| Peterson Medical Associates | |
|
575 Hill Country Dr Ste 202 Kerrville TX 78028-6024 | |
| (830) 258-6237 | |
| (830) 315-1366 |
| Full Name | Peterson Medical Associates |
|---|---|
| Speciality | Obstetrics & Gynecology |
| Location | 575 Hill Country Dr, Kerrville, Texas |
| Authorized Official Name and Position | Lisa Medovich (CFO) |
| Authorized Official Contact | 8302587632 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peterson Medical Associates Po Box 26499 Belfast ME 04915-2015 Ph: (830) 258-7343 | Peterson Medical Associates 575 Hill Country Dr Ste 202 Kerrville TX 78028-6024 Ph: (830) 258-6237 |
| NPI Number | 1770800575 |
|---|---|
| Provider Enumeration Date | 05/03/2010 |
| Last Update Date | 03/11/2023 |
| Medicare PECOS PAC ID | 1355467887 |
|---|---|
| Medicare Enrollment ID | O20100922000142 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770800575 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 550119 (Texas) | Secondary |
| 207R00000X | Internal Medicine | 550119 (Texas) | Secondary |
| 207V00000X | Obstetrics & Gynecology | 550119 (Texas) | Primary |
| Provider Name | Bonnie Y Mckenzie |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1861491227 PECOS PAC ID: 9436056157 Enrollment ID: I20031218000863 |
| Provider Name | Dawn E Gonzalez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245292937 PECOS PAC ID: 8426957945 Enrollment ID: I20040105000313 |
| Provider Name | Robert F Profeta |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1821086950 PECOS PAC ID: 7719877919 Enrollment ID: I20040319000807 |
| Provider Name | Molly A Johnston |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1770685356 PECOS PAC ID: 4183612385 Enrollment ID: I20040505001046 |
| Provider Name | Tyson D Hale |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205809357 PECOS PAC ID: 0345222667 Enrollment ID: I20040602000192 |
| Provider Name | Julie H Lunsford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316186133 PECOS PAC ID: 0042286098 Enrollment ID: I20040909001264 |
| Provider Name | Michael David Shaffer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417949983 PECOS PAC ID: 0648239574 Enrollment ID: I20041006001342 |
| Provider Name | Richard Lowe |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700999216 PECOS PAC ID: 9032012380 Enrollment ID: I20041023000251 |
| Provider Name | Larry D Edwards |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205801081 PECOS PAC ID: 2062474851 Enrollment ID: I20041103000606 |
| Provider Name | Allan Kapilivsky |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962512269 PECOS PAC ID: 1850349028 Enrollment ID: I20050105000414 |
| Provider Name | David L Stoddard |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124095815 PECOS PAC ID: 5890745574 Enrollment ID: I20050131000466 |
| Provider Name | Jacinto Zambrano |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1043315542 PECOS PAC ID: 5294789517 Enrollment ID: I20050309000952 |
| Provider Name | David W Peters |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275518912 PECOS PAC ID: 9335187780 Enrollment ID: I20050418000755 |
| Provider Name | Mir Alikhan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790747921 PECOS PAC ID: 5991741407 Enrollment ID: I20050706001125 |
| Provider Name | Shannon Patrick Calhoun |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1598715278 PECOS PAC ID: 7911804398 Enrollment ID: I20050826000631 |
| Provider Name | Cynthia R Mcneely |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962627653 PECOS PAC ID: 2860412418 Enrollment ID: I20051129000287 |
| Provider Name | Harry R Parvey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326157454 PECOS PAC ID: 7214998244 Enrollment ID: I20060104000834 |
| Provider Name | Klaus M Schroeder |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437175247 PECOS PAC ID: 6800806837 Enrollment ID: I20060504000368 |
| Provider Name | Lukas Erik Burton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548224322 PECOS PAC ID: 9739199712 Enrollment ID: I20060504000827 |
| Provider Name | Eric A Appelt |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841210564 PECOS PAC ID: 4587667712 Enrollment ID: I20060808000561 |
| Provider Name | Karen T Allsup |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871521823 PECOS PAC ID: 9739186289 Enrollment ID: I20061026000283 |
| Provider Name | John Juarez |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1588647663 PECOS PAC ID: 8729085568 Enrollment ID: I20061108000574 |
