| |
1500 University Dr E #100 College Station TX 77840-2600 | |
(979) 846-1100 | |
(979) 260-9390 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 1500 University Dr E, College Station, Texas |
Authorized Official Name and Position | Theresa Sabella (CEO) |
Authorized Official Contact | 9793832340 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
1500 University Dr E College Station TX 77840-2600 Ph: (979) 810-8148 | 1500 University Dr E #100 College Station TX 77840-2600 Ph: (979) 846-1100 |
NPI Number | 1821185299 |
---|---|
Provider Enumeration Date | 10/06/2006 |
Last Update Date | 12/27/2024 |
Medicare PECOS PAC ID | 4284542127 |
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Medicare Enrollment ID | O20040708001095 |
Identifier | Type | State | Issuer |
---|---|---|---|
1821185299 | NPI | - | NPPES |
000951607 | Medicaid | TX | |
154467803 | Medicaid | TX | |
1700973187 | Other | TX | NPI G |
185649401 | Medicaid | TX | |
187842302 | Medicaid | TX | |
000951608 | Medicaid | TX | |
1275620551 | Other | TX | NPI ROBERTSON CHC |
187842301 | Medicaid | TX | |
21721320 | Medicaid | TX | |
1275726853 | Other | TX | NPI CS |
154467801 | Medicaid | TX | |
1649265646 | Other | TX | NPI BCS |
1750470084 | Other | TX | NPI M |
1912056730 | Other | TX | NPI PHARM |
1568519122 | Other | TX | NPI L |
1043527476 | Other | TX | COLLEGE STATION FAMILY MEDICINE CLINIC - NPI |
1407163660 | Other | TX | ROCK PRAIRIE FAMILY MEDICINE AND OBSTETRICS-NPI |
1811171580 | Other | TX | NPI MEDICAID GROUP OB BILLING |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Provider Name | Pramoda K Mohapatra |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1447237243 PECOS PAC ID: 6901790195 Enrollment ID: I20040210000069 |
Provider Name | Adil Noshir Nicolwala |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1922060391 PECOS PAC ID: 8628039484 Enrollment ID: I20041025000627 |
Provider Name | Lara C Thibodeaux |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902894595 PECOS PAC ID: 4789648825 Enrollment ID: I20041117001019 |
Provider Name | Maryann Miyun Choi |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1982673083 PECOS PAC ID: 1557272416 Enrollment ID: I20050602000701 |
Provider Name | Chanseya Davis |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1578593810 PECOS PAC ID: 6507862273 Enrollment ID: I20061020000159 |
Provider Name | Kristel D. Leubner |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1316069982 PECOS PAC ID: 4486754652 Enrollment ID: I20070717000609 |
Provider Name | Nicole Rene Marietta |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1639189632 PECOS PAC ID: 6800984162 Enrollment ID: I20071120000337 |
Provider Name | Amol Deshpande |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1922140615 PECOS PAC ID: 1355470089 Enrollment ID: I20100518000834 |
Provider Name | Barbara L Pierce |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1477653962 PECOS PAC ID: 8921036245 Enrollment ID: I20100615000565 |
Provider Name | Roland Robert Garza |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1275530768 PECOS PAC ID: 8426224775 Enrollment ID: I20120109000236 |
Provider Name | Rebekah Solis |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225308133 PECOS PAC ID: 7315186731 Enrollment ID: I20130615000114 |
Provider Name | Jamie King South |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1245467026 PECOS PAC ID: 0840432084 Enrollment ID: I20130816000816 |
Provider Name | Lea Brown |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164771259 PECOS PAC ID: 3678703220 Enrollment ID: I20140228000035 |
Provider Name | Janelle Perrone |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1982950424 PECOS PAC ID: 3678790045 Enrollment ID: I20140807001849 |
Provider Name | Karla A Woods |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699179275 PECOS PAC ID: 7315269669 Enrollment ID: I20141124000734 |
Provider Name | Britni Lehde |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417328261 PECOS PAC ID: 2668773417 Enrollment ID: I20151221000715 |
Provider Name | Yolanda Sahagun |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437501210 PECOS PAC ID: 4688958556 Enrollment ID: I20170222000293 |
Provider Name | Brandi M Stewart |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093242208 PECOS PAC ID: 1557627288 Enrollment ID: I20171113001076 |
Provider Name | Isaiah R Logan |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1215318696 PECOS PAC ID: 0042557027 Enrollment ID: I20190129002791 |
Provider Name | Tammy Lynn Bradford |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1801237771 PECOS PAC ID: 2567790140 Enrollment ID: I20190820003469 |
Provider Name | Jordan William Conway |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1497296610 PECOS PAC ID: 9133541469 Enrollment ID: I20200615003255 |
Provider Name | April Thompson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1659973493 PECOS PAC ID: 7012328271 Enrollment ID: I20201119003388 |
Provider Name | Blake K Mcdaniel |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750973681 PECOS PAC ID: 5294137220 Enrollment ID: I20210713001686 |
