| Timberland Medical Group | |
|
1401 Medical Pkwy Cedar Park TX 78613-7763 | |
| (512) 528-7227 | |
| (512) 528-7223 |
| Full Name | Timberland Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 1401 Medical Pkwy, Cedar Park, Texas |
| Authorized Official Name and Position | Jennifer L Jackson (SR DIRECTOR, PROVIDER ENROLLMENT) |
| Authorized Official Contact | 6154653334 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Timberland Medical Group Po Box 689022 Franklin TN 37068-9022 Ph: (615) 465-7042 | Timberland Medical Group 1401 Medical Pkwy Cedar Park TX 78613-7763 Ph: (512) 528-7227 |
| NPI Number | 1528061157 |
|---|---|
| Provider Enumeration Date | 05/27/2005 |
| Last Update Date | 04/21/2022 |
| Medicare PECOS PAC ID | 7719875491 |
|---|---|
| Medicare Enrollment ID | O20040514000302 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528061157 | NPI | - | NPPES |
| 0044JK | Other | TX | BLUE CROSS-BLUE SHIELD |
| 0074DQ | Other | TX | BCBS |
| 080580602 | Medicaid | TX | |
| 080580601 | Medicaid | TX |
| Provider Name | Andrew S Walker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1144332396 PECOS PAC ID: 9032013057 Enrollment ID: I20031121000372 |
| Provider Name | Gerhard Moeller |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508972142 PECOS PAC ID: 8820984784 Enrollment ID: I20040226000535 |
| Provider Name | Kimberly A Hilmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902021850 PECOS PAC ID: 6002706322 Enrollment ID: I20040318001302 |
| Provider Name | Howell Anson Cone |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114978640 PECOS PAC ID: 5799770475 Enrollment ID: I20040420001613 |
| Provider Name | John B Delcambre |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1700957222 PECOS PAC ID: 8820069164 Enrollment ID: I20040802001121 |
| Provider Name | Roane H Mclaughlin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851327084 PECOS PAC ID: 8527034792 Enrollment ID: I20040908001499 |
| Provider Name | Thomas Patton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205813854 PECOS PAC ID: 9830157429 Enrollment ID: I20041229000524 |
| Provider Name | Edward B Blackmon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114092251 PECOS PAC ID: 4688625452 Enrollment ID: I20050210000140 |
| Provider Name | Elcy M John |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083611628 PECOS PAC ID: 7719933316 Enrollment ID: I20050328000246 |
| Provider Name | Walter L Chesshir |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043285836 PECOS PAC ID: 6406893759 Enrollment ID: I20050408000587 |
| Provider Name | Paul Knight Piper |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1760412035 PECOS PAC ID: 2466497094 Enrollment ID: I20050624000076 |
| Provider Name | Jean Paicurich Cole |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1962451807 PECOS PAC ID: 4789617028 Enrollment ID: I20050916000085 |
| Provider Name | Mickey Cho |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1811002348 PECOS PAC ID: 4587680590 Enrollment ID: I20051019000628 |
| Provider Name | Maria Liliana Asprilla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558339192 PECOS PAC ID: 0446276349 Enrollment ID: I20051020000273 |
| Provider Name | Manuel A Jovel-barriere |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1609967926 PECOS PAC ID: 5799701207 Enrollment ID: I20051024000184 |
| Provider Name | Fermin Romero Arreola |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1396717872 PECOS PAC ID: 2961429022 Enrollment ID: I20051027000872 |
| Provider Name | Eugenie J Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659475093 PECOS PAC ID: 4183635030 Enrollment ID: I20060508000345 |
| Provider Name | Michael R Gonzales |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1609810175 PECOS PAC ID: 4981607629 Enrollment ID: I20060817000468 |
| Provider Name | Tim R Tarkenton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1003990615 PECOS PAC ID: 1951495167 Enrollment ID: I20070919000414 |
| Provider Name | Edward J Bombach |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659466738 PECOS PAC ID: 6507955408 Enrollment ID: I20071129000610 |
| Provider Name | Shantanu S Naik |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1942362520 PECOS PAC ID: 3375583529 Enrollment ID: I20080324000552 |