| Provider Name | Alyson L Redman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114120680 PECOS PAC ID: 9335232487 Enrollment ID: I20070905000352 |
| Provider Name | John K Gresham |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1619170347 PECOS PAC ID: 9537253984 Enrollment ID: I20070917000474 |
| Provider Name | Thomas C Brown |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1851399398 PECOS PAC ID: 1254350200 Enrollment ID: I20071030000167 |
| Provider Name | Rajesh Gogia |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679528467 PECOS PAC ID: 9032212006 Enrollment ID: I20071212000320 |
| Provider Name | Michael J Streitmann |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1386624450 PECOS PAC ID: 6709976590 Enrollment ID: I20071217000658 |
| Provider Name | Joe M Pruneda |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306819602 PECOS PAC ID: 7315978731 Enrollment ID: I20071226000446 |
| Provider Name | Bridget Robledo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841297652 PECOS PAC ID: 2961585831 Enrollment ID: I20080215000213 |
| Provider Name | Luis J Acosta |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1720106966 PECOS PAC ID: 5890761001 Enrollment ID: I20080417000082 |
| Provider Name | Annette C Jones |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1821051954 PECOS PAC ID: 4981762812 Enrollment ID: I20081022000353 |
| Provider Name | Waheed Jalalzai |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669444246 PECOS PAC ID: 6305816513 Enrollment ID: I20081204000076 |
| Provider Name | Marc D Feldman |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1083721070 PECOS PAC ID: 5294882221 Enrollment ID: I20090409000121 |
| Provider Name | Julie S Merritt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942459425 PECOS PAC ID: 7618024415 Enrollment ID: I20090414000447 |
| Provider Name | M. Elizabeth Wilfong |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164661989 PECOS PAC ID: 3072667302 Enrollment ID: I20090820000297 |
| Provider Name | Jason C Bradford |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861651424 PECOS PAC ID: 6406901321 Enrollment ID: I20090828000350 |
| Provider Name | Jonathan Jaksha |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871555649 PECOS PAC ID: 3274632054 Enrollment ID: I20090904000224 |
| Provider Name | Shelia Mays |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770712325 PECOS PAC ID: 0042358202 Enrollment ID: I20091109000103 |
| Provider Name | Marcie J Sweat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013242288 PECOS PAC ID: 4082753801 Enrollment ID: I20091207000669 |
| Provider Name | Niessa C Meier |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1043545437 PECOS PAC ID: 6002956141 Enrollment ID: I20091221000435 |
| Provider Name | Dennis A Benfield |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1356319719 PECOS PAC ID: 1052335551 Enrollment ID: I20100217000842 |
| Provider Name | Michael D Ross |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1952365975 PECOS PAC ID: 0840326120 Enrollment ID: I20100325000517 |
| Provider Name | Benjamin Harper |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093763906 PECOS PAC ID: 5092842823 Enrollment ID: I20100427000187 |
| Provider Name | James A Young |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760590137 PECOS PAC ID: 4284690801 Enrollment ID: I20100830001134 |
| Provider Name | Raleigh Johnson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255347340 PECOS PAC ID: 3476454877 Enrollment ID: I20100902000669 |
| Provider Name | Robert Martel Reynolds |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1063473767 PECOS PAC ID: 1951314848 Enrollment ID: I20100902000741 |
| Provider Name | Houston Aaron |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295949220 PECOS PAC ID: 4789709627 Enrollment ID: I20100915000398 |
| Provider Name | Ralph J Fritzsch |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1508874157 PECOS PAC ID: 5890719504 Enrollment ID: I20100921001287 |
| Provider Name | Pamela D Cantu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437107901 PECOS PAC ID: 3476740697 Enrollment ID: I20101214000186 |
| Provider Name | Randy Niblett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154304434 PECOS PAC ID: 2961392782 Enrollment ID: I20101230000815 |
| Provider Name | Lindy Thaddeus Rachal |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275533150 PECOS PAC ID: 1052353224 Enrollment ID: I20110413000472 |
