| Usmd Physician Services | |
|
811 W. I-20 Suite 120 Arlington TX 76017-2694 | |
| (972) 847-0712 | |
| (817) 419-4605 |
| Full Name | Usmd Physician Services |
|---|---|
| Speciality | Internal Medicine |
| Location | 811 W. I-20, Arlington, Texas |
| Authorized Official Name and Position | Michael W Bukosky (PRESIDENT PPM) |
| Authorized Official Contact | 9728470712 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Usmd Physician Services Po Box 678095 Dallas TX 75267-8095 Ph: (972) 847-0712 | Usmd Physician Services 811 W. I-20 Suite 120 Arlington TX 76017-2694 Ph: (972) 847-0712 |
| NPI Number | 1033167234 |
|---|---|
| Provider Enumeration Date | 05/04/2006 |
| Last Update Date | 11/08/2016 |
| Medicare PECOS PAC ID | 9830084540 |
|---|---|
| Medicare Enrollment ID | O20040430001258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033167234 | NPI | - | NPPES |
| CU0775 | Other | TX | MEDICARE RAILROAD GROUP |
| CD2314 | Other | TX | MEDICARE RAILROAD GROUP |
| CG2930 | Other | TX | MEDICARE RAILROAD GROUP |
| 00R86C | Other | TX | MEDICARE GROUP NUMBER |
| CC7989 | Other | TX | MEDICARE RAILROAD GROUP |
| 084933301 | Other | TX | MEDICAID GROUP NUMBER |
| Provider Name | Karen K Klatte |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1376519991 PECOS PAC ID: 5294630059 Enrollment ID: I20031204000547 |
| Provider Name | Maria M Mendez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548267255 PECOS PAC ID: 2062404619 Enrollment ID: I20040401001525 |
| Provider Name | Holly R Battaile |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255495982 PECOS PAC ID: 7012908262 Enrollment ID: I20040518001309 |
| Provider Name | Ruth A Adell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467494807 PECOS PAC ID: 3577545342 Enrollment ID: I20040604000342 |
| Provider Name | Peter A Lanasa |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1265482475 PECOS PAC ID: 1355326869 Enrollment ID: I20040621000145 |
| Provider Name | Carlos M Kier |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1093766701 PECOS PAC ID: 0547231961 Enrollment ID: I20040802000184 |
| Provider Name | Christopher T Buchanan |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1194728865 PECOS PAC ID: 5698746253 Enrollment ID: I20040806000896 |
| Provider Name | Gerald Edelman |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1831131739 PECOS PAC ID: 4587636360 Enrollment ID: I20040811001007 |
| Provider Name | Lashonda M Burns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356383301 PECOS PAC ID: 5799753968 Enrollment ID: I20040924000469 |
| Provider Name | Craig Keathley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1194799171 PECOS PAC ID: 6103895230 Enrollment ID: I20040927000449 |
| Provider Name | Julie L Olivo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124061015 PECOS PAC ID: 3173583945 Enrollment ID: I20041015000366 |
| Provider Name | Hector M Lopez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487611471 PECOS PAC ID: 5597727107 Enrollment ID: I20041027000212 |
| Provider Name | Ramon A Cintron |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912981655 PECOS PAC ID: 4385607910 Enrollment ID: I20041104001183 |
| Provider Name | Augustus E Lyons |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487627972 PECOS PAC ID: 5092778803 Enrollment ID: I20041111000449 |
| Provider Name | Van Lam |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689647133 PECOS PAC ID: 4183689623 Enrollment ID: I20041124000312 |
| Provider Name | Rupal Chiniwala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013956408 PECOS PAC ID: 8325003494 Enrollment ID: I20041130001072 |
| Provider Name | Michael S Auvenshine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669580957 PECOS PAC ID: 7113977919 Enrollment ID: I20050129000002 |
| Provider Name | Mark A Godfrey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659329241 PECOS PAC ID: 7719934058 Enrollment ID: I20050407001053 |
| Provider Name | Megan J Conoley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689611485 PECOS PAC ID: 5496714669 Enrollment ID: I20050509001071 |
| Provider Name | Bradley M Leonard |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1932156213 PECOS PAC ID: 8123069143 Enrollment ID: I20050519000350 |
| Provider Name | Christopher Jordan |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1679523625 PECOS PAC ID: 4587694443 Enrollment ID: I20050819000545 |
| Provider Name | Himabindu R Reddy |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1780658708 PECOS PAC ID: 1052342409 Enrollment ID: I20050825000168 |
| Provider Name | Frederick P Cummings |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720089048 PECOS PAC ID: 9335171735 Enrollment ID: I20050907000395 |
| Provider Name | Rachael K Dabelic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194760074 PECOS PAC ID: 5193750172 Enrollment ID: I20050928000966 |
| Provider Name | Courtney K Barton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053354654 PECOS PAC ID: 4183659097 Enrollment ID: I20050929000371 |
| Provider Name | Jodie Peden Dejecacion |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487692067 PECOS PAC ID: 8729013560 Enrollment ID: I20050930000196 |
| Provider Name | Jelena Bucan-kurepa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841226172 PECOS PAC ID: 1355366741 Enrollment ID: I20051014000361 |