| Provider Name | Karen R Vaughn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972605459 PECOS PAC ID: 3678519196 Enrollment ID: I20080522000116 |
| Provider Name | Manuel R Flores |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023287653 PECOS PAC ID: 7618047689 Enrollment ID: I20080603000094 |
| Provider Name | Harsh Babbar |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1114105418 PECOS PAC ID: 5799856621 Enrollment ID: I20080619000372 |
| Provider Name | Nelson Uzquiano |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477549830 PECOS PAC ID: 9537143615 Enrollment ID: I20081024000108 |
| Provider Name | Ronald Clay Mcgaugh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023200383 PECOS PAC ID: 7618948688 Enrollment ID: I20081226000116 |
| Provider Name | Laura Davidson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881778561 PECOS PAC ID: 0345266375 Enrollment ID: I20090113000334 |
| Provider Name | David R Nichols |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003951245 PECOS PAC ID: 0749388817 Enrollment ID: I20090131000007 |
| Provider Name | Travis C Burns |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1487678702 PECOS PAC ID: 8729144795 Enrollment ID: I20090227000400 |
| Provider Name | Claudio A Ruiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376702902 PECOS PAC ID: 4385700939 Enrollment ID: I20090305000377 |
| Provider Name | Sandra D Rodriguez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861428948 PECOS PAC ID: 6709942949 Enrollment ID: I20090312000657 |
| Provider Name | Patricia A Henry |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1699856146 PECOS PAC ID: 0143377127 Enrollment ID: I20090408000403 |
| Provider Name | Melinda D Banister |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1770567109 PECOS PAC ID: 6002966405 Enrollment ID: I20090605000112 |
| Provider Name | Jessica A Ramsey Robbins |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801018379 PECOS PAC ID: 7719032341 Enrollment ID: I20090903000670 |
| Provider Name | Rochelle A Sohl |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1033126669 PECOS PAC ID: 3678562600 Enrollment ID: I20091019000329 |
| Provider Name | Michael T Charlton |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1588655799 PECOS PAC ID: 2466547096 Enrollment ID: I20091112000130 |
| Provider Name | Gregory Cain Bratton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861657355 PECOS PAC ID: 1456490374 Enrollment ID: I20091204000575 |
| Provider Name | Michael Putney |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1760596597 PECOS PAC ID: 0941387112 Enrollment ID: I20100129000061 |
| Provider Name | Richard C Bang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467442848 PECOS PAC ID: 2466587944 Enrollment ID: I20100323000508 |
| Provider Name | Anesia K Garmon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770574105 PECOS PAC ID: 9234260118 Enrollment ID: I20100622000570 |
| Provider Name | Eduardo Benjamin Fernandez |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1437209228 PECOS PAC ID: 3072522499 Enrollment ID: I20100810000401 |
| Provider Name | Timothy Paul Bumann |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306934435 PECOS PAC ID: 2769532217 Enrollment ID: I20100810001046 |
| Provider Name | Edward L Terrasson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376585406 PECOS PAC ID: 7113051608 Enrollment ID: I20100819000553 |
| Provider Name | Luis Egelsee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407969140 PECOS PAC ID: 9638215288 Enrollment ID: I20100902000322 |
| Provider Name | Michael Bogdanovich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386609048 PECOS PAC ID: 1951390491 Enrollment ID: I20101023000127 |
| Provider Name | Richard A Alexander |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1164679627 PECOS PAC ID: 7113106600 Enrollment ID: I20110131000384 |
| Provider Name | Isela Vasquez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194929513 PECOS PAC ID: 5991985764 Enrollment ID: I20110210000961 |
| Provider Name | Samuel J Harden |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1316022148 PECOS PAC ID: 8123087012 Enrollment ID: I20110519000856 |
| Provider Name | Theresa A Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790937019 PECOS PAC ID: 7416134028 Enrollment ID: I20110608000392 |
| Provider Name | James Lindberg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1922025550 PECOS PAC ID: 9739179193 Enrollment ID: I20110623000711 |
