surgery - Surgical Critical Care | L9764 (Texas) | Secondary |
Entity Name | Providence Health & Services Washington |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1174744304 PECOS PAC ID: 6709782600 Enrollment ID: O20031211000028 |
Mailing Address | Practice Location Address |
---|---|
Lois Archer Killewich, MD 7703 Floyd Curl Dr, Mc7977, San Antonio, TX 78229-3901 Ph: (210) 450-9000 | Lois Archer Killewich, MD 4502 Medical Dr, 3rd Floor, San Antonio, TX 78229-4402 Ph: (210) 358-2074 |
Anas Mouchli, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 7703 Floyd Curl Dr # Mc7742, San Antonio, TX 78229 Phone: 210-567-5711 | |
Dr. Agustin Cornejo Esquerra, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 311 Camden St Ste 409, San Antonio, TX 78215 Phone: 210-228-9605 Fax: 210-228-9632 | |
Dr. Robert P Thomas, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 4499 Medical Dr, Suite 347, San Antonio, TX 78229 Phone: 210-615-8757 Fax: 210-615-8789 | |
Grant Harrison Gershner, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 7703 Floyd Curl Dr, San Antonio, TX 78229 Phone: 210-567-7000 | |
Dr. Donald Howard Jenkins, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 4502 Medical Dr, San Antonio, TX 78229 Phone: 210-358-4000 | |
Dr. Donald David Dilworth, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 8715 Village Dr, Suite 608, San Antonio, TX 78217 Phone: 210-657-2100 Fax: 210-675-2110 | |
Marlin W Causey, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 3851 Roger Brooke Dr, San Antonio, TX 78234 Phone: 210-539-9360 |