| Ministering Physicians, P.a. | |
|
3000 Joe Dimaggio Blvd Bldg 400 Ste 15 Round Rock TX 78665-3922 | |
| (512) 246-6170 | |
| (512) 246-6174 |
| Full Name | Ministering Physicians, P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 3000 Joe Dimaggio Blvd, Round Rock, Texas |
| Authorized Official Name and Position | Linda F Hammons (PRACTICE MANAGER) |
| Authorized Official Contact | 5122711821 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ministering Physicians, P.a. 3000 Joe Dimaggio Blvd Ste 15 Round Rock TX 78665-3922 Ph: (512) 246-6170 | Ministering Physicians, P.a. 3000 Joe Dimaggio Blvd Bldg 400 Ste 15 Round Rock TX 78665-3922 Ph: (512) 246-6170 |
| NPI Number | 1619987252 |
|---|---|
| Provider Enumeration Date | 08/08/2006 |
| Last Update Date | 06/10/2016 |
| Medicare PECOS PAC ID | 2365450202 |
|---|---|
| Medicare Enrollment ID | O20060404000119 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619987252 | NPI | - | NPPES |
| 179415801 | Medicaid | TX | |
| 0013NP | Other | TX | BLUE CROSS PROV # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | J3658 (Texas) | Primary |
| Provider Name | Philip M Woodall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164487260 PECOS PAC ID: 9436040631 Enrollment ID: I20040324001048 |
| Provider Name | Suzanne E Buchner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669430419 PECOS PAC ID: 2961488937 Enrollment ID: I20040629000912 |
| Provider Name | Karen Ann Greenberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104906601 PECOS PAC ID: 6800865726 Enrollment ID: I20040928000745 |
| Provider Name | Kristi R Clendennen |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1811170269 PECOS PAC ID: 7618025156 Enrollment ID: I20090511000350 |
| Provider Name | Lori J Wingate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801090865 PECOS PAC ID: 0648305920 Enrollment ID: I20100312000341 |
| Provider Name | Kerry Carroll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871027904 PECOS PAC ID: 3173888369 Enrollment ID: I20180516002727 |
| Provider Name | Sarah Beth Wilke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144848516 PECOS PAC ID: 7012336779 Enrollment ID: I20200929002810 |
| Provider Name | Brandi Avila |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811755846 PECOS PAC ID: 4385081512 Enrollment ID: I20240325000937 |
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