| Provider Name | Ivan A Mederos |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1205809258 PECOS PAC ID: 8426067976 Enrollment ID: I20110826000148 |
| Provider Name | Joshua H Reinhart |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225229412 PECOS PAC ID: 1951573492 Enrollment ID: I20111005000856 |
| Provider Name | Mario Alberto Gutierrez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306897038 PECOS PAC ID: 6305914508 Enrollment ID: I20111209000068 |
| Provider Name | Linda Bassam Mughrabi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235316449 PECOS PAC ID: 0840466611 Enrollment ID: I20111228000329 |
| Provider Name | Muhammad I Choudhry |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1710197363 PECOS PAC ID: 1153414040 Enrollment ID: I20120313000986 |
| Provider Name | Angela L Madewell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417231044 PECOS PAC ID: 8628238664 Enrollment ID: I20120328000531 |
| Provider Name | Kristin C Bell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023113404 PECOS PAC ID: 6002805827 Enrollment ID: I20120814000600 |
| Provider Name | Laura N Higginbotham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659630069 PECOS PAC ID: 1456508761 Enrollment ID: I20120821000876 |
| Provider Name | Javaria Asif |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538355441 PECOS PAC ID: 2466646575 Enrollment ID: I20120910000621 |
| Provider Name | Arpita Patel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538343769 PECOS PAC ID: 2365591864 Enrollment ID: I20120918000717 |
| Provider Name | Patricia D Thompson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518980465 PECOS PAC ID: 8729009998 Enrollment ID: I20121025000360 |
| Provider Name | Reddiah B Mummaneni |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568516987 PECOS PAC ID: 8921199365 Enrollment ID: I20121211000480 |
| Provider Name | Ekta S. Escovar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710201363 PECOS PAC ID: 7012159080 Enrollment ID: I20130805000564 |
| Provider Name | Raphael M. Escovar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063723831 PECOS PAC ID: 1052557147 Enrollment ID: I20130814000772 |
| Provider Name | Paul A Fabela |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700103132 PECOS PAC ID: 7719120625 Enrollment ID: I20130826000054 |
| Provider Name | Sonya L. Brock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750316410 PECOS PAC ID: 5799928644 Enrollment ID: I20130826000505 |
| Provider Name | Nicole L Reid |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215089891 PECOS PAC ID: 9436193174 Enrollment ID: I20130917000539 |
| Provider Name | John K Ray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619101409 PECOS PAC ID: 2466613484 Enrollment ID: I20130925000818 |
| Provider Name | Mohsen Ghadimi Mahani |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1881845253 PECOS PAC ID: 0345476693 Enrollment ID: I20131115001066 |
| Provider Name | Natalie Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306153325 PECOS PAC ID: 1153558614 Enrollment ID: I20131209001253 |
| Provider Name | Marianne B Peck |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851647887 PECOS PAC ID: 3577791128 Enrollment ID: I20140106001260 |
| Provider Name | Lucas M Duvall |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1598975898 PECOS PAC ID: 5597845370 Enrollment ID: I20140422001745 |
| Provider Name | James B Hurlburt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538429725 PECOS PAC ID: 1759507395 Enrollment ID: I20140717000436 |
| Provider Name | Melissa M Piper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306252390 PECOS PAC ID: 0446478739 Enrollment ID: I20140828000913 |
| Provider Name | Miral Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457664583 PECOS PAC ID: 8325276413 Enrollment ID: I20140924001496 |
| Provider Name | Sandra Ordonez-sanchez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780025593 PECOS PAC ID: 1052533387 Enrollment ID: I20141120001949 |
| Provider Name | Danielle M Stockhorst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154727790 PECOS PAC ID: 0547584708 Enrollment ID: I20150116000077 |
| Provider Name | Mamatha Bollineni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639353139 PECOS PAC ID: 0941363634 Enrollment ID: I20150129001829 |