| Provider Name | Robert G Parham |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1437151487 PECOS PAC ID: 7618924994 Enrollment ID: I20051220000444 |
| Provider Name | David L Shepherd |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1730166893 PECOS PAC ID: 5799708764 Enrollment ID: I20060105000607 |
| Provider Name | Theodore J Krum |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700811387 PECOS PAC ID: 9537175096 Enrollment ID: I20060222000037 |
| Provider Name | Matthew G Meyer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467499459 PECOS PAC ID: 4486663812 Enrollment ID: I20060413000147 |
| Provider Name | Pamela A Lancarte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205855616 PECOS PAC ID: 7517961493 Enrollment ID: I20060907000275 |
| Provider Name | Doreen A Moser |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1194721944 PECOS PAC ID: 3274531918 Enrollment ID: I20061113000534 |
| Provider Name | Linda K Phan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235245895 PECOS PAC ID: 2860493210 Enrollment ID: I20070126000619 |
| Provider Name | Heather M Hsu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790876746 PECOS PAC ID: 0042212656 Enrollment ID: I20070212000283 |
| Provider Name | Vincent N Mccolm |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235234139 PECOS PAC ID: 1850496670 Enrollment ID: I20070423000417 |
| Provider Name | Eric B Jacoby |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437158441 PECOS PAC ID: 4981703030 Enrollment ID: I20070630000100 |
| Provider Name | Robert S Krombach |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952504276 PECOS PAC ID: 8325130552 Enrollment ID: I20070817000430 |
| Provider Name | Edward E Bates |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639179013 PECOS PAC ID: 8820036874 Enrollment ID: I20070905000291 |
| Provider Name | Jeffrey K Leitko |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245374537 PECOS PAC ID: 1355439159 Enrollment ID: I20071112000603 |
| Provider Name | Andrew C Roberts |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1700826260 PECOS PAC ID: 9133191372 Enrollment ID: I20080311000649 |
| Provider Name | Paul D Lyde |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336321207 PECOS PAC ID: 1052376407 Enrollment ID: I20080414000471 |
| Provider Name | Kory Jones |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033235627 PECOS PAC ID: 5890864474 Enrollment ID: I20080522000196 |
| Provider Name | Gary V Bartholomew |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1316077761 PECOS PAC ID: 6901975598 Enrollment ID: I20080522000266 |
| Provider Name | Aaron M Amos |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1881689479 PECOS PAC ID: 2466522461 Enrollment ID: I20080603000315 |
| Provider Name | Emily M. Isaacs |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1114927779 PECOS PAC ID: 9436106440 Enrollment ID: I20080611000537 |
| Provider Name | Hedieh Davanloo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659567758 PECOS PAC ID: 4082786678 Enrollment ID: I20080626000016 |
| Provider Name | James S Childers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629078290 PECOS PAC ID: 7517914526 Enrollment ID: I20080715000306 |
| Provider Name | Erin E Wallace |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396952263 PECOS PAC ID: 0941376990 Enrollment ID: I20080827000697 |
| Provider Name | Glenda M Kremer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932239100 PECOS PAC ID: 6709975964 Enrollment ID: I20081008000703 |
| Provider Name | Hobing P Oei |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1811191786 PECOS PAC ID: 9335207588 Enrollment ID: I20081017000099 |
| Provider Name | Awilda M Luciano |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1023212990 PECOS PAC ID: 3870651292 Enrollment ID: I20081028000868 |
| Provider Name | Steven G Trostel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1689667735 PECOS PAC ID: 5890854400 Enrollment ID: I20081111000225 |
| Provider Name | Cesar Albarracin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457331456 PECOS PAC ID: 0446313753 Enrollment ID: I20090113000681 |
| Provider Name | Albert Sean Dalley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164478194 PECOS PAC ID: 3779646963 Enrollment ID: I20090114000481 |
| Provider Name | Bibi T Sattar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477728079 PECOS PAC ID: 6204991979 Enrollment ID: I20090212000137 |
| Provider Name | Ashley U So |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790719789 PECOS PAC ID: 3678639564 Enrollment ID: I20090302000073 |
| Provider Name | Samuel V Davila |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023227063 PECOS PAC ID: 1759448913 Enrollment ID: I20090316000482 |
| Provider Name | Jenny A Bickerstaff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578681938 PECOS PAC ID: 4789733486 Enrollment ID: I20090529000359 |
| Provider Name | Lynn M Speaks |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1710993605 PECOS PAC ID: 7618029067 Enrollment ID: I20090715000317 |
| Provider Name | Jolly Jose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316182462 PECOS PAC ID: 4486708872 Enrollment ID: I20090819000769 |
| Provider Name | Stephen Sakovich |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508869769 PECOS PAC ID: 8224124219 Enrollment ID: I20090824000154 |