Provider Name | Katelyn Jo Light |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1477189355 PECOS PAC ID: 7315369881 Enrollment ID: I20220523000775 |
Provider Name | Charlotte Ellis |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316640832 PECOS PAC ID: 2567837487 Enrollment ID: I20230406002257 |
Provider Name | Amber R Simpson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477148054 PECOS PAC ID: 7416365119 Enrollment ID: I20230511001169 |
Provider Name | Clayton Thomas Kruger |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1003376591 PECOS PAC ID: 0446622161 Enrollment ID: I20230613000626 |
Provider Name | Leslie Marice De Los Santos |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1316406218 PECOS PAC ID: 8325479975 Enrollment ID: I20230629004169 |
Provider Name | Jerry Don Lloyd |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225103773 PECOS PAC ID: 9830269018 Enrollment ID: I20230711000154 |
Provider Name | Shelly Dawn Hitchcock |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386364859 PECOS PAC ID: 6204279946 Enrollment ID: I20240208004573 |
Provider Name | Michele Lynn Armstrong |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043070246 PECOS PAC ID: 5698113777 Enrollment ID: I20240801004437 |
Provider Name | Darhonda M Swallow |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992575534 PECOS PAC ID: 8426595893 Enrollment ID: I20240802001076 |
Provider Name | Wendy Treat Lusk |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1659129674 PECOS PAC ID: 9537606785 Enrollment ID: I20240806000078 |
Provider Name | Tracy Ayers |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194458836 PECOS PAC ID: 4385829761 Enrollment ID: I20240808000353 |
Provider Name | Sheena R Alegun |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215464599 PECOS PAC ID: 8123435914 Enrollment ID: I20240808001474 |
Provider Name | Theresa Fusaro |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1689335895 PECOS PAC ID: 0749728350 Enrollment ID: I20240814001988 |
Provider Name | Donald Jackman |
---|---|
Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1124023395 PECOS PAC ID: 9234556051 Enrollment ID: I20240816003951 |
Provider Name | Michael J Burrows |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952063299 PECOS PAC ID: 0345600169 Enrollment ID: I20240819000214 |
Provider Name | Donna S Ohde |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1003373838 PECOS PAC ID: 1153653860 Enrollment ID: I20240819000533 |
Provider Name | Katherine Ahlstrom |
---|---|
Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1467180497 PECOS PAC ID: 2264970326 Enrollment ID: I20240820003260 |
Provider Name | Ashley Shanise Richardson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841902533 PECOS PAC ID: 6103282173 Enrollment ID: I20240820004133 |
Provider Name | Sierra Rogers |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457076010 PECOS PAC ID: 8022465376 Enrollment ID: I20240821000152 |
Provider Name | Brenda Clarke |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164858767 PECOS PAC ID: 8123255056 Enrollment ID: I20240821004639 |
Provider Name | Alexander Richard Hunt |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1588240352 PECOS PAC ID: 9133668890 Enrollment ID: I20240826002034 |
Provider Name | Kimberly M Buenger |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1568458321 PECOS PAC ID: 1658543707 Enrollment ID: I20240827004299 |
Provider Name | Theresa Coronado Foreman |
---|---|
Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1497039846 PECOS PAC ID: 4284173626 Enrollment ID: I20240828005405 |
Provider Name | Veena Anand |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1104812965 PECOS PAC ID: 4587834395 Enrollment ID: I20240830003131 |
Provider Name | Crystal James Mable |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508409533 PECOS PAC ID: 3678014925 Enrollment ID: I20240926001172 |
Provider Name | Michael J Bates |
---|---|
Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1073673752 PECOS PAC ID: 9931413465 Enrollment ID: I20241007001847 |
Doc Healthcare, P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 18395 Anasazi Bluff Dr, College Station, TX 77845 Phone: 979-571-1967 Fax: 979-256-0869 | |
Symetria Health Of Texas, L.l.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1651 Rock Prairie Rd Ste 101, College Station, TX 77845 Phone: 979-599-9580 | |
Regional Employee Assistance Program Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1602 Rock Prairie Rd, Ste 460, College Station, TX 77845 Phone: 979-696-0267 Fax: 979-694-4703 | |
Integrative Medical Care Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2700 Earl Rudder Fwy S Ste 2100, College Station, TX 77845 Phone: 979-221-2610 | |
Texas Endocrinology Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1721 Birmingham Dr Ste 200, College Station, TX 77845 Phone: 979-977-7012 Fax: 979-977-7013 | |
Medical Care Innovation, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Quality Circle, College Station, TX 77845 Phone: 979-268-8237 |