| Provider Name | James R Mckenzie |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1669785473 PECOS PAC ID: 4587835178 Enrollment ID: I20110910002940 |
| Provider Name | Michael Lloyd |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982801700 PECOS PAC ID: 6709051899 Enrollment ID: I20111220000063 |
| Provider Name | Lisa L Solder |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1447209192 PECOS PAC ID: 8628073855 Enrollment ID: I20120312000800 |
| Provider Name | Jammie K Barnes |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1952551988 PECOS PAC ID: 6305093089 Enrollment ID: I20120831000315 |
| Provider Name | Jenna L Cummings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114275922 PECOS PAC ID: 9436307162 Enrollment ID: I20120920000795 |
| Provider Name | Jarrod Stirling Wiggins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861668691 PECOS PAC ID: 2668626599 Enrollment ID: I20130131000184 |
| Provider Name | Brian V Given |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386732782 PECOS PAC ID: 9335163179 Enrollment ID: I20130919000155 |
| Provider Name | Jodie Lyn Baker |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1174956460 PECOS PAC ID: 3476788803 Enrollment ID: I20131021000509 |
| Provider Name | Sandra M Garred |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770578478 PECOS PAC ID: 1658388830 Enrollment ID: I20131028000611 |
| Provider Name | Sreechandra Donepudi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578686242 PECOS PAC ID: 0941354195 Enrollment ID: I20131121001021 |
| Provider Name | David S Stevener |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609193721 PECOS PAC ID: 4486883915 Enrollment ID: I20140204000522 |
| Provider Name | Lindsey N Neel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730515503 PECOS PAC ID: 6406089317 Enrollment ID: I20140430001013 |
| Provider Name | Jason Grennan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457313314 PECOS PAC ID: 9830179092 Enrollment ID: I20140812001681 |
| Provider Name | Timothy A Berg |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1568494490 PECOS PAC ID: 3072639509 Enrollment ID: I20140829002096 |
| Provider Name | Marco A De Los Santos |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1932390119 PECOS PAC ID: 1355561374 Enrollment ID: I20140925000904 |
| Provider Name | James E Truett |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1588944367 PECOS PAC ID: 4183896996 Enrollment ID: I20141010000157 |
| Provider Name | Michael J Barker |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417147687 PECOS PAC ID: 2567782451 Enrollment ID: I20150515001650 |
| Provider Name | Alicia Napper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063883999 PECOS PAC ID: 6800106105 Enrollment ID: I20151116001800 |
| Provider Name | Almas A Syed |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821358698 PECOS PAC ID: 0345541017 Enrollment ID: I20151222002169 |
| Provider Name | Brittany I Harris |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1164880829 PECOS PAC ID: 8123324381 Enrollment ID: I20160315000264 |
| Provider Name | James West |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245596014 PECOS PAC ID: 2466759642 Enrollment ID: I20160404000531 |
| Provider Name | Sharrel Marie Carlton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831157403 PECOS PAC ID: 3072587252 Enrollment ID: I20160425002626 |
| Provider Name | Adam M Branch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942601497 PECOS PAC ID: 9830414002 Enrollment ID: I20160509000051 |
| Provider Name | Karen P Aycock |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1114379849 PECOS PAC ID: 8123312352 Enrollment ID: I20160810001116 |
| Provider Name | Shannon F Klump |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942360730 PECOS PAC ID: 9830483957 Enrollment ID: I20160811001321 |
| Provider Name | Darren Ramoutar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578706172 PECOS PAC ID: 1456580356 Enrollment ID: I20161220001062 |
| Provider Name | James R Johnson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1053426320 PECOS PAC ID: 7810989258 Enrollment ID: I20161230001552 |
| Provider Name | Ryan H Patrick |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346560026 PECOS PAC ID: 3173741238 Enrollment ID: I20170119000690 |
| Provider Name | Sindhura Alapati |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528370319 PECOS PAC ID: 7012220189 Enrollment ID: I20170315001813 |
| Provider Name | John D Nelson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1760749154 PECOS PAC ID: 6002030889 Enrollment ID: I20171006000868 |