| Provider Name | Dennisse Ruiz-adib |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134322423 PECOS PAC ID: 2264587088 Enrollment ID: I20090831000623 |
| Provider Name | Katherine W Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194050245 PECOS PAC ID: 8123165693 Enrollment ID: I20091102000619 |
| Provider Name | Shailendra N Chavda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922132562 PECOS PAC ID: 3870687809 Enrollment ID: I20091109000621 |
| Provider Name | Thomas C Truelson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1780670810 PECOS PAC ID: 0749350692 Enrollment ID: I20091202000112 |
| Provider Name | Roger S Eppstein |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902843709 PECOS PAC ID: 2769574565 Enrollment ID: I20100324000651 |
| Provider Name | James K Eldridge |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467491803 PECOS PAC ID: 5991831281 Enrollment ID: I20100325000573 |
| Provider Name | Lynn A Lester |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275570939 PECOS PAC ID: 2668564469 Enrollment ID: I20100327000561 |
| Provider Name | Mark Alan Mccurdy |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1255327383 PECOS PAC ID: 3678609179 Enrollment ID: I20100408000346 |
| Provider Name | Beth A Mewis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164469136 PECOS PAC ID: 6103918909 Enrollment ID: I20100414000561 |
| Provider Name | Christian L Carr |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1124070909 PECOS PAC ID: 6103840467 Enrollment ID: I20100428000183 |
| Provider Name | John W Freeman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669415147 PECOS PAC ID: 2961594759 Enrollment ID: I20100429000464 |
| Provider Name | Robert L Graham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871536367 PECOS PAC ID: 9234221037 Enrollment ID: I20100506000493 |
| Provider Name | Russell A Dickey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114960333 PECOS PAC ID: 8022929124 Enrollment ID: I20100506000579 |
| Provider Name | Steven E Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801837935 PECOS PAC ID: 1153413943 Enrollment ID: I20100507000191 |
| Provider Name | Thomas E Barker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295775542 PECOS PAC ID: 8325176670 Enrollment ID: I20100507000305 |
| Provider Name | Audrey C Morrill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497793459 PECOS PAC ID: 2769510999 Enrollment ID: I20100510000477 |
| Provider Name | Kenneth A Shore |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114960606 PECOS PAC ID: 9739271529 Enrollment ID: I20100511001001 |
| Provider Name | Joel W Walker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942243878 PECOS PAC ID: 4183716988 Enrollment ID: I20100514000116 |
| Provider Name | Edwin Matthews |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588607030 PECOS PAC ID: 5092843839 Enrollment ID: I20100514000396 |
| Provider Name | Baron C Atkins |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841239415 PECOS PAC ID: 4688702483 Enrollment ID: I20100517000032 |
| Provider Name | Bryan K Demarie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225085822 PECOS PAC ID: 2769511104 Enrollment ID: I20100524000820 |
| Provider Name | Margaret M Alloy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053359562 PECOS PAC ID: 1850420126 Enrollment ID: I20100525000415 |
| Provider Name | Keith S Livingstone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093747842 PECOS PAC ID: 9335279876 Enrollment ID: I20100610000383 |
| Provider Name | Christopher R Cooper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043228018 PECOS PAC ID: 6002813490 Enrollment ID: I20100622000548 |
| Provider Name | Raul Martinez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508073073 PECOS PAC ID: 8325105828 Enrollment ID: I20100720000196 |
| Provider Name | Stephanie M Copeland |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740221860 PECOS PAC ID: 2769515352 Enrollment ID: I20100803000752 |
| Provider Name | Laxman Bhatia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235219270 PECOS PAC ID: 7214060789 Enrollment ID: I20100804000587 |
| Provider Name | Ryan F Jones |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790983682 PECOS PAC ID: 2567596570 Enrollment ID: I20100812000680 |
| Provider Name | Antonio Asis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205877214 PECOS PAC ID: 7214831510 Enrollment ID: I20100907000282 |
| Provider Name | Jennifer T Arnouville |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1417152000 PECOS PAC ID: 7911191077 Enrollment ID: I20101102001149 |
| Provider Name | Douglas D Lorimer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356308571 PECOS PAC ID: 3476748195 Enrollment ID: I20101108001039 |
| Provider Name | Stephen B Johnston |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1831163153 PECOS PAC ID: 6901710698 Enrollment ID: I20101130000145 |
| Provider Name | Allen B. Hornell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366470247 PECOS PAC ID: 9638368772 Enrollment ID: I20110105000865 |
| Provider Name | Gordy S Hall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598762296 PECOS PAC ID: 7012196587 Enrollment ID: I20110131000137 |
| Provider Name | Nanda K Bysani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801852025 PECOS PAC ID: 2961391206 Enrollment ID: I20110328000865 |
