| Northeast Prohealth | |
|
7585 Kitty Hawk Suite 201 Converse TX 78109 | |
| (210) 468-2333 | |
| (210) 667-4044 |
| Full Name | Northeast Prohealth |
|---|---|
| Speciality | Internal Medicine |
| Location | 7585 Kitty Hawk, Converse, Texas |
| Authorized Official Name and Position | Orlando Kypuros (MEDICAL DOCTOR) |
| Authorized Official Contact | 2105994086 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Prohealth 7585 Kitty Hawk Suite 201 Converse TX 78109 Ph: (210) 468-2333 | Northeast Prohealth 7585 Kitty Hawk Suite 201 Converse TX 78109 Ph: (210) 468-2333 |
| NPI Number | 1336491315 |
|---|---|
| Provider Enumeration Date | 10/15/2012 |
| Last Update Date | 05/13/2021 |
| Medicare PECOS PAC ID | 3577709849 |
|---|---|
| Medicare Enrollment ID | O20130412000072 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336491315 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | M5312 (Texas) | Primary |
| Provider Name | Orlando Kypuros |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225103872 PECOS PAC ID: 1456353119 Enrollment ID: I20070208000378 |
| Provider Name | Ismael T Sosa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689868267 PECOS PAC ID: 4880888338 Enrollment ID: I20101028001552 |
| Provider Name | Won H. Park |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932337896 PECOS PAC ID: 8123283918 Enrollment ID: I20120628000536 |
| Provider Name | Matthew Shieh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1477997054 PECOS PAC ID: 0840565131 Enrollment ID: I20171012002734 |
| Provider Name | Yvette Marie Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962913830 PECOS PAC ID: 8527321512 Enrollment ID: I20180611000353 |
| Provider Name | Homero Almaraz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871072611 PECOS PAC ID: 2163767054 Enrollment ID: I20181220003235 |
| Provider Name | Valerie T Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043860158 PECOS PAC ID: 9133546039 Enrollment ID: I20200824001588 |
| Provider Name | Courtney Ibarra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417576448 PECOS PAC ID: 6507270592 Enrollment ID: I20210203000740 |
| Provider Name | Kristine Faith Park |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497355135 PECOS PAC ID: 9133533060 Enrollment ID: I20210204000037 |
| Provider Name | Tiffany Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790459212 PECOS PAC ID: 6901203140 Enrollment ID: I20210930001270 |
| Provider Name | Eugenia Leonidivna Tidwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285369736 PECOS PAC ID: 4284019639 Enrollment ID: I20220921000649 |
| Provider Name | Ashley Murillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881373397 PECOS PAC ID: 0941657076 Enrollment ID: I20231113000323 |
Prohealth Inpatient Consultants Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7585 Kitty Hawk Rd Ste 201, Converse, TX 78109 Phone: 210-468-2333 Fax: 210-667-4044 | |
Centromed Family First Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9135 Schaefer Rd Ste 4, Converse, TX 78109 Phone: 210-922-7000 Fax: 210-928-9699 |