| Komedix Medical Associates Pa | |
|
189 E Austin St Ste. 106 New Braunfels TX 78130-4104 | |
| (830) 708-8182 | |
| Not Available |
| Full Name | Komedix Medical Associates Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 189 E Austin St, New Braunfels, Texas |
| Authorized Official Name and Position | Roger Dale Kelly (COO) |
| Authorized Official Contact | 8307088182 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Komedix Medical Associates Pa 189 E Austin St Ste. 106 New Braunfels TX 78130-4104 Ph: () - | Komedix Medical Associates Pa 189 E Austin St Ste. 106 New Braunfels TX 78130-4104 Ph: (830) 708-8182 |
| NPI Number | 1679978977 |
|---|---|
| Provider Enumeration Date | 10/29/2014 |
| Last Update Date | 10/29/2014 |
| Medicare PECOS PAC ID | 0446574222 |
|---|---|
| Medicare Enrollment ID | O20150127001447 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679978977 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Jose J Silva |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326118811 PECOS PAC ID: 0749244515 Enrollment ID: I20041112000436 |
| Provider Name | Mark S Hickman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1427160118 PECOS PAC ID: 5496718223 Enrollment ID: I20100820000173 |
| Provider Name | Dawn E Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235570888 PECOS PAC ID: 6709010804 Enrollment ID: I20131003000113 |
| Provider Name | William Pollan |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1053392506 PECOS PAC ID: 8325274491 Enrollment ID: I20131119001491 |
| Provider Name | Eva Y Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730538281 PECOS PAC ID: 2769770411 Enrollment ID: I20161012000825 |
| Provider Name | John E Stanhope |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740331016 PECOS PAC ID: 4486790748 Enrollment ID: I20170823003396 |
| Provider Name | Jinjoo Hong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588133052 PECOS PAC ID: 8224378286 Enrollment ID: I20190329000357 |
| Provider Name | Patricia Tokunbo Aniekwena |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699938530 PECOS PAC ID: 9739587379 Enrollment ID: I20211012001195 |
| Provider Name | Reanna Kay Crisler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710646583 PECOS PAC ID: 6002207081 Enrollment ID: I20211230000373 |
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