| Provider Name | Lauri M Ballard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689624488 PECOS PAC ID: 3072790534 Enrollment ID: I20110609000277 |
| Provider Name | Samantapudi Daya |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1053356220 PECOS PAC ID: 1658346861 Enrollment ID: I20110630000289 |
| Provider Name | Achal P Modi |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1255540514 PECOS PAC ID: 4688843949 Enrollment ID: I20110803000517 |
| Provider Name | Heather H Gardow |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1154521029 PECOS PAC ID: 3971773789 Enrollment ID: I20110906000472 |
| Provider Name | Gladys Tse |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942235536 PECOS PAC ID: 5890723464 Enrollment ID: I20110907001452 |
| Provider Name | Rebecca Gray |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952501777 PECOS PAC ID: 6406027010 Enrollment ID: I20110912000255 |
| Provider Name | Aric C Gillen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720285158 PECOS PAC ID: 3870765738 Enrollment ID: I20111019000245 |
| Provider Name | Benjamin L Bowers |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275506776 PECOS PAC ID: 8729252085 Enrollment ID: I20111122000794 |
| Provider Name | Harry P Stiefel |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417929183 PECOS PAC ID: 5193636298 Enrollment ID: I20111130000461 |
| Provider Name | Gilda Md Cipriano |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942342779 PECOS PAC ID: 1951564087 Enrollment ID: I20120529000444 |
| Provider Name | Jennifer L Duewall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558534016 PECOS PAC ID: 0648434027 Enrollment ID: I20120614000735 |
| Provider Name | Manisha S Parikh |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770625196 PECOS PAC ID: 5294991642 Enrollment ID: I20120730000442 |
| Provider Name | Stephanie J Hiraki |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841587284 PECOS PAC ID: 5395992580 Enrollment ID: I20120822000772 |
| Provider Name | Frank A Nwankwo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780918185 PECOS PAC ID: 4981851714 Enrollment ID: I20120829000390 |
| Provider Name | Jennifer L Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871860700 PECOS PAC ID: 5395992150 Enrollment ID: I20120829000807 |
| Provider Name | Kristen M Vallery |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508811274 PECOS PAC ID: 4789612995 Enrollment ID: I20120911000782 |
| Provider Name | Ezell S Autrey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942217013 PECOS PAC ID: 0042387854 Enrollment ID: I20121003000521 |
| Provider Name | Patricia D O Toole |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1649432402 PECOS PAC ID: 4587815345 Enrollment ID: I20121105000217 |
| Provider Name | Vartika Atrey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801026000 PECOS PAC ID: 5890948202 Enrollment ID: I20130116000150 |
| Provider Name | Amanda P Muir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932301637 PECOS PAC ID: 1557531175 Enrollment ID: I20130309000058 |
| Provider Name | Neepa R Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316934862 PECOS PAC ID: 8628043247 Enrollment ID: I20130322000368 |
| Provider Name | Rebecca Izquierdo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053601427 PECOS PAC ID: 6709024227 Enrollment ID: I20130522000672 |
| Provider Name | Sarah M Kent |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457573222 PECOS PAC ID: 7911052592 Enrollment ID: I20130620000151 |
| Provider Name | Heather J Havener |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275736480 PECOS PAC ID: 3274772751 Enrollment ID: I20130824000079 |
| Provider Name | Christina Daniel Grubbs |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1548494040 PECOS PAC ID: 9931342615 Enrollment ID: I20130828000292 |
| Provider Name | Nicole B Jouett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790126738 PECOS PAC ID: 4183867401 Enrollment ID: I20130905000109 |
| Provider Name | Ayesha N Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316176894 PECOS PAC ID: 7113173519 Enrollment ID: I20130912000756 |
| Provider Name | Audrey Rachelle Puentes |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1366678468 PECOS PAC ID: 0345474136 Enrollment ID: I20131010000557 |
| Provider Name | John A Pumphrey |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1700833704 PECOS PAC ID: 1052219235 Enrollment ID: I20140106000519 |
| Provider Name | Monaben I Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588916514 PECOS PAC ID: 1355594136 Enrollment ID: I20140313001043 |
| Provider Name | Kristin A Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194154641 PECOS PAC ID: 1850522459 Enrollment ID: I20140325000401 |
| Provider Name | Michael C Walter |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1023056165 PECOS PAC ID: 4183781909 Enrollment ID: I20140422001391 |
| Provider Name | April Enard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558654087 PECOS PAC ID: 5193942407 Enrollment ID: I20140811001291 |
| Provider Name | Hanh Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063708634 PECOS PAC ID: 7719105022 Enrollment ID: I20140828001593 |
