HMO Blue TexasSM
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Table of Contents
Independent Provider Network (IPN)
Primary Care Physicians ......................................................................................... 2
Specialists.............................................................................................................. 59
Supervised and Sponsored Providers ................................................................. 282
Hospitals .............................................................................................................. 293
AIM Specialty Health®’ (AIM) ............................................................................... 294
Quest Diagnostics (Quest)................................................................................... 295
Ancillary Providers ............................................................................................... 296
Listing of Providers .............................................................................................. 305
Behavioral Health Providers (including Chemical Dependency Providers) ................. 320
Behavioral Health Hospitals......................................................................................... 355
Vision Providers ........................................................................................................... 356
Pharmacy Providers..................................................................................................... 360
Index of Primary Care Providers.................................................................................. 365
Index of Specialists ...................................................................................................... 371
Search Criteria
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Last Updated:
HMO
AUSTIN
October 15, 2014
Limited Provider Networks
Your primary care physician is part of a provider network or association of health care professionals who work together to provide a full range of
health care services. That means, when you choose your primary care physician, you are also choosing a limited provider network and in most
instances, for services to be covered by your health care benefit plan, you are not allowed to receive services from any physician or health care
professional that is not also part of your primary care physician’s network. You will not be able to select any physician or provider outside of your
primary care physician’s network, even if that physician or provider is participating in HMO Blue Texassm. All of your care will be provided by or
arranged for within the limited provider network to which your primary care physician belongs, so make sure that your primary care physician’s
network includes the specialists and hospitals that you prefer.
ATTENTION FEMALE ENROLLEES: Choosing OB/GYN Services
In selecting your primary care physician, remember that your primary care physician’s network affects your choice of an OB/GYN. For preventive
care (well-woman exams), gynecological conditions, or maternity care, female members may see a network OB/GYN without first obtaining a
referral from their primary care physician. If you choose to select an OB/GYN, the OB/GYN you select must belong to the same limited provider
network as your primary care physician. This is another reason to make certain that your primary care physician’s network includes the specialists,
particularly the OB/GYN, and hospitals that you prefer. You are not required to select an OB/GYN; you may elect to receive your OB/GYN services
from your primary care physician.
A Division of Health Care Service Corporation, a Mutual Legal Reserve Company,
an Independent Licensee of the Blue Cross and Blue Shield Association
AUSTIN
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
INDEPENDENT
O
ctober 15, 2014PROVIDER NETW ORK ( IPN)
AUSTIN
FAMILY PRACTICE
" Aberra, Getnet, MD
Aus tin
Gender: Male
PCP # 8EQ04001
NPI: 1801839170
1210 W Braker Ln
(512) 978-9300
Hospital Affiliation: Medical Center
Hospital
Clinic Affiliation: Communitycare
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: Family
Practice
" Agueros, Horacio M, MD
Aus tin
Gender: Male
# PCP # 0063DD01
PCP # 8DE40901
NPI: 1477586618
2609 E Seventh St
J (512) 474-6836
Hospital Affiliation: St Davids Medical
Center
Clinic Affiliation: Clinica Siete
Practice Information: No Patients Under 1
yrs old
Board Certified Specialties: Family
Practice
" Alamia, Rodolfo R, MD
Aus tin
J
Gender: Male
PCP # 0002DY01
NPI: 1346321098
1221 W Ben White B212
(512) 443-8500
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: Family
Practice
" Ambler, Mark S, MD
Austin
Gender: Male
PCP # 8814M501
NPI: 1851310965
1807 W Slaughter Ln
Ste 490
J (512) 282-8967
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Gender: Male
PCP # 8A319701
NPI: 1386690477
1313 Red River St
Ste 100
J (512) 324-8600
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Northwest Hospital, Seton Southwest,
University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Family
Practice
" Armstrong, Michael L, DO
Austin
Gender: Male
# PCP # 8CY93301
NPI: 1295734937
2802 Webberville Rd
(512) 978-9400
Hospital Affiliation: Ballinger Memorial
Hospital, Palo Pinto General Hospital,
Weatherford Regional Med Ctr
Clinic Affiliation: Communitycare
Board Certified Specialties: Family
Practice
" Allen, Gregory G, MD
Aus tin
Gender: Male
PCP # 8CZ03201
NPI: 1124060389
2909 N IH 35
(512) 478-4939
Clinic Affiliation: Peoples Community Clinic
Inc
Board Certified Specialties: Family
Practice
" Alward, Ian S, MD
Aus tin
Gender: Male
# PCP # 8H197501
NPI: 1790764058
2555 Western Trails Blvd
Ste 101
J (512) 892-6600
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, St Davids S
Austin Medical Center
Clinic Affiliation: South Austin Medical
Clinic PA
Board Certified Specialties: Family
Practice
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Male
PCP # 86302J01
NPI: 1245252576
1313 Red River
Ste 100
J (512) 324-8600
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Northwest Hospital, Seton Southwest,
University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Family
Practice
" Arnecilla, Jennifer A, MD
Gender: Female
PCP # 8K904001
NPI: 1982604161
7600 Burnet Rd Ste 270
J (512) 377-2336
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austins Friendly Family
Med PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Family
Practice
" Bolton, Kim P, MD
Austin
!
J
" Brimberry, Matthew, MD
Gender: Male
# PCP # 8DF53301
NPI: 1578791976
5625 Eiger Rd
Ste 200
J (512) 892-7076
Hospital Affiliation: St Davids S Austin
Medical Center
Clinic Affiliation: South Austin Family
Practiceclinic LLP
Board Certified Specialties: Family
Practice
" Brinson, Cynthia C, MD
Austin
Gender: Female
PCP # 8DZ32101
NPI: 1093766396
1313 Red River
Ste 100
(512) 324-8600
Hospital Affiliation: St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Family
Practice
" Bingham, Julie A, MD
Gender: Female
PCP # 8ED57701
NPI: 1548375272
6835 Austin Center Blvd
(512) 346-6611
Hospital Affiliation: Parkview Regional
Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Aseh, Omerine Y, MD
Gender: Female
PCP # 8CY63701
NPI: 1649429556
3816 S First St
(512) 443-1311
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Birdwell, Larry R, DO
Austin
Gender: Male
# PCP # 8CY93401
NPI: 1063466761
2529 S First St
(512) 978-9500
Clinic Affiliation: Communitycare
Board Certified Specialties: Family
Practice
" Balderas, Dagoberto, DO
Austin
Gender: Male
PCP # 8ED51501
NPI: 1699835843
14101 Hwy 290 W
Ste 200A
J (512) 301-6400
Clinic Affiliation: Lewis Family Medicine
Board Certified Specialties: Family
Practice
Austin
" Bangston, John F, MD
Austin
Gender: Male
PCP # 8A272001
NPI: 1457361800
11671 Jollyville Rd
Ste 203
J (512) 338-5150
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Northwest Hospital, St Davids Medical
Center
Clinic Affiliation: North Austin Family
Medicinepa
Board Certified Specialties: Family
Practice
!
Blair, Stephen, MD
Gender: Male
PCP # 8EF66301
NPI: 1962404244
1000 E 41st St
Ste 925
(512) 978-9940
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Communitycare
Board Certified Specialties: None
" Bockmon, Kimball W, MD
Austin
Gender: Male
PCP # 8W587301
NPI: 1548212152
4515 Seton Center Pkwy
Ste 220
(512) 338-8388
Hospital Affiliation: Park Plaza Hospital,
Seton Medical Center, Seton Northwest
Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Gender: Female
PCP # 88879S01
NPI: 1558376608
6835 Austin Center Blvd
(512) 346-6611
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Austin
Austin
Austin
" Alberda, Kelly J, MD
J
" Benold, Terrell B, MD
Austin
Austin
Aus tin
Gender: Male
PCP # 8K823601
NPI: 1972525376
1313 Red River St
Ste 100
(512) 324-8600
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Scott & White Hlthcare Round
Rock, St Davids Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Family
Practice
" Barta, Adam P, MD
Austin
Bristol, Paul E, MD
Gender: Male
PCP # 0096DK01
NPI: 1780760595
2013 Wells Branch Pwky
Ste 113
J (512) 251-2828
Hospital Affiliation: St Davids Medical
Center
Practice Information: No Patients Under 7
yrs old
Board Certified Specialties: None
Austin
!
" Brode, Donald R, MD
Austin
J
Gender: Male
PCP # 82414S01
NPI: 1669417580
3828 S First St
(512) 443-1311
# PCP # 8CY94301
NPI: 1669417580
4614 N IH 35
(512) 978-9100
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Northwest Hospital, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Regional Clinic PA,
Communitycare
Board Certified Specialties: Family
Practice
" Brooke, William F, MD
Austin
Gender: Male
PCP # 8BT49001
NPI: 1659358430
4515 Seton Center
Pkwy Ste 220
(512) 338-8388
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
J - Wheelchair Access
2
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
AUSTIN
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Calderon, April M, DO
" Chaudhury, Saswati, MD
Aus tin
AUSTIN Cont
FAMILY PRACTICE Cont
" Browning, Stewart R, MD
Austin
Gender: Male
PCP # 8B074101
NPI: 1699781971
1807 W Slaughter Ln
Ste 490
J (512) 282-8967
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
J
!
Bui, Thieu, MD
Gender: Male
# PCP # 00SA9901
NPI: 1811003296
8738 N Lamar Blvd
J (512) 834-2035
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Board Certified Specialties: None
Austin
" Burnell, Elizabeth E, MD
Austin
Gender: Female
PCP # 8DB88601
NPI: 1255325429
7610 W Hwy 71
Ste F
(512) 288-0859
Hospital Affiliation: River Oaks Endoscopy
Center Llp, West Houston Medical Center
Clinic Affiliation: National House Call
Practitioners
Practice Information: No Patients Under 4
yrs old
Board Certified Specialties: Family
Practice
Butler, David T, MD
Gender: Male
!# PCP # 8K667001
NPI: 1295703254
11940 Jollyville Rd
Ste 115S
J (512) 258-5800
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Butler David T MD
Practice Information: No Patients Under 5
yrs old
Board Certified Specialties: None
Austin
" Buttrey, Sarah, MD
Austin
Gender: Female
PCP # 8DJ77001
NPI: 1922018852
2811 E Second St
(512) 324-4930
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Northwest Hospital, Seton Southwest,
University Med Ctr Brackenridge
Clinic Affiliation: Seton Community Health
Centers
Board Certified Specialties: Family
Practice
Callaway, Susan, MD
Gender: Female
PCP # 86C68301
NPI: 1083620363
3828 S First St
J (512) 443-1311
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
" Chen, Anthony Y, MD
Gender: Male
PCP # 8DW58001
NPI: 1619289949
1807 Slaughter Ln
Ste 490
(512) 282-8967
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Canon, Todd A, MD
Gender: Male
# PCP # 8CJ05101
NPI: 1275553901
2555 Western Trails
Blvd Ste 101
(512) 892-6600
Hospital Affiliation: St Davids S Austin
Medical Center
Clinic Affiliation: South Austin Medical
Clinic PA
Board Certified Specialties: Family
Practice
Austin
Carlson, Kevin R, MD
Gender: Male
PCP # 0094DK01
NPI: 1366528184
2013 Wells Branch Pkwy
Ste 113
J (512) 251-2828
Hospital Affiliation: St Davids Medical
Center
Practice Information: No Patients Under 7
yrs old
Board Certified Specialties: None
Childers, Jacob A, MD
Gender: Male
! PCP # 8CC72801
NPI: 1255411617
6835 Austin Center Blvd
(512) 346-6611
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Austin
" Casas, Cheyanne M, MD
Aus tin
Gender: Female
# PCP # 8DQ60401
NPI: 1528047693
5625 Eiger Rd
Ste 200
(512) 892-7076
Clinic Affiliation: South Austin Family
Practiceclinic LLP
Board Certified Specialties: Family
Practice
" Chuo, Li Tai, MD
Austin
Gender: Male
PCP # 8BJ80301
NPI: 1841384211
2900 N Quinlan Park Rd
Ste 430
(512) 266-8877
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center
Clinic Affiliation: Capital Area Primary Care
PLLC
Board Certified Specialties: Family
Practice
" Cauvin, Paul D, MD
Aus tin
Aus tin
!
Aus tin
Chen, Helo, DO
Gender: Male
PCP # 8EN01101
NPI: 1760491047
8900 Shoal Creek Blvd
Bldg 200
(512) 323-6000
PCP # 8DS13001
PCP # 8W769001
NPI: 1760491047
8900 Shoal Creek Blvd
Ste 200
(512) 323-6900
Clinic Affiliation: Greentree Health, Union
Treatment Centers, Utc Health and Rehab
Austin
Board Certified Specialties: None
Aus tin
J
" Cole III, Donald, MD
Austin
Gender: Female
PCP # 8BS97501
NPI: 1710157938
1807 Slaughter Ln
Ste 490
(512) 282-8967
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Gender: Male
PCP # 8R680701
NPI: 1700892080
3828 S First St
(512) 443-1311
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Austin
Aus tin
" Byrd Jr, Charles R, MD
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
!
Aus tin
Austin
Gender: Male
PCP # 0099GU01
NPI: 1225056328
2765 Bee Caves Rd
J (512) 328-2752
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Practice Information: No Patients Under 8
yrs old
Board Certified Specialties: Family
Practice
Austin
Gender: Female
PCP # 8CL98604
NPI: 1437475191
12129 FM 620 Ste 600 E
(512) 336-3400
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Gender: Male
PCP # 87J44001
NPI: 1447265590
11714 Wilson Parke Ave
Ste 150
(512) 250-5571
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: Family
Practice
Clark Brown, Cheryl M, MD
Gender: Female
PCP # 0026ST01
NPI: 1619000239
2113 E Martin Luther King
Jr Blvd Ste 101
J (512) 391-9700
Hospital Affiliation: University Med Ctr
Brackenridge
Board Certified Specialties: None
Austin
Chang, Christopher, MD
Gender: Male
PCP # 8EK10801
NPI: 1518251800
11714 Wilson Parke Ave
Ste 150
(512) 272-4636
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
" Clemons, Lisa K, MD
Austin
Chapa, Yesica, MD
Gender: Female
PCP # 8EM42701
NPI: 1467747741
1807 Slaughter Ln
Ste 490
(512) 282-8967
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
J
Gender: Female
PCP # 8B609401
NPI: 1285656603
1313 Red River St
Ste 100
(512) 324-8880
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Family
Practice
" Cortez, Monique, MD
Austin
Gender: Female
PCP # 8F707401
NPI: 1619983996
3828 S First St
J (512) 443-1311
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
!
" Cox, Geoffrey H, MD
Austin
Gender: Male
PCP # 8511M001
NPI: 1700849353
7900 FM 1826 Ste 202
J (512) 416-0044
Hospital Affiliation: Seton Medical Center,
Seton Southwest, University Med Ctr
Brackenridge
Clinic Affiliation: South Oaks Medical
Board Certified Specialties: Family
Practice
" Crook, Gretchen L, MD
Austin
Gender: Female
PCP # 8F707201
NPI: 1346255403
6835 Austin Center Blvd
J (512) 346-6611
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Crow, Steven C, MD
Gender: Male
# PCP # 82A57901
NPI: 1720010903
2909 N IH 35
J (512) 478-4939
Austin
# PCP # 8CY94601
NPI: 1720010903
4614 N IH 35
(512) 978-9100
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Communitycare, Peoples
Community Clinic Inc
Board Certified Specialties: None
" Dang, Tony, MD
Austin
Gender: Male
# PCP # 8CW36201
NPI: 1083795199
11207 N Lamar Blvd
Ste B
(512) 832-1300
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: North Lamar Family
Medicine
Board Certified Specialties: Family
Practice
Austin
Dawson, Mark C, MD
Gender: Male
PCP # 8CS94301
NPI: 1164400867
5625 Eiger Rd
Ste 200
(812) 892-5881
Hospital Affiliation: St Davids S Austin
Medical Center
Clinic Affiliation: South Austin Family
Practiceclinic LLP
Practice Information: No Patients Under 1
yrs old
Board Certified Specialties: None
J - Wheelchair Access
3
AUSTIN
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Escamilla, David F, MD
" Fite, Kevin D, MD
Austin
AUSTIN Cont
FAMILY PRACTICE Cont
" Dent, Marenda D, DO
Aus tin
Gender: Female
# PCP # 8DS46102
NPI: 1821121112
11521 Ranch Rd 620 B
Ste 100
(512) 402-6830
Clinic Affiliation: Medspring Prime of Texas
PA
Practice Information: No Patients Under 7
yrs old
Board Certified Specialties: Family
Practice
" Easterling, Amy K, DO
Aus tin
Gender: Female
# PCP # 8CE47601
NPI: 1881897270
2555 Western Trails Blvd
Ste 101
J (512) 892-6600
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: South Austin Medical
Clinic PA
Board Certified Specialties: Family
Practice
" Elmore, Ellen L, MD
Aus tin
!
Gender: Female
PCP # 8BS97601
NPI: 1164694634
6835 Austin Center Blvd
(512) 346-6611
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Austin
Gender: Male
PCP # 8CY95107
NPI: 1427093434
1200 Montopolis Dr
J (512) 978-9800
Gender: Male
PCP # 8CQ80501
NPI: 1730372491
12201 Renfert Way Ste 315
(512) 837-6000
Hospital Affiliation: North Austin Medical
Center
Clinic Affiliation: Austin Medical Group
PLLC
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: Family
Practice
PCP # 8CY95105
NPI: 1427093434
211 Comal St
J (512) 978-9200
PCP # 8CY95112
NPI: 1427093434
2529 S First St
J (512) 978-9500
" Foadey, Tongny W, MD
Austin
Gender: Male
PCP # 8V437301
NPI: 1902035801
5625 Eiger Rd
Ste 200
J (512) 892-7076
Hospital Affiliation: St Davids Medical
Center
Clinic Affiliation: South Austin Family
Practiceclinic LLP
Board Certified Specialties: Family
Practice
PCP # 8CY95110
NPI: 1427093434
2802 Webberville Rd
J (512) 978-9400
# PCP # 8CY95103
NPI: 1427093434
500 E Seventh St
J (512) 978-9920
# PCP # 8CY95113
NPI: 1427093434
6801 S IH 35
Ste 1E
J (512) 978-9960
J
Ganta, Neelima, MD
Gender: Female
PCP # 8CY95301
NPI: 1619186681
1200 Montopolis Dr
J (512) 978-9800
Clinic Affiliation: Communitycare
Board Certified Specialties: None
" Garcia, Derrick, MD
Austin
J
" Franklin, William G, MD
Gender: Male
# PCP # 84490S03
NPI: 1609948314
3003 Bee Caves Rd
Ste 201
J (512) 652-0122
PCP # 8CY95101
NPI: 1427093434
7112 Ed Bluestein
Blvd Ste 155
J (512) 978-9300
# PCP # 84490S01
NPI: 1609948314
4303 Victory Dr
J (512) 462-3627
Hospital Affiliation: Seton Medical Center,
St Davids S Austin Medical Center
Clinic Affiliation: Victory Medical & Family
Care
Board Certified Specialties: Family
Practice
PCP # 8CY95111
NPI: 1427093434
825 E Rundberg Ln
Ste B1
J (512) 978-9600
PCP # 8CY95102
NPI: 1427093434
928 Blackson Ave
J (512) 978-9740
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: Communitycare
Board Certified Specialties: Family
Practice
" Frazier, Jenny M, MD
Austin
Gender: Female
PCP # 8BG94901
NPI: 1962441030
1807 W Slaughter Ln
Ste 490
(512) 282-8967
Hospital Affiliation: Lake Pointe Medical
Center, Seton Medical Center, Seton
Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Under 5
yrs old, No Patients Under 8 yrs old
Board Certified Specialties: Family
Practice
Fannin, Tuyet M, DO
Gender: Female
PCP # 8U207001
NPI: 1235126194
711 W 38th St Ste C9
J (512) 454-3500
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Symphony Healthcare PA
Board Certified Specialties: None
Austin
Geyer, Darren E, MD
Gender: Male
# PCP # 85083Y01
NPI: 1053311985
5625 Eiger Rd
Ste 200
J (512) 892-7076
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: South Austin Family
Practiceclinic LLP
Board Certified Specialties: None
" Ghaffar, Anila J, MD
Austin
Gender: Female
PCP # 8DV04701
NPI: 1639346950
1015 W 39 1/2 St
(512) 371-7478
Clinic Affiliation: Pro Care Medical Center
Board Certified Specialties: Family
Practice
" Gildersleeve, Roger W, MD
Austin
Gender: Male
PCP # 8CB72901
NPI: 1770554149
1221 W Ben White Blvd
Ste B100 300
(877) 800-5722
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Ctr Williamson, Seton
Northwest Hospital
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: Family
Practice
" Frederick, John, MD
" Fincken, Gerald T, DO
Austin
Gender: Male
PCP # 83039Y01
NPI: 1841206117
6835 Austin Center Blvd
J (512) 346-6611
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Freeman, Georgeanne, DO
Gender: Female
PCP # 8DB56901
NPI: 1194838409
1611 W Fifth St
Ste 180
J (512) 391-9400
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Downtown Doctor
Board Certified Specialties: None
Austin
Gender: Male
PCP # 8B074401
NPI: 1134135403
6835 Austin Center Blvd
(512) 346-6611
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Austin
Austin
Gender: Male
PCP # 85082Y01
NPI: 1316932221
5625 Eiger Rd
Ste 200
J (512) 892-7076
Hospital Affiliation: St Davids S Austin
Medical Center
Clinic Affiliation: South Austin Family
Practiceclinic LLP
Board Certified Specialties: Family
Practice
Gender: Female
PCP # 8DU47701
NPI: 1245318138
11111 Research Blvd
Ste 310
(877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: Family
Practice
Austin
Austin
PCP # 8CY95108
NPI: 1427093434
8656A W Hwy 71 Ste C
J (512) 978-9820
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
" Gangupantula, Gopika, MD
Austin
" Glawe, Jane M, MD
Austin
J
Gender: Female
PCP # 8B074601
NPI: 1952317224
3828 S First St
(512) 443-1311
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
J - Wheelchair Access
4
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
AUSTIN
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Gutierrez, Michael L, MD
Gender: Male
! PCP # 00U83W01
NPI: 1770664427
1009 E 40th St
Ste 300B
J (512) 482-8280
Hospital Affiliation: North Austin Medical
Center, St Davids Medical Center, St Davids
S Austin Medical Center
Board Certified Specialties: None
" Hill, Svetlana M, MD
Aus tin
AUSTIN Cont
FAMILY PRACTICE Cont
" Glaze, Sylvia, MD
Austin
Gender: Female
PCP # 89C01101
NPI: 1225043383
4515 Seton Ctr Pkwy 220
J (512) 338-8388
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Ha, Chen X, MD
Guel, Mario H, MD
Gender: Male
PCP # 8EJ10301
NPI: 1629274626
5510 S IH 35
Ste 250A
(512) 301-1166
Hospital Affiliation: Mission Regional
Medical Center, South Texas Health System,
South Texas Regional Medical Center,
University Medical Center
Clinic Affiliation: Wellness Med Clinics LLC
Practice Information: No Patients Under 1
yrs old
Board Certified Specialties: None
!
J
Gender: Male
PCP # 0088AA01
NPI: 1457330292
631 W 38th St Ste 2
(512) 459-3177
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: Family
Practice
Austin
Gender: Female
PCP # 8DY03501
NPI: 1669487724
10401 Anderson Mill Rd
Ste 110-B
(512) 250-5571
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
PCP # 8CZ64901
NPI: 1134120579
4303 Victory Dr
(512) 462-3627
Hospital Affiliation: Arise Austin Medical
Center, Seton Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Victory Medical & Family
Care
Practice Information: No Patients Under 5
yrs old
Board Certified Specialties: Family
Practice
" Gupta, Ajay K, MD
Austin
!