| Provider Name | Benjamin W Szerlip |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1407153943 PECOS PAC ID: 7315262714 Enrollment ID: I20150205001935 |
| Provider Name | Gary D Paradiso |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033213640 PECOS PAC ID: 1254501489 Enrollment ID: I20150206000450 |
| Provider Name | Karen Johnston Jones |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1184690034 PECOS PAC ID: 9133224439 Enrollment ID: I20150519001158 |
| Provider Name | Jessica D Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649533944 PECOS PAC ID: 7113247685 Enrollment ID: I20150522002081 |
| Provider Name | Guillermo Heard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437579802 PECOS PAC ID: 8729309893 Enrollment ID: I20150602001786 |
| Provider Name | Mayra Pliego |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659704625 PECOS PAC ID: 1759602741 Enrollment ID: I20150602002664 |
| Provider Name | Tasha D Norman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053716787 PECOS PAC ID: 4082928130 Enrollment ID: I20150803000754 |
| Provider Name | Ashwini Kumar |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215184841 PECOS PAC ID: 6103131214 Enrollment ID: I20150819007321 |
| Provider Name | Jorge Ramirez |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1003127002 PECOS PAC ID: 6800103946 Enrollment ID: I20150922001297 |
| Provider Name | Chante Monique Ellison-hodges |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548338619 PECOS PAC ID: 8921296781 Enrollment ID: I20150930002159 |
| Provider Name | Sakthiraj Subramanian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669676326 PECOS PAC ID: 4284728262 Enrollment ID: I20151002002160 |
| Provider Name | Nicole Lashawn Zenon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497137731 PECOS PAC ID: 2567770969 Enrollment ID: I20151005002627 |
| Provider Name | Leah Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700288149 PECOS PAC ID: 3173823424 Enrollment ID: I20151118002325 |
| Provider Name | Adam Khadbai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144588401 PECOS PAC ID: 9931400736 Enrollment ID: I20151221002143 |
| Provider Name | Selena J Stuart |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1629236575 PECOS PAC ID: 6204013485 Enrollment ID: I20160301000295 |
| Provider Name | Craig Thompson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457356594 PECOS PAC ID: 4789570177 Enrollment ID: I20160330000796 |
| Provider Name | Ngozi V Ibe |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1407019276 PECOS PAC ID: 4880840420 Enrollment ID: I20160502000402 |
| Provider Name | Dinesh K Sundarakumar |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1417235714 PECOS PAC ID: 5193024412 Enrollment ID: I20160509000038 |
| Provider Name | Miranda G Mcmillin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1568720555 PECOS PAC ID: 5991094963 Enrollment ID: I20160513001143 |
| Provider Name | Sabrina Collins |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881761187 PECOS PAC ID: 5597736157 Enrollment ID: I20160524001044 |
| Provider Name | Margarito Benitez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699165043 PECOS PAC ID: 5597055111 Enrollment ID: I20160609000899 |
| Provider Name | John Patrick Fardal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578900387 PECOS PAC ID: 1557580149 Enrollment ID: I20160811000124 |
| Provider Name | Sweta Narasimhan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023456506 PECOS PAC ID: 3870887086 Enrollment ID: I20160811000544 |
| Provider Name | Brandi Addison |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1891115275 PECOS PAC ID: 6800183872 Enrollment ID: I20160920001716 |
| Provider Name | Angele A Applegate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518417906 PECOS PAC ID: 1052699139 Enrollment ID: I20161024002471 |
| Provider Name | Russell Wise |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750313375 PECOS PAC ID: 1759669443 Enrollment ID: I20161101000464 |
| Provider Name | Richard K Milian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124464953 PECOS PAC ID: 4789988643 Enrollment ID: I20161102001231 |
| Provider Name | Micah Ryan Bosley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144666785 PECOS PAC ID: 9830494525 Enrollment ID: I20161109002156 |