| Provider Name | Haley C Newton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942590690 PECOS PAC ID: 3779702220 Enrollment ID: I20140915001687 |
| Provider Name | Anna Camungol Lavedan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073568416 PECOS PAC ID: 7214052034 Enrollment ID: I20140926001548 |
| Provider Name | Mohita A Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023300449 PECOS PAC ID: 0840410650 Enrollment ID: I20140930000149 |
| Provider Name | Anne L Moser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902928948 PECOS PAC ID: 7315080975 Enrollment ID: I20141010002318 |
| Provider Name | Iffat Jahan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861705113 PECOS PAC ID: 8123272127 Enrollment ID: I20141013002362 |
| Provider Name | Marquita D Anderson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922323864 PECOS PAC ID: 1759502594 Enrollment ID: I20141021001227 |
| Provider Name | Sarah V Gardner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750659082 PECOS PAC ID: 6507087079 Enrollment ID: I20141027000791 |
| Provider Name | Juby A Joseph |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437447588 PECOS PAC ID: 3274788575 Enrollment ID: I20141031000489 |
| Provider Name | Megan D Gillem |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093005704 PECOS PAC ID: 1658593462 Enrollment ID: I20141111002355 |
| Provider Name | Shumaila Athar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174813380 PECOS PAC ID: 9638491764 Enrollment ID: I20141201000891 |
| Provider Name | Zaira Jorai-khan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750525226 PECOS PAC ID: 1456674811 Enrollment ID: I20141216002360 |
| Provider Name | Laura A Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801158134 PECOS PAC ID: 1153646179 Enrollment ID: I20150216001639 |
| Provider Name | Irwin R Endelman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083705362 PECOS PAC ID: 4789653163 Enrollment ID: I20150306000104 |
| Provider Name | Nasiha Ahmad |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821050071 PECOS PAC ID: 2860713179 Enrollment ID: I20150611000672 |
| Provider Name | Eseosa Eguae |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427310200 PECOS PAC ID: 1153638986 Enrollment ID: I20150911000231 |
| Provider Name | James Paul Carleo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750384228 PECOS PAC ID: 0840382248 Enrollment ID: I20150930000974 |
| Provider Name | Amanda B Hall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154736833 PECOS PAC ID: 8224346838 Enrollment ID: I20151001000572 |
| Provider Name | Atiq Budhani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336560101 PECOS PAC ID: 4880902188 Enrollment ID: I20151007000359 |
| Provider Name | Gina M Constantine |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689850489 PECOS PAC ID: 4981860939 Enrollment ID: I20151102002398 |
| Provider Name | Melissa Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225379241 PECOS PAC ID: 7113227190 Enrollment ID: I20151123002494 |
| Provider Name | Imran Solaiman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659638898 PECOS PAC ID: 6305166190 Enrollment ID: I20160321001557 |
| Provider Name | Jacquelyn Elizabeth Alvarado |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1528430410 PECOS PAC ID: 8022308865 Enrollment ID: I20160607000245 |
| Provider Name | Nasser D Askari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508112582 PECOS PAC ID: 3476841594 Enrollment ID: I20161005001512 |
| Provider Name | Chong Y Yun |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912347394 PECOS PAC ID: 3173801131 Enrollment ID: I20161025002614 |
| Provider Name | Robert Charles Rigby |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487734752 PECOS PAC ID: 6002805652 Enrollment ID: I20161122001501 |
| Provider Name | Kacy N Carpenter |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871930388 PECOS PAC ID: 2668752262 Enrollment ID: I20161216000195 |
| Provider Name | Vanessa Mcdaniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962947283 PECOS PAC ID: 9739461732 Enrollment ID: I20170127001126 |
| Provider Name | Joby T James |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669738522 PECOS PAC ID: 7517281405 Enrollment ID: I20170421001312 |
| Provider Name | Anup Sushman Kumar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669882163 PECOS PAC ID: 8729200225 Enrollment ID: I20170822002893 |
| Provider Name | Melanie Mary Vettimattam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265848782 PECOS PAC ID: 6406146331 Enrollment ID: I20170822003752 |
| Provider Name | Munawar Hayat |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285044487 PECOS PAC ID: 9931471083 Enrollment ID: I20170824000264 |
| Provider Name | Beenish Badruddin Bhaidani |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881937597 PECOS PAC ID: 1658644588 Enrollment ID: I20170829000693 |
| Provider Name | Giri R Sura |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164786737 PECOS PAC ID: 7113217662 Enrollment ID: I20170912001624 |
| Provider Name | Samim Giotis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093194912 PECOS PAC ID: 0941517809 Enrollment ID: I20170920001926 |
| Provider Name | William J Nutting |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902216120 PECOS PAC ID: 8224394366 Enrollment ID: I20171107000321 |
