| Kellum Physician Partners, Pa | |
|
3903 Wiseman Blvd Suite 215 San Antonio TX 78251-4401 | |
| (210) 675-6724 | |
| (210) 675-1759 |
| Full Name | Kellum Physician Partners, Pa |
|---|---|
| Speciality | Obstetrics & Gynecology |
| Location | 3903 Wiseman Blvd, San Antonio, Texas |
| Authorized Official Name and Position | Daniel Hansford Kellum (PRESIDENT) |
| Authorized Official Contact | 2109452121 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kellum Physician Partners, Pa 8870 Us Highway 87 E San Antonio TX 78263-2242 Ph: (210) 648-0152 | Kellum Physician Partners, Pa 3903 Wiseman Blvd Suite 215 San Antonio TX 78251-4401 Ph: (210) 675-6724 |
| NPI Number | 1073880092 |
|---|---|
| Provider Enumeration Date | 11/18/2011 |
| Last Update Date | 04/07/2015 |
| Medicare PECOS PAC ID | 1850553058 |
|---|---|
| Medicare Enrollment ID | O20120504000381 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073880092 | NPI | - | NPPES |
| 3009748-01 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | J1533 (Texas) | Secondary |
| 207V00000X | Obstetrics & Gynecology | J0844 (Texas) | Primary |
| Provider Name | Arthur Gonzales |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265613483 PECOS PAC ID: 1153460597 Enrollment ID: I20091125000155 |
| Provider Name | Daniel Hansford Kellum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205820990 PECOS PAC ID: 1456386655 Enrollment ID: I20100324000814 |
| Provider Name | John Hansford Kellum |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255326989 PECOS PAC ID: 7315022704 Enrollment ID: I20100324000844 |
| Provider Name | Molly D Shields |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396971255 PECOS PAC ID: 1759524929 Enrollment ID: I20130909000213 |
| Provider Name | Ashley Nicole Courchesne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922528645 PECOS PAC ID: 3476828393 Enrollment ID: I20171003006069 |
| Provider Name | Christina Ann Hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972162451 PECOS PAC ID: 9638403496 Enrollment ID: I20190627001709 |
| Provider Name | Krista Gisele Celedon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558842948 PECOS PAC ID: 4688065840 Enrollment ID: I20211222001662 |
| Provider Name | Annalysa Diaz Elizondo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831868942 PECOS PAC ID: 5991197493 Enrollment ID: I20220112002905 |
| Provider Name | Kathleen Marie Calara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982204731 PECOS PAC ID: 7810380193 Enrollment ID: I20220209001009 |
| Provider Name | Richard J Mello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801539622 PECOS PAC ID: 9931587565 Enrollment ID: I20220609001685 |
| Provider Name | Brandi Breuer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548710858 PECOS PAC ID: 3173910932 Enrollment ID: I20221014000059 |
| Provider Name | Kathryn E Camplen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851881171 PECOS PAC ID: 6507105004 Enrollment ID: I20221102000053 |
| Provider Name | Sara L Akin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841904273 PECOS PAC ID: 2860864550 Enrollment ID: I20230206002187 |
| Provider Name | Lisa A Gurwitz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1306814942 PECOS PAC ID: 7618297276 Enrollment ID: I20230222001394 |
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Communicare Health Centers Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1200 Brooklyn Ave Ste 300, San Antonio, TX 78212 Phone: 210-225-5930 Fax: 210-476-0246 | |
Insulin Rounds P A Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12951 Huebner Rd, #780355, San Antonio, TX 78278 Phone: 210-862-5506 | |
Omni Vision Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9218 Potranco Rd, Suite 105, San Antonio, TX 78251 Phone: 832-331-9831 Fax: 210-855-8365 |