| Provider Name | Robyn L Pipkin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497296040 PECOS PAC ID: 6709151301 Enrollment ID: I20171009000270 |
| Provider Name | Samantha Marie Pierce |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1447650619 PECOS PAC ID: 9436419736 Enrollment ID: I20180206001600 |
| Provider Name | Trista Ranton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801307897 PECOS PAC ID: 3971864984 Enrollment ID: I20180307000946 |
| Provider Name | Edward L Erb |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1053313163 PECOS PAC ID: 4789675216 Enrollment ID: I20180329000403 |
| Provider Name | Sherry Stewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639328222 PECOS PAC ID: 0345307914 Enrollment ID: I20180416001797 |
| Provider Name | Srikanth Medarametla |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770842817 PECOS PAC ID: 2365768124 Enrollment ID: I20180501002794 |
| Provider Name | Aftab Haq |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326302985 PECOS PAC ID: 8426341728 Enrollment ID: I20180612002758 |
| Provider Name | Steven Todd Mccormack |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023000338 PECOS PAC ID: 4183651987 Enrollment ID: I20180914000083 |
| Provider Name | Daniel Fung |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497012199 PECOS PAC ID: 9739430075 Enrollment ID: I20180925003109 |
| Provider Name | Fred F. Salley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821193749 PECOS PAC ID: 8325176118 Enrollment ID: I20181011002170 |
| Provider Name | Laura M Teveni |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871972588 PECOS PAC ID: 7113217530 Enrollment ID: I20181022001474 |
| Provider Name | Charles Nicholson Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013485713 PECOS PAC ID: 4880939958 Enrollment ID: I20181218000833 |
| Provider Name | Kathryn Cambron |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396749867 PECOS PAC ID: 8224016530 Enrollment ID: I20190114000247 |
| Provider Name | David Scott Henley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770518128 PECOS PAC ID: 2769374032 Enrollment ID: I20190115000657 |
| Provider Name | Bryan Waits |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1891952917 PECOS PAC ID: 6103075429 Enrollment ID: I20190227001172 |
| Provider Name | Ramez S Nairooz |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1750710810 PECOS PAC ID: 9032411095 Enrollment ID: I20190404000287 |
| Provider Name | Toni L Terry |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1972525806 PECOS PAC ID: 8022093897 Enrollment ID: I20190409001235 |
| Provider Name | Timothy Conner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750385357 PECOS PAC ID: 6709784119 Enrollment ID: I20190501001441 |
| Provider Name | Jennifer Lynne Erian |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1760809644 PECOS PAC ID: 9739422973 Enrollment ID: I20190510000271 |
| Provider Name | Jeffrey Stevens |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164868212 PECOS PAC ID: 6608157664 Enrollment ID: I20190627002721 |
| Provider Name | William Christopher Garre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275980948 PECOS PAC ID: 9931494192 Enrollment ID: I20190905002106 |
| Provider Name | Amy Diane Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346713328 PECOS PAC ID: 0941530976 Enrollment ID: I20190918000867 |
| Provider Name | Iliana Arellano |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1710917794 PECOS PAC ID: 9436047248 Enrollment ID: I20191008003935 |
| Provider Name | Jordan Cluck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851933451 PECOS PAC ID: 6709218183 Enrollment ID: I20191125000780 |
| Provider Name | Winslett M Cox |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376987362 PECOS PAC ID: 8820379795 Enrollment ID: I20200211002524 |
| Provider Name | Samantha D Eubanks |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1811353642 PECOS PAC ID: 4688933237 Enrollment ID: I20200313001137 |
| Provider Name | Jason E Rogers |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366885840 PECOS PAC ID: 4789927260 Enrollment ID: I20200414003009 |
| Provider Name | Ashley M. Lopez |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1790319333 PECOS PAC ID: 4284064916 Enrollment ID: I20200421002553 |
| Provider Name | Meagan Grace Dodd |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1316327687 PECOS PAC ID: 1658622931 Enrollment ID: I20200625000001 |