| Provider Name | Amanda Dutro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033636477 PECOS PAC ID: 7517225337 Enrollment ID: I20171227000375 |
| Provider Name | Adam M Bsiso |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568882405 PECOS PAC ID: 2961624432 Enrollment ID: I20171228000456 |
| Provider Name | Suman Donepudi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295153914 PECOS PAC ID: 7113214768 Enrollment ID: I20180109001220 |
| Provider Name | Kelsey B Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285149385 PECOS PAC ID: 1456610351 Enrollment ID: I20180123001803 |
| Provider Name | Alicia Marie Segovia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225542855 PECOS PAC ID: 0840550331 Enrollment ID: I20180131003097 |
| Provider Name | Kimberly K Petrie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922507961 PECOS PAC ID: 8123380409 Enrollment ID: I20180326002569 |
| Provider Name | Tochukwu Toby Udegbune |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467964221 PECOS PAC ID: 1355605338 Enrollment ID: I20180426002275 |
| Provider Name | Sreedhar R Tallapureddy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063424166 PECOS PAC ID: 9638171200 Enrollment ID: I20180514000879 |
| Provider Name | Dominic H Tang |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1215222989 PECOS PAC ID: 0446506133 Enrollment ID: I20180711001371 |
| Provider Name | Niraj Badhiwala |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1912346024 PECOS PAC ID: 9638425341 Enrollment ID: I20180711002219 |
| Provider Name | Angalene D Jackson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770994766 PECOS PAC ID: 5092062091 Enrollment ID: I20180723001411 |
| Provider Name | Aurora D Lopez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821418575 PECOS PAC ID: 7012265614 Enrollment ID: I20180730001285 |
| Provider Name | Sydney Nicole Styron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932619848 PECOS PAC ID: 6507116514 Enrollment ID: I20180912000404 |
| Provider Name | Julia M Willingham |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1154765147 PECOS PAC ID: 6507161866 Enrollment ID: I20180919002808 |
| Provider Name | Ammar A Majeed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174967087 PECOS PAC ID: 9739473067 Enrollment ID: I20181026000704 |
| Provider Name | Siavosh Vafadari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154732030 PECOS PAC ID: 0042591919 Enrollment ID: I20181030002530 |
| Provider Name | Paulina Thanawala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740669746 PECOS PAC ID: 1153674676 Enrollment ID: I20181031001542 |
| Provider Name | Shawn Michelle Stevens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316415508 PECOS PAC ID: 8123018959 Enrollment ID: I20190107003220 |
| Provider Name | Lisa Michele Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508334624 PECOS PAC ID: 9133465909 Enrollment ID: I20190116000033 |
| Provider Name | Christie Sharee Muguerza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821462896 PECOS PAC ID: 1658617360 Enrollment ID: I20190116002051 |
| Provider Name | Erica Lin Berry |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1104154178 PECOS PAC ID: 3577800416 Enrollment ID: I20190130001467 |
| Provider Name | Sojin Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982138608 PECOS PAC ID: 4880961754 Enrollment ID: I20190131001115 |
| Provider Name | Rashmi Bolinjkar |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518271543 PECOS PAC ID: 5092935569 Enrollment ID: I20190205001239 |
| Provider Name | Candace L Adkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609330810 PECOS PAC ID: 6204175557 Enrollment ID: I20190304001322 |
| Provider Name | Shariq I Chudhri |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1710277751 PECOS PAC ID: 0749408821 Enrollment ID: I20190411000307 |
| Provider Name | Noel Truong Pearson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194283895 PECOS PAC ID: 2466794128 Enrollment ID: I20190429001460 |
| Provider Name | Gayel Renee Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568922292 PECOS PAC ID: 0143554287 Enrollment ID: I20190625000013 |
| Provider Name | Kristal D Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881929214 PECOS PAC ID: 7911231733 Enrollment ID: I20190628000481 |
| Provider Name | Janki N Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114580453 PECOS PAC ID: 4284969718 Enrollment ID: I20190705000238 |
| Provider Name | Kristi Jean Garrett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649618612 PECOS PAC ID: 4789991068 Enrollment ID: I20190726001279 |
| Provider Name | Sajish Eapen Jacob |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164653853 PECOS PAC ID: 2769602028 Enrollment ID: I20190823000497 |
| Provider Name | Parth K Shah |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1184037590 PECOS PAC ID: 5294043543 Enrollment ID: I20190827001140 |
| Provider Name | Caitlin Ellesse Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194284489 PECOS PAC ID: 3870822976 Enrollment ID: I20190916002279 |
| Provider Name | Taylor B Diehl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285281857 PECOS PAC ID: 2365774247 Enrollment ID: I20191025000630 |
| Provider Name | Sarojini Kala Velamasetti |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285041129 PECOS PAC ID: 8921225277 Enrollment ID: I20191031000382 |