Gender: Female
PCP # 8EF74101
NPI: 1942366638
6633 US 290 Frontage
Rd Ste 300
(512) 872-6868
PCP # 8DJ04701
NPI: 1942366638
7200 Wyoming Springs Dr
Ste 1500
(512) 218-8696
Clinic Affiliation: Capital Area Primary Care
PLLC, Lamia Kadir MD
Board Certified Specialties: Family
Practice
" Kapadia, Deepti G, MD
Austin
Gender: Female
PCP # 89C02101
NPI: 1649285701
1807 W Slaughter Ln
Ste 490
J (512) 282-8967
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Karst, Fernando E, MD
Austin
Gender: Male
PCP # 8EK12201
NPI: 1326148586
6633 E Hwy 290
Ste 101
(512) 314-3834
Hospital Affiliation: Christus Santa Rosa
New Braunfels, University Health System
Clinic Affiliation: James McKinney DO PA
Board Certified Specialties: Family
Practice
" Hutchens, Mark H, MD
J
" Heisler, Gerald P, MD
Austin
" Kadir, Lamia, MD
Austin
Austin
Aus tin
J
Hon, Serena, MD
Gender: Female
PCP # 8EK11201
NPI: 1093002537
11714 Wilson Parke Ave
Ste 150
(512) 231-5548
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
" Hooda, Madhu, MD
Gender: Female
PCP # 8CZ64902
NPI: 1134120579
3003 Bee Caves Rd
Ste 201
(512) 462-3627
Jones, Patsy, MD
Gender: Female
PCP # 0039DP01
NPI: 1275636607
2113 E MLK Jr Blvd
Ste 106
J (512) 472-9664
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Austin
Gender: Male
PCP # 8CZ79601
NPI: 1699757641
706 W Ben White Blvd
Ste A100
(512) 442-1996
Hospital Affiliation: Seton Medical Center,
Seton Southwest, St Davids Medical Center,
St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Wellmed Medical Group
PA
Board Certified Specialties: Family
Practice
Austin
" Hanley, Patricia S, MD
Aus tin
Gender: Female
PCP # 8DF20901
NPI: 1104029735
2301 W N Loop
Blvd
J (512) 452-2506
Hospital Affiliation: North Austin Medical
Center
Clinic Affiliation: Inspire Family Health PA
Board Certified Specialties: Family
Practice
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
J
" Hahn, James S, MD
" Guerra, Adriana, MD
Gutierrez, Emilio F, MD
Gender: Male
PCP # 0065DK01
PCP # 8DC97601
NPI: 1659467447
4400 Red River St
J (512) 474-9000
Hospital Affiliation: St Davids Medical
Center
Clinic Affiliation: Emilio Gutierrez MD
Board Certified Specialties: None
Austin
Aus tin
Austin
Gender: Male
PCP # 82T24801
NPI: 1629026067
1101 W 40th St
J (512) 459-4147
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Jefferson Street Family
Practice
Board Certified Specialties: Family
Practice
" Holme, Josef E, MD
Gender: Female
PCP # 8EE73801
NPI: 1538171277
9801 Anderson Mill Rd
Ste 105
(512) 999-7010
Hospital Affiliation: Dallas Regional Med
Ctr I 30, St Davids Medical Center
Clinic Affiliation: Texas Medical Wellness
Center
Board Certified Specialties: Family
Practice
" Gonzalez, Ernesto A, MD
Austin
Gender: Female
PCP # 8EH92601
NPI: 1922162726
11420 Bee Caves Rd
Ste A150
(512) 520-7222
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Hill Family Medicine &
Skin Care
Board Certified Specialties: Family
Practice
Aus tin
Austin
Gender: Male
PCP # 8EC28901
NPI: 1871528091
3828 S First St
(512) 443-1311
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Austin
Gender: Male
PCP # 8EC38101
NPI: 1245310168
1221 W Ben White Blvd
(877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: Family
Practice
Gender: Male
PCP # 8G896001
NPI: 1467461293
3200 Red River St
Ste 201
(512) 473-0201
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Texas Sports and Family
Medicine PLLC
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: Family
Practice
" Jewell, Janet, MD
Austin
" Hill, Matthew S, DO
Aus tin
Gender: Male
# PCP # 8EH92501
NPI: 1568665313
11420 Bee Caves Rd
Ste A150
J (512) 520-7222
Hospital Affiliation: Arise Austin Medical
Center
Clinic Affiliation: Hill Family Medicine &
Skin Care
Board Certified Specialties: Family
Practice
J
Gender: Female
PCP # 87J40701
NPI: 1821003989
6835 Austin Center Blvd
(512) 346-6611
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Johnson, Jason D, MD
Austin
Gender: Male
PCP # 8BS97101
NPI: 1295727410
1807 Slaughter Ln
Ste 490
(512) 282-8967
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Keinarth, Paul D, MD
Gender: Male
PCP # 8F144101
NPI: 1730182601
5222 Burnet Rd Ste 200
J (512) 459-9889
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Margolin & Keinarth PA
Practice Information: No Patients Under 6
yrs old
Board Certified Specialties: None
Austin
" Keller, Katherine D, DO
Austin
Gender: Female
# PCP # 8CX99102
NPI: 1356634760
3003 Bee Caves Rd
Ste 201
J (512) 462-3627
# PCP # 8CX99101
NPI: 1356634760
4303 Victory Dr
J (512) 462-3627
Hospital Affiliation: Arise Austin Medical
Center
Clinic Affiliation: Victory Medical & Family
Care
Board Certified Specialties: Family
Practice
J - Wheelchair Access
5
AUSTIN
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Kim, Yun W, MD
" Lee, Emmanuel J, MD
Austin
AUSTIN Cont
FAMILY PRACTICE Cont
" Kempf, Melissa M, MD
Aus tin
!
Aus tin
Gender: Female
PCP # 8CU43202
NPI: 1568541043
12180 N Mopac
Ste B
(512) 836-8800
Hospital Affiliation: Northeast Baptist
Hospital
Clinic Affiliation: San Antonio Osteo Relief
Ctr PA
Board Certified Specialties: Family
Practice
Kenneally, Gaila M, DO
Gender: Female
PCP # 8BJ95801
NPI: 1700831468
4515 Seton Center
Pkwy Ste 220
(512) 338-8388
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Austin
Austin
" Kerr, Jacqueline M, MD
Aus tin
Gender: Female
# PCP # 8DJ77501
NPI: 1215948120
2811 E Second St
(512) 324-4930
PCP # 8DJ77502
NPI: 1215948120
3706 S First St
(512) 324-4930
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Seton Community Health
Centers
Board Certified Specialties: Family
Practice
" Khambati, Munira A, MD
Aus tin
Gender: Female
PCP # 8DA26001
NPI: 1215958624
4007 James Casey St
Ste D 240
(512) 440-8989
Hospital Affiliation: St Davids S Austin
Medical Center
Clinic Affiliation: R N Poonawala PA
Board Certified Specialties: Family
Practice
Aus tin
Khunti, Anuja, DO
Gender: Female
PCP # 8EG95501
NPI: 1629319769
1807 Slaughter Ln
Ste 490
(512) 282-8967
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
# PCP # 8H174001
NPI: 1427123900
4303 Victory Dr
J (512) 462-3627
Clinic Affiliation: Victory Medical & Family
Care
Board Certified Specialties: Family
Practice
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
# PCP # 8DJ75001
NPI: 1821163122
8913 Collinfield Dr
(512) 324-6850
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Northwest Hospital, Seton Southwest,
University Med Ctr Brackenridge
Clinic Affiliation: Seton Community Health
Centers
Board Certified Specialties: Family
Practice
Kohli, Anumeha, MD
Gender: Female
PCP # 8EB61301
NPI: 1932436532
4534 Westgate Blvd
Ste 108
(512) 892-7076
Clinic Affiliation: South Austin Family
Practiceclinic LLP
Board Certified Specialties: None
" Legere, Claudia L, MD
Gender: Female
PCP # 8BJ80401
NPI: 1568653061
2900 N Quinlan Park Rd
Ste 430
J (512) 266-8877
Hospital Affiliation: North Austin Medical
Center, St Davids Hospital, St Davids
Medical Center
Clinic Affiliation: Capital Area Primary Care
PLLC
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: Family
Practice
Kohli, Gurneet S, MD
Gender: Male
PCP # 8EB61401
NPI: 1225291784
4534 Westgate Blvd
Ste 108
(512) 892-7076
Clinic Affiliation: South Austin Family
Practiceclinic LLP
Board Certified Specialties: None
Gender: Male
PCP # 89C03501
NPI: 1912913260
4515 Seton Ctr Pkwy 220
J (512) 338-8388
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Austin
" Krienke, Russell, MD
Austin
Gender: Male
PCP # 88334301
NPI: 1821004177
3828 S First St
J (512) 443-1311
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Lerma III, Sammy, MD
Gender: Male
PCP # 8EP19801
NPI: 1871571950
1034 Liberty Park Dr
(512) 452-2100
Hospital Affiliation: Seton Smithville Reg
Hospital
Clinic Affiliation: Chudleigh PA
Practice Information: No Patients Under 1
yrs old
Board Certified Specialties: None
" Levy, Mark J, MD
" Liu, Yu Mei, MD
Austin
Gender: Female
PCP # 8DJ74802
NPI: 1215949607
3706 S First St
(512) 324-4940
# PCP # 8DJ74801
NPI: 1215949607
8913 Collinfield Dr
(512) 324-6850
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Seton Community Health
Centers
Board Certified Specialties: Family
Practice
Malleske, Joseph J, MD
Gender: Male
# PCP # 88C34401
NPI: 1013911700
2555 Western Trails Blvd
Ste 101
J (512) 892-6600
Hospital Affiliation: Seton Medical Center,
St Davids S Austin Medical Center
Clinic Affiliation: South Austin Medical
Clinic PA
Board Certified Specialties: None
Austin
" Malpani, Vishal B, MD
Austin
Austin
Gender: Male
# PCP # 8H197201
NPI: 1801890595
2555 Western Trails Blvd
Ste 101
J (512) 892-6600
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: South Austin Medical
Clinic PA
Board Certified Specialties: Family
Practice
" Lall, Asha R, MD
Austin
Gender: Female
PCP # 8J403901
NPI: 1457366510
6811 Austin Center Blvd
Ste 300
(512) 346-6611
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Lewis, Harold D, DO
Austin
Gender: Male
PCP # 00BL1701
NPI: 1689773459
1901 W Wm Cannon Dr
Ste 123
J (512) 444-2661
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids S
Austin Medical Center, The Hosp At
Westlake Med Ctr, University Med Ctr
Brackenridge
Board Certified Specialties: Family
Practice
" Lamy, Keith H, MD
Austin
Gender: Male
# PCP # 8AW35601
NPI: 1164430278
1106 Clayton Ln
Ste 102W
J (512) 453-7356
Hospital Affiliation: Scott & White Hlthcare
Round Rock, Seton Medical Center, St
Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Keith Lamy MD
Board Certified Specialties: Family
Practice
Lewis, Kevin W, DO
Gender: Male
PCP # 8DW34401
NPI: 1033312426
14101 Hwy 290 W
Ste 200A
(512) 301-6400
!# PCP # 0043ST02
NPI: 1033312426
1901 W William Cannon
Ste 125
J (512) 444-2661
Hospital Affiliation: Seton Southwest, St
Davids S Austin Medical Center, The Hosp
At Westlake Med Ctr
Clinic Affiliation: Lewis Family Medicine
Board Certified Specialties: None
Austin
" Kravitz, Larry C, MD
" Kim, John S, MD
Austin
Gender: Male
PCP # 8DJ75002
NPI: 1821163122
3706 S First St
(512) 324-4940
Austin
Aus tin
Gender: Male
# PCP # 8H174002
NPI: 1427123900
3003 Bee Caves Rd
Ste 201
J (512) 462-3627
Austin
Gender: Male
PCP # 8DX08201
NPI: 1730404138
3200 Red River St
Ste 210
(512) 472-3161
Hospital Affiliation: St Davids Medical
Center
Clinic Affiliation: Yun W Kim MD
Board Certified Specialties: Family
Practice
!
J
Gender: Male
PCP # 8CY25801
NPI: 1225030281
2222 Rosewood Ave
(512) 465-4840
Hospital Affiliation: Scott And White
Memorial Hospital, Seton Medical Center
Clinic Affiliation: Wellmed Medical Group
PA
Board Certified Specialties: Family
Practice
" Marchand, Gregory, MD
Austin
Gender: Male
PCP # 0010ZW01
PCP # 8EP22401
NPI: 1033104336
4534 Westgate Blvd
Ste 113
(512) 394-6020
# PCP # 85080Y01
NPI: 1033104336
5625 Eiger Rd
Ste 200
J (512) 892-7076
Hospital Affiliation: St Davids S Austin
Medical Center
Clinic Affiliation: Marchand and Assoc
Family Me, South Austin Family
Practiceclinic LLP
Board Certified Specialties: Family
Practice
J - Wheelchair Access
6
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
AUSTIN
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Martin, Manuel J, MD
" Miller, Hillary, MD
Aus tin
AUSTIN Cont
FAMILY PRACTICE Cont
Margolin, Steven P, MD
Gender: Male
# PCP # 8F144001
NPI: 1598768475
5222 Burnet Rd Ste 200
J (512) 459-9889
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Margolin & Keinarth PA
Practice Information: No Patients Under 7
yrs old
Board Certified Specialties: None
Austin
" Marking, George, MD
Austin
Gender: Male
PCP # 88874301
NPI: 1801801972
3828 S First St
J (512) 443-1311
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Markley, Michelle L, MD
Gender: Female
PCP # 83037Y01
NPI: 1801802160
6811 Austin Center Blvd
Ste 300
J (512) 346-8888
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Austin
Martens, Thomas E, DO
Gender: Male
PCP # 8EN01001
NPI: 1144333055
8900 Shoal Creek Blvd
Bldg 200
(512) 323-6000
# PCP # 8AK60901
NPI: 1144333055
8900 Shoal Crk Blvd
Ste 200
J (512) 323-6900
Clinic Affiliation: Union Treatment Centers,
Utc Health and Rehab Austin
Board Certified Specialties: None
Austin
Martin, David L, MD
Gender: Male
PCP # 8AS10001
NPI: 1912114307
12411 Hymeadow Dr
Ste 3A
(512) 258-2500
Hospital Affiliation: St Davids Medical
Center
Clinic Affiliation: David L Martin MD
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
J
Moran, William J, MD
Gender: Male
PCP # 0016HB01
NPI: 1114922325
4201 Marathon Blvd
Ste 204
J (512) 459-3205
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Board Certified Specialties: None
Morrow, John M, MD
Gender: Male
PCP # 89C01801
NPI: 1609882950
10401 Anderson Mill Rd
Ste 110B
J (512) 250-5571
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Under 6
yrs old
Board Certified Specialties: None
Austin
" McCarty, Robyn E, MD
Aus tin
!
J
Gender: Female
PCP # 8G896101
NPI: 1730293929
3200 Red River St
Ste 201
(512) 473-0201
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Texas Sports and Family
Medicine PLLC
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: Family
Practice
" Munoz, Abilio, MD
Austin
" McGaugh Jr, Ronald C, MD
Aus tin
J
Gender: Male
PCP # 8DR90701
NPI: 1023200383
15004 Avery Ranch
Blvd Ste 105
(512) 528-7420
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Nacogdoches Medical Center,
St Davids Georgetown Hospital
Clinic Affiliation: Timberland Medical Group
Practice Information: No Patients Under 6
yrs old
Board Certified Specialties: Family
Practice
Merian, Frederick L, MD
Gender: Male
PCP # 8W687101
NPI: 1861508293
8302 Minnesota Ln
J (512) 891-0056
Hospital Affiliation: Detar Hospital Navarro,
Detar Hospital North
Clinic Affiliation: The Doctor Is At Your
Door PA
Board Certified Specialties: None
Aus tin
Gender: Male
# PCP # 8K933001
NPI: 1154498228
2115 Northland Dr
J (512) 377-3400
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Munoz Abilio MD
Practice Information: No Patients Under 1
yrs old
Board Certified Specialties: Family
Practice
" Nugent, Mark A, MD
Austin
Gender: Male
PCP # 83040Y01
NPI: 1356357610
3828 S First St
J (512) 443-1311
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Obrien, Katharine M, DO
Austin
Gender: Female
PCP # 83032Y01
NPI: 1083720718
10401 Anderson Mill Rd
Ste 110B
J (512) 250-5571
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Olagundoye, Olasupo A, MD
Gender: Male
PCP # 8CY98601
NPI: 1164455598
2802 Webberville Rd
J (512) 978-9400
Clinic Affiliation: Communitycare
Board Certified Specialties: None
Austin
" Oubre, Philip B, MD
Austin
Gender: Male
PCP # 8EB23601
NPI: 1750693529
4107 S Capital of TX Hwy
Ste 100A
(512) 443-9355
Clinic Affiliation: David L Sneed DO PA
Board Certified Specialties: Family
Practice
Naglieri, Lori M, MD
Gender: Female
PCP # 8A554401
NPI: 1528073699
6937 N IH 35 Ste 200
J (512) 407-8686
PCP # 8CB40301
NPI: 1528073699
7011 Ribelin Ranch Rd
Ste 200
(512) 345-7436
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA,
River Hills Family Medicine
Board Certified Specialties: None
" Navarro, Carlos F, MD
Austin
" Merryman, James R, DO
J
Gender: Male
PCP # 8J403601
NPI: 1528074861
3828 S First St
(512) 443-1311
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
!
J
Gender: Male
PCP # 89C03901
NPI: 1710993076
4515 Seton Center Pkwy
Ste 220
(512) 338-8388
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Norris, Robert W, MD
Austin
Austin
Aus tin
!
Gender: Female
PCP # 86C68801
NPI: 1538175898
6811 Austin Center Blvd
Ste 300
(512) 346-8888
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Austin
Martinez, George D, MD
Gender: Male
PCP # 82A26201
NPI: 1619010451
13450 Research Blvd
Ste 100
J (512) 250-5577
Hospital Affiliation: Seton Northwest
Hospital
Clinic Affiliation: The Austin Clinic
Board Certified Specialties: None
" Marroquin, Robbin B, MD
Austin
!
Aus tin
Austin
Gender: Female
PCP # 8DL99601
NPI: 1457532871
6448 E Hwy 290
Ste D103
J (512) 452-2100
Clinic Affiliation: Lake Mi Mobile Doctors
PC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Family
Practice
Austin
Gender: Male
# PCP # 8H197001
NPI: 1710981402
2555 Western Trails Blvd
Ste 101
J (512) 892-6600
Hospital Affiliation: Seton Medical Center,
St Davids Georgetown Hospital, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge, Valley Baptist Medical Center
Clinic Affiliation: South Austin Medical
Clinic PA
Board Certified Specialties: Family
Practice
J
Gender: Male
PCP # 8EM23701
NPI: 1801802152
706 W Ben White Blvd
Bldg A Ste 100
(512) 442-1996
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Wellmed Medical Group
PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Family
Practice
" Newbould, Samantha, MD
Austin
Gender: Female
PCP # 8DB47601
NPI: 1790763282
3828 S First St
(512) 443-1311
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Pampe, Eugene D, MD
Austin
Gender: Male
!# PCP # 82910B01
NPI: 1710964382
6012 W William Cannon Dr
Ste D101
J (512) 892-6441
Hospital Affiliation: St Davids S Austin
Medical Center
Clinic Affiliation: Pampe Eugene D MD
Board Certified Specialties: Family
Practice
" Paul, Love D, MD
Austin
Gender: Male
PCP # 8CC71101
NPI: 1730147018
12201 Renfert Way Dr
Ste 315
(512) 837-6000
Hospital Affiliation: Detar Hospital Navarro,
Detar Hospital North, North Austin Medical
Center
Clinic Affiliation: Austin Medical Group
PLLC
Practice Information: No Patients Under 11
yrs old
Board Certified Specialties: Family
Practice
J - Wheelchair Access
7
AUSTIN
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
AUSTIN Cont
FAMILY PRACTICE Cont
" Pekar, Nathan H, MD
Aus tin
Gender: Male
# PCP # 8CH35902
NPI: 1760479059
3003 Bee Caves Rd
Ste 201
J (512) 652-0122
# PCP # 8CH35901
NPI: 1760479059
4303 Victory Dr
J (512) 462-3627
Clinic Affiliation: Victory Medical & Family
Care
Board Certified Specialties: Family
Practice
" Pena, Roberto M, MD
Aus tin
Gender: Male
PCP # 8CG79801
NPI: 1366451759
2911 Medical Arts St
Ste 14
(512) 477-4693
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Family Practice
Practice Information: No Patients Under 1
yrs old
Board Certified Specialties: Family
Practice
Perez, Kenneth A, DO
Gender: Male
PCP # 8J403401
NPI: 1649286907
3828 S First St
J (512) 443-1311
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Aus tin
" Pittman, Bradley, MD
Aus tin
J
Gender: Male
PCP # 8DM56101
NPI: 1740357524
1221 W Ben White Blvd
Ste B200
(877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Practice Information: No Patients Under 1
yrs old
Board Certified Specialties: Family
Practice
" Pollard, Jennifer B, MD
Aus tin
Gender: Female
PCP # 0067YK01
NPI: 1417915802
4701 Westgate Blvd
Ste A
(512) 693-4373
Board Certified Specialties: Family
Practice
" Poole, Lena A, MD
Aus tin
!
Gender: Female
PCP # 8EG10101
NPI: 1992986962
3708 Jefferson St
Ste A
(512) 459-6503
Clinic Affiliation: Wellmed Medical Group
PA
Board Certified Specialties: Family
Practice
Poonawala, Robina N, MD
Gender: Female
PCP # 8AJ97601
NPI: 1124025390
4007 James Casey St
Ste D240
J (512) 440-8989
Hospital Affiliation: St Davids Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: R N Poonawala PA
Board Certified Specialties: None
Aus tin
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
" Porter, Barbara, MD
" Rahman, Sangita P, MD
Austin
Austin
Gender: Female
PCP # 82412S01
NPI: 1699780767
11714 Wilson Parke Ave
Ste 150
J (512) 282-8967
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Gender: Female
PCP # 8AQ20001
NPI: 1457343428
7900 FM 1826
Ste 202
J (512) 416-0044
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: South Oaks Medical
Board Certified Specialties: Family
Practice
Pothuluri, Nomita J, MD
Gender: Female
# PCP # 8DT72801
NPI: 1013070754
4303 Victory Dr
J (512) 462-3627
Hospital Affiliation: Kingwood Medical
Center
Clinic Affiliation: Victory Medical & Family
Care
Board Certified Specialties: None
Austin
" Salazar, Dora L, MD
Austin
J
" Raley, Robert C, MD
Austin
Gender: Male
PCP # 00910D01
NPI: 1154460590
2301 W N Loop
J (512) 452-2506
PCP # 8CZ09101
NPI: 1154460590
2301 W N Loop Blvd
(512) 452-2506
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Rc Raley Professional
Assoc
Practice Information: No Obstetrics, No
Patients Under 13 yrs old
Board Certified Specialties: Family
Practice
" Powell, Steven Z, MD
Austin
Gender: Male
PCP # 8V911801
NPI: 1548247356
6835 Austin Center Blvd
(512) 346-6611
Hospital Affiliation: Christus Santa Rosa
Hosp City Ctr, Seton Medical Center, Seton
Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Sanchez Ellig, Marina, MD
Austin
Gender: Female
PCP # 8AM79101
NPI: 1932220704
3828 S First St
(512) 443-1311
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Sanchez Fuentes, Elizabeth P, MD
Austin
Gender: Female
# PCP # 8DJ83101
NPI: 1063492395
3706 S First St
J (512) 324-4940
" Reddy, Padma P, MD
Austin
Gender: Female
PCP # 8CY98901
NPI: 1396779823
928 Blackson Ave
J (512) 978-9740
Hospital Affiliation: Mem Hermann
Southwest Hospital
Clinic Affiliation: Communitycare
Board Certified Specialties: Family
Practice
" Prajapati, Sarita H, MD
Austin
Gender: Female
# PCP # 8CH36002
NPI: 1346337490
3003 Bee Caves Rd
Ste 201
(512) 652-0122
" Rhodes, Kerry D, MD
# PCP # 8CH36001
NPI: 1346337490
4303 Victory Dr
(512) 462-3627
Clinic Affiliation: Victory Medical & Family
Care
Board Certified Specialties: Family
Practice
Austin
Gender: Male
PCP # 0088AR01
NPI: 1083697593
631 W 38th St Ste 2
J (512) 459-3177
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Board Certified Specialties: Family
Practice
!