| Provider Name | Jan Merck F Demasiado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265880629 PECOS PAC ID: 9739468695 Enrollment ID: I20161116001812 |
| Provider Name | Elisa Gutierrez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225581531 PECOS PAC ID: 1850671579 Enrollment ID: I20161214001955 |
| Provider Name | Karen J Romero |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063770972 PECOS PAC ID: 4880974567 Enrollment ID: I20161215001536 |
| Provider Name | Tracey Maciel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124574298 PECOS PAC ID: 5193091023 Enrollment ID: I20171020002390 |
| Provider Name | Scott C Robertson |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1356394423 PECOS PAC ID: 7719975325 Enrollment ID: I20180124001758 |
| Provider Name | Virginie N Drummond |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437416369 PECOS PAC ID: 8224323605 Enrollment ID: I20180827000550 |
| Provider Name | Shannon Lorraine-konopik Wassel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801375027 PECOS PAC ID: 3577814615 Enrollment ID: I20180928000944 |
| Provider Name | Amanda Lequire |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104287887 PECOS PAC ID: 3577862937 Enrollment ID: I20190813003142 |
| Provider Name | Rachel N Woolley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972133965 PECOS PAC ID: 3971916230 Enrollment ID: I20210105000994 |
| Provider Name | Aaron R Kirkpatrick |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093035172 PECOS PAC ID: 2062652332 Enrollment ID: I20210505002311 |
| Provider Name | Mitul Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770080350 PECOS PAC ID: 4880942739 Enrollment ID: I20210623003250 |
| Provider Name | Nicole Catherine Ryman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427552579 PECOS PAC ID: 8921355231 Enrollment ID: I20211004003216 |
| Provider Name | John Clingan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750975165 PECOS PAC ID: 5597153874 Enrollment ID: I20211020000482 |
| Provider Name | Jun Yi Lai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689106791 PECOS PAC ID: 0749524874 Enrollment ID: I20211122001914 |
| Provider Name | Siva Rama Krishna Marri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366755126 PECOS PAC ID: 5294030300 Enrollment ID: I20211201000303 |
| Provider Name | Kamal Vats |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881340958 PECOS PAC ID: 2567849797 Enrollment ID: I20220510000181 |
| Provider Name | Mona Liza Flores |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699416081 PECOS PAC ID: 9739567108 Enrollment ID: I20220526001505 |
| Provider Name | Danielle Marie Spallin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063770055 PECOS PAC ID: 5991076663 Enrollment ID: I20230319000087 |
| Provider Name | Valere Koski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912611401 PECOS PAC ID: 2466817549 Enrollment ID: I20230425000042 |
| Provider Name | Diane Patricia Bonsall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144652751 PECOS PAC ID: 9436385804 Enrollment ID: I20240326002454 |
| Provider Name | Heather Calmes Bylander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174384531 PECOS PAC ID: 8527408285 Enrollment ID: I20240429000133 |
Cedar Park Covid Test Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1120 Cottonwood Creek Trl Ste 180b, Cedar Park, TX 78613 Phone: 512-737-2662 | |
Rrcp Medical, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 W Whitestone Blvd, Suite 105, Cedar Park, TX 78613 Phone: 512-918-2225 Fax: 512-918-2229 | |
Cedar Park Pediatric And Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 345 Cypress Creek Rd, Suite 104, Cedar Park, TX 78613 Phone: 512-336-2777 | |
Texas Cardiac Arrhythmia Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1460 E Whitestone Blvd, Suite 230, Cedar Park, TX 78613 Phone: 512-206-2999 | |
Capital Endocrine & Diabetes Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1515 Medical Pkwy Ste 200, Cedar Park, TX 78613 Phone: 512-765-7806 Fax: 512-456-7039 | |
Lone Star Circle Of Care At Cedar Park Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1401 Medical Pkwy Bldg B, Ste 311, Cedar Park, TX 78613 Phone: 877-800-5722 | |
Complete Cure Healthcare Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2800 E Whitestone Blvd Ste 120, Cedar Park, TX 78613 Phone: 512-297-8044 Fax: 512-918-2933 |