| Provider Name | Cynthia Gutierrez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528536596 PECOS PAC ID: 4082047303 Enrollment ID: I20191127000789 |
| Provider Name | Katie Nicole Nacpil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184267221 PECOS PAC ID: 3971937566 Enrollment ID: I20200108000285 |
| Provider Name | Juliana Marie Cruz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972071066 PECOS PAC ID: 1759710858 Enrollment ID: I20200409003320 |
| Provider Name | Marva Denise Durgin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083998355 PECOS PAC ID: 1658701628 Enrollment ID: I20200416000054 |
| Provider Name | Robert A. Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639704539 PECOS PAC ID: 3577984590 Enrollment ID: I20200529002229 |
| Provider Name | Jack Byron Lewis |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1396706487 PECOS PAC ID: 4688753965 Enrollment ID: I20200601000609 |
| Provider Name | Raven Aravind |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518592534 PECOS PAC ID: 1850714684 Enrollment ID: I20200713000181 |
| Provider Name | Lauren C Walden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376991026 PECOS PAC ID: 9436441904 Enrollment ID: I20200715002581 |
| Provider Name | Annie Lam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124556873 PECOS PAC ID: 2567730286 Enrollment ID: I20200716001445 |
| Provider Name | Gabrielle E. Mavelian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003347964 PECOS PAC ID: 0345519401 Enrollment ID: I20200716002040 |
| Provider Name | Sean Neller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255866844 PECOS PAC ID: 3779860838 Enrollment ID: I20200716002751 |
| Provider Name | Curtis J Boyd |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346501020 PECOS PAC ID: 7911297346 Enrollment ID: I20200810003685 |
| Provider Name | Sharan Lynn Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003430026 PECOS PAC ID: 4981021102 Enrollment ID: I20200902000099 |
| Provider Name | Samuel Olatundun Iranloye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205467537 PECOS PAC ID: 3779900923 Enrollment ID: I20200902001189 |
| Provider Name | Kimberly A Misamore |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1306170642 PECOS PAC ID: 8224457338 Enrollment ID: I20200923000761 |
| Provider Name | Megan Freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265045678 PECOS PAC ID: 4587083274 Enrollment ID: I20200930000161 |
| Provider Name | Francesca G Diggs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457880981 PECOS PAC ID: 3870864960 Enrollment ID: I20201001001682 |
| Provider Name | Laura S Nasrallah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558978569 PECOS PAC ID: 3870903180 Enrollment ID: I20201027002496 |
| Provider Name | Nazleen Abdulrahim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790318731 PECOS PAC ID: 5395156632 Enrollment ID: I20201118000475 |
| Provider Name | Jordan Leigh Dabel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104436310 PECOS PAC ID: 0749692853 Enrollment ID: I20201215000598 |
| Provider Name | Sobia Nabeel |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1306088950 PECOS PAC ID: 2062720311 Enrollment ID: I20210121002252 |
| Provider Name | Karla Daniela Douglas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871185033 PECOS PAC ID: 9931514999 Enrollment ID: I20210310001608 |
| Provider Name | Rachel Davis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841725298 PECOS PAC ID: 3375942295 Enrollment ID: I20210526001927 |
| Provider Name | Elise Edoka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477050003 PECOS PAC ID: 7214284637 Enrollment ID: I20210607002250 |
| Provider Name | Holly Karen Mullins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457940827 PECOS PAC ID: 7315349776 Enrollment ID: I20210708001394 |
| Provider Name | James Minhyuk Yoo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194212241 PECOS PAC ID: 4587910112 Enrollment ID: I20210719002470 |
| Provider Name | Safa Esam Jassim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891377396 PECOS PAC ID: 5890199376 Enrollment ID: I20210805000432 |
| Provider Name | Sarah J Strickland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568931418 PECOS PAC ID: 7719222488 Enrollment ID: I20210816001533 |
| Provider Name | Meghan Nicole Hughey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831860931 PECOS PAC ID: 7214335819 Enrollment ID: I20211012003454 |
| Provider Name | Melissa Ann Scrivner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760146179 PECOS PAC ID: 7416345251 Enrollment ID: I20211027000674 |
| Provider Name | Katrina Nolan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942964408 PECOS PAC ID: 5698164440 Enrollment ID: I20211116002378 |
| Provider Name | Kiara Jean Erazo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669144143 PECOS PAC ID: 3072903566 Enrollment ID: I20211123001991 |
| Provider Name | Scarlett Marie Nerios |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467119040 PECOS PAC ID: 7618367053 Enrollment ID: I20211129002602 |
| Provider Name | Stephanie Michele Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114679404 PECOS PAC ID: 5890188155 Enrollment ID: I20220209000396 |
| Provider Name | April Brandi Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215530373 PECOS PAC ID: 7012301179 Enrollment ID: I20220307000933 |