| Provider Name | Dian Elizabeth Horton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447781273 PECOS PAC ID: 3375812597 Enrollment ID: I20200715001947 |
| Provider Name | Katlyn E Hoover |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396199121 PECOS PAC ID: 6305139031 Enrollment ID: I20200819003876 |
| Provider Name | George Ongera |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1831758770 PECOS PAC ID: 3173851862 Enrollment ID: I20200924000446 |
| Provider Name | Monjari Gillian |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265533665 PECOS PAC ID: 4587550876 Enrollment ID: I20201109003331 |
| Provider Name | Lauren Foreman |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1063915668 PECOS PAC ID: 6901153667 Enrollment ID: I20201120000427 |
| Provider Name | Amanda Razo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588270623 PECOS PAC ID: 2961813464 Enrollment ID: I20201203002420 |
| Provider Name | Jason Robert Divito |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558604876 PECOS PAC ID: 4183981947 Enrollment ID: I20210125002430 |
| Provider Name | Kelli Mccall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023480274 PECOS PAC ID: 8022328566 Enrollment ID: I20210211001395 |
| Provider Name | Andrew J Madden |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1982920930 PECOS PAC ID: 1254527104 Enrollment ID: I20210219001464 |
| Provider Name | Kaleigh Pruett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104410703 PECOS PAC ID: 0941616395 Enrollment ID: I20210309002229 |
| Provider Name | Kevin W Marcum |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619166675 PECOS PAC ID: 0042480303 Enrollment ID: I20210309002840 |
| Provider Name | Zi Rong Xu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114258191 PECOS PAC ID: 3173657624 Enrollment ID: I20210519001495 |
| Provider Name | Sean Biggs |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518282441 PECOS PAC ID: 7113151697 Enrollment ID: I20210624003456 |
| Provider Name | Daniel Harwood |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851787303 PECOS PAC ID: 6406169044 Enrollment ID: I20210630000121 |
| Provider Name | Lee Morris |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326400490 PECOS PAC ID: 9931495876 Enrollment ID: I20210712003069 |
| Provider Name | Lee Hewett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881040020 PECOS PAC ID: 9234533076 Enrollment ID: I20210802001890 |
| Provider Name | Tracie Diane Leveridge |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1053980565 PECOS PAC ID: 1456755032 Enrollment ID: I20210804000145 |
| Provider Name | Akshita Mehta |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679927776 PECOS PAC ID: 5698170371 Enrollment ID: I20210818001436 |
| Provider Name | Derrick J Borecky |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861446585 PECOS PAC ID: 4082756549 Enrollment ID: I20210910002283 |
| Provider Name | Hugh David Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639846702 PECOS PAC ID: 8527465327 Enrollment ID: I20210921003062 |
| Provider Name | Tombra Lucky Govina |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1548688039 PECOS PAC ID: 6305140856 Enrollment ID: I20220329001979 |
| Provider Name | Stephanie A Calderon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851043384 PECOS PAC ID: 4981081833 Enrollment ID: I20220513001511 |
| Provider Name | Rakesh S Ahuja |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1538576483 PECOS PAC ID: 9133421571 Enrollment ID: I20220608002145 |
| Provider Name | Stephen Johnston |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730525841 PECOS PAC ID: 0042574048 Enrollment ID: I20220613000630 |
| Provider Name | Satyam Veean |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447785480 PECOS PAC ID: 3779856653 Enrollment ID: I20220614003245 |
| Provider Name | Sydnee Danielle Kern |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619638285 PECOS PAC ID: 8820478886 Enrollment ID: I20220707003362 |
| Provider Name | Carrie Michelle Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700513504 PECOS PAC ID: 8123404910 Enrollment ID: I20221003000015 |
| Provider Name | James King |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1811622392 PECOS PAC ID: 5597141259 Enrollment ID: I20221003003127 |
| Provider Name | Amanda C Condon |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1396412953 PECOS PAC ID: 1254707839 Enrollment ID: I20221024000559 |
| Provider Name | Jessica K Levey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265158034 PECOS PAC ID: 3577930486 Enrollment ID: I20221107001434 |