" Pyron, Martha I, MD
Austin
Gender: Female
# PCP # 8BX01001
NPI: 1184667123
13805 Research Blvd
Ste 150
(512) 257-2500
Clinic Affiliation: Medicine In Motion Martha
Pyron M
Board Certified Specialties: Family
Practice
J
Santiago, Jose F, MD
Gender: Male
# PCP # 00773G01
NPI: 1023121613
2624 W Wm Cannon
J (512) 443-7746
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Board Certified Specialties: None
" Schroeder, Lorraine K, MD
Austin
" Rie, Michael, MD
" Queng, John A, MD
Austin
Gender: Male
PCP # 8B074801
NPI: 1558377812
6835 Austin Ctr Blvd
J (512) 346-6611
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Austin
" Quintana, Max E, MD
Austin
Gender: Male
# PCP # 8BR92801
NPI: 1538392345
1221 W Ben White Blvd
Ste B200
J (877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: Family
Practice
Roth, Stephanie D, MD
Gender: Female
PCP # 8EH48101
NPI: 1528022472
1210 W Braker Ln
(512) 978-9300
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center
Clinic Affiliation: Communitycare
Board Certified Specialties: None
" Russell, Michael A, DO
Austin
Gender: Male
PCP # 8DU89601
NPI: 1023336039
7900 FM 1826 Bldg 2
Ste 202
(512) 416-0044
Clinic Affiliation: South Oaks Medical
Board Certified Specialties: Family
Practice
PCP # 8DJ83102
NPI: 1063492395
8913 Collinfield Dr
(512) 324-6850
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Seton Community Health
Centers
Board Certified Specialties: Family
Practice
Austin
Austin
Gender: Male
# PCP # 8DK26201
NPI: 1902009301
2555 Western Trails Blvd
Ste 101
(512) 892-6600
Clinic Affiliation: South Austin Medical
Clinic PA
Board Certified Specialties: Family
Practice
Gender: Female
PCP # 00L30M01
NPI: 1013064880
3303 Northland Dr
Ste 220
(512) 476-0275
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Practice Information: No Patients Under 8
yrs old
Board Certified Specialties: Family
Practice
J
Gender: Female
PCP # 0097DK01
NPI: 1760568588
2013 Wells Branch Pkwy
Ste 113
(512) 251-2828
Hospital Affiliation: Round Rock Medical
Center, St Davids Medical Center
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: Family
Practice
Schultz, Rita M, DO
Gender: Female
# PCP # 8V437101
NPI: 1124116926
5625 Eiger Rd
Ste 200
(512) 892-7076
Hospital Affiliation: St Davids Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: South Austin Family
Practiceclinic LLP
Board Certified Specialties: None
Austin
" Sethi, Shelly, DO
Austin
Gender: Female
PCP # 8W587001
NPI: 1982710612
6835 Austin Center Blvd
(512) 346-8888
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
J - Wheelchair Access
8
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
AUSTIN
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Spencer, Kevin P, MD
Gender: Male
PCP # 8V437001
NPI: 1417996570
5625 Eiger Rd
Ste 200
J (512) 892-7076
Hospital Affiliation: Seton Southwest, St
Davids Medical Center, St Davids S Austin
Medical Center
Clinic Affiliation: South Austin Family
Practiceclinic LLP
Board Certified Specialties: None
" Treadwell, Leah J, MD
Aus tin
AUSTIN Cont
FAMILY PRACTICE Cont
" Sheff, Gregory S, MD
Austin
Gender: Male
PCP # 8S554501
NPI: 1205842564
1807 Slaughter Ln
Ste 490
(512) 282-8967
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, Seton Southwest,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
J
Aus tin
" Smith, Melissa C, MD
Austin
Gender: Female
# PCP # 8DJ82901
NPI: 1225049166
2811 E Second St
(512) 324-4930
" Sneed, David L, DO
PCP # 0079JU01
NPI: 1134113137
4107 S Capital of Texas
Hwy Ste 100A
J (512) 443-9355
Hospital Affiliation: St Davids S Austin
Medical Center
Clinic Affiliation: David L Sneed DO PA
Board Certified Specialties: Family
Practice
" Underhill, Carla S, MD
Steffy, Daniel A, MD
Gender: Male
PCP # 8DY16302
NPI: 1740419712
10526 W Parmer Ln
(512) 310-4700
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
J
Gender: Female
PCP # 00JX8401
NPI: 1295750149
3200 Red River Ste 210
(512) 472-3161
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Practice Information: No Patients Under 5
yrs old
Board Certified Specialties: Family
Practice
" Vachris, Timothy P, MD
J
Gender: Male
PCP # 8CG17601
NPI: 1285872143
3200 Red River St
Ste 201
(512) 473-0201
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Texas Sports and Family
Medicine PLLC
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: Family
Practice
" Vander Straten, David, MD
Austin
Gender: Male
PCP # 8CY99701
NPI: 1528013281
2529 S First St
(512) 978-9500
Clinic Affiliation: Communitycare
Board Certified Specialties: Family
Practice
" Tham, Marlene M, DO
" Velasquez, Nelly D, MD
Austin
Gender: Female
PCP # 8DV61701
NPI: 1851462139
1611 W Fifth St
Ste 180
(512) 391-9400
Hospital Affiliation: John Peter Smith
Hospital, Plaza Medical Center Fort Worth
Clinic Affiliation: Downtown Doctor
Board Certified Specialties: Family
Practice
J
Gender: Female
PCP # 8M250001
NPI: 1619955218
900 E 30th St Ste 200
(512) 236-1100
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Velasquez Nelly MD
Board Certified Specialties: Family
Practice
" Velez Rodriguez, Frances M, MD
Austin
" Tran, Ngoc Phuong T, DO
Aus tin
J
" Walz, Danielle, MD
Austin
Gender: Female
PCP # 8DD67801
NPI: 1386844587
7610 W Hwy 71
Ste F
(512) 288-0859
Clinic Affiliation: National House Call
Practitioners
Board Certified Specialties: Family
Practice
" Warfield, Kimberly L, MD
Austin
Gender: Female
PCP # 8W229901
NPI: 1174571582
6301 W Parmer Ln Ste 102
J (512) 834-9999
Hospital Affiliation: North Austin Medical
Center, St Davids Medical Center
Clinic Affiliation: Dominion Medical Assoc
PA
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: Family
Practice, Internal Medicine
" Weary, Andrew H, MD
Austin
Gender: Male
PCP # 8EN69901
NPI: 1609861517
1000 E 41st St
Ste 925
(512) 978-9940
Hospital Affiliation: Seton Medical Center,
St Davids S Austin Medical Center
Clinic Affiliation: Communitycare
Board Certified Specialties: Family
Practice
Austin
Gender: Female
PCP # 8511M201
NPI: 1083676126
7900 FM 1826
Ste 202
(512) 416-0044
Hospital Affiliation: Seton Southwest,
University Med Ctr Brackenridge
Clinic Affiliation: South Oaks Medical
Board Certified Specialties: Family
Practice
Aus tin
Gender: Male
PCP # 8EM27101
NPI: 1457442113
2222 Rosewood Ave
J (512) 465-4840
Gender: Female
PCP # 82513K01
NPI: 1326054602
10401 Anderson Mill Rd
Ste 110B
(512) 250-5571
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Austin
Swamy, Sunita, MD
Gender: Female
PCP # 8K795001
NPI: 1164423521
900 E 30th St
Ste 200
J (512) 236-1100
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Swamy Sunita MD
Practice Information: No Patients Under 5
yrs old
Board Certified Specialties: None
" Sooriarachchi, Sanjaya P, MD
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
J
Aus tin
Austin
PCP # 8CY99201
NPI: 1457442113
825 E Rundberg Ln
Ste B 1
J (512) 978-9600
Clinic Affiliation: Communitycare, Wellmed
Medical Group PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Family
Practice
Gender: Female
PCP # 80069K01
NPI: 1295754406
1313 Red River St
Ste 100
(512) 324-8600
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Family
Practice
" Stiegler, Ashley, MD
Austin
Gender: Male
PCP # 8EC50201
NPI: 1134113137
4107 S Capital of TX Hwy
Ste 100A
(512) 443-9355
" Truong, Kimphuong, MD
Aus tin
J
Gender: Female
PCP # 8V911301
NPI: 1437267291
1807 W Slaughter Ln
Ste 490
(512) 282-8967
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Austin
" Sprute, Dana, MD
" Smith, Donovan D, MD
PCP # 8DJ82902
NPI: 1225049166
3706 S First St
(512) 324-4930
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Seton Community Health
Centers
Board Certified Specialties: Family
Practice
!
Aus tin
Austin
Gender: Female
# PCP # 8H197401
NPI: 1699752774
2555 Western Trails Blvd
Ste 101
J (512) 892-6600
Hospital Affiliation: Seton Southwest
Clinic Affiliation: South Austin Medical
Clinic PA
Board Certified Specialties: Family
Practice
Austin
Gender: Female
# PCP # 8EN70101
NPI: 1316189756
2802 Webberville Rd
(512) 978-9400
Clinic Affiliation: Communitycare
Board Certified Specialties: Family
Practice
Gender: Female
PCP # 00H46M01
NPI: 1215944087
1611 Ohlen Rd
(512) 873-7173
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Practice Information: No Patients Under 4
yrs old
Board Certified Specialties: Family
Practice
" Weidmann, Eric W, MD
Austin
Gender: Male
# PCP # 88C34501
NPI: 1922002617
2555 Western Trails
Blvd Ste 101
J (512) 892-6600
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, St Davids S
Austin Medical Center
Clinic Affiliation: South Austin Medical
Clinic PA
Board Certified Specialties: Family
Practice
" White, Richard H, MD
Austin
Gender: Male
PCP # 00T59X01
NPI: 1588659452
631 W 38th St
J (512) 459-1203
Hospital Affiliation: Arise Austin Medical
Center, Seton Medical Center, St Davids
Medical Center, University Med Ctr
Brackenridge
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: Family
Practice
" Wiggins, Terry S, MD
Austin
Gender: Male
PCP # 8BF03701
NPI: 1164432621
2765 Bee Caves Rd Ste 201
(512) 328-2752
Hospital Affiliation: Seton Medical Center,
St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Terry Wiggins MD
Practice Information: No Patients Under 5
yrs old
Board Certified Specialties: Family
Practice
J - Wheelchair Access
9
AUSTIN
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Zamora, Guadalupe, MD
Gender: Male
PCP # 8AJ25601
NPI: 1588795348
2100 E Sixth St
Ste A
J (512) 482-0248
Hospital Affiliation: St Davids Medical
Center
Clinic Affiliation: Guadalupe Zamora MD
Board Certified Specialties: None
Austin
AUSTIN Cont
FAMILY PRACTICE Cont
Willhelm, Gevin W, DO
Gender: Male
! PCP # 8AJ07901
NPI: 1700069689
11645 Angus Rd
Ste 9
(512) 346-7661
Hospital Affiliation: Seton Northwest
Hospital, St Davids Medical Center
Clinic Affiliation: Gevin W Willhelm DO
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: None
Aus tin
Aus tin
Woerner, David R, MD
Gender: Male
PCP # 8W587901
NPI: 1932119773
6835 Austin Center Blvd
(512) 346-8888
Hospital Affiliation: Seton Medical Center,
Seton Southwest, St Davids Medical Center,
St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Zamora, Santiago A, MD
Gender: Male
# PCP # 88750S01
NPI: 1194733568
7408 Cameron Rd
Ste A
J (512) 459-7275
Hospital Affiliation: St Davids Medical
Center
Clinic Affiliation: Santiago A Zamora MD
Board Certified Specialties: None
Austin
J
Yeh, Grace S, MD
Gender: Female
! PCP # 0049EJ01
NPI: 1033193271
3624 N Hills Dr
Ste B102
J (512) 343-8011
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, Seton Southwest,
St Davids Medical Center, University Med Ctr
Brackenridge
Practice Information: No Patients Under 4
yrs old
Board Certified Specialties: None
" Zamora, Belda M, MD
J
Gender: Female
PCP # 87920N01
NPI: 1770594764
2100 E Sixth St Ste B
(512) 474-7824
Hospital Affiliation: St Davids Medical
Center
Clinic Affiliation: Capitol City Family
Practice
Practice Information: No infants under 6
months old
Board Certified Specialties: Family
Practice
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
" Bermudez, Jairo L, MD
Gender: Male
PCP # 8DT95301
NPI: 1578550919
3828 S First St
(512) 443-1311
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties: Internal
Medicine
" Bezerra, Herminio Q, MD
Austin
Gender: Male
PCP # 8CY94101
PCP # 8EQ03001
NPI: 1275569659
2529 S First St
(512) 978-9500
Clinic Affiliation: Communitycare
Board Certified Specialties: Internal
Medicine
" Aventa, Tony R, MD
Austin
Gender: Male
PCP # 8CZ79401
PCP # 88333601
NPI: 1689680944
3708 Jefferson St
Ste A
(512) 346-6611
(512) 459-6503
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA,
Wellmed Medical Group PA
Board Certified Specialties: Family
Practice
Gender: Male
PCP # 8F989001
NPI: 1801875034
1301 W 38th St
Ste 601
J (512) 454-5171
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Capital Medical Clinic
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
" Blancarte, Gilbert, MD
Austin
J
" Bartos, Sara J, MD
Austin
Gender: Female
PCP # 89980X01
NPI: 1326254673
2911 Medical Arts St
Ste 7
J (512) 476-9934
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Bartos Sara MD
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: Internal
Medicine
" Zook, Marc E, MD
Austin
!
Gender: Male
PCP # 8P554401
NPI: 1497761753
11714 Wilson Parke Ave
STE150
(512) 244-9024
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Aus tin
Aus tin
Avashia, Swati B, MD
Gender: Female
PCP # 8CE12401
NPI: 1740291319
1313 Red River St
Ste 100
J (512) 324-8600
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Northwest Hospital, Seton Southwest,
University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: None
GENERAL PRACTICE
" Booton, Steven K, MD
J
" Bell, Kristin C, MD
Minto, Lester J, MD
Gender: Male
# PCP # 8R051401
NPI: 1902986276
8401 N Interstate 35
Ste 200
J (512) 250-1005
Clinic Affiliation: Whole Womans Health of
Austin
Board Certified Specialties: None
!
Gender: Female
PCP # 8DH45601
NPI: 1023113404
11521 FM 620 N
Ste C 800
(512) 219-0670
Hospital Affiliation: Cedar Park Regional
Medical Ctr
Clinic Affiliation: Timberland Medical Group
Board Certified Specialties: Internal
Medicine
Gender: Male
PCP # 8AM93001
NPI: 1265410773
1701 W Ben White Blvd
Ste 140
(512) 441-8666
Hospital Affiliation: St Davids S Austin
Medical Center
Clinic Affiliation: Austin Internal Medicine
Clinic P
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
Austin
Austin
Austin
Gender: Male
PCP # 8A381101
NPI: 1699824193
4301 Burnet Rd
Ste A
(512) 380-9441
Hospital Affiliation: Cornerstone Hosp Of
Austin, Seton Medical Center, St Davids
Medical Center
Clinic Affiliation: Primary Physicians of
Austinpa
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties: Internal
Medicine
Austin
Austin
" Zavaleta, Thomas P, MD
" Wright, David P, MD
Gender: Male
PCP # 86607J01
NPI: 1487677282
1313 Red River
Ste 100
(512) 324-8600
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Northwest Hospital, St Davids Hospital,
University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Family
Practice
Gender: Male
PCP # 8CY94001
NPI: 1659436004
2802 Webberville Rd
(512) 978-9400
Clinic Affiliation: Communitycare
Board Certified Specialties: Internal
Medicine
Austin
Aus tin
J
" Aung, Myo, MD
Gender: Female
PCP # 8EB82501
NPI: 1164670550
1313 Red River
Ste 100
(512) 324-8600
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Family
Practice
!
!
" Berent, Craig T, MD
Austin
Austin
" Zarndt, Jessica R, DO
" Wong, Albert J, MD
Reilly, William G, MD
Gender: Male
PCP # 8DW30216
NPI: 1447260963
11814 Jollyville Rd
Ste 103
(512) 250-9202
Hospital Affiliation: Basin Healthcare
Center, Odessa Regional Medical Center
Clinic Affiliation: Low-T Physicians
Professional Mbr
Board Certified Specialties: None
INTERNAL MEDICINE
Austin
Aus tin
Gender: Male
PCP # 8R680801
NPI: 1770599037
10401 Anderson Mill 110B
(512) 250-5571
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Austin
Gender: Male
PCP # 8DH19901
NPI: 1093740987
720 W 34th St
Ste 100
(512) 381-5599
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Steven K Booton MD
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Internal
Medicine
" Brod, Delbert R, MD
Austin
Gender: Male
PCP # 8EJ51201
NPI: 1013936103
4534 Westgate Blvd
Ste 108
(512) 892-7076
Hospital Affiliation: North Austin Medical
Center, St Davids Medical Center, St Davids
S Austin Medical Center
Clinic Affiliation: South Austin Family
Practiceclinic LLP
Board Certified Specialties: Internal
Medicine
J - Wheelchair Access
10
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
AUSTIN
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Coughlin, Sean J, MD
" Dehipitiya, C S, MD
Aus tin
AUSTIN Cont
INTERNAL MEDICINE Cont
" Burugu, Sukanya, MD
Austin
Gender: Female
PCP # 0022YK01
NPI: 1992710040
11615 Angus Rd Ste 108
(512) 372-4400
PCP # 8CQ17803
NPI: 1992710040
2806 Real St
J (512) 474-1411
" Cheruku, Sunil R, MD
Austin
Gender: Male
PCP # 8EF55901
NPI: 1235173345
5508 Parkcrest Dr
Ste 310
(512) 420-9900
Hospital Affiliation: Healthsouth
Rehabilitation Hospital Of Austin, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Sleep Medicine
Consultants of Cen
Board Certified Specialties: Internal
Medicine
" Daghestani, Anas, MD
Gender: Male
PCP # 8S554001
NPI: 1366458630
6835 Austin Center Blvd
(512) 346-6611
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Internal
Medicine
# PCP # 8DJ83001
NPI: 1902915119
3706 S First St
(512) 324-4940
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Seton Community Health
Centers
Board Certified Specialties: Internal
Medicine
" Coats, Teresa L, MD
Gender: Female
PCP # 8CE55401
NPI: 1992889844
313 E 12th St
Ste 102
(512) 324-9650
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: University Physicians
Group
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Internal
Medicine
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
J
Gender: Female
PCP # 87J46301
NPI: 1275549545
4515 Seton Center Pkwy
Ste 220
(512) 338-8388
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
" Doner, Kevin T, MD
Austin
Gender: Male
PCP # 8DZ93401
NPI: 1336115880
12717 Shops Pkwy
Ste 500
(512) 222-8667
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, St Davids
Medical Center
Clinic Affiliation: Total Mens Physicians
Group LLC
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Internal
Medicine
" Daniels, Sarah R, MD
Gender: Female
PCP # 8CP11801
NPI: 1861652711
1301 W 38th St
Ste 601
(512) 454-5171
Hospital Affiliation: Heart Hospital Of
Austin, Seton Medical Center, Seton
Northwest Hospital, University Med Ctr
Brackenridge
Clinic Affiliation: Capital Medical Clinic
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
" Date, Swati D, MD
Aus tin
Austin
!
!
Aus tin
J
" Edoka, Emmanuel C, MD
Austin
Gender: Male
PCP # 8AW51701
NPI: 1598857682
805 E 32nd St
Ste 103
J (512) 322-0800
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Emmanuel Edoka MD
Practice Information: No Patients Under 14
yrs old
Board Certified Specialties: Internal
Medicine
Austin
" Dollar, Debra L, MD
Dang, Hoa T, MD
Gender: Male
# PCP # 00U26N01
NPI: 1841354586
8745 N Lamar Blvd
J (512) 832-4739
Hospital Affiliation: Seton Northwest
Hospital, St Davids Medical Center
Practice Information: No infants under 6
months old
Board Certified Specialties: None
" Clark, Margaret K, MD
Gender: Male
PCP # 8F989101
NPI: 1659377125
1301 W 38th St
Ste 601
(512) 454-5171
Hospital Affiliation: Seton Medical Center,
St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Capital Medical Clinic
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
Austin
Aus tin
Austin
Gender: Female
PCP # 8DJ83002
NPI: 1902915119
2811 E Second St
(512) 324-4930
J
Aus tin
PCP # 8CQ17801
NPI: 1992710040
5301 Duval Rd
Ste A500
J (512) 222-0000
PCP # 8CQ17802
NPI: 1992710040
9801 S First St
J (512) 292-3071
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Adult Primary Care
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties: Internal
Medicine
Austin
Gender: Male
PCP # 8EL84901
NPI: 1912911009
11714 Wilson Parke
Ste 150
(512) 272-4636
Hospital Affiliation: Baptist Health System,
Christus Santa Rosa Hosp City Ctr, Seton
Medical Center, St Davids Medical Center
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Internal
Medicine
Gender: Female
PCP # 87J45601
NPI: 1982619045
4515 Seton Center
Pkwy 220
(512) 338-8388
Hospital Affiliation: Healthsouth
Rehabilitation Hospital Of Austin, Seton
Medical Center, Seton Northwest Hospital,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
" Davis, Gregory T, MD
Aus tin
Gender: Male
PCP # 8EF06201
NPI: 1255362448
4101 Marathon Blvd
(512) 323-9222
Hospital Affiliation: University Medical
Center
Clinic Affiliation: Rational Intergrative
Medicine Pl
Board Certified Specialties: Internal
Medicine
" Fagerberg, Marcia D, MD
Austin
Gender: Female
PCP # 82418S01
NPI: 1235144395
6835 Austin Center Blvd
J (512) 346-6611
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Internal
Medicine
" Folarin, Hope, MD
Austin
Gender: Female
# PCP # 8CQ13901
NPI: 1720286347
1221 W Ben White Blvd
Ste 200B
(877) 800-5722
PCP # 8EL39901
NPI: 1720286347
3828 S First St
(512) 443-1311
Clinic Affiliation: Austin Regional Clinic PA,
Lone Star Circle of Care
Board Certified Specialties: Internal
Medicine
" Dooley, Linda W, MD
Austin
Gender: Female
# PCP # 8CY95001
NPI: 1164460036
4614 N IH 35
J (512) 978-9100
Clinic Affiliation: Communitycare
Board Certified Specialties: Internal
Medicine
Austin
Dubois, Susan K, MD
Gender: Female
PCP # 8DC02701
NPI: 1114091675
2901 N IH 35
Ste 101
(512) 232-3900
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: Communitycare
Board Certified Specialties: None
" Eapen, Prakash S, MD
Austin
Gender: Male
PCP # 8CY70701
NPI: 1255595435
1221 W Ben White Blvd
Ste 200B
(877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: Internal
Medicine
Ericson, Stephanie A, MD
Gender: Female
PCP # 8EM77301
NPI: 1699067173
6835 Austin Center Blvd
(512) 272-4636
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
" Fought, Jason R, MD
Austin
Gender: Male
PCP # 8EJ51301
NPI: 1851312029
4534 Westgate Blvd
Ste 108
(512) 892-7076
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: South Austin Family
Practiceclinic LLP
Board Certified Specialties: Internal
Medicine
Galloway, Robert E, MD
Gender: Male
PCP # 8DT63001
NPI: 1760464770
7610 W Hwy 71
Ste F
J (512) 288-0859
Clinic Affiliation: National House Call
Practitioners
Board Certified Specialties: None
Austin
Ganta, Neelima, MD
Gender: Female
PCP # 8CY95301
NPI: 1619186681
1200 Montopolis Dr
J (512) 978-9800
Clinic Affiliation: Communitycare
Board Certified Specialties: None
Austin
J - Wheelchair Access
11
AUSTIN
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Haydon, Hans, MD
" Kolte, Bharati P, MD
Austin
AUSTIN Cont
INTERNAL MEDICINE Cont
" Gaur, Sunita, MD
Aus tin
J
PCP # 82669S01
NPI: 1598770653
3828 S First St
(512) 443-1311
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Internal
Medicine
" Gray, Carlos E, MD
Aus tin
Gender: Male
PCP # 00SZ8301
NPI: 1881671352
2900 S IH-35 Ste 108
(512) 445-5085
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
" Griffin, Robert, MD
Aus tin
!
J
Gender: Male
PCP # 87J38701
NPI: 1447266788
6835 Austin Center Blvd
(512) 346-6611
Hospital Affiliation: Healthsouth
Rehabilitation Hospital Of Austin, Seton
Medical Center, Seton Northwest Hospital,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Internal
Medicine
" Grossmann, Alicia W, MD
Aus tin
" Groves, Robert L, MD
J
Gender: Male
PCP # 80352801
NPI: 1124007356
1301 W 38th St
Ste 601
(512) 454-5171
Hospital Affiliation: Heart Hospital Of
Austin, Seton Medical Center
Clinic Affiliation: Capital Medical Clinic
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties: Internal
Medicine
" Gupta, Abhilasha, MD
Aus tin
!
Gender: Female
PCP # 8W543801
NPI: 1225032931
12505 Hymeadow Dr
(512) 219-0129
Hospital Affiliation: Round Rock Medical
Center, St Davids Georgetown Hospital
Clinic Affiliation: Wellmed Medical Group
PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Female
PCP # 8EF37101
NPI: 1285649343
2911 Medical Arts St
Ste 7
(512) 476-9934
Hospital Affiliation: Central Texas Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids S Austin
Medical Center
Clinic Affiliation: Flora Medical Clinic PLLC
Board Certified Specialties: Internal
Medicine
" Hull, James, MD
" Krishnarajah, Amirthananthar, MD
Austin
Austin
Gender: Male
PCP # 89C01701
NPI: 1326054693
6835 Austin Ctr Blvd
J (512) 346-6611
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
Gender: Male
PCP # 8EH40401
NPI: 1518994052
1631 E Second St
(512) 804-3913
Clinic Affiliation: Communitycare
Board Certified Specialties: Internal
Medicine
" Kroll, Kenneth C, MD
Austin
Gender: Male
PCP # 80352101
NPI: 1831179589
1301 W 38th St
Ste 601
J (512) 454-5171
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Capital Medical Clinic
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
" James, Jeffree A, MD
Austin
Gender: Male
# PCP # 00PT9501
NPI: 1023119716
3232 E Martin Luther King
J (512) 477-7076
Hospital Affiliation: Northwest Hills Surgical
Hospital, Seton Medical Center, St Davids
Medical Center, University Med Ctr
Brackenridge
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Internal
Medicine
" Lepgold, Edith L, MD
Austin
J
" MacKay, Daniel A, MD
Gender: Male
# PCP # 88106Q01
NPI: 1962450916
12007 Technology Blvd
Ste 210
(512) 610-1660
Hospital Affiliation: Round Rock Medical
Center
Clinic Affiliation: Care Physicians PA
Board Certified Specialties: Internal
Medicine
" Maldonado Jr, Humberto, MD
Austin
J
" Kumar, Ullattil N, MD
Gender: Male
PCP # 8CF29801
NPI: 1275694291
2200 Park Bend Dr
Bldg 2 Ste 300
(512) 836-5665
Hospital Affiliation: North Austin Medical
Center
Clinic Affiliation: Austin Primary Care
Physicians
Board Certified Specialties: Internal
Medicine
" Katkuri, Rajani R, MD
Gender: Female
PCP # 8CY97802
NPI: 1871607911
1210 W Braker Ln
(512) 978-9300
Hospital Affiliation: Seton Northwest
Hospital
Clinic Affiliation: Communitycare
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
" Mankey, Celina G, MD
Gender: Female
PCP # 8CM71201
NPI: 1427048149
313 E 12th St
(512) 324-9650
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Internal
Medicine
" Laviolette, Amanda, MD
" Klocek, Jonathan R, MD
Austin
Gender: Male
PCP # 85876G01
NPI: 1265412910
1301 W 38th St
Ste 601
J (512) 454-5171
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Capital Medical Clinic
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties: Internal
Medicine
" Leija, Graciela M, MD
Austin
Gender: Female
PCP # 8EK95301
NPI: 1679674170
5802 Berkman Dr
Unit A
(512) 363-5725
Hospital Affiliation: Valley Baptist Medical
Center Brownsville, Valley Regional Medical
Center
Clinic Affiliation: Eastside Clinic and
Wellness Cent
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
" Kohli, Nandini D, MD
Austin
Gender: Female
PCP # 0065JE01
PCP # 8W519101
NPI: 1942308804
2200 Park Bend Dr
Bldg 2 Ste 300
J (512) 836-5665
Hospital Affiliation: North Austin Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: Austin Primary Care
Physicians
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: Internal
Medicine
Gender: Male
PCP # 85875G01
NPI: 1598745259
1301 W 38th St
Ste 601
(512) 454-5171
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Capital Medical Clinic
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties: Internal
Medicine
Austin
Austin
Gender: Female
PCP # 8CF34201
NPI: 1538363106
313 E 12th
Ste 102
J (512) 324-9650
Hospital Affiliation: Seton Highland Lakes,
University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Internal
Medicine
Gender: Female
PCP # 8F989201
NPI: 1972619658
1301 W 38th St
Ste 601
(512) 454-5171
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Capital Medical Clinic
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
Austin
Austin
Austin
Gender: Female
PCP # 8CK75601
NPI: 1225296320
6301 W Parmer Ln
Ste 102
(512) 568-3565
Hospital Affiliation: North Austin Medical
Center
Clinic Affiliation: Alicia W Grossmann MD
Board Certified Specialties: Internal
Medicine
Aus tin
Austin
Gender: Male
! PCP # 88876001
NPI: 1205841368
6835 Austin Center Blvd
J (512) 346-6611
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
" Marcus, Howard, MD
Austin
J
Gender: Male
PCP # 88875301
NPI: 1255347514
6835 Ausitn Ctr Blvd
(512) 346-6611
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
" Markowitz, Sheldon L, MD
Austin
Gender: Male
PCP # 8BW27001
NPI: 1407835648
1305 W 34th St
Ste 204
(512) 243-6868
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Sheldon L Markowitz MD
Practice Information: Call for new patient
availability, No Patients Under 18 yrs old
Board Certified Specialties: Internal
Medicine
J - Wheelchair Access
12
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
AUSTIN
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Rhodes, Roxana A, MD
Gender: Female
! PCP # 82Z14101
NPI: 1629131941
631 W 38th St
J (512) 453-3542
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Partners In Health MD
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
" Morrison, Robert G, MD
Aus tin
AUSTIN Cont
INTERNAL MEDICINE Cont
" Marroquin, James C, MD
Austin
Gender: Male
PCP # 8BX14401
NPI: 1902014392
1301 W 38th St
Ste 601
J (512) 454-5171
Hospital Affiliation: Heart Hospital Of
Austin, Seton Medical Center
Clinic Affiliation: Capital Medical Clinic
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties: Internal
Medicine
J
" Nagavarapu, Shantisony P, MD
Aus tin
J
" Martin, Dieter R, MD
Austin
Gender: Male
PCP # 8EJ51401
NPI: 1548298391
4534 Westgate Blvd
Ste 108
(512) 892-7076
Hospital Affiliation: North Austin Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: South Austin Family
Practiceclinic LLP
Board Certified Specialties: Internal
Medicine
Mewhinney, Hugh S, MD
Gender: Male
# PCP # 8CY98201
NPI: 1205880705
2529 S First St
(512) 978-9500
Clinic Affiliation: Communitycare
Board Certified Specialties: None
J
PCP # 86603J01
NPI: 1285708305
313 E 12th St
Ste 102
J (512) 324-9650
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: None
J
Aus tin
J
Aus tin
" Monge, Maria C, MD
Austin
Gender: Female
PCP # 8EC51001
NPI: 1851567556
2909 N IH 35
(512) 478-4939
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Peoples Community Clinic
Inc
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Internal
Medicine
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
PCP # 8CY98401
NPI: 1215131891
7112 Ed Bluestein
Blvd Ste 155
(512) 978-9300
Clinic Affiliation: Communitycare
Board Certified Specialties: Internal
Medicine
" Schneider, Adam J, MD
Austin
Gender: Male
PCP # 8CZ79801
NPI: 1720088206
3708 Jefferson St
Ste A
(512) 459-6503
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Wellmed Medical Group
PA
Board Certified Specialties: Internal
Medicine
!