| Provider Name | Priscilla Campos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073260592 PECOS PAC ID: 5698160109 Enrollment ID: I20220321000677 |
| Provider Name | Kristine Ann Pike |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417608282 PECOS PAC ID: 2860889938 Enrollment ID: I20220420002537 |
| Provider Name | Natalia Sampaio Goodwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912420217 PECOS PAC ID: 6002203460 Enrollment ID: I20220503002946 |
| Provider Name | Olga Cortez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558479857 PECOS PAC ID: 1658372578 Enrollment ID: I20220601000214 |
| Provider Name | Alice Babst |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134162753 PECOS PAC ID: 3678535986 Enrollment ID: I20220628000236 |
| Provider Name | Brian Bordelon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164984126 PECOS PAC ID: 9739560285 Enrollment ID: I20220715000679 |
| Provider Name | Muhammad Azharuddin |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1669867024 PECOS PAC ID: 0547517948 Enrollment ID: I20220722002644 |
| Provider Name | Melissa Bradlo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578586491 PECOS PAC ID: 2062466428 Enrollment ID: I20220816002115 |
| Provider Name | Kimberly Farias |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871153106 PECOS PAC ID: 4688057888 Enrollment ID: I20220822001459 |
| Provider Name | Elisha Jno-baptiste |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871915454 PECOS PAC ID: 6507240363 Enrollment ID: I20220829002820 |
| Provider Name | Rebecca Marie Hernandez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073173829 PECOS PAC ID: 2365826971 Enrollment ID: I20220831001938 |
| Provider Name | Taylor Nielsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548997349 PECOS PAC ID: 6901280262 Enrollment ID: I20220906000935 |
| Provider Name | Simon Kabututwa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437612975 PECOS PAC ID: 1153714563 Enrollment ID: I20220909001339 |
| Provider Name | Nida Noor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083175855 PECOS PAC ID: 5496089542 Enrollment ID: I20221017002378 |
| Provider Name | Stefan Dean Arias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952918690 PECOS PAC ID: 9931576105 Enrollment ID: I20221031002395 |
| Provider Name | Esther Han |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1215292743 PECOS PAC ID: 4284854928 Enrollment ID: I20221212003033 |
| Provider Name | Aradhana Gyanwali |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881306744 PECOS PAC ID: 4789056219 Enrollment ID: I20230210000061 |
| Provider Name | Grace Hampton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043920721 PECOS PAC ID: 8729451901 Enrollment ID: I20230309000950 |
| Provider Name | Shilpa R Kranthi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437355237 PECOS PAC ID: 9537351846 Enrollment ID: I20230327000329 |
| Provider Name | Margaret Lacuesta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831613074 PECOS PAC ID: 2860766730 Enrollment ID: I20230502001527 |
| Provider Name | Robert H Streck |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477917003 PECOS PAC ID: 1456784438 Enrollment ID: I20230515003402 |
| Provider Name | Emily Rebekah Lydick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962193219 PECOS PAC ID: 1355708603 Enrollment ID: I20230601002112 |
| Provider Name | Olivia Ajaero |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417330028 PECOS PAC ID: 0648520288 Enrollment ID: I20230629001595 |
| Provider Name | Jessie Yuyue Chen |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1245684760 PECOS PAC ID: 4880054097 Enrollment ID: I20230719004389 |
| Provider Name | Pranav Dadhich |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1053845362 PECOS PAC ID: 8820425127 Enrollment ID: I20230725003710 |
| Provider Name | Nkeiruka Mbah |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841854122 PECOS PAC ID: 1759744618 Enrollment ID: I20230825001734 |
| Provider Name | Thomas M Bell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871055640 PECOS PAC ID: 6608107271 Enrollment ID: I20231018002837 |
| Provider Name | Keely B Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346713963 PECOS PAC ID: 3971955485 Enrollment ID: I20240120000200 |
Arlington Premier Health Clinic Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 501 Rita Ln, Ste 109, Arlington, TX 76014 Phone: 817-465-4141 Fax: 817-465-9714 | |
Arlington Gastroenterology Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 515 W Mayfield Rd, Suite# 403, Arlington, TX 76014 Phone: 817-417-4027 Fax: 817-417-4043 | |
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Radhika Kolli, Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 800 W Arbrook Blvd, Suite 325, Arlington, TX 76015 Phone: 817-472-9869 | |
Arlington Vision Care Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5425 Matlock Rd Ste 100, Arlington, TX 76018 Phone: 817-557-4100 Fax: 817-557-4176 | |
I Care Network Consultants, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6201 Matlock Rd Ste 125, Arlington, TX 76002 Phone: 214-210-9969 Fax: 214-574-9344 | |
Doctors At Home Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5802 Berryhill Dr, Arlington, TX 76017 Phone: 682-321-7007 Fax: 682-321-7036 |