| Sievers Medical Clinic | |
|
1110 N Sarah Dewitt Dr Gonzales TX 78629-3311 | |
| (830) 672-7581 | |
| (830) 672-2401 |
| Full Name | Sievers Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1110 N Sarah Dewitt Dr, Gonzales, Texas |
| Authorized Official Name and Position | Brandon Anzaldua (CEO ADMINISTRATOR) |
| Authorized Official Contact | 8306727581 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sievers Medical Clinic Po Box 587 Gonzales TX 78629-0587 Ph: (830) 672-7581 | Sievers Medical Clinic 1110 N Sarah Dewitt Dr Gonzales TX 78629-3311 Ph: (830) 672-7581 |
| NPI Number | 1013916287 |
|---|---|
| Provider Enumeration Date | 07/19/2005 |
| Last Update Date | 02/26/2024 |
| Medicare PECOS PAC ID | 8527963776 |
|---|---|
| Medicare Enrollment ID | O20040316001074 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013916287 | NPI | - | NPPES |
| 130781103 | Medicaid | TX | |
| 130781102 | Medicaid | TX | |
| 130781104 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 000130 (Texas) | Secondary |
| 208000000X | Pediatrics | 000103 (Texas) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (Texas) | Primary |
| Provider Name | Humberto J Rivas |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376547919 PECOS PAC ID: 9638101579 Enrollment ID: I20050831000543 |
| Provider Name | Lisa D Henderson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1003898446 PECOS PAC ID: 7315957693 Enrollment ID: I20060502000091 |
| Provider Name | Christopher L Walker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326225822 PECOS PAC ID: 5991875817 Enrollment ID: I20080604000579 |
| Provider Name | John W Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881857498 PECOS PAC ID: 1456426816 Enrollment ID: I20080906000042 |
| Provider Name | Commie Hisey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730181421 PECOS PAC ID: 7113052069 Enrollment ID: I20100317000168 |
| Provider Name | David Meredith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427041383 PECOS PAC ID: 0648305599 Enrollment ID: I20100317000195 |
| Provider Name | Gloria G Box |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1386628246 PECOS PAC ID: 9335242114 Enrollment ID: I20100527000063 |
| Provider Name | Kathleen Mary Koerner |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1093936171 PECOS PAC ID: 8729149844 Enrollment ID: I20120118000836 |
| Provider Name | Catherine R Carpenter |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1255449286 PECOS PAC ID: 3678558822 Enrollment ID: I20140219000288 |
| Provider Name | Cynthia Green |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1568565497 PECOS PAC ID: 8628393238 Enrollment ID: I20150202001058 |
| Provider Name | Sue Hanner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477892206 PECOS PAC ID: 3971806340 Enrollment ID: I20161112000144 |
| Provider Name | Kody Lee Selzer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265894323 PECOS PAC ID: 4385904036 Enrollment ID: I20180129001335 |
| Provider Name | Diana Marie Mikulencak-picha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790283596 PECOS PAC ID: 8527320654 Enrollment ID: I20180329000622 |
| Provider Name | Sean A Hattenbach |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225415359 PECOS PAC ID: 9234437435 Enrollment ID: I20180524001372 |
| Provider Name | Heather Brooke Domel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295405371 PECOS PAC ID: 4284032053 Enrollment ID: I20211213001937 |
| Provider Name | Celina D Mccown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942967500 PECOS PAC ID: 7315337938 Enrollment ID: I20211214000348 |
| Provider Name | Kristen Wollmuth |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1508647710 PECOS PAC ID: 2668823485 Enrollment ID: I20240105002287 |
Community Health Centers Of South Central Texas, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 228 Saint George St, Gonzales, TX 78629 Phone: 830-672-6511 Fax: 830-672-3024 | |
Women's Health And Wic Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 229 St. George Street, Gonzales, TX 78629 Phone: 830-672-6511 Fax: 830-672-3981 |