J
Pearlson, Yale S, MD
Gender: Male
PCP # 8EB97901
NPI: 1962553149
7610 W Hwy 71
Ste F
(512) 288-0859
Clinic Affiliation: National House Call
Practitioners
Board Certified Specialties: None
Aus tin
Gender: Male
PCP # 85874G01
NPI: 1215917679
1301 W 38th St
Ste 601
(512) 454-5171
Hospital Affiliation: Heart Hospital Of
Austin, Seton Medical Center
Clinic Affiliation: Capital Medical Clinic
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties: Internal
Medicine
" Sepehri, Sogol, MD
Austin
" Prete, Michael, MD
" Mondy, Kristin E, MD
Gender: Female
PCP # 8CE60801
NPI: 1265459762
313 E 12th St
Ste 101
(512) 324-9650
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Internal
Medicine
Gender: Female
# PCP # 8DJ77701
NPI: 1700897634
8913 Collinfield Dr
(512) 324-6850
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, Seton Southwest
Clinic Affiliation: Seton Community Health
Centers
Board Certified Specialties: Internal
Medicine
Aus tin
Austin
!
" Risinger, Christy T, MD
Austin
" Nutson, Peter A, MD
Austin
!
Gender: Female
PCP # 8CY98402
NPI: 1215131891
1210 W Braker Ln
(512) 978-9300
Aus tin
Austin
Miller, Beth W, MD
Gender: Female
! PCP # 86603J02
NPI: 1285708305
1301 W 38th St
Ste 113
J (512) 324-3395
Austin
Gender: Male
PCP # 8CY98301
NPI: 1407911969
4614 N IH 35
(512) 978-9100
Clinic Affiliation: Communitycare
Board Certified Specialties: Internal
Medicine
Gender: Male
PCP # 87J37901
NPI: 1417962580
6835 Austin Center Blvd
(512) 346-6611
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
Punjabi, Narendra S, MD
Gender: Male
PCP # 8CM79201
NPI: 1295740751
11615 Angus Rd
Ste 106
(512) 346-8652
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center
Clinic Affiliation: Narendra Punjabi MD
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Rao, Jalaja K, MD
Gender: Female
PCP # 8DN89601
NPI: 1679627467
12201 Renfert Way
Ste 315
(512) 837-6000
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Austin Medical Group
PLLC
Board Certified Specialties: None
Gender: Female
# PCP # 8DA44601
NPI: 1942468103
11601 Faubian Ln
J (512) 666-5169
Hospital Affiliation: North Austin Medical
Center, Reliant Rehab Hosp Central Tx Lp
Clinic Affiliation: Expert Care PLLC
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties: Internal
Medicine
" Shih, Angela H, MD
Austin
Gender: Female
PCP # 8AJ33101
NPI: 1912011271
11673 Jollyville Rd
Ste B101
J (512) 339-1535
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center
Clinic Affiliation: Angela Shih MD
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
" Shulman, Edie E, MD
Austin
Gender: Female
PCP # 8BE63001
NPI: 1659304673
11673 Jollyville Rd
Ste B101
J (512) 339-1535
Hospital Affiliation: North Austin Medical
Center, Seton Northwest Hospital
Clinic Affiliation: Edie E Shulman MD PLLC
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Internal
Medicine
Shung, Sheila X, MD
Gender: Female
! PCP # 8DM51901
NPI: 1407839848
12319 N Mopac Expwy
Ste C-240
(512) 833-0140
Hospital Affiliation: North Austin Medical
Center
Clinic Affiliation: Sheila Shung MD PLLC
Internal Med
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: None
Austin
" Siegel, Amy B, MD
Austin
Gender: Female
PCP # 8EL45501
NPI: 1558394759
6835 Austin Center Blvd
(512) 346-6611
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Internal
Medicine
" Shah, Rita R, MD
Austin
J
Gender: Female
PCP # 89775601
NPI: 1396751657
6835 Austin Center Blvd
(512) 346-6611
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Internal
Medicine
" Shekarchi, Azim G, MD
Austin
J
Gender: Male
PCP # 86780N01
NPI: 1770598849
3828 S First St
(512) 443-1311
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Internal
Medicine
" Smith, Ferril C, MD
Austin
Gender: Male
PCP # 00A52T01
NPI: 1740382084
4207 James Casey St
Ste 304 Med Ctr So Bldg
J (512) 440-8307
Hospital Affiliation: St Davids S Austin
Medical Center
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
Stoufflet, Paul E, MD
Gender: Male
PCP # 8X210001
NPI: 1386754083
711 W 38th St Ste C5
J (512) 651-5558
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Westlake Medicine
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
Austin
J - Wheelchair Access
13
AUSTIN
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
OBSTETRICS-GYNECOLOGY
" Vo, Phu T, MD
Austin
AUSTIN Cont
INTERNAL MEDICINE Cont
" Stroud, Robert L, MD
Aus tin
Gender: Male
# PCP # 00JK8401
NPI: 1851407043
4007 James Casey Ste C120
J (512) 441-4028
Hospital Affiliation: Seton Medical Center,
South Austin Surgery Center, St Davids S
Austin Medical Center
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
" Tannous, Rawah, MD
Aus tin
Gender: Female
PCP # 8S554101
NPI: 1114932282
1807 W Slaughter Ln
Ste 490
(512) 282-8967
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Internal
Medicine
" Thadani, Anita, MD
Aus tin
J
Gender: Female
PCP # 87J42901
NPI: 1932114006
4515 Seton Ctr Pkwy 220
(512) 338-8388
Hospital Affiliation: Northwest Hills Surgical
Hospital, Seton Medical Center, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
Gender: Male
# PCP # 00817D01
NPI: 1730130295
822 Fairfield Dr St 100
J (512) 837-5911
Hospital Affiliation: North Austin Medical
Center, Seton Northwest Hospital, University
Med Ctr Brackenridge
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: Internal
Medicine
" Warfield, Kimberly L, MD
Gender: Female
PCP # 8W229901
NPI: 1174571582
6301 W Parmer Ln Ste 102
J (512) 834-9999
Hospital Affiliation: North Austin Medical
Center, St Davids Medical Center
Clinic Affiliation: Dominion Medical Assoc
PA
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: Family
Practice, Internal Medicine
" Vandel, Jerry D, MD
Aus tin
J
Gender: Male
PCP # 00RX3301
NPI: 1588699466
900 E 30th St Ste 205
(512) 477-1405
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Internal
Medicine
" Vlahakos, Victor, MD
Aus tin
Gender: Male
PCP # 8DD67401
NPI: 1437199353
7610 W Hwy 71
Ste F
(512) 288-0859
Hospital Affiliation: Mem Hermann
Northwest Hosp
Clinic Affiliation: National House Call
Practitioners
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Austin
" Weeks, David D, MD
Austin
Gender: Male
PCP # 8F707701
NPI: 1326054685
6835 Austin Center Blvd
J (512) 346-6611
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Internal
Medicine
Austin
" Wolf, Lydia L, MD
Austin
Gender: Female
PCP # 8W525201
NPI: 1467433375
4515 Seton Center Pkwy
Ste 220
(512) 338-8388
Hospital Affiliation: Clear Lake Regional
Medical Center, Mem Hermann Hospital,
Seton Medical Center, Seton Northwest
Hospital
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
" Toupin, Leo R, MD
J
Gender: Male
PCP # 8EC36801
NPI: 1982795407
11111 Research Blvd
Ste 230
J (877) 800-5722
Hospital Affiliation: Seton Northwest
Hospital
Clinic Affiliation: Lone Star Circle of Care
Practice Information: Female Patients only,
No Patients Under 2 yrs old
Board Certified Specialties:
Obstetrics-Gynecology
Austin
Aus tin
Gender: Male
PCP # 8AW41901
NPI: 1518052224
12335 Hymeadow Dr
Ste 150
(512) 977-8300
Hospital Affiliation: North Austin Medical
Center, St Davids Medical Center
Clinic Affiliation: Leo Toupin MD
Practice Information: No Patients Under 14
yrs old
Board Certified Specialties: Internal
Medicine
" Billue, David C, MD
Austin
Braunstein, Maryjane E, MD
Gender: Female
PCP # 8DU34801
NPI: 1265449623
11111 Research Blvd
Ste 230
(877) 800-5722
Hospital Affiliation: Round Rock Medical
Center, Seton Northwest Hospital, St Davids
Medical Center
Clinic Affiliation: Lone Star Circle of Care
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Mendelson, Edward G, MD
Gender: Male
PCP # 8DD76001
NPI: 1881669349
7610 W Hwy 71
Ste F
(512) 288-0859
Hospital Affiliation: Mem Hermann Katy
Hospital
Clinic Affiliation: National House Call
Practitioners
Practice Information: No Patients Under 11
yrs old
Board Certified Specialties: None
Avashia, Swati B, MD
Gender: Female
PCP # 8CE12401
NPI: 1740291319
1313 Red River St
Ste 100
J (512) 324-8600
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Northwest Hospital, Seton Southwest,
University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: None
Austin
" Azuma, Lynn M, MD
Austin
J
" Barrera, Rodolfo C, DO
Austin
J
" Bartlett, Elizabeth A, MD
" Sorin, Robert, MD
" Yalamanchili, Vijayalakshmi, MD
Austin
PEDIATRICS
Gender: Female
PCP # 00JV6601
NPI: 1356442784
12411 Hymeadow Dr Ste 3E
J (512) 331-5321
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Center, Seton
Northwest Hospital
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Internal
Medicine
" Alcorn, Amy M, MD
Austin
Gender: Female
PCP # 82413S01
NPI: 1942229059
1807 W Slaughter Ln
Ste 490
J (512) 282-8967
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Zhou, Chen, MD
Austin
Gender: Female
PCP # 8DN93801
NPI: 1851595458
13376 N Hwy 183
Ste 110
(512) 219-0129
Hospital Affiliation: Heart Hospital Of
Austin, Scott And White Memorial Hospital,
St Davids Georgetown Hospital, St Davids
Medical Center
Clinic Affiliation: Wellmed Medical Group
PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
Austin
Austin, Geshia, MD
Gender: Female
PCP # 8DS36601
NPI: 1295053643
1807 Slaughter Ln
Ste 490
(512) 282-8967
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Gender: Male
PCP # 80270B01
NPI: 1588763130
1015 E 32nd St Ste 203
(512) 476-5437
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, St Davids Medical Center, St
Davids S Austin Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Pediatric Care of Austin
PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Austin
Austin
Gender: Male
PCP # 86058K01
NPI: 1154307833
2909 N IH 35
J (512) 478-4939
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Peoples Community Clinic
Inc
Board Certified Specialties:
Obstetrics-Gynecology
Gender: Female
PCP # 8AB53604
NPI: 1295782043
2113 Wells Branch Pkwy
Ste 1200
(254) 724-2111
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
J
Gender: Female
PCP # 81192Z01
NPI: 1295778876
6618 Sitio Del Rio Blvd
Ste A101
(512) 241-1370
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Hill Country Pediatrics PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Bayer, Michael, MD
Austin
Gender: Male
# PCP # 88215701
NPI: 1750469623
711 W 38th St Ste C2
J (512) 458-6717
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Austin Pediatric Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Bell, Anna C, MD
Austin
J
Gender: Female
PCP # 8BD26001
NPI: 1063616662
1912 W 35th St
(512) 451-5161
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Northwest Hospital, Seton Southwest, St
Davids Medical Center
Clinic Affiliation: Childrens Medical Group
PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
J - Wheelchair Access
14
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
AUSTIN
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Brooke, Dawn S, MD
Gender: Female
PCP # 88872S01
NPI: 1376559641
10401 Anderson Mill Ste 110B
J (512) 250-5571
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
" Cepeda, Nitzia E, MD
Aus tin
AUSTIN Cont
PEDIATRICS Cont
" Benchekroune, Ghizlane, MD
Austin
Gender: Female
PCP # 8DQ47801
NPI: 1497922132
1221 W Ben White Blvd
Ste B200
(877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: Pediatrics
" Bryant, Deborah K, MD
" Benhammou, Rania O, MD
J
Aus tin
" Bocchicchio, Jeffrey F, MD
Austin
Gender: Male
PCP # 8DZ68201
NPI: 1912912064
5339 N IH 35
J (877) 800-5722
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Lone Star Circle of Care
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Aus tin
" Brekken, Alissa, MD
Austin
Gender: Female
PCP # 8DY08301
NPI: 1043414535
10401 Anderson Mill Rd
Ste 110-B
(512) 250-5571
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Brieno, Elsa G, MD
Gender: Female
PCP # 00L65D01
NPI: 1477647048
4201 Marathon Blvd
Ste 201
J (512) 323-0276
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Practice Information: No Patients Over 19
yrs old
Board Certified Specialties: None
Austin
" Broberg, Scott A, MD
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Female
PCP # 88594J01
NPI: 1508872888
4515 Seton Center Parkway
Ste 220
(512) 338-8388
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Chapa, Ricardo J, MD
Burnett, Melissa S, MD
Gender: Female
PCP # 8AH35701
NPI: 1770542409
3816 S First St
(512) 443-1311
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Busceme, Heidi W, MD
Gender: Female
PCP # 8BK94201
NPI: 1851391759
1807 W Slaughter Ln
Ste 490
(512) 282-8967
Hospital Affiliation: Christus St Michael
Health System, Dell Childrens Med Ctr Cent
Tx, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, University Med Ctr
Brackenridge, Wadley Regional Medical
Center
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
" Caldwell, William D, MD
!
J
Gender: Male
PCP # 8U794001
NPI: 1053361113
1305 W 34th St
Ste 210
(512) 454-0406
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: William D Caldwell MD
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: Pediatrics
Gender: Male
PCP # 8DW59601
NPI: 1073830246
1015 E 32nd St
Ste 203
(512) 476-5437
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, St Davids Medical Center, St
Davids S Austin Medical Center
Clinic Affiliation: Pediatric Care of Austin
PA
Practice Information: No Patients Over 20
yrs old
Board Certified Specialties: Pediatrics
Concepcion, Constancio V, MD
Gender: Male
PCP # 8CY94501
NPI: 1770574659
1210 W Braker Ln
J (512) 978-9300
Clinic Affiliation: Communitycare
Board Certified Specialties: None
Austin
" Dawson, Thomas B, MD
Austin
Gender: Male
PCP # 8EE54401
NPI: 1922011857
1111 W 34th St
Ste 102
(512) 467-1600
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Dawson Ramirez
Pediatrics
Board Certified Specialties: Pediatrics
" Day, Avis, MD
Austin
J
" De Wette, Julia, MD
" Cassels, Melody D, MD
Gender: Female
PCP # 8BP72001
NPI: 1467664003
1305 W 34th St Ste 210
(512) 454-0406
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: William D Caldwell MD
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: Pediatrics
Gender: Male
PCP # 87J38101
NPI: 1609881762
3816 S First St
(512) 443-1311
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Austin
Aus tin
J
Gender: Female
PCP # 8AB08101
NPI: 1154412237
11851 Jollyville Rd
Ste 204
(512) 219-5550
Hospital Affiliation: Houston Methodist
Sugar Land Hosp, North Austin Medical
Center, Oakbend Medical Center, Round
Rock Medical Center, Seton Northwest
Hospital
Clinic Affiliation: Moms2moms Pediatrics
PLLC
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Austin
Aus tin
Austin
Gender: Male
PCP # 89C03001
NPI: 1003822727
3816 S First St
J (512) 443-1311
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
J
Aus tin
Austin
Gender: Female
# PCP # 8BZ19401
NPI: 1669590444
4700 Seton Ctr Pkwy
Ste 125
(512) 338-8500
Hospital Affiliation: Seton Medical Center,
St Davids S Austin Medical Center, Texas
Childrens Hospital
Clinic Affiliation: Northwest Pediatrics and
Adolescents
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Austin
J
Gender: Female
PCP # 88875801
NPI: 1427063585
1807 W Slaughter Ln
Ste 490
(512) 282-8967
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Deshpande, Mrudula A, MD
Gender: Female
# PCP # 8B114001
NPI: 1245240647
13740 Research Blvd
Ste V1
(512) 250-0406
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Deshpande Mrudula MD
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Austin
Dudley, Courtney R, MD
Gender: Female
PCP # 8W149001
NPI: 1144242173
12120 Ranch Rd 620 N
J (512) 833-7334
Hospital Affiliation: North Austin Medical
Center, Seton Northwest Hospital
Clinic Affiliation: Lone Star Pediatrics
Practice Information: No Patients Over 19
yrs old
Board Certified Specialties: None
Austin
" Duong, Mai X, MD
Austin
Gender: Male
PCP # 82664S01
NPI: 1184630451
1807 W Slaughter Ln
Ste 490
J (512) 282-8967
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Austin
Eagleton, Mary K, MD
Gender: Female
PCP # 8EJ92301
NPI: 1669765350
1912 W 35th St
(512) 451-5161
Clinic Affiliation: Childrens Medical Group
PA
Board Certified Specialties: None
" Edoka, Joanne W, MD
Austin
Gender: Female
PCP # 0044BW01
NPI: 1700987500
805 E 32nd St Ste 102
J (512) 582-1201
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Practice Information: No Patients Over 16
yrs old
Board Certified Specialties: Pediatrics
" Essandoh, Yvonne A, DO
Austin
Gender: Female
PCP # 8EQ01501
NPI: 1598911596
1210 W Braker Ln
(512) 978-9300
# PCP # 8CR21602
NPI: 1598911596
2410 E Riverside Dr
Ste G 3
(512) 744-6000
# PCP # 8CR21601
NPI: 1598911596
5339 N I-H 35
(512) 744-6000
Clinic Affiliation: Communitycare, Glenn
Wood MD
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
J - Wheelchair Access
15
AUSTIN
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Getman, William F, MD
" Hebner, Claire M, MD
Austin
AUSTIN Cont
PEDIATRICS Cont
Aus tin
Aus tin
Estrada, Franchesca C, MD
Gender: Female
PCP # 8EL28201
NPI: 1497769020
11714 Wilson Parke Ave
Ste 150
(512) 231-5548
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Ferguson, Laura E, MD
Gender: Female
PCP # 8ED89501
NPI: 1316981863
6811 Austin Center Blvd
Ste 300
(512) 346-8888
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Florer, Christine M, MD
Gender: Female
# PCP # 8CP00601
NPI: 1851519763
6835 Austin Ctr Blvd
(512) 346-6611
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Austin
Gender: Male
PCP # 88877S01
NPI: 1043226319
6835 Austin Center Blvd
J (512) 346-6611
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Gender: Female
PCP # 8BJ95701
NPI: 1225057060
3816 S First St
(512) 443-1311
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Gonzalez, Helena C, MD
Austin
" Henderson, Kathleen A, DO
Austin
Gender: Female
PCP # 8DT66301
NPI: 1851619589
6835 Austin Center Blvd
(512) 346-6611
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Gender: Female
# PCP # 8CW38101
NPI: 1174782742
4700 Seton Center
Pkwy Ste 125
J (512) 338-8500
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, St Davids S
Austin Medical Center
Clinic Affiliation: Northwest Pediatrics and
Adolescents
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Goodman, James M, MD
Austin
Gender: Male
PCP # 8CA44301
NPI: 1962606525
1807 W Slaughter Ln
Ste 490
(512) 282-8967
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Aus tin
" Frank, Allan L, MD
Gender: Male
# PCP # 81993401
NPI: 1164537270
1100 W 39th 1/2 St
J (512) 454-4545
J
PCP # 81993403
NPI: 1164537270
4100 Duval Rd
Bldg 4 Ste 100
(512) 250-0220
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, Seton Medical Ctr
Williamson, Seton Northwest Hospital, St
Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Capital Pediatric Group
Asso
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Gender: Male
PCP # 80X86101
NPI: 1083685788
4007 James Casey St
Ste D140
J (512) 443-3883
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Pediatrics of South Austin
PA
Practice Information: No Patients Over 17
yrs old
Board Certified Specialties: Pediatrics
" Gennrich, Michael J, MD
Aus tin
Gender: Male
PCP # 8DN82401
NPI: 1609087899
4515 Seton Center Pkwy
Ste 220
(512) 338-8388
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
J
Gender: Male
# PCP # 8CH55601
NPI: 1588868152
12120 Ranch Rd 620 N
J (512) 833-7334
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Lone Star Pediatrics
Practice Information: No Patients Over 19
yrs old
Board Certified Specialties: Pediatrics
Gender: Male
PCP # 8DN68501
NPI: 1407862758
2499 S Capital of Texas
Bldg B Ste 100
(512) 328-7666
PCP # 8U684001
NPI: 1407862758
4515 Seton Center Parkway
Ste 220
(512) 338-8388
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA,
Bee Caves Pediatrics PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Austin
" Jain, Sangeeta S, MD
Gender: Female
PCP # 8W525501
NPI: 1013921261
6835 Austin Center Blvd
(512) 346-6611
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, Seton Southwest,
St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
PCP # 8CY97602
NPI: 1366776031
825 E Rundberg Ln
Ste B1
(512) 978-9600
Clinic Affiliation: Communitycare
Board Certified Specialties: None
" Gupta, Indu R, MD
Austin
Gender: Female
PCP # 8DU96501
NPI: 1255442067
6836 Bee Cave Rd
Ste 180
(512) 328-2333
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Round
Rock Medical Center, Seton Northwest
Hospital, St Davids Medical Center, St
Davids S Austin Medical Center
Clinic Affiliation: Tarrant Angelyn L MD
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Austin
Holzman, Grace B, MD
Gender: Female
PCP # 8CY97603
NPI: 1366776031
2529 S First St
(512) 978-9500
PCP # 8CY97601
NPI: 1366776031
7112 Ed Bluestein
Blvd Ste 155
(512) 978-9300
PCP # 81993303
NPI: 1235244369
4100 Duval Rd
Ste 1- 101
(512) 250-0220
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Capital Pediatric Group
Asso
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Austin
" Holmes, Michael C, MD
" Grier, Mark W, MD
Gender: Female
# PCP # 8CD12901
NPI: 1609812015
2499 S Capital of Texas
Hwy Ste B100
(512) 328-7666
Hospital Affiliation: Seton Medical Center,
Texas Childrens Hospital
Clinic Affiliation: Bee Caves Pediatrics PA
Board Certified Specialties: Pediatrics
Gender: Male
# PCP # 81993301
NPI: 1235244369
1100 W 39th 1/2 St
J (512) 454-4545
Austin
Austin
" Garcia, Eugenia, MD
" Hughes, Thomas E, MD
!
