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7021 Kewanee Ave 6-104 Lubbock TX 79424-7048 | |
| (806) 355-1313 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 7021 Kewanee Ave, Lubbock, Texas |
| Authorized Official Name and Position | Allan James Mccorkle (OWNER) |
| Authorized Official Contact | 8063551313 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
7021 Kewanee Ave 6-104 Lubbock TX 79424-7048 Ph: (806) 355-1313 | 7021 Kewanee Ave 6-104 Lubbock TX 79424-7048 Ph: (806) 355-1313 |
| NPI Number | 1477719292 |
|---|---|
| Provider Enumeration Date | 07/31/2008 |
| Last Update Date | 07/24/2024 |
| Certification Date | 07/24/2024 |
| Medicare PECOS PAC ID | 9537233978 |
|---|---|
| Medicare Enrollment ID | O20080804000479 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477719292 | NPI | - | NPPES |
| 260029779 | Other | PALMETTO GBA | |
| 123652303 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Teresa L Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649378712 PECOS PAC ID: 8820090442 Enrollment ID: I20070212000424 |
| Provider Name | Allan J Mccorkle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124077342 PECOS PAC ID: 1456425891 Enrollment ID: I20080804000470 |
| Provider Name | Chirise A Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992248249 PECOS PAC ID: 4789969114 Enrollment ID: I20170327000128 |
| Provider Name | Mirlene Exume Appolon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376743153 PECOS PAC ID: 0345674552 Enrollment ID: I20191221000315 |
| Provider Name | Mary Amanda Abila |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902412976 PECOS PAC ID: 4183043540 Enrollment ID: I20201005000205 |
| Provider Name | Hector Medellin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497355929 PECOS PAC ID: 3870908403 Enrollment ID: I20210212001179 |
| Provider Name | Angela Kay Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053064030 PECOS PAC ID: 1153717491 Enrollment ID: I20220413001153 |
| Provider Name | Hannah Breanne Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942942214 PECOS PAC ID: 2860879434 Enrollment ID: I20220520000251 |
| Provider Name | Lisa G Herterich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841918885 PECOS PAC ID: 0244605566 Enrollment ID: I20230418002138 |
| Provider Name | Yvonne Castro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184354631 PECOS PAC ID: 9234504507 Enrollment ID: I20230419000978 |
| Provider Name | Annisha Mcgowan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669239471 PECOS PAC ID: 6305286782 Enrollment ID: I20240502000751 |
| Provider Name | Rene Rueben Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487493185 PECOS PAC ID: 9739621756 Enrollment ID: I20240605004089 |
| Provider Name | Molly Beel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578391629 PECOS PAC ID: 5799222675 Enrollment ID: I20240809000510 |
| Provider Name | Mary Richelle Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962249680 PECOS PAC ID: 8426596222 Enrollment ID: I20240812001802 |
Gabrielle K Keenum Ma Lpc Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6309 Indiana Ave Ste D, Lubbock, TX 79413 Phone: 806-790-1327 Fax: 806-863-3874 | |
Lubbock Accident & Injury Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5201 Indiana Ave, Lubbock, TX 79413 Phone: 806-793-7246 | |
Desert Sky Family Therapy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5504 Wayne Ave Ste 109, Lubbock, TX 79414 Phone: 806-853-7292 | |
Denovo Therapy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2345 50th St Ste 501, Lubbock, TX 79412 Phone: 806-370-3157 Fax: 806-243-4002 | |
G. Gary Walker, Ph.d., P.c. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 5120 29th Dr Ste D, Lubbock, TX 79407 Phone: 806-798-8855 Fax: 806-792-5715 | |
Swmh Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4413 71st St Ste G101, Lubbock, TX 79424 Phone: 806-438-8089 | |
John Cobb, M.d., Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6502 Slide Road, Suite 311, Lubbock, TX 79424 Phone: 806-771-1386 Fax: 806-771-1388 |