| Provider Name | Maria Santos Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043929714 PECOS PAC ID: 3072982107 Enrollment ID: I20221213001488 |
| Provider Name | Nicole Mari Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053029454 PECOS PAC ID: 7315319605 Enrollment ID: I20230215000321 |
| Provider Name | Patrick Reidy Lower |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164198982 PECOS PAC ID: 0840663803 Enrollment ID: I20230222002733 |
| Provider Name | Adriana Arguello |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407030067 PECOS PAC ID: 1254414469 Enrollment ID: I20230527000142 |
| Provider Name | Kevin Taylor |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396122149 PECOS PAC ID: 6901214774 Enrollment ID: I20230719004310 |
| Provider Name | Sophia Lisa Korkis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023713419 PECOS PAC ID: 3971964610 Enrollment ID: I20230728000191 |
| Provider Name | Tyler Ulmer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801419627 PECOS PAC ID: 7618398546 Enrollment ID: I20230810003303 |
| Provider Name | Syed Safiuddin Hashmi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992060198 PECOS PAC ID: 5294006409 Enrollment ID: I20230817001147 |
| Provider Name | Bosten Miller |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932554896 PECOS PAC ID: 8022304666 Enrollment ID: I20230822003202 |
| Provider Name | Reshu Saini |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922461250 PECOS PAC ID: 6800187899 Enrollment ID: I20231018001579 |
| Provider Name | Laura Real |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1548624810 PECOS PAC ID: 5698066967 Enrollment ID: I20231110001170 |
| Provider Name | Heather Armstrong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023890951 PECOS PAC ID: 9032568415 Enrollment ID: I20231211001778 |
| Provider Name | Daniel Devincent |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942627054 PECOS PAC ID: 5395070569 Enrollment ID: I20231219000094 |
| Provider Name | Sandra Gallo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184753717 PECOS PAC ID: 9133268758 Enrollment ID: I20231222002252 |
| Provider Name | John Odeghe |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780046219 PECOS PAC ID: 9638567241 Enrollment ID: I20231228000536 |
| Provider Name | Michael Rolen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730316118 PECOS PAC ID: 8022330893 Enrollment ID: I20240106000313 |
| Provider Name | Jonathan Lewis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205246741 PECOS PAC ID: 2668690256 Enrollment ID: I20240321003008 |
| Provider Name | James Roger Sluss |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245261783 PECOS PAC ID: 2163405283 Enrollment ID: I20240328000373 |
| Provider Name | Venu Vadlamudi |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1952508699 PECOS PAC ID: 2062656903 Enrollment ID: I20240328002344 |
| Provider Name | Samuel Dawn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295797322 PECOS PAC ID: 1456301126 Enrollment ID: I20240401000492 |
| Provider Name | Nicholas Lambert |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902225295 PECOS PAC ID: 0648692806 Enrollment ID: I20240404001315 |
| Provider Name | Melissa Castillo Lozano |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1447027750 PECOS PAC ID: 2961841234 Enrollment ID: I20240418004376 |
Kerrville Mec, Lp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 723 Hill Country Dr Ste C, Kerrville, TX 78028 Phone: 830-792-5800 Fax: 830-792-5848 | |
Peterson Urgent Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1740 Junction Hwy, Kerrville, TX 78028 Phone: 830-258-7669 Fax: 830-315-1344 | |
Kerrville Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 707 Hill Country Dr, Ste 106, Kerrville, TX 78028 Phone: 830-896-0404 Fax: 830-896-4343 | |
Care Clinics, Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 703 Hill Country Dr Ste 301, Kerrville, TX 78028 Phone: 830-792-4805 Fax: 830-792-4883 | |
Genesis Gynecology Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 176 Fairway Dr, Kerrville, TX 78028 Phone: 830-792-0805 Fax: 830-792-0833 | |
Lisa Rouse, M.d., P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 707 Hill Country Dr Ste 106, Kerrville, TX 78028 Phone: 830-896-0404 Fax: 830-896-4343 | |
Sierra Ridge Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 936 Junction Hwy, Suite F, Kerrville, TX 78028 Phone: 830-895-5510 Fax: 214-722-1545 |