Gender: Female
# PCP # 8CJ32301
NPI: 1548436496
13917 W Hwy 71
Ste A
J (512) 610-7030
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Beansprout Pediatrics
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: Pediatrics
Gender: Male
PCP # 87J44101
NPI: 1689680951
1807 W Slaughter Ln
Ste 490
(512) 282-8967
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Austin
" Hine, Peter W, MD
" Grant, Danielle D, MD
Aus tin
J
Austin
Austin
Aus tin
" Horton, Jack, MD
Austin
Jolet, Kelly, MD
Gender: Female
PCP # 0055NS01
PCP # 8AB34201
NPI: 1972601680
7900 FM 1826 Bldg 1
Ste 220
(512) 288-9669
Hospital Affiliation: Seton Medical Center,
Seton Southwest, St Davids Medical Center,
St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Southwest Pediatrics
Assoc
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
" Kangos, Peter A, MD
Austin
Gender: Male
# PCP # 8B041001
NPI: 1285745547
12411 Hymeadow Dr
Ste 3F
J (512) 250-1997
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center
Clinic Affiliation: Kangos Peter A MD
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
J - Wheelchair Access
16
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
AUSTIN
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Aus tin
AUSTIN Cont
PEDIATRICS Cont
" Knapp, Elizabeth C, MD
Austin
Gender: Female
PCP # 8B074201
NPI: 1003822354
6835 Austin Ctr Blvd
J (512) 346-6611
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Gender: Female
# PCP # 8AT50501
NPI: 1104024207
11111 Research Blvd
Ste 230
J (877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
PCP # 8CY93601
NPI: 1558520544
2529 S First St
(512) 978-9500
" Lingle, Susan, MD
Austin
PCP # 8CY93612
NPI: 1558520544
2802 Webberville Rd
(512) 978-9400
" Kyu, Win W, MD
Austin
" Li Pelaez, Joanne R, DO
Austin
PCP # 8CY93606
NPI: 1558520544
211 Comal St
(512) 978-9200
Austin
Gender: Female
PCP # 8CY98001
NPI: 1699835421
7112 Ed Bluestein
Blvd Ste 155
J (512) 978-9300
Hospital Affiliation: North Central Baptist
Hospital, Northeast Baptist Hospital, Seton
Medical Center
Clinic Affiliation: Communitycare
Board Certified Specialties: Pediatrics
Lama Briseno, Tracy R, DO
Gender: Female
PCP # 8CY93608
NPI: 1558520544
1200 Montopolis Dr
(512) 978-9800
J
PCP # 8CY93604
NPI: 1558520544
500 E Seventh St
(512) 978-9920
# PCP # 8CY93613
NPI: 1558520544
6801 S IH 35
Ste 1E
(512) 978-9960
" Lopez, Ramona C, MD
Austin
Gender: Female
PCP # 80X86001
NPI: 1659342350
4007 James Casey St
Ste D140
(512) 443-3883
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Pediatrics of South Austin
PA
Practice Information: No Patients Over 17
yrs old
Board Certified Specialties: Pediatrics
PCP # 8CY93609
NPI: 1558520544
7112 Ed Bluestein Blvd
Ste 155
(512) 978-9300
Lal, Arti, MD
Gender: Female
PCP # 8CS29802
NPI: 1417047077
12129 FM 620
(512) 918-2500
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
PCP # 8CY93602
NPI: 1558520544
825 E Rundberg Ln
Ste B1
(512) 978-9600
PCP # 8CY93610
NPI: 1558520544
8656A Hwy 71 W Ste C
(512) 978-9820
" Louis, Jack A, MD
Austin
Gender: Male
# PCP # 88215601
NPI: 1740368406
711 W 38th St
Ste C2
J (512) 458-6717
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Pediatric Clinic PA
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: Pediatrics
PCP # 8CY93603
NPI: 1558520544
928 Blackson Ave
(512) 978-9740
Clinic Affiliation: Communitycare
Board Certified Specialties: None
" Leong, Sharon C, MD
Aus tin
J
Gender: Female
PCP # 87J46201
NPI: 1760498018
4515 Seton Center Parkway
Ste 220
(512) 338-8388
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Malik, Durdana A, MD
Austin
Gender: Female
PCP # 0056ED01
NPI: 1184734261
4207 James Casey St
Ste 111
J (512) 444-9800
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Practice Information: No Patients Over 14
yrs old
Board Certified Specialties: Pediatrics
Mani, Jayashree, MD
Gender: Female
# PCP # 81993601
NPI: 1285749382
1100 W 39th 1/2 St
J (512) 454-4545
Austin
PCP # 81993603
NPI: 1285749382
4100 Duval Rd
Bldg 5 Ste 100
J (512) 250-0220
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center
Clinic Affiliation: Capital Pediatric Group
Asso
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
" Mathai, Cynthia P, DO
Austin
Gender: Female
PCP # 8CY04501
NPI: 1013176197
1807 W Claughter Ln
Ste 490
(512) 282-8967
Hospital Affiliation: Texas Childrens
Hospital
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Lowrey, Robert, MD
J
" Lewellyn, Larry L, DO
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
PCP # 86021Y03
NPI: 1134234388
4100 Duval Rd
Bldg IV Ste 100
J (512) 250-0220
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Capital Pediatric Group
Asso
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Austin
Aus tin
J
Gender: Female
PCP # 88873701
NPI: 1346256609
6835 Austin Center Blvd
(512) 346-6611
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Ma, Helen, DO
Gender: Female
# PCP # 86021Y01
NPI: 1134234388
1100 W 39th 1/2 St
J (512) 454-4545
Austin
Gender: Male
PCP # 00FR2701
NPI: 1821064098
4007 James Casey St
Ste A150
(512) 447-0707
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Gender: Male
PCP # 89774901
NPI: 1356356414
6835 Austin Center Blvd
(512) 346-6611
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" McConnell, Tammy S, DO
Austin
Gender: Female
PCP # 8CF24501
NPI: 1801896246
1912 W 35th St
(512) 451-5161
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Childrens Medical Group
PA
Board Certified Specialties: Pediatrics
J - Wheelchair Access
17
AUSTIN
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
AUSTIN Cont
PEDIATRICS Cont
" McMains, Merrick J, MD
Aus tin
Gender: Male
PCP # 8DP78301
NPI: 1518964014
2911 Medical Arts St
Ste 20
(512) 236-9306
Clinic Affiliation: Longhorn Pediatrics
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Mitchell, Janet, MD
Aus tin
J
Gender: Female
PCP # 89C04501
NPI: 1164438412
4515 Seton Center Parkway
Ste 220
(512) 338-8388
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Mouser, Rebecca, MD
Aus tin
J
Gender: Female
PCP # 89C01201
NPI: 1700891876
1807 W Slaughter Ln
Ste 490
(512) 282-8967
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Mulcihy, Casey, MD
Gender: Male
PCP # 00JQ4101
NPI: 1386757953
4007 James Casey Ste D200
J (512) 447-5588
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, St Davids
Medical Center, St Davids S Austin Medical
Center
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
Aus tin
" Muzaffar, Syema, MD
Aus tin
J
" Nakonechna, Olena L, MD
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
" Rannefeld, Marcia E, DO
Austin
Austin
Gender: Female
# PCP # 8DJ77603
NPI: 1629254883
3706 S First St
J (512) 324-4940
Gender: Female
PCP # 8AB34001
NPI: 1487752127
7900 FM 1826 Bldg 1
Ste 220
J (512) 288-9669
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, Seton Southwest,
St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Southwest Pediatrics
Assoc
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Gender: Female
# PCP # 8CF76111
NPI: 1699738849
2237 E Riverside Dr
Ste 101C
J (512) 744-6000
PCP # 8DJ77602
NPI: 1629254883
8913 Collinfield Dr
J (512) 324-6850
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Medical Center Hays, Seton Medical Ctr
Williamson, Seton Northwest Hospital, Seton
Southwest
Clinic Affiliation: Seton Community Health
Centers
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Petropoulos, Mary C, MD
Austin
Gender: Female
PCP # 84111F01
NPI: 1750483707
11673 Jollyville Rd
Ste 104
J (512) 338-5130
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center
Clinic Affiliation: Austin Childrens Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Norton, Lydia W, MD
Austin
Gender: Female
# PCP # 8H492201
NPI: 1366419442
2499 S Cap of TX Hwy
Bldg B 100
J (512) 328-7666
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Bee Caves Pediatrics PA
Board Certified Specialties: Pediatrics
" Oliveras Rentas, Edith J, MD
Austin
" Prochnow, Ross, MD
Austin
Gender: Female
# PCP # 8H131601
NPI: 1861555195
2237 E Riverside Dr
Ste 101C
J (512) 744-6000
Gender: Male
PCP # 84G10201
NPI: 1235144304
4515 Seton Center Parkway
Ste 220
J (512) 338-8388
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
# PCP # 8H131604
NPI: 1861555195
2621 Ridgepoint Dr
Ste 140
J (512) 583-9640
# PCP # 8H131606
NPI: 1861555195
6425 S IH 35
Ste 100
J (512) 744-6000
Austin
Austin
# PCP # 8CF76110
NPI: 1699738849
2321 Ridgepoint Dr
Ste 140
J (512) 744-6000
# PCP # 8CF76101
NPI: 1699738849
6425 S IH 35
Ste 100
J (512) 744-6000
# PCP # 8CF76108
NPI: 1699738849
7112 Ed Bluestein Blvd
Ste 100
J (512) 744-6000
Hospital Affiliation: Baylor All Saints
Medical Center At Fort Worth, Cook
Childrens Medical Center, Plaza Medical
Center Fort Worth, Tx Hlth Harris Methodist
Hosp Fw, Tx Hlth Harris Methodist Hosp Sw
Clinic Affiliation: Glenn Wood MD
Practice Information: No Patients Over 17
yrs old
Board Certified Specialties: Pediatrics
" Rimer, Haydee C, MD
Austin
J
" Qian, Baoping, MD
Austin
Gender: Male
PCP # 8EM75301
NPI: 1144415936
1111 Research Blvd
Ste 230
(877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: Pediatrics
# PCP # 8H131602
NPI: 1861555195
7112 Ed Bluestein Blvd
Ste 100
J (512) 744-6000
Clinic Affiliation: Glenn Wood MD
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
PCP # 8DJ74902
NPI: 1033120936
2811 E Second St
(512) 324-4930
# PCP # 8DJ74901
NPI: 1033120936
8913 Collinfield Dr
J (512) 324-5860
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Medical Center Hays, Seton Medical Ctr
Williamson, Seton Northwest Hospital, Seton
Southwest, University Med Ctr Brackenridge
Clinic Affiliation: Seton Community Health
Centers
Board Certified Specialties: Pediatrics
" Patil, Vaishalee S, MD
Austin
" Ramirez, Jaime E, MD
Austin
Gender: Male
PCP # 8EE54501
NPI: 1598778409
1111 W 34th St
Ste 102
(512) 467-1600
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Dawson Ramirez
Pediatrics
Board Certified Specialties: Pediatrics
Pannell, Jennifer, MD
Gender: Female
PCP # 8R680101
NPI: 1730195090
1807 W Slaughter Ln
Ste 490
(512) 282-8967
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
" Rane, Nishigandha Y, MD
Austin
Patel, Ranita, MD
Gender: Female
PCP # 8EL75601
NPI: 1265722789
6835 Austin Center Blvd
(512) 346-6611
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Gender: Female
# PCP # 8G170301
NPI: 1902830946
4700 Seton Center Pkwy
Ste 125
J (512) 338-8500
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, St Davids
Medical Center
Clinic Affiliation: Northwest Pediatrics and
Adolescents
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Gender: Female
PCP # 8AB34101
NPI: 1255439931
7900 FM 1826 Bldg 1
Ste 220
(512) 288-9669
Hospital Affiliation: Seton Medical Center,
Seton Southwest, St Davids Medical Center,
St Davids S Austin Medical Center
Clinic Affiliation: Southwest Pediatrics
Assoc
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Rodriguez, Roberto L, MD
Gender: Male
PCP # 8CY99001
NPI: 1548252836
211 Comal St
J (512) 978-9200
Clinic Affiliation: Communitycare
Board Certified Specialties: None
Austin
" Ruiz, Elena, MD
Austin
Gender: Female
# PCP # 8H492101
NPI: 1356352637
2499 S Cap of TX Hwy B100
(512) 328-7666
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Bee Caves Pediatrics PA
Board Certified Specialties: Pediatrics
" Rusk, Natalie W, MD
Austin
Gender: Female
PCP # 8V911201
NPI: 1407861578
4515 Seton Center Parkway
Ste 220
(512) 338-8388
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
J - Wheelchair Access
18
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
AUSTIN
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Shieh, Sue A, MD
" Temple, Brian W, MD
Aus tin
AUSTIN Cont
PEDIATRICS Cont
Russell, Terri A, MD
Gender: Female
PCP # 8BF00502
NPI: 1700985553
2911 Medical Arts St
Ste 16
J (512) 467-7111
Hospital Affiliation: St Davids Medical
Center
Clinic Affiliation: Terri Anne Russell MD
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Austin
Austin
Sabri, Nadia A, MD
Gender: Female
PCP # 8DT73601
NPI: 1922324797
6835 Austin Center Blvd
(512) 346-6611
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
" Sarathy, Rama, MD
Austin
Gender: Female
PCP # 8CS01708
NPI: 1023010287
2237 E Riverside Dr
Ste 101C
(512) 744-6000
PCP # 8CS01707
NPI: 1023010287
2621 Ridgepoint Dr
Ste 140
(512) 744-6000
PCP # 8CS01706
NPI: 1023010287
6425 S IH 35
Ste 100
(512) 744-6000
PCP # 8CS01702
NPI: 1023010287
7112 Ed Bluestein
Blvd Ste 100
(512) 744-6000
# PCP # 8CS01701
NPI: 1023010287
9411 N Lamar Blvd
Ste 120
(512) 744-6000
Hospital Affiliation: Cleveland Regional
Medical Center, Memorial Medical Center
Livingston
Clinic Affiliation: Glenn Wood MD
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Shah, Avni A, DO
Gender: Female
# PCP # 8EA09601
NPI: 1700103926
1100 W 39 1/2 St
J (512) 454-4545
Austin
PCP # 8EA09602
NPI: 1700103926
4100 Duval Rd
Ste 100 Bldg 4
J (512) 250-0220
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Capital Pediatric Group
Asso
Practice Information: No Patients Over 20
yrs old
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
J
Austin
PCP # 83042Y01
NPI: 1265447320
4515 Seton Center Parkway
Ste 220
(512) 338-8388
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Gender: Male
# PCP # 8DT89801
NPI: 1689863649
13917 W Hwy 71
Ste A
(512) 610-7030
Hospital Affiliation: Lakeway Regional
Medical Ctr Llc
Clinic Affiliation: Beansprout Pediatrics
Board Certified Specialties: Pediatrics
Austin
" Sood, Lily, MD
Aus tin
J
Gender: Female
PCP # 88873601
NPI: 1598771859
3816 S First St
(512) 443-1311
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Spence, Timothy A, MD
Gender: Male
! PCP # 8EJ84901
NPI: 1710969415
11714 Wilson Parke Ave
Ste 150
(512) 231-5548
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Aus tin
Thant, Lewai, MD
Gender: Female
PCP # 8CY99601
NPI: 1104870641
2529 S First St
(512) 978-9500
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, University Med Ctr Brackenridge
Clinic Affiliation: Communitycare
Board Certified Specialties: None
" Thorstad, Kelly G, MD
Austin
Gender: Female
# PCP # 8J803001
NPI: 1174508832
12120 Ranch Rd 620 N
J (512) 833-7334
Hospital Affiliation: North Austin Medical
Center, Seton Northwest Hospital
Clinic Affiliation: Lone Star Pediatrics
Practice Information: No Patients Over 19
yrs old
Board Certified Specialties: Pediatrics
Torres, Manuel A, MD
Gender: Male
PCP # 8AJ92601
NPI: 1972713410
1110 W William Cannon Dr
Ste 502
J (512) 474-2660
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Manuel A Torres MD
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Austin
Spencer, Evelyn E, MD
Gender: Female
PCP # 8AB08001
NPI: 1740371764
11851 Jollyville Rd
Ste 204
J (512) 219-5550
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center
Clinic Affiliation: Moms2moms Pediatrics
PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Aus tin
Tarrant, Angelyn L, MD
Gender: Female
PCP # 8M643001
NPI: 1740389402
6836 Bee Cave Rd
Ste 180
J (512) 328-2333
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, St Davids Medical Center, St
Davids S Austin Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Tarrant Angelyn L MD
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
" Trevino, Christine A, DO
Austin
Aus tin
J
Gender: Female
PCP # 8CF07001
NPI: 1164626727
7900 FM 1826 Bldg 1
Ste 220
(512) 288-9669
Clinic Affiliation: Southwest Pediatrics
Assoc
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Treybig, Sandra K, MD
Gender: Female
# PCP # 81993901
NPI: 1336254507
1100 W 39th 1/2 St
J (512) 454-4545
Austin
Tarrant, Natalie B, MD
Gender: Female
# PCP # 8J031101
NPI: 1861492514
6618 Sitio Del Rio Blvd
Ste A101
J (512) 241-1370
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Hill Country Pediatrics PA
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
Aus tin
J
PCP # 81993903
NPI: 1336254507
4100 Duval Rd Bldg 4
Ste 100
(512) 250-0220
Hospital Affiliation: North Austin Medical
Center, St Davids Medical Center
Clinic Affiliation: Capital Pediatric Group
Asso
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Villarreal-Levy, Christine C, MD
Gender: Female
# PCP # 8CZ06402
NPI: 1588944920
4800 Manor Rd
J (512) 499-0090
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Peoples Community Clinic
Inc
Board Certified Specialties: None
Austin
" Wagner, Nicholas J, MD
Austin
Gender: Male
PCP # 8AB34501
NPI: 1497915565
7900 FM 1826 Bldg 1
Ste 220
J (512) 288-9669
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Southwest
Clinic Affiliation: Southwest Pediatrics
Assoc
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Ward, Michael H, MD
Austin
Gender: Male
PCP # 82665S01
NPI: 1952317216
3816 S First St
J (512) 443-1311
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Wells, Leslie L, MD
Austin
Gender: Female
# PCP # 8J031001
NPI: 1528067907
6618 Sitio Del Rio Blvd
Ste A101
J (512) 241-1370
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Hill Country Pediatrics PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Wheelock, Valerie G, MD
Gender: Female
PCP # 8W669001
NPI: 1871694349
7004 W Bee Caves Rd
Bldg 1 Ste 210
J (512) 327-0562
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Valerie Wheelock MD
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Austin
" White, Alan, MD
Austin
Gender: Male
PCP # 87J44802
NPI: 1861408122
11111 Research Blvd 485
J (512) 244-9024
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
J - Wheelchair Access
19
AUSTIN
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Vocal, Laurier A, MD
Gender: Male
PCP # 8DE24001
NPI: 1821102005
3101 Hwy 71 E
Ste 101
(512) 304-0300
Hospital Affiliation: Seton Smithville Reg
Hospital
Clinic Affiliation: Family Health Center of
Bastrop
Practice Information: No Obstetrics
Board Certified Specialties: None
" Ziari, Alison D, MD
Austin
AUSTIN Cont
PEDIATRICS Cont
" White, Amy L, MD
Aus tin
Gender: Female
# PCP # 8EE54601
NPI: 1821169004
1111 W 34th St
Ste 102
(512) 467-1600
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, St Davids
Medical Center, St Davids S Austin Medical
Center
Clinic Affiliation: Dawson Ramirez
Pediatrics
Board Certified Specialties: Pediatrics
" Wiseman, Lisa, MD
Aus tin
Gender: Female
# PCP # 8BZ21601
NPI: 1992946669
4700 Seton Center
Pkwy Ste 125
(512) 338-8500
Hospital Affiliation: North Austin Medical
Center
Clinic Affiliation: Northwest Pediatrics and
Adolescents
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Wood, Glenn G, MD
Aus tin
# PCP # 8H131006
NPI: 1346247749
6425 S IH 35
Ste 100
J (512) 744-6000
Gender: Male
# PCP # 8V380001
NPI: 1902985427
195 S Hasler Blvd Ste B1
J (512) 308-1555
Hospital Affiliation: Seton Smithville Reg
Hospital
Clinic Affiliation: Bastrop Medical Clinic PA
Board Certified Specialties: Internal
Medicine
" Akkanti, Yamini A, MD
Gender: Female
# PCP # 8CR50901
NPI: 1760659973
201 Childers Dr Ste 109
(512) 321-3430
Hospital Affiliation: Seton Edgar B Davis,
Seton Smithville Reg Hospital
Clinic Affiliation: Sai Medical Group PA
Board Certified Specialties: Family
Practice
Gender: Female
PCP # 8DU73001
NPI: 1972794162
12005 Bee Cave Rd
Ste 2A
(512) 225-0766
Clinic Affiliation: Bee Well Pediatrics of
Central Te
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Thompson, Carla J, MD
Bee Cave
Gender: Female
PCP # 8EL30601
NPI: 1003021593
11701 Bee Cave Rd
Ste 130
(512) 892-7076
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center
Clinic Affiliation: South Austin Family
Practiceclinic LLP
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Gupta, Rajeev, MD
Gender: Male
# PCP # 85180X01
NPI: 1417936261
475 Hwy 71 W
J (512) 321-9091
Hospital Affiliation: Seton Smithville Reg
Hospital
Clinic Affiliation: Bastrop County Medical
Assoc PA
Practice Information: No Patients Under 1
yrs old
Board Certified Specialties: Internal
Medicine
" Chavez, Pompeyo C, MD
Gender: Male
PCP # 8DE24101
NPI: 1821292426
3101 Hwy 71 E
Ste 101
(512) 304-0300
Clinic Affiliation: Family Health Center of
Bastrop
Board Certified Specialties: Family
Practice
" Porter, Brent A, MD
Bastrop
" Van Benthuysen, Suzanne L, MD
Bee Cave
Gender: Female
PCP # 8DU73101
NPI: 1962673301
12005 Bee Cave Rd
Ste 2A
(512) 225-0766
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Bee Well Pediatrics of
Central Te
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Gender: Male
PCP # 8CV13401
NPI: 1588680672
441 W Hwy 71 Ste C
(512) 791-1224
Hospital Affiliation: Doctors Hospital,
Medical Center Of Plano
Clinic Affiliation: Seton Family of Doctors
Board Certified Specialties: Internal
Medicine
" Dougherty Jr, Robert J, MD
Bastrop
Gender: Male
PCP # 0068JE01
NPI: 1114935210
441 Hwy 71 W
J (512) 581-5016
!
PCP # 8BV29001
NPI: 1114935210
441 Hwy 71 W
Ste B1
(512) 581-5016
Hospital Affiliation: Seton Smithville Reg
Hospital
Clinic Affiliation: Robert James Dougherty
MD
Board Certified Specialties: Family
Practice
BEE CAVE
FAMILY PRACTICE
" Fagerberg, Kristyn T, MD
BEE CAVES
FAMILY PRACTICE
Bee Cave
Gender: Female
PCP # 8DF72001
NPI: 1154332054
11805 Bee Caves Rd
Ste 100
(512) 402-9013
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, St Davids S
Austin Medical Center
Clinic Affiliation: Lrmc Physician Services
Inc
Board Certified Specialties: Family
Practice
Lerma III, Sammy, MD
Gender: Male
PCP # 83460Y01
NPI: 1871571950
1109 Church St
J (512) 321-3311
Hospital Affiliation: Seton Smithville Reg
Hospital
Clinic Affiliation: Lerma III Sammy MD
Practice Information: No Patients Under 1
yrs old
Board Certified Specialties: None
Bastrop
" Jones, Mason D, MD
Bee Caves
Gender: Male
PCP # 8EN23401
NPI: 1639220551
12717 Shops Pkwy
Ste 500
(512) 222-8667
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center
Clinic Affiliation: Total Mens Physicians
Group LLC
Board Certified Specialties: Family
Practice
" Gabriel, David J, MD
Bee Cave
Gender: Male
PCP # 8CW04801
NPI: 1619084993
11701 Bee Caves Rd
Ste 130
(512) 892-7076
Hospital Affiliation: North Austin Medical
Center, Seton Northwest Hospital
Clinic Affiliation: South Austin Family
Practiceclinic LLP
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: Family
Practice
" Ortega, Juan C, MD
Bastrop
Gender: Male
PCP # 8EC40701
NPI: 1720074529
3101 Hwy 71 E
Ste 101
(512) 304-0300
Hospital Affiliation: Columbus Community
Hospital
Clinic Affiliation: Family Health Center of
Bastrop
Board Certified Specialties: Family
Practice
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
" Morgan, Jessica A, MD
Bee Cave
Bastrop
Bastrop
# PCP # 8H131001
NPI: 1346247749
7112 Ed Bluestein Blvd
Ste 100
J (512) 744-6000
PEDIATRICS
" Batlle, Augustin R, MD
Bastrop
!
