| Med Management Associates Of Colorado Llc | |
|
7272 Wurzbach Rd Ste 601 San Antonio TX 78240-4803 | |
| (888) 365-6271 | |
| Not Available |
| Full Name | Med Management Associates Of Colorado Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 7272 Wurzbach Rd Ste 601, San Antonio, Texas |
| Authorized Official Name and Position | Paul Alan Boskind (CEO-OWNER) |
| Authorized Official Contact | 2106153483 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Med Management Associates Of Colorado Llc 7272 Wurzbach Rd Ste 601 San Antonio TX 78240-4803 Ph: (210) 615-3483 | Med Management Associates Of Colorado Llc 7272 Wurzbach Rd Ste 601 San Antonio TX 78240-4803 Ph: (888) 365-6271 |
| NPI Number | 1376064600 |
|---|---|
| Provider Enumeration Date | 06/27/2017 |
| Last Update Date | 04/24/2019 |
| Medicare PECOS PAC ID | 1557631256 |
|---|---|
| Medicare Enrollment ID | O20170727002265 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376064600 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | DR.0058661 (Colorado) | Primary |
| Provider Name | Christopher Reyburn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770624017 PECOS PAC ID: 6901880897 Enrollment ID: I20111014000037 |
| Provider Name | Virginia Chacon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922491059 PECOS PAC ID: 2163749060 Enrollment ID: I20150401001994 |
| Provider Name | Riaz Rahman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275630717 PECOS PAC ID: 8729077235 Enrollment ID: I20200616002229 |
| Provider Name | Syretta Mcgraw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083203590 PECOS PAC ID: 7810304086 Enrollment ID: I20210406001204 |
| Provider Name | Gilberto R Miranda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528598059 PECOS PAC ID: 5395146799 Enrollment ID: I20210623000792 |
| Provider Name | Sam Anthony Melton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841519626 PECOS PAC ID: 6103223201 Enrollment ID: I20210915003942 |
| Provider Name | Drew Cameron |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346776978 PECOS PAC ID: 0446589394 Enrollment ID: I20210928001638 |
| Provider Name | Angel L Julmy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598546400 PECOS PAC ID: 3072961689 Enrollment ID: I20231120003572 |
| Provider Name | Timberly Klinestiver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245566256 PECOS PAC ID: 2567814346 Enrollment ID: I20240117002251 |
| Provider Name | Catherine Liqian Wu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144089756 PECOS PAC ID: 3476994708 Enrollment ID: I20240516003673 |
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