Gaertner, James S, MD
Gender: Male
PCP # 8DF72101
NPI: 1225068315
11805 Bee Caves Rd
Ste 100
(512) 402-9013
Clinic Affiliation: Lrmc Physician Services
Inc
Board Certified Specialties: None
Bee Cave
Bastrop
FAMILY PRACTICE
PCP # 8DR85001
NPI: 1346247749
6610 McNeil Dr
(512) 583-9679
# PCP # 8H131010
NPI: 1346247749
9411 N Lamar Blvd
Ste 120
J (512) 744-6000
Hospital Affiliation: St Davids S Austin
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Glenn Wood MD, McNeil
Pediatrics PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
INTERNAL MEDICINE
BASTROP
Gender: Male
# PCP # 8H131009
NPI: 1346247749
2237 E Riverside Dr
Ste 101 C
J (512) 744-6000
# PCP # 8H131008
NPI: 1346247749
2621 Ridgepoint Dr
Ste 140
J (512) 744-6000
Bastrop
Gender: Female
PCP # 8W525801
NPI: 1881669711
11714 Wilson Parke Ave
Ste 150
(512) 528-2300
Hospital Affiliation: Mother Frances
Hospital, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
BELLMEAD
FAMILY PRACTICE
Paltjon, Jason M, MD
Gender: Male
! PCP # 8S039302
NPI: 1336100114
556 N Loop 340
(254) 412-5700
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
Bellmead
J - Wheelchair Access
20
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
BRYAN
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Holland Barki, Penelope A, MD
" Sanchez, Ernesto H, MD
Belton
BELLMEAD Cont
FAMILY PRACTICE Cont
" Partin, Patrick B, MD
Bellmead
Gender: Male
! PCP # 8F557002
NPI: 1629039417
556 N Loop 340
J (254) 412-5700
Hospital Affiliation: Scott And White
Memorial Hospital, Stephens Memorial
Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Ryman, James L, MD
Bellmead
Gender: Male
PCP # 8CG85202
NPI: 1841352424
556 N Loop
J (254) 215-9791
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
BELTON
FAMILY PRACTICE
" Bartels, Walton G, MD
Belton
Gender: Male
PCP # 80753801
NPI: 1740240084
1505 N Main St
J (254) 933-4040
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Dale, Andrew M, MD
J
Gender: Male
PCP # 8DL85401
NPI: 1255492765
2851 N Main
Ste 1
(254) 939-1844
Clinic Affiliation: Lhp Texas MD Services
Inc
Board Certified Specialties: Family
Practice
" Fasolino, Edward, MD
Hovland, Sarah, MD
Gender: Female
PCP # 8EL06501
NPI: 1295027803
1001 Arbor Park Dr
J (254) 933-4100
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
PCP # 87G90001
NPI: 1982664751
1505 N Main St
J (254) 933-4040
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Davis, Tinku, MD
Belton
PCP # 80427F01
NPI: 1821059080
1505 N Main St
(254) 933-4040
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
J
Drigalla, Jessica W, MD
Gender: Female
PCP # 8X205104
NPI: 1770641706
1009 Arbor Park Dr
J (254) 933-4100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
" McDonald, Darin K, MD
Gender: Male
PCP # 8AB76002
NPI: 1821210899
1505 N Main St
(254) 933-2040
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Guptha, Sushma N, MD
Gender: Female
# PCP # 8DU83402
NPI: 1710064357
1505 N Main
J (254) 933-4040
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
Belton
" Mueller, Jessie M, MD
Belton
J
Gender: Female
PCP # 8CL41502
NPI: 1578721882
309 Lake Rd Ste A
(254) 933-5600
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
BELTRON
PEDIATRICS
" Nieland, Melissa J, MD
Belton
J
J
Gender: Female
PCP # 8CY45602
NPI: 1730384405
1001 Arborpark Dr
(254) 933-4100
" Baca, Katrina M, MD
Beltron
PCP # 8CY45601
NPI: 1730384405
1505 N Main St
(254) 933-4040
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
J
Gender: Female
PCP # 8F557602
NPI: 1346209616
1009 Arbor Park Dr
(254) 933-4100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
BERTRAM
FAMILY PRACTICE
" Franz, Charles M, DO
Bertram
Gender: Male
PCP # 8J562302
NPI: 1912978206
160 N Lampasas St
J (512) 355-9233
Hospital Affiliation: Seton Highland Lakes,
The Medical Ctr Of Southeast Tx Lp
Clinic Affiliation: Seton Healthcare
Practice Information: No Obstetrics, No
Patients Under 1 yrs old
Board Certified Specialties: Family
Practice
INTERNAL MEDICINE
" Deng, Yue, MD
Bertram
Gender: Female
PCP # 8AK93605
NPI: 1821292483
160 N Lampasas St
J (512) 355-9233
Hospital Affiliation: Seton Highland Lakes,
Seton Medical Center, Seton Northwest
Hospital
Clinic Affiliation: Seton Healthcare
Board Certified Specialties: Internal
Medicine
BRYAN
FAMILY PRACTICE
" Adams, Rae A, MD
Bryan
Gender: Female
# PCP # 8CW85201
NPI: 1508019001
2900 E 29th St
Ste 200
J (979) 776-8440
Hospital Affiliation: College Station Medical
Center, St Joseph Regional Health Center
Clinic Affiliation: The Texas A&M University
System H
Board Certified Specialties: Family
Practice
Biles, Russell K, MD
Gender: Male
PCP # 84M13204
NPI: 1871552687
748 N Earl Rudder Frwy
J (979) 691-3170
Hospital Affiliation: Scott And White
Memorial Hospital, St Joseph Regional
Health Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
Bryan
Daftarian, Arezu, MD
Gender: Female
PCP # 8BR01301
NPI: 1881659589
2900 E 29th St
Ste 200
J (979) 774-8440
Hospital Affiliation: St Joseph Regional
Health Center
Clinic Affiliation: The Texas A&M University
System H
Board Certified Specialties: None
Bryan
" Dhaduk, Shailesh D, MD
Bryan
Gender: Male
# PCP # 8U423001
NPI: 1326047259
2709 Osler Blvd
J (979) 776-2200
Hospital Affiliation: College Station Medical
Center, St Joseph Regional Health Center,
The Physicians Centre
Clinic Affiliation: Bryan Family Medicine
Clinic PA
Board Certified Specialties: Family
Practice
" Parker Jr, E Don, MD
Belton
J
Gender: Female
PCP # 8CB05702
NPI: 1477757037
1009 Arbor Park Dr
(254) 933-4100
Clinic Affiliation: Scott and White Clinic
Practice Information: No Patients Over 17
yrs old
Board Certified Specialties: Pediatrics
Belton
Belton
J
PCP # 8AR18502
NPI: 1184690232
1505 N Main St
(254) 933-4040
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
PEDIATRICS
" Ligon Jr, William F, MD
" Hagen, Michael P, MD
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
J
Belton
Belton
Gender: Male
PCP # 80755001
NPI: 1881654580
1505 N Main St
J (254) 933-4040
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Sewell, Stephen J, MD
Gender: Male
PCP # 8AR18503
NPI: 1184690232
1001 Arborpark Dr
J (254) 933-4100
Howell, Shelley M, DO
Gender: Male
! PCP # 8EC59301
NPI: 1295748598
2851 N Main St Ste 1
(254) 939-1844
Hospital Affiliation: Metroplex Hospital
Clinic Affiliation: Lhp Texas MD Services
Inc
Board Certified Specialties: None
J
Gender: Male
PCP # 8368NC02
NPI: 1407840259
309 Lake Rd A
(254) 939-5800
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
Belton
Belton
Belton
Gender: Male
PCP # 87G90002
NPI: 1982664751
1001 Arbor Park Dr
J (254) 933-4100
J
Belton
Belton
!
Belton
PCP # 87190N01
NPI: 1679533129
1505 N Main St
(254) 933-4040
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Gender: Male
PCP # 8B091501
NPI: 1588625370
1505 N Main St
(254) 933-4040
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
J - Wheelchair Access
21
BRYAN
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Maedo, Kelly M, MD
" Sabrsula Jr, Irvin F, MD
Bryan
BRYAN Cont
FAMILY PRACTICE Cont
" Dickey, Nancy W, MD
Bryan
Gender: Female
PCP # 8BR01501
NPI: 1932215258
2900 E 29th St
Ste 200
(979) 776-8440
Hospital Affiliation: College Station Medical
Center, St Joseph Regional Health Center
Clinic Affiliation: The Texas A&M University
System H
Board Certified Specialties: Family
Practice
" Gill, Kory L, DO
J
PCP # 8DR07501
NPI: 1154582716
3201 University Dr E
Ste 115
(979) 776-0169
Hospital Affiliation: College Station Medical
Center, St Joseph Regional Health Center
Clinic Affiliation: Central Texas Sports
Medicin& Ortho PA, The Texas A&M
University System H
Board Certified Specialties: Family
Practice
" Kakwan, Ume Haney Y, MD
Bryan
J
Gender: Female
PCP # 8EC60201
NPI: 1699761536
2703 Osler Blvd
(979) 776-0055
Hospital Affiliation: College Station Medical
Center, St Joseph Regional Health Center
Clinic Affiliation: Family Medicine and
Senior Care
Board Certified Specialties: Family
Practice
Lichorad, Anna, MD
Gender: Female
PCP # 8BR01901
NPI: 1750392056
2900 E 29th St
Ste 200
J (979) 776-8440
Hospital Affiliation: Burleson St Joseph
Health Center, College Station Medical
Center, Madison St Joseph Health Center, St
Joseph Regional Health Center
Clinic Affiliation: The Texas A&M University
System H
Board Certified Specialties: None
Bryan
" Loyd, Ryan A, MD
Bryan
J
Gender: Male
PCP # 8BR21101
NPI: 1487851226
2900 E 29th St
Ste 200
(979) 776-8440
Hospital Affiliation: College Station Medical
Center, St Joseph Regional Health Center
Clinic Affiliation: The Texas A&M University
System H
Board Certified Specialties: Family
Practice
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Male
PCP # 8DW37603
NPI: 1609196401
748 N Earl Rudder Frwy
(979) 207-2900
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
PCP # 8EL13501
NPI: 1750602199
3201 University Dr E
Ste 115
(979) 776-0169
Hospital Affiliation: St Joseph Regional
Health Center
Clinic Affiliation: Central Texas Sports
Medicin& Ortho PA, The Texas A&M
University System H
Board Certified Specialties: Family
Practice
Bryan
Gender: Male
PCP # 8BZ69501
NPI: 1154582716
2900 E 29th St
Ste 200
(979) 776-8440
" Sanchez, Jorge E, MD
Gender: Female
PCP # 8EA41901
NPI: 1750602199
2900 E 29th St
(979) 776-8440
Gender: Female
PCP # 8EL72301
NPI: 1073809794
2900 E 29th St
(979) 776-8440
Hospital Affiliation: College Station Medical
Center, St Joseph Regional Health Center
Clinic Affiliation: The Texas A&M University
System H
Board Certified Specialties: Family
Practice
Gender: Male
PCP # 8DE64301
NPI: 1730140906
2900 E 29th St
(979) 776-8440
Hospital Affiliation: College Station Medical
Center, Mother Frances Hospital, Scott And
White Memorial Hospital, St Joseph
Regional Health Center
Clinic Affiliation: The Texas A&M University
System H
Board Certified Specialties: Internal
Medicine
Bry an
" Marsh, Laura E, MD
" Fuller, Katie J, DO
" Lindzey, David L, MD
Bryan
Gender: Male
PCP # 8DU58701
NPI: 1548266679
2900 E 29th St Ste 200
J (979) 776-8440
Hospital Affiliation: College Station Medical
Center, St Joseph Regional Health Center
Clinic Affiliation: The Texas A&M University
System H
Board Certified Specialties: Family
Practice
Bryan
Bryan
J
Bry an
Gender: Female
PCP # 8BR21201
NPI: 1104838887
2900 E 29th St
Ste 200
(979) 776-8440
Hospital Affiliation: Burleson St Joseph
Health Center, College Station Medical
Center, St Joseph Regional Health Center
Clinic Affiliation: The Texas A&M University
System H
Board Certified Specialties: Family
Practice
" Ogden, Paul E, MD
Bryan
Gender: Male
PCP # 8CJ87601
NPI: 1285695056
2900 E 29th St
(979) 776-8440
Hospital Affiliation: College Station Medical
Center, Scott And White Memorial Hospital
Clinic Affiliation: The Texas A&M University
System H
Board Certified Specialties: Internal
Medicine
" Severson, Sarah K, DO
Bry an
Gender: Female
PCP # 8EC47002
NPI: 1114185451
748 N Earl Rudder Frwy
J (979) 207-2900
Hospital Affiliation: Bayshore Medical
Center, El Campo Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
" McClellan, David A, MD
Bryan
Gender: Male
PCP # 8BR21401
NPI: 1154333847
2900 E 29th St
Ste 200
J (979) 776-8440
Hospital Affiliation: College Station Medical
Center, St Joseph Medical Center
Clinic Affiliation: The Texas A&M University
System H
Board Certified Specialties: Family
Practice
PEDIATRICS
" Soriano, Maria C, MD
Bryan
Gender: Female
PCP # 8DZ05501
NPI: 1376733899
2901 E 29th St
Ste 123
(979) 776-9400
" Simmons Jr, John F, MD
Bry an
Gender: Male
PCP # 8CA07201
NPI: 1942452123
2900 E 29th St
Ste 200
J (979) 776-8440
Hospital Affiliation: College Station Medical
Center, St Joseph Regional Health Center
Clinic Affiliation: The Texas A&M University
System H
Board Certified Specialties: Family
Practice
Ormberg, Audrey, MD
Gender: Female
# PCP # 8BR21601
NPI: 1891781506
2900 E 29th St
Ste 200
J (979) 776-8440
Hospital Affiliation: College Station Medical
Center, St Joseph Regional Health Center
Clinic Affiliation: The Texas A&M University
System H
Board Certified Specialties: None
Bryan
" Villarreal, Roque, MD
Bry an
Gender: Male
PCP # 84E44304
NPI: 1568424588
748 N Earl Rudder Frwy
J (979) 691-3170
Hospital Affiliation: College Station Medical
Center, Scott And White Memorial Hospital,
St Joseph Regional Health Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Pope, Robert A, MD
Bryan
Gender: Male
PCP # 8BR21801
NPI: 1518979103
2900 E 29th St
Ste 200
J (979) 776-8440
Hospital Affiliation: College Station Medical
Center, St Joseph Regional Health Center
Clinic Affiliation: The Texas A&M University
System H
Board Certified Specialties: Family
Practice
INTERNAL MEDICINE
" Bonds Jr, James, MD
Bry an
Gender: Male
! PCP # 8AJ81201
NPI: 1093709511
3201 University Dr E
Ste 360
J (979) 731-8686
Hospital Affiliation: College Station Medical
Center, St Joseph Regional Health Center
Clinic Affiliation: James Bonds MD
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties: Internal
Medicine
Roberman, Susan G, MD
Gender: Female
PCP # 8BR21901
NPI: 1982635348
2900 E 29th St Ste 200
J (979) 776-8440
Hospital Affiliation: Baylor Medical Center
At Garland, College Station Medical Center,
St Joseph Regional Health Center
Clinic Affiliation: The Texas A&M University
System H
Board Certified Specialties: None
Bryan
J
PCP # 8U590801
NPI: 1376733899
2901 E 29th St Ste 123
(979) 776-9400
Hospital Affiliation: St Joseph Regional
Health Center
Clinic Affiliation: St Joseph Physician
Assoc, St Joseph Regional Health Center
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Pediatrics
BUDA
FAMILY PRACTICE
Carney, Linda K, MD
Gender: Female
PCP # 8V564001
NPI: 1356317929
1760 FM 967 Ste B
J (512) 295-7877
Hospital Affiliation: Central Texas Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: All Med Physicians PLLC
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: None
Buda
Clogston, Curtis P, MD
Gender: Male
# PCP # 8P232002
NPI: 1174543524
118 Trademark St
J (512) 392-5556
Hospital Affiliation: Seton Medical Center,
Southwest General Hospital
Clinic Affiliation: Curtis P Clogston MD
Board Certified Specialties: None
Buda
" Viscardi, Marjorie E, MD
Buda
Gender: Female
# PCP # 8BN26001
NPI: 1710046206
155 Cimarron Park L00p
Ste A
J (512) 295-2121
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Gary L Gilcrease MD
Board Certified Specialties: Family
Practice
J - Wheelchair Access
22
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
CEDAR PARK
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Graves, Robert A, DO
Burnet
BUDA Cont
PEDIATRICS
" Collins, Karyn W, MD
Buda
Gender: Female
PCP # 8S519101
NPI: 1245246420
211 Railroad St
J (512) 312-5312
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Southwest
Clinic Affiliation: Pediatric Junction PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Lincoln, Anna P, MD
Buda
Gender: Female
PCP # 8S519001
NPI: 1518973791
211 Railroad St
J (512) 312-5312
Hospital Affiliation: Seton Medical Center
Hays, Seton Southwest, St Davids S Austin
Medical Center
Clinic Affiliation: Pediatric Junction PA
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: Pediatrics
J
Robinson, Jere L, MD
Gender: Male
PCP # 00SX4801
NPI: 1467440636
2309 W US Hwy 29
J (512) 756-2784
Hospital Affiliation: Seton Highland Lakes
Practice Information: No infants under 6
months old
Board Certified Specialties: None
Bogdanovich, Michael B, MD
Gender: Male
# PCP # 87690Y01
NPI: 1386609048
500 W Whitestone
Blvd Ste 100
J (512) 250-3900
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Center, Seton
Northwest Hospital
Clinic Affiliation: Northwest Diagnostic
Clinic
Board Certified Specialties: None
Gender: Male
PCP # 85794G01
NPI: 1922058502
1103 Woodson Dr
(979) 567-7080
Hospital Affiliation: Burleson St Joseph
Health Center, St Joseph Regional Health
Center
Clinic Affiliation: St Joseph Regional
Health Center
Board Certified Specialties: Family
Practice
" Butler, Harrell D, MD
Cedar Park
J
Gender: Male
PCP # 8G934101
NPI: 1174539456
801 E Whitestone Bldg B
(512) 259-3467
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Calderon, April M, DO
Cedar Park
CAMERON
FAMILY PRACTICE
" Barkis, Leslie A, DO
Cameron
Gender: Male
PCP # 8DU64905
NPI: 1669468039
708 N Crockett Ave
(254) 697-6554
Hospital Affiliation: Little River Healthcare,
Metroplex Hospital, Scott And White
Memorial Hospital, Seton Medical Ctr Harker
Heights
Clinic Affiliation: Little River Healthcare
Family Ca
Board Certified Specialties: Family
Practice
INTERNAL MEDICINE
" Deng, Yue, MD
Burnet
" Frazier, Viviana C, MD
Cedar Park
Gender: Female
PCP # 8BG94001
NPI: 1093897555
801 E Whitestone Blvd B
(512) 259-3467
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Cedar Park
" Parsi, Kia E, MD
" Franz, Charles M, DO
Gender: Female
PCP # 8AK93601
NPI: 1821292483
200 County Rd 340A
J (512) 715-3110
Hospital Affiliation: Seton Highland Lakes,
Seton Medical Center, Seton Northwest
Hospital
Clinic Affiliation: Seton Healthcare
Board Certified Specialties: Internal
Medicine
Gender: Female
PCP # 8DE94701
NPI: 1396777355
921 W New Hope Dr
Ste 401
(512) 986-8858
Clinic Affiliation: Rosie Augustin Wheeler
MD
Board Certified Specialties: Family
Practice
Caldwell
J
Gender: Female
PCP # 8CH34701
NPI: 1467459115
500 W Whitestone 100
(512) 250-3900
Hospital Affiliation: Round Rock Medical
Center
Clinic Affiliation: Northwest Diagnostic
Clinic
Board Certified Specialties: Family
Practice
" Augustin Wheeler, Rosie, MD
Gender: Male
PCP # 8DZ20101
NPI: 1013945070
1012 Woodson Dr
(979) 567-4900
Hospital Affiliation: Burleson St Joseph
Health Center
Clinic Affiliation: Burleson County Family
Medicine P
Board Certified Specialties: Family
Practice
!
" Eady, Christine M, DO
Cedar Park
Cedar Park
" Chennault, John S, DO
Burnet
PCP # 8J562308
NPI: 1912978206
3201 S Water St
J (830) 596-3081
Hospital Affiliation: Seton Highland Lakes,
The Medical Ctr Of Southeast Tx Lp
Clinic Affiliation: Seton Healthcare
Practice Information: No Obstetrics, No
Patients Under 1 yrs old
Board Certified Specialties: Family
Practice
Gender: Female
PCP # 8CP18101
NPI: 1912191982
450 Cypress Creek Rd
Bldg 5
(512) 249-1400
Hospital Affiliation: Cedar Park Regional
Medical Ctr
Clinic Affiliation: Timberland Medical Group
Board Certified Specialties: Family
Practice
Caldwell
" Cravey, Bruce M, MD
Gender: Male
PCP # 8J562301
NPI: 1912978206
200 County Rd 340A
J (512) 715-3110
" Akin, Angela R, DO
Cedar Park
FAMILY PRACTICE
Burnet
Gender: Female
PCP # 8DS46101
NPI: 1821121112
1335 E Whitestone Blvd
Ste 100
(512) 400-6840
Clinic Affiliation: Medspring Prime of Texas
PA
Practice Information: No Patients Under 7
yrs old
Board Certified Specialties: Family
Practice
FAMILY PRACTICE
CALDWELL
FAMILY PRACTICE
Gender: Male
PCP # 8CS19903
NPI: 1487636064
101 E Jackson St
(512) 756-7510
Hospital Affiliation: Scott & White Hospital
Llano
Clinic Affiliation: Scott and White Hospital
Llano
Board Certified Specialties: Family
Practice
CEDAR PARK
Burnet
BURNET
" Dent, Marenda D, DO
Cedar Park
Gender: Male
PCP # 8G328601
NPI: 1982624854
200 County Rd 340A
(512) 715-3110
Hospital Affiliation: Seton Highland Lakes
Clinic Affiliation: Seton Healthcare
Practice Information: No Patients Under 14
yrs old
Board Certified Specialties: Internal
Medicine
" Cantu, James R, MD
Cameron
Gender: Male
PCP # 8CW90302
NPI: 1780977512
101 Lafferty
(254) 605-1100
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
J
J
Gender: Female
PCP # 8CL98603
NPI: 1437475191
900 Quest Pkwy
(254) 724-2111
PCP # 8CL98606
NPI: 1437475191
910 E Whitestone Blvd
(512) 260-6100
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Dandekar, Meghana S, MD
Cedar Park
Gender: Female
PCP # 8BK94401
NPI: 1932127834
801 E Whitestone Blvd
Ste B
(512) 259-3467
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Gogulski, David H, MD
Cedar Park
Gender: Male
PCP # 84194K04
NPI: 1245290931
900 E Whitestone Blvd
J (512) 684-4911
PCP # 84194K03
NPI: 1245290931
900 Quest Parkway
J (512) 509-0200
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Gray, Nadeen L, MD
Cedar Park
Gender: Female
!# PCP # 8DR05701
NPI: 1770598831
345 Cypress Creek Rd
Ste 104
(512) 336-2777
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Cedar Park Pediatric and
Family Med
Board Certified Specialties: Family
Practice
Hathcock, Ann E, DO
Gender: Female
PCP # 8BT30501
NPI: 1649339870
450 Cypress Creek Rd
Bldg 5
(512) 249-1400
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center
Clinic Affiliation: Timberland Medical Group
Practice Information: No Patients Under 6
yrs old
Board Certified Specialties: None
Cedar Park
Locklear, Mike L, MD
Gender: Male
PCP # 8CL49302
NPI: 1598713174
101 Lafferty
J (254) 605-1100
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
Cameron
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
J - Wheelchair Access
23
CEDAR PARK
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Morrison, Bryan K, MD
" Stewart, Christopher A, MD
Cedar Park
CEDAR PARK Cont
FAMILY PRACTICE Cont
" Hughes, Eric M, MD
Cedar Park
Gender: Male
PCP # 8BG94501
NPI: 1891809513
801 E Whitestone Blvd
Ste B
(512) 259-3467
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Overstreet, Haley C, MD
Gender: Female
PCP # 8ED05701
NPI: 1700107323
450 Cypress Creek Rd
Bldg 5
(512) 249-1400
Hospital Affiliation: Cedar Park Regional
Medical Ctr
Clinic Affiliation: Timberland Medical Group
Board Certified Specialties: Family
Practice
" Kappler, Julie E, MD
" King, Cameron T, MD
Cedar Park
Gender: Male
# PCP # 8S530101
NPI: 1457338436
345 Cypress Creek Rd
Ste 104
J (512) 336-2777
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center
Clinic Affiliation: Cedar Park Pediatric and
Family Med
Board Certified Specialties: Family
Practice
" King, Susan C, MD
Cedar Park
Gender: Female
# PCP # 0054GQ01
NPI: 1669459327
1907 Cypress Creek Rd
Ste 104
J (512) 346-7966
Hospital Affiliation: North Austin Medical
Center, Seton Northwest Hospital, St Davids
Medical Center
Board Certified Specialties: Family
Practice
" Mansolo, Ron M, MD
Cedar Park
Gender: Male
PCP # 8CL02101
NPI: 1871586933
500 W Whitestone Blvd
Ste 105
(512) 918-2225
Hospital Affiliation: River Oaks Endoscopy
Center Llp, Round Rock Medical Center,
Seton Northwest Hospital, West Houston
Medical Center
Clinic Affiliation: Rrcp Medical PLLC
Practice Information: No Patients Under 4
yrs old
Board Certified Specialties: Family
Practice
Merola, Wendy M, MD
Gender: Female
PCP # 8X259001
NPI: 1285603613
901 Cypress Creek Rd
Bldg 1 Ste 100
J (512) 615-9191
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, St
Davids Medical Center
Clinic Affiliation: Specialists In Family
Medicine PA
Board Certified Specialties: None
Cedar Park
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Fowler, John T, MD
Gender: Male
PCP # 8EG91401
NPI: 1528075348
1201 N Lakeline Blvd
Ste 400
(512) 379-7272
Hospital Affiliation: Baptist Beaumont
Hospital, Christus Dubuis Hospital
Beaumont, Christus Hospital
Clinic Affiliation: Zest Family Practice
PLLC
Board Certified Specialties: None
Cedar Park
Gender: Male
PCP # 86774K03
NPI: 1184686230
900 Quest Parkway
J (512) 509-0200
Cedar Park
Cedar Park
Gender: Female
PCP # 8DP38602
NPI: 1285895086
900 Quest Pkwy
(512) 260-6100
Hospital Affiliation: Tx Hlth Presbyterian
Hosp Allen
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
Cedar Park
Gender: Male
PCP # 8BK94901
NPI: 1013912823
801 E Whitestone Blvd
Bldg B
(512) 259-3467
Hospital Affiliation: Round Rock Medical
Center
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Patel, Smita C, MD
Cedar Park
Gender: Female
PCP # 8AB53306
NPI: 1235166786
900 Quest Pkwy
J (512) 250-6100
PCP # 86774K05
NPI: 1184686230
910 E Whitestone Blvd
J (512) 260-6100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Stoeckel, Mark D, MD
Gender: Male
PCP # 8CT13501
NPI: 1689671042
450 Cypress Creek Rd
Bldg 5
J (512) 249-1400
Hospital Affiliation: Cedar Park Regional
Medical Ctr
Clinic Affiliation: Timberland Medical Group
Board Certified Specialties: None
" Kohli, Nandini D, MD
Cedar Park
Gender: Female
PCP # 8W519102
NPI: 1942308804
11901 W Parmer Ln
Ste 300
(512) 652-0050
Hospital Affiliation: North Austin Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: Austin Primary Care
Physicians
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: Internal
Medicine
Cedar Park
Yee, Bing G, MD
Gender: Male
PCP # 82400X01
NPI: 1770683484
200 S Bell Bldg B-4
J (512) 249-0880
Hospital Affiliation: Round Rock Medical
Center, St Davids Georgetown Hospital
Clinic Affiliation: Cedar Park Family
Practice
Practice Information: No infants under 6
months old
Board Certified Specialties: None
J
Cedar Park
PCP # 8AB53307
NPI: 1235166786
910 E Whitestone Blvd
J (512) 260-6100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
Young, Blake A, MD
Gender: Male
PCP # 8EK63702
NPI: 1205124252
910 E Whitestone Blvd
J (512) 260-6100
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
" Naik, Manish M, MD
Cedar Park
Gender: Male
PCP # 87J45901
NPI: 1184630436
1401 Medical Pkwy
Ste 220 Bldg B
(512) 260-1581
Hospital Affiliation: Healthsouth
Rehabilitation Hospital Of Austin, Seton
Medical Center, Seton Northwest Hospital,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
J
Cedar Park
Ringler Jr, Robert L, MD
Gender: Male
PCP # 8DT66002
NPI: 1225005051
900 Quest Pkwy
(512) 260-6100
Cedar Park
PCP # 8DT66003
NPI: 1225005051
910 E Whitestone Blvd
(512) 260-6100
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
" Pegany, Mohinder S, MD
Cedar Park
Gender: Male
PCP # 8AM79301
NPI: 1992798987
1401 Medical Bldg B 220
(512) 260-1581
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Internal
Medicine
INTERNAL MEDICINE
" Agarwal, Nikhil, MD
Cedar Park
Gender: Male
PCP # 8DB46101
NPI: 1124173513
11901 W Parmer Ln
Ste 300
J (512) 652-0050
Hospital Affiliation: Cedar Park Regional
Medical Ctr
Clinic Affiliation: Austin Primary Care
Physicians
Board Certified Specialties: Internal
Medicine
" Smith, Benjamin L, MD
Cedar Park
Gender: Male
PCP # 87430Y02
NPI: 1336101641
900 Quest Pkwy
J (512) 509-0200
PCP # 87430Y03
NPI: 1336101641
910 E Whitestone Blvd
J (512) 260-6100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Farmer, Christopher M, MD
" Reinhart, Joshua H, MD
Cedar Park
J
Cedar Park
Surapaneni, Veena, MD
Gender: Female
PCP # 8DD87801
NPI: 1235212580
11901 W Parmer Ln
Ste 110
(512) 260-5206
Cedar Park
Gender: Male
PCP # 8DB47903
NPI: 1619136462
900 E Whitestone Blvd
J (512) 684-4911
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
" Steffy, Krista M, MD
Cedar Park
Gender: Female
PCP # 8DZ22502
NPI: 1366681678
900 Quest Pkwy
J (512) 260-6100
Foster, Steven K, MD
Gender: Male
# PCP # 8CE99501
NPI: 1245276682
190 Buttercup Creek
Blvd
(512) 336-5824
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Round Rock Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Family Medical Center
Board Certified Specialties: None
Cedar Park
PCP # 8DZ22503
NPI: 1366681678
910 E Whitestone Blvd
J (512) 260-6100
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
Gender: Male
PCP # 8CQ96201
NPI: 1225229412
190 Buttercup Creek
Blvd
(512) 336-5824
Clinic Affiliation: Family Medical Center
Board Certified Specialties: Internal
Medicine
J
PCP # 0088ED01
NPI: 1235212580
11901 W Parmer Ln Ste 110
(512) 260-5206
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center
Clinic Affiliation: Veena Surapaneni PA
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties: None
J - Wheelchair Access
24
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
COLLEGE STATION
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Foster, Steven K, MD
Gender: Male
# PCP # 8CE99501
NPI: 1245276682
190 Buttercup Creek
Blvd
(512) 336-5824
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Round Rock Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Family Medical Center
Board Certified Specialties: None
" Pandya, Charuben C, MD
Cedar Park
CEDAR PARK Cont
INTERNAL MEDICINE Cont
Wu, Jennifer Q, MD
Gender: Female
PCP # 8DW21501
NPI: 1275858367
1401 Medical Pkwy
Bldg B Ste 220
(512) 260-1581
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Cedar Park
PEDIATRICS
" Cardwell, Brent S, MD
Cedar Park
Gender: Male
# PCP # 8S530001
NPI: 1720065709
345 Cypress Creek Rd
Ste 104
J (512) 336-2777
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Cedar Park Pediatric and
Family Med
Board Certified Specialties: Pediatrics
" Cardwell, Jennifer M, MD
Cedar Park
Gender: Female
# PCP # 8S530701
NPI: 1699824706
345 Cypress Creek Rd
Ste 104
(512) 336-2777
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Cedar Park Pediatric and
Family Med
Board Certified Specialties: Pediatrics
" Cheng, Arthur C, MD
Cedar Park
Gender: Male
PCP # 8AQ06601
NPI: 1669472866
801 E Whitestone Blvd
Bldg B
(512) 259-3467
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Cohen, Joseph I, MD
Cedar Park
Gender: Male
PCP # 8U337001
NPI: 1932119930
200 Buttercup Creek Blvd
Ste 100
J (512) 335-9600
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, University Med Ctr
Brackenridge
Clinic Affiliation: Cedar Park Pediatrics
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: Pediatrics
" Coldwater, Cheryl L, MD
Cedar Park
Cedar Park
Gender: Female
PCP # 8BG94201
NPI: 1710091855
715 Discovery Blvd
Ste 117
(512) 528-2300
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Hutchens, Lisa W, MD
Gender: Female
# PCP # 8CG54501
NPI: 1730287525
345 Cypress Creek Rd
Ste 104
(512) 336-2777
Clinic Affiliation: Cedar Park Pediatric and
Family Med
Board Certified Specialties: None
Cedar Park
" Pezzullo, Rosemarie A, MD
Cedar Park
Jackson, Charity L, MD
Gender: Female
PCP # 8CW07701
NPI: 1033382262
715 Discovery Blvd
Ste 117
(512) 528-2300
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Cedar Park
" Keegan, Lee O, MD
Cedar Park
" Rice Monteiro, Kellie A, DO
Cedar Park
Gender: Female
PCP # 8W525901
NPI: 1174563605
715 Discovery Blvd Ste 117
(512) 528-2300
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Pediatrics
" Spencer, Chris C, MD
Cedar Park
Gender: Female
# PCP # 8S530901
NPI: 1134323629
345 Cypress Creek Rd 104
(512) 336-2777
Hospital Affiliation: Cedar Park Regional
Medical Ctr
Clinic Affiliation: Cedar Park Pediatric and
Family Med
Board Certified Specialties: Pediatrics
J
" Mathew, Betzi S, MD
Cedar Park
Gender: Female
# PCP # 8S530501
NPI: 1073510566
345 Cypress Creek Rd
Ste 104
(512) 336-2777
Hospital Affiliation: Round Rock Medical
Center, Seton Northwest Hospital
Clinic Affiliation: Cedar Park Pediatric and
Family Med
Board Certified Specialties: Pediatrics
Gender: Male
PCP # 87J46701
NPI: 1316953672
715 Discovery Blvd
Ste 117
(512) 528-2300
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" West, Deborah P, MD
Cedar Park
Gender: Female
# PCP # 8CF35601
NPI: 1548267040
1730 E Whitestone Blvd
Ste 101
(877) 800-5722
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Dell Childrens Med Ctr Cent Tx,
Seton Medical Ctr Williamson
Clinic Affiliation: Lone Star Circle of Care
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Moore, Lindsey N, MD
Cedar Park
Gender: Female
# PCP # 8DG83501
NPI: 1184867632
345 Cypress Creek Rd
Ste 104
J (512) 336-2777
Hospital Affiliation: Seton Northwest
Hospital
Clinic Affiliation: Cedar Park Pediatric and
Family Med
Board Certified Specialties: Pediatrics
COLLEGE STATION
FAMILY PRACTICE
" Allen Jr, James H, MD
College Station
Gender: Female
PCP # 8CY43701
NPI: 1346255494
190 Buttercup Creek
Blvd
(512) 336-5824
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Family Medical Center
Board Certified Specialties: Pediatrics
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Female
PCP # 8DM70601
NPI: 1235221607
200 Buttercup Creek
Blvd Ste 100
(512) 335-9600
Clinic Affiliation: Cedar Park Pediatrics
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
J
Gender: Male
PCP # 8CA00802
NPI: 1912983362
1600 University Dr E
(979) 691-3300
Hospital Affiliation: Heart Of Texas
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Bacak, Russell B, MD
College Station
Gender: Male
PCP # 8M186001
NPI: 1184705741
2803 Earl Rudder Frwy S
Ste 201
J (979) 695-3570
Hospital Affiliation: College Station Medical
Center, St Joseph Regional Health Center
Clinic Affiliation: BCS Abundant Life Family
Practice PA
Board Certified Specialties: Family
Practice
" Barrow, Justin B, MD
College Station
Gender: Male
PCP # 8F119402
NPI: 1376503607
1600 University Dr E
J (979) 691-3300
Hospital Affiliation: Muleshoe Area Medical
Center, Scott And White Memorial Hospital,
University Medical Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Biles, Russell K, MD
Gender: Male
PCP # 84M13203
NPI: 1871552687
1600 University Dr E
J (979) 691-3300
Hospital Affiliation: Scott And White
Memorial Hospital, St Joseph Regional
Health Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
College Station
" Blazo, Maria A, MD
College Station
Gender: Female
PCP # 8EQ85702
NPI: 1902986334
1600 University Dr E
J (979) 691-3300
Hospital Affiliation: Chi St Lukes Hlth
Baylor Coll Med, Houston Methodist
Hospital, Texas Childrens Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Bramson, Rachel, MD
College Station
Gender: Female
PCP # 84M15403
NPI: 1437118213
1600 University Dr E
J (254) 724-2911
Hospital Affiliation: College Station Medical
Center, Scott And White Memorial Hospital,
St Joseph Regional Health Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Brieger, Duane A, MD
Gender: Male
PCP # 84015K02
NPI: 1205896230
1600 University Dr E
J (254) 724-2911
Hospital Affiliation: College Station Medical
Center, Scott And White Memorial Hospital,
St Joseph Regional Health Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
College Station
" English, Mark, MD
College Station
Gender: Male
PCP # 84E44803
NPI: 1134189996
1600 University Dr E
J (254) 724-2911
Hospital Affiliation: College Station Medical
Center, Scott And White Memorial Hospital,
St Joseph Regional Health Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
!
J - Wheelchair Access
25
COLLEGE STATION
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Higgins, Mark S, MD
Gender: Male
PCP # 81X05902
NPI: 1043270648
1600 University Dr E
J (254) 724-2911
Hospital Affiliation: College Station Medical
Center, Scott And White Memorial Hospital,
St Joseph Regional Health Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
" Poling, Matthew C, MD
College Station
COLLEGE STATION Cont
FAMILY PRACTICE Cont
Eschberger, Anne M, MD
Gender: Female
PCP # 8DW94702
NPI: 1295056638
1600 University Dr E
(979) 691-3300
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
College Station
" Feaster, Robert S, MD
College Station
Gender: Male
PCP # 8BZ31002
NPI: 1891951018
1600 University Dr E
(979) 691-3300
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Gehring, Donald, DO
College Station
!
J
Gender: Male
PCP # 84M13303
NPI: 1043270739
1600 University Dr E
(254) 724-2911
Hospital Affiliation: College Station Medical
Center, Scott And White Memorial Hospital,
St Joseph Regional Health Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Goerig, Brian J, MD
College Station
Gender: Male
PCP # 8EL08501
NPI: 1477593051
2849 Barron Rd
(979) 703-1902
Hospital Affiliation: El Campo Memorial
Hospital, Gulf Coast Medical Center, Mother
Frances Hosp Winnsboro
Clinic Affiliation: Regional Employee
Assistance Program
Board Certified Specialties: Family
Practice
Greiner, Kathryn, MD
Gender: Female
PCP # 8EL06302
NPI: 1548556269
700 Scott& White Dr
(979) 201-0100
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
College Station
Herron, Richard E, MD
Gender: Male
PCP # 80568Y01
NPI: 1780646687
1602 Rock Prairie Rd
Ste 230
J (979) 693-2586
Hospital Affiliation: St Joseph Regional
Health Center
Clinic Affiliation: Regional Employee
Assistance Program
Board Certified Specialties: None
College Station
" Higginbotham, Steven W, MD
College Station
Gender: Male
PCP # 8F270602
NPI: 1073566758
1600 University Dr E
(254) 724-2911
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
College Station
Gender: Male
PCP # 8F119902
NPI: 1922069327
1600 University Dr E
J (254) 724-2911
Hospital Affiliation: Scott And White
Memorial Hospital, St Joseph Regional
Health Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Knoop, Kristopher D, MD
College Station
Richardson, Wade A, MD
Gender: Male
PCP # 81X06003
NPI: 1326009978
1296 Arrington Rd
J (979) 691-3300
Hospital Affiliation: College Station Medical
Center, Scott And White Memorial Hospital,
St Joseph Regional Health Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
Gender: Male
PCP # 8CA74302
NPI: 1598759318
1296 Arrington Rd
J (979) 691-3300
Hospital Affiliation: St Joseph Regional
Health Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
College Station
" Marley, Laneece D, MD
College Station
" Rutland, Kathryn T, MD
" Villarreal, Roque, MD
College Station
J
" Wagner, Thomas J, MD
College Station
J
College Station
Gender: Female
PCP # 8EN11002
NPI: 1477849198
1600 University Dr E
(979) 691-3300
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Gender: Female
PCP # 8EG06002
NPI: 1851586176
1730 Birmingham Dr
Ste 100
(979) 774-7587
PCP # 8EG06003
NPI: 1851586176
2849 Barron Rd
(979) 703-1902
" Moscoso-Donoso, Wilson R, MD
College Station
Gender: Male
PCP # 8DL34702
NPI: 1093762940
1600 University Dr E
J (979) 691-3300
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
# PCP # 8EG06001
NPI: 1851586176
711 Church Ave
Ste 101
(979) 485-2827
Hospital Affiliation: College Station Medical
Center
Clinic Affiliation: Regional Employee
Assistance Program
Board Certified Specialties: Family
Practice
Ngo, Van T, MD
Gender: Female
PCP # 81X06202
NPI: 1003877929
1600 University Dr E
J (254) 724-2911
Hospital Affiliation: College Station Medical
Center, Scott And White Memorial Hospital,
St Joseph Regional Health Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
College Station
Waguespack, Jeffrey W, MD
Gender: Male
PCP # 84009K02
NPI: 1619939634
1296 Arrington Rd
J (979) 691-3300
Hospital Affiliation: College Station Medical
Center, Scott And White Memorial Hospital,
St Joseph Regional Health Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
" Welch, Thomas K, MD
College Station
J
" Sanchez, Jorge E, MD
Ormberg, Audrey, MD
Gender: Female
# PCP # 8BR21602
NPI: 1891781506
1264 Texas A and M
University
J (979) 458-8374
Hospital Affiliation: College Station Medical
Center, St Joseph Regional Health Center
Clinic Affiliation: The Texas A&M University
System H
Board Certified Specialties: None
College Station
Sterling, James, DO
Gender: Male
! PCP # 84M12903
NPI: 1588626816
1600 University Dr E
J (254) 724-2911
Hospital Affiliation: College Station Medical
Center, Scott And White Memorial Hospital,
St Joseph Regional Health Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
College Station
" Pockrus, Mandy J, MD
College Station
Gender: Female
PCP # 8DJ35902
NPI: 1578890216
1600 University Dr E
J (979) 691-3300
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
" Turner, Denise K, MD
College Station
Gender: Female
PCP # 8CW14702
NPI: 1952312563
1600 University Dr E
J (979) 691-3300
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Gender: Male
PCP # 84M14302
NPI: 1639131659
1296 Arrington Rd
(979) 691-3300
Hospital Affiliation: College Station Medical
Center, Scott And White Memorial Hospital,
St Joseph Regional Health Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
College Station
College Station
Gender: Male
PCP # 8DW37602
NPI: 1609196401
1600 E University Dr
(979) 691-3300
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
Gender: Male
PCP # 84E44303
NPI: 1568424588
1600 University Dr E
(254) 724-2911
Hospital Affiliation: College Station Medical
Center, Scott And White Memorial Hospital,
St Joseph Regional Health Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Gender: Male
PCP # 84M14402
NPI: 1720040637
1600 University Dr E
(254) 724-2911
Hospital Affiliation: College Station Medical
Center, Scott And White Memorial Hospital,
St Joseph Regional Health Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Wiprud, Robert, MD
College Station
J
Gender: Male
PCP # 84E42503
NPI: 1740242148
1600 University Dr E
(254) 724-2911
Hospital Affiliation: College Station Medical
Center, Scott And White Memorial Hospital,
St Joseph Regional Health Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
INTERNAL MEDICINE
" Alikhan, Amina, MD
College Station
Gender: Female
PCP # 8BZ13002
NPI: 1518124171
1600 University Dr E
(979) 691-3300
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Bota, Vasile M, MD
College Station
Gender: Male
PCP # 8EK56702
NPI: 1447488176
1600 E University Dr
(979) 691-3300
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
J - Wheelchair Access
26
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
COPPERAS COVE
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Mitter, Ajay, MD
Gender: Male
PCP # 80563Y01
NPI: 1174587307
1602 Rock Prairie Rd
Ste 2660
J (979) 694-2984
Hospital Affiliation: Chi St Lukes Hlth
Baylor Coll Med, College Station Medical
Center, Mem Hermann Southeast Hosp,
Mem Hermann Southwest Hospital, Park
Plaza Hospital
Clinic Affiliation: Regional Employee
Assistance Program
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
College Station
COLLEGE STATION Cont
INTERNAL MEDICINE Cont
Covington, Bill R, MD
Gender: Male
PCP # 8DV00302
NPI: 1912168279
1600 University Dr E
(979) 691-3300
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
College Station
" Goraya, Nimrit, MD
College Station
Gender: Female
PCP # 8CN06702
NPI: 1518168723
1600 University Dr E
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
J
Gender: Male
PCP # 80744202
NPI: 1306806914
1600 University Dr E
J (979) 691-3300
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Practice Information: Practice Limited to
Geriatrics
Board Certified Specialties: Internal
Medicine
" Meade, Linda P, MD
Gender: Female
PCP # 85422Y02
NPI: 1457311946
1600 University Dr E
J (254) 724-2911
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Male
PCP # 8CF33903
NPI: 1336107549
1600 E University Dr
(979) 691-3300
Hospital Affiliation: John Peter Smith
Hospital, Parkland Health And Hospital Sys
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Meyer, Arlene, MD
J
J
Gender: Female
PCP # 84M13402
NPI: 1982665949
1600 University Dr E
(254) 724-2911
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
" Ransom, Daniel G, MD
College Station
J
" White, Heath D, DO
J
Gender: Male
PCP # 81X06502
NPI: 1073574216
1600 University Dr E
(254) 724-2911
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
College Station
College Station
Gender: Male
PCP # 8CW55706
NPI: 1134392582
700 Scott & White Dr
(979) 207-0100
Gender: Male
PCP # 84E42802
NPI: 1104887892
1600 University Dr E
(254) 724-2911
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
" Sicilio, Mark S, MD
College Station
PCP # 8CW55705
NPI: 1134392582
800 Scott & White Dr
(979) 207-4000
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
J
Gender: Male
PCP # 84E41602
NPI: 1477514149
1600 University Dr E
(254) 724-2911
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
" Svendsen, Betty Ann E, MD
College Station
PEDIATRICS
" Agadi, Satish, MD
College Station
College Station
College Station
J
" Schlabach, Michael R, MD
" Issac, Tony, MD
Mahajan, Ashutosh K, MD
Gender: Male
PCP # 8DW39702
NPI: 1932140183
1600 University Dr E
J (979) 691-3300
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
" Lawrence, Glenn L, MD
College Station
J
Gender: Male
PCP # 8CW38803
NPI: 1700999265
1600 E University Dr
(979) 691-3300
Hospital Affiliation:
ChildrensHospitalSanAntonio', Christus
Santa Rosa Hosp City Ctr, University Health
System
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
College Station
Gender: Male
PCP # 8BG56102
NPI: 1710902960
1600 University Dr E
(979) 691-3300
Hospital Affiliation: St Marks Medical
Center
Clinic Affiliation: Scott and White Clinic
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Internal
Medicine
College Station
Gender: Male
PCP # 8CW94102
NPI: 1447440912
1600 University Dr E
J (979) 691-3300
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
J
" Pieratt III, William H, DO
" Guo, Jadie Y, MD
" Hackethorn, David L, MD
" Kane, Javier R, MD
College Station
College Station
College Station
Gender: Female
PCP # 8CL71502
NPI: 1578721940
1600 University Dr E
(979) 691-3300
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Gender: Male
PCP # 84E40702
NPI: 1104886571
1600 University Dr E
(254) 724-2911
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
College Station
" Phan, Kelly M, MD
" Grillo, Kelly H, MD
Gender: Female
PCP # 8AD06702
NPI: 1619156056
1600 University Dr E
J (979) 691-3300
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
J
College Station
College Station
Gender: Female
PCP # 8AD06303
NPI: 1306851274
700 Scott and White Dr
J (979) 207-0100
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Foster, D M, MD
College Station
J
Gender: Male
PCP # 8EB57802
NPI: 1275724585
700 Scott and White Dr
(254) 724-2111
Hospital Affiliation: Texas Childrens
Hospital
Clinic Affiliation: Scott and White Clinic
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
J
PCP # 84016K02
NPI: 1740242296
1600 University Dr E
(254) 724-2911
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
COPPERAS COVE
FAMILY PRACTICE
" Chikkala, Subha, MD
Copperas Cove
Gender: Female
# PCP # 8DV94401
NPI: 1245505254
2401 Walker Place Blvd
J (254) 547-5516
Hospital Affiliation: Metroplex Hospital,
Valley Baptist Medical Center
Clinic Affiliation: Family Medicine Rural
Health
Board Certified Specialties: Family
Practice
" Go, David Y, MD
Copperas Cove
Gender: Male
PCP # 8EB57401
NPI: 1962479212
2401 Walker Place Blvd
(254) 547-5516
Hospital Affiliation: Seton Medical Ctr
Harker Heights
Clinic Affiliation: Family Medicine Rural
Health
Board Certified Specialties: Family
Practice
Morsch, James K, MD
Gender: Male
PCP # 8EC14501
NPI: 1851385371
806 E Ave D
Ste H
(254) 518-5511
Clinic Affiliation: Cove Medical Clinic PA
Board Certified Specialties: None
Copperas Cove
" Patteson Jr, Morris K, MD
Copperas Cove
Gender: Male
# PCP # 89Y90103
NPI: 1609858232
2401 Walker Place Blvd
Ste 300
J (254) 547-5516
Hospital Affiliation: Metroplex Hospital,
Rollins Brook Community Hospital
Clinic Affiliation: Family Medicine Rural
Health
Board Certified Specialties: Family
Practice
" Reddy, Rajesh, MD
Copperas Cove
Gender: Male
PCP # 8ER03501
NPI: 1205029287
239 W Hwy 190
J (254) 542-9000
Hospital Affiliation: Metroplex Hospital,
Scott And White Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
INTERNAL MEDICINE
" Harrison, Karen P, MD
Copperas Cove
Gender: Female
PCP # 82708N01
NPI: 1902866460
239 W Hwy 190
J (254) 724-2111
# PCP # 8X900101
NPI: 1902866460
806 E Ave D
Ste E
J (254) 547-0006
Hospital Affiliation: Metroplex Hospital
Clinic Affiliation: Harrison and Harrison
Internal Me, Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs, No Patients
Under 18 yrs old
Board Certified Specialties: Internal
Medicine
" Flippin, Jill M, MD
College Station
Gender: Female
PCP # 8BU45102
NPI: 1871767087
1600 University Dr E
(979) 691-3300
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
J - Wheelchair Access
27
COPPERAS COVE
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
PEDIATRICS
" Stockman, Gail D, MD
Corsicana
COPPERAS COVE Cont
INTERNAL MEDICINE Cont
Harrison, Raymond J, MD
Gender: Male
PCP # 82707N02
NPI: 1699735324
239 E Business 190
J (254) 542-9000
Copperas Cove
PCP # 8X900001
NPI: 1699735324
806 E Ave D
Ste E
(254) 547-0006
Hospital Affiliation: Metroplex Hospital
Clinic Affiliation: Harrison and Harrison
Internal Me, Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs, No Patients
Under 18 yrs old
Board Certified Specialties: None
J
CORSICANA
FAMILY PRACTICE
" Giessel, Barton E, MD
Corsicana
Gender: Male
PCP # 8DQ23501
NPI: 1578616504
400 Hospital Dr
Ste 101
(903) 641-3800
Hospital Affiliation: Bellville St Joseph
Health Center, Scott & White Hospital
Brenham, Scott And White Memorial
Hospital
Clinic Affiliation: Regional Employee
Assistance Program
Board Certified Specialties: Family
Practice
J
" Mataoui, Noha, MD
Corsicana
Gender: Female
PCP # 8DQ29301
NPI: 1366670440
400 Hospital Dr Ste 104
(903) 641-3848
Hospital Affiliation: Baylor Medical Center
At Mckinney
Clinic Affiliation: Regional Employee
Assistance Program
Board Certified Specialties: Family
Practice
J
INTERNAL MEDICINE
" Rogers, Kent E, MD
Corsicana
Gender: Male
PCP # 8AL34701
NPI: 1740255587
301 Hospital Dr
Ste 195
(903) 872-3305
Hospital Affiliation: Parkland Health And
Hospital Sys
Clinic Affiliation: Medical Surg Assocs
Corsicana
Board Certified Specialties: Internal
Medicine
Stevener, David S, MD
Gender: Male
PCP # 8EA27901
NPI: 1609193721
401 Hospital Dr
Ste 140
(903) 872-3005
Clinic Affiliation: Medical Surg Assocs
Corsicana
Board Certified Specialties: None
Corsicana
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Female
PCP # 8G241501
NPI: 1588730170
400 Hospital Dr
Ste 200
J (903) 654-4578
Hospital Affiliation: Good Shepherd
Medical Center, Longview Regional Medical
Center
Clinic Affiliation: Regional Employee
Assistance Program
Board Certified Specialties: Internal
Medicine
Haslund, Karen, MD
Gender: Female
PCP # 8CY95501
NPI: 1972566941
5301 Ross Rd
Ste H
(512) 386-3335
Clinic Affiliation: Communitycare
Board Certified Specialties: None
ELGIN
Del Valle
Lama Briseno, Tracy R, DO
Gender: Female
PCP # 8CY93605
NPI: 1558520544
3518 FM 973
(512) 978-9820
Clinic Affiliation: Communitycare
Board Certified Specialties: None
Del Valle
COTTONWOOD SHORES
FAMILY PRACTICE
Liggett, Scott P, MD
Gender: Male
PCP # 8CS20703
NPI: 1336121953
100 Pecan Crossing
(830) 598-4405
Hospital Affiliation: Scott & White Hospital
Llano, Seton Highland Lakes
Clinic Affiliation: Scott and White Hospital
Llano
Board Certified Specialties: None
Cottonwood Shores
FAMILY PRACTICE
Biel, William T, MD
Gender: Male
!# PCP # 83690Y01
NPI: 1366437485
209 E Second St
J (512) 285-3315
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Elgin Medical Center PA
Board Certified Specialties: None
Elgin
" Molina Batlle, Claudia M, MD
Elgin
Gender: Female
PCP # 8CV13101
NPI: 1508800863
428 S Main St
(512) 791-1224
Clinic Affiliation: Seton Family of Doctors
Board Certified Specialties: Family
Practice
DRIPPING SPRINGS
FAMILY PRACTICE
Buchanan, Todd D, MD
Gender: Male
PCP # 86210S01
NPI: 1164456646
104 W Mercer St
J (512) 858-4166
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Dripping Springs Family
Clin
Board Certified Specialties: None
Dripping Springs
INTERNAL MEDICINE
Jones, Shirley F, MD
Gender: Female
PCP # 8CS30204
NPI: 1750304200
100 Pecan Crossing
(830) 598-4055
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Hospital
Llano
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Cottonwood Shores
Sharman Jr, Ralph S, MD
Gender: Male
PCP # 8DW40801
NPI: 1548297096
104 W Mercer
(512) 892-7076
Dripping Springs
PCP # 8AJ05101
NPI: 1548297096
104 W Mercer St
Ste H
J (512) 858-2997
Hospital Affiliation: Central Texas Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: Ralph S Sharman Jr MD,
South Austin Family Practiceclinic LLP
Board Certified Specialties: None
Turner, Terry L, MD
Gender: Male
PCP # 8CS22803
NPI: 1982686481
100 Pecan Crossing
(830) 598-4405
Hospital Affiliation: Scott & White Hospital
Llano
Clinic Affiliation: Scott and White Hospital
Llano
Board Certified Specialties: None
Cottonwood Shores
" Ruiz, Marilyn, MD
Elgin
Gender: Female
!# PCP # 8BN74001
NPI: 1528273281
209 E Second St
J (512) 285-3315
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Elgin Medical Center PA
Board Certified Specialties: Family
Practice
Sherman, Kenneth B, MD
Gender: Male
!# PCP # 83691Y01
NPI: 1710972476
209 E Second St
J (512) 285-3315
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Elgin Medical Center PA
Board Certified Specialties: None
Elgin
PEDIATRICS
" English, Karen E, MD
Elgin
PEDIATRICS
J
" Boes, Sheila D, MD
Dripping Springs
Gender: Female
PCP # 8EB71101
NPI: 1396708103
331 Sportsplex Dr
Ste C
(512) 894-3737
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Dripping Springs
Pediatrics
Board Certified Specialties: Pediatrics
DEL VALLE
FAMILY PRACTICE
" Escamilla, David F, MD
Del Valle
Gender: Male
PCP # 8CY95104
NPI: 1427093434
3518 FM 973
J (512) 978-9820
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: Communitycare
Board Certified Specialties: Family
Practice
Stinson, Kathleen S, MD
Gender: Female
PCP # 8W060001
NPI: 1659312262
331 Sportsplex Dr
Ste C
J (512) 894-3737
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Southwest, St Davids S
Austin Medical Center
Clinic Affiliation: Dripping Springs
Pediatrics
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
Dripping Springs
INTERNAL MEDICINE
" Sasson, Bobby, MD
Del Valle
Gender: Female
PCP # 8CY99101
NPI: 1528181344
3518 FM 973
(512) 978-9760
Clinic Affiliation: Communitycare
Board Certified Specialties: Internal
Medicine
Gender: Female
PCP # 8K528001
NPI: 1891752697
218 W US Hwy 290
(512) 281-1900
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Elgin Pediatrics PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
FAIRFIELD
FAMILY PRACTICE
Berger III, Joseph R, DO
Gender: Male
PCP # 8P880501
NPI: 1508859596
734 W Commerce St
J (903) 289-2181
Hospital Affiliation: East Texas Medical
Center Fairfield, Parkview Regional Hospital
Clinic Affiliation: Etmc Jewett Health Clinic
Practice Information: No Obstetrics
Board Certified Specialties: None
F airfield
J - Wheelchair Access
28
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
GEORGETOWN
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Vo, Thu P, DO
" Duperval-Brownlee, Tamarah, MD
Gatesv ille
FAIRFIELD Cont
FAMILY PRACTICE Cont
Orms, James M, MD
Gender: Male
PCP # 8M680602
NPI: 1487694717
125 Newman St
J (903) 389-2181
Fairfield
J
Routhouska, Glenn A, DO
Gender: Male
PCP # 81W71701
NPI: 1821091703
106 N Keechi St
J (903) 389-6112
Hospital Affiliation: East Texas Medical
Center Fairfield, Palestine Regional Medical
Center
Clinic Affiliation: East Texas Physicians
Alliance LLP
Board Certified Specialties: None
" Wuenschel, Diedra D, DO
FAMILY PRACTICE
" Clay, Nancy J, MD
Gatesville
Gender: Female
PCP # 8BQ53001
PCP # 8U777201
NPI: 1962542118
1507 W Main St
(254) 865-2166
(254) 865-8251
Hospital Affiliation: Coryell Memorial
Hospital
Clinic Affiliation: Coryell Memorial
Hospital-HBP
Board Certified Specialties: Family
Practice
Gender: Male
PCP # 8DE87201
NPI: 1104973304
1507 W Main St
J (254) 865-2166
Hospital Affiliation: Coryell Memorial
Hospital
Clinic Affiliation: Coryell Memorial
Hospital-HBP
Board Certified Specialties: Family
Practice
" Hart, Kathryn D, MD
Gender: Female
PCP # 8DN81904
NPI: 1073876306
1507 River Blvd
(512) 509-9550
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
GEORGETOWN
Bohmfalk, Thomas C, MD
Gender: Male
PCP # 8CQ94701
NPI: 1083794077
3201 S Austin Ave
Ste 210
(512) 763-4000
Hospital Affiliation: Seton Medical Ctr
Williamson, St Davids Georgetown Hospital
Clinic Affiliation: Capital Area Primary Care
PLLC
Board Certified Specialties: None
Georgetown
" Paul, Love D, MD
Georgetown
Gender: Male
PCP # 8CC71102
NPI: 1730147018
7600 W Hwy 29
Ste 5
(512) 930-0363
Hospital Affiliation: Detar Hospital Navarro,
Detar Hospital North, North Austin Medical
Center
Clinic Affiliation: Austin Medical Group
PLLC
Practice Information: No Patients Under 11
yrs old
Board Certified Specialties: Family
Practice
" Calderon, April M, DO
Georgetown
Gender: Female
PCP # 8CL98602
NPI: 1437475191
4945 Williams Dr
(512) 819-0500
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Jones, William R, DO
Gender: Male
PCP # 00MH5601
NPI: 1366464596
3008 Dawn Dr Ste 201
J (512) 863-4596
Hospital Affiliation: Round Rock Medical
Center, St Davids Georgetown Hospital
Board Certified Specialties: None
Georgetown
Latta, Tamika D, MD
Gender: Female
PCP # 8DH72501
NPI: 1386872901
2423 Williams Dr
Ste 105
J (877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: None
Georgetown
Scanlan, Lynne, MD
Gender: Female
PCP # 8CW16202
NPI: 1285898668
4945 Williams Dr
J (512) 819-0500
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
Georgetown
" Shifley, Jennifer M, MD
Georgetown
Gender: Female
PCP # 8P148902
NPI: 1902867666
4945 Williams Dr
(512) 819-0500
Hospital Affiliation: Scott And White
Memorial Hospital, Seton Medical Center,
Seton Southwest
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Male Jr, Richard C, DO
Georgetown
" Dewitte, David M, MD
Georgetown
Gender: Male
PCP # 8CY00101
NPI: 1780666388
3201 S Austin Ave
Ste 210
(512) 763-4000
Hospital Affiliation: St Davids Hospital, St
Davids Medical Center
Clinic Affiliation: Capital Area Primary Care
PLLC
Board Certified Specialties: Family
Practice
Gender: Male
# PCP # 89M68201
NPI: 1134129596
3721 Williams Dr
J (512) 869-7310
Hospital Affiliation: Round Rock Medical
Center, St Davids Georgetown Hospital
Clinic Affiliation: Physicians Center PA
Board Certified Specialties: Family
Practice
" Okunade, Adeyoyin O, MD
Georgetown
J
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Male
# PCP # 8P861001
NPI: 1730266420
908 Rockmoor Dr
J (512) 868-0901
Hospital Affiliation: Round Rock Medical
Center, St Davids Medical Center
Clinic Affiliation: Family Med Ctr of
Georgetown PA
Board Certified Specialties: Family
Practice
Gender: Female
PCP # 8CQ95601
NPI: 1265644975
3201 S Austin Ave
Ste 210
(512) 763-4000
Hospital Affiliation: Seton Medical Ctr
Williamson, Seton Northwest Hospital, St
Davids Georgetown Hospital
Clinic Affiliation: Capital Area Primary Care
PLLC
Board Certified Specialties: Family
Practice
Berg, Paul A, MD
Gender: Male
PCP # 8CQ87204
NPI: 1417037409
1507 Riverly Blvd
J (512) 509-9550
Hospital Affiliation: St Davids Georgetown
Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
J
" Otto, Richard E, MD
Georgetown
" In, Kwang Il, MD
Georgetown
" Sheffield, Jesse D, DO
PCP # 8CF92101
NPI: 1710964226
3201 Austin Ave
Ste 210
(512) 763-4000
Hospital Affiliation: St Davids Georgetown
Hospital
Clinic Affiliation: Capital Area Primary Care
PLLC
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: Family
Practice
Georgetown
FAMILY PRACTICE
J
Gender: Male
PCP # 8M008904
NPI: 1811947948
2423 Willimas Dr
Ste 105
(877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: Family
Practice
Georgetown
Powell, Justin W, DO
Gender: Male
PCP # 8DR94101
NPI: 1487663191
1507 W Main St
(254) 865-2166
Clinic Affiliation: Coryell Memorial
Hospital-HBP
Board Certified Specialties: None
Gatesville
Gender: Male
PCP # 8CD03701
NPI: 1265408298
1507 W Main St
(254) 865-2166
Hospital Affiliation: Coryell Memorial
Hospital, Hillcrest Baptist Medical Center
Clinic Affiliation: Coryell Memorial
Hospital-HBP
Board Certified Specialties: Family
Practice
J
Gatesv ille
" Gibby, Mark H, MD
Gender: Male
PCP # 8CF92102
NPI: 1710964226
2508 Williams Dr
Ste 170
(512) 763-4000
" Fiedler, Benjamin P, MD
PEDIATRICS
Gatesville
" Only, Ronald C, DO
Georgetown
Gender: Female
PCP # 8CT52401
NPI: 1215047733
2423 Williams Dr
Ste 105
(877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: Family
Practice
Georgetown
Gender: Female
PCP # 8CX44901
NPI: 1902105471
1507 W Main St
(254) 865-2166
Hospital Affiliation: Coryell Memorial
Hospital
Clinic Affiliation: Coryell Memorial
Hospital-HBP
Board Certified Specialties: Family
Practice
Fairfield
GATESVILLE
J
Gatesv ille
PCP # 8M680601
NPI: 1487694717
734 W Commerce
J (903) 389-2181
PCP # 88331Y01
NPI: 1487694717
734 W Commerce St
J (903) 389-2181
Hospital Affiliation: East Texas Medical
Center Fairfield
Clinic Affiliation: Etmc Jewett Health Clinic,
First Physicians
Board Certified Specialties: None
Georgetown
Gender: Female
PCP # 8CC97702
NPI: 1932186319
227 Memorial Dr
(254) 248-6500
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Gender: Female
PCP # 8DK60701
NPI: 1407967359
2423 Williams Dr
Ste 105
(877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: Family
Practice
Snook, Murray A, MD
Gender: Male
# PCP # 84961N01
NPI: 1326125097
908 Rockmoor Dr
J (512) 868-0901
Hospital Affiliation: Round Rock Medical
Center
Clinic Affiliation: Family Med Ctr of
Georgetown PA
Board Certified Specialties: None
Georgetown
J - Wheelchair Access
29
GEORGETOWN
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Willis, John G, MD
" Farmer, Christopher M, MD
Georgetown
GEORGETOWN Cont
FAMILY PRACTICE Cont
" Spitler, Florence C, DO
Georgetown
Gender: Female
PCP # 8CM91301
NPI: 1952381071
3201 S Austin Ave
Ste 210
(512) 763-4000
Hospital Affiliation: Round Rock Medical
Center, St Davids Georgetown Hospital
Clinic Affiliation: Capital Area Primary Care
PLLC
Board Certified Specialties: Family
Practice
" Suffridge, Candida D, MD
Georgetown
Gender: Female
PCP # 8EQ63902
NPI: 1407054646
1507 Rivery Blvd
(512) 509-9550
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
Thompson, James B, MD
Gender: Male
PCP # 8X787001
NPI: 1447250790
105 Wildwood Dr
Ste 105
J (512) 763-3220
Hospital Affiliation: Round Rock Medical
Center, St Davids Georgetown Hospital
Clinic Affiliation: Georgetown Family
Health Clinic
Board Certified Specialties: None
Georgetown
" Trevino, Rogelio, MD
Georgetown
J
!
Gender: Male
PCP # 8BX17401
NPI: 1477682938
103 Thousand Oaks
Blvd
(512) 869-4800
PCP # 8DU40801
NPI: 1477682938
103 Thousand Oaks Blvd
(512) 869-4800
Hospital Affiliation: Seton Medical Ctr
Williamson, Seton Northwest Hospital, St
Davids Georgetown Hospital
Clinic Affiliation: Georgetown Family and
Geriatric M, Wellmed Medical Group PA
Board Certified Specialties: Family
Practice
Umstattd, William R, DO
Gender: Male
PCP # 00MP1901
NPI: 1124046701
3008 Dawn Dr Ste 201
J (512) 863-4596
Hospital Affiliation: St Davids Georgetown
Hospital
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: None
Georgetown
" Voss, Daniel S, MD
Georgetown
Gender: Male
PCP # 8CQ96501
NPI: 1639259625
3201 S Austin Ave
Ste 210
(512) 763-4000
Hospital Affiliation: St Davids Georgetown
Hospital
Clinic Affiliation: Capital Area Primary Care
PLLC
Board Certified Specialties: Family
Practice
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Georgetown
Gender: Male
PCP # 8CQ98501
NPI: 1730269721
3201 S Austin Ave
Ste 210
(512) 763-4000
Hospital Affiliation: St Davids Georgetown
Hospital
Clinic Affiliation: Capital Area Primary Care
PLLC
Board Certified Specialties: Family
Practice
Gender: Male
PCP # 8DB47902
NPI: 1619136462
4945 Williams Dr
J (512) 819-0500
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
" Hearne, Christopher B, MD
Rashid, Sadia, MD
Gender: Female
PCP # 8ER17501
NPI: 1124319819
4945 Williams Dr
(512) 819-0500
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Georgetown
" Sathianathan, Kumar, MD
Georgetown
Georgetown
Gender: Male
PCP # 84375F02
NPI: 1134189863
4945 Williams Rd
J (512) 509-0200
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
GENERAL PRACTICE
Reilly, William G, MD
Gender: Male
PCP # 8DW30214
NPI: 1447260963
100 River Hills Dr
Ste 100
(877) 544-5698
Hospital Affiliation: Basin Healthcare
Center, Odessa Regional Medical Center
Clinic Affiliation: Low-T Physicians
Professional Mbr
Board Certified Specialties: None
Georgetown
J
" Hudgins, John R, MD
Georgetown
Gender: Male
# PCP # 8CT53001
NPI: 1679560551
2423 Williams Dr
Ste 105
J (877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: Internal
Medicine
INTERNAL MEDICINE
" Carlson, John E, MD
Georgetown
Gender: Male
PCP # 8DK36502
NPI: 1659352680
4945 Williams Dr
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
" Shallin, Anthony, MD
Georgetown
J
" Jose, Manuel C, MD
Georgetown
Gender: Male
PCP # 88884K02
NPI: 1427018001
4945 Williams Dr
J (512) 819-0500
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Clark, Jennifer L, MD
Georgetown
Gender: Female
PCP # 8J987302
NPI: 1003876095
4945 Williams Dr
J (512) 509-0200
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Lawlis, Stephen R, MD
Georgetown
Gender: Male
PCP # 87434Y02
NPI: 1710948955
4945 Williams Rd
J (512) 509-0200
Hospital Affiliation: Covenant Medical
Center Lakeside, Hereford Regional Medical
Center, Scott And White Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Corak, Ksenija, MD
Georgetown
Gender: Female
PCP # 8DQ48101
NPI: 1336135862
2423 Williams Dr
Ste 113
J (877) 800-5722
Hospital Affiliation: Cornerstone Hosp Of
Austin, Healthsouth Rehabilitation Hospital
Of Austin, North Austin Medical Center,
Seton Medical Center, Seton Medical Ctr
Williamson, St Davids Medical Center
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: Internal
Medicine
Miller, Gwendolyn B, MD
Gender: Female
PCP # 8CQ79002
NPI: 1700812716
4945 Williams Dr
J (512) 819-0500
Hospital Affiliation: Doctors Hospital, North
Austin Medical Center, Round Rock Medical
Center, St Davids Medical Center
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
" D Mello, Anita M, MD
Gender: Female
PCP # 8CC71002
NPI: 1043236581
4945 Williams Dr
J (512) 509-0200
Hospital Affiliation: Tx Hlth Presbyterian
Hosp Dallas
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Nacol, Michael E, MD
Georgetown
Gender: Male
PCP # 00GX2301
NPI: 1114915030
3201 S Austin Ave
Ste 130
J (512) 863-7440
Hospital Affiliation: Round Rock Medical
Center, St Davids Georgetown Hospital
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties: Internal
Medicine
Dayalan, Sangeetha, MD
Gender: Female
PCP # 8EF48302
NPI: 1982880902
603 W University Ave
(512) 509-9550
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Georgetown
Gender: Male
PCP # 8AJ88201
NPI: 1891734968
3613 Williams Dr Ste 404
(512) 930-4275
Hospital Affiliation: St Davids Georgetown
Hospital
Clinic Affiliation: Tony Shallin MD
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties: Internal
Medicine
PEDIATRICS
" Day, Baraka L, MD
Georgetown
Gender: Female
# PCP # 8BR92901
NPI: 1023209202
2423 Williams Dr
(512) 930-5437
Clinic Affiliation: Lone Star Circle of Care
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Duble, Shannon L, MD
Georgetown
Gender: Female
PCP # 8DK11901
NPI: 1457428609
600 High Tech Dr
(512) 930-4776
Clinic Affiliation: Chisholm Trail Pediatrics
Inc PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Georgetown
Georgetown
Gender: Male
PCP # 8AJ88301
NPI: 1831144161
3613 Williams Dr Ste 404
(512) 930-4275
Hospital Affiliation: Round Rock Medical
Center, St Davids Georgetown Hospital
Clinic Affiliation: Dr Kumar Sathianathan
MD
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: Internal
Medicine
" Flachs, Lisa S, MD
Georgetown
Gender: Female
# PCP # 8CR36101
NPI: 1366751133
600 High Tech Dr
(512) 930-4776
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Chisholm Trail Pediatrics
Inc PA
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: Pediatrics
" Pickens, Steven G, MD
Georgetown
Gender: Male
# PCP # 8R749201
NPI: 1932293016
600 High Tech Dr
J (512) 930-4776
Hospital Affiliation: St Davids Georgetown
Hospital
Clinic Affiliation: Chisholm Trail Pediatrics
Inc PA
Board Certified Specialties: Pediatrics
J - Wheelchair Access
30
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
HARKER HEIGHTS
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
GEORGETOWN Cont
PEDIATRICS Cont
Ramsey, David A, MD
Gender: Male
# PCP # 88280Y01
NPI: 1861586943
600 High Tech Dr
J (512) 930-4776
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, St Davids Georgetown Hospital
Clinic Affiliation: Chisholm Trail Pediatrics
Inc PA
Board Certified Specialties: None
Georgetown
GIDDINGS
FAMILY PRACTICE
" Hughes, Larry C, DO
Groesbeck
Gender: Male
PCP # 8DS23701
NPI: 1619062734
801 McClintic Dr
(254) 729-3411
Hospital Affiliation: Limestone Medical
Center
Clinic Affiliation: South Limestone Hospital
District
Board Certified Specialties: Family
Practice
" Rettig, Jeffrey D, DO
Groesbeck
FAMILY PRACTICE
" Birnbaum, Laura M, MD
Giddings
Gender: Female
PCP # 8S710001
NPI: 1053309088
219 A E Railroad Row
J (979) 542-9000
Hospital Affiliation: St Marks Medical
Center
Clinic Affiliation: Laura Birnbaum MD
Practice Information: No Obstetrics
Board Certified Specialties: Family
Practice
" Blackwell, Wess J, MD
Giddings
Gender: Male
PCP # 8F094203
NPI: 1780679662
185 Decker Dr
(979) 542-7400
Hospital Affiliation: St Marks Medical
Center
Clinic Affiliation: McBroom Clinic PA
Board Certified Specialties: Family
Practice
" Borgstedte, Thomas O, DO
Giddings
Gender: Male
PCP # 8K172003
NPI: 1295877264
185 Decker Dr
J (979) 542-7400
PCP # 8K172004
NPI: 1295877264
843 E Industry St
J (979) 542-7400
Hospital Affiliation: St Marks Medical
Center
Clinic Affiliation: McBroom Clinic PA
Practice Information: No Obstetrics
Board Certified Specialties: Family
Practice
" McBroom, William M, MD
Giddings
Gender: Male
PCP # 8F094003
NPI: 1407998461
185 Decker Dr
J (979) 542-7400
Hospital Affiliation: St Marks Medical
Center
Clinic Affiliation: McBroom Clinic PA
Board Certified Specialties: Family
Practice
" Lee, James R, MD
GROESBECK
J
Gender: Male
PCP # 80790G01
NPI: 1528005550
204 W Trinity St
(254) 729-3740
Hospital Affiliation: Limestone Medical
Center, Parkview Regional Hospital
Clinic Affiliation: Rettig Family Health Care
Board Certified Specialties: Family
Practice
HAMILTON
FAMILY PRACTICE
" Craig, William S, MD
Hamilton
Gender: Male
# PCP # 8R983501
NPI: 1417132192
400 N Brown St
Bldg 2
J (254) 796-4224
Hospital Affiliation: Hamilton General
Hospital
Clinic Affiliation: Hamilton General Hospital
Board Certified Specialties: Family
Practice
" Horne, Monte H, MD
Hamilton
Gender: Male
# PCP # 8R983201
NPI: 1184613473
400 N Brown St
Bldg 2
J (254) 386-1700
Hospital Affiliation: Hamilton General
Hospital
Clinic Affiliation: Hamilton General Hospital
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
" Johnson, Charles F, MD
Hamilton
" Jatzlau, Amy J, MD
Giddings
Gender: Female
PCP # 0096LP01
NPI: 1235198706
219B E Railroad
J (979) 542-0710
Hospital Affiliation: St Marks Medical
Center
Board Certified Specialties: Pediatrics
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Male
PCP # 8DH84201
NPI: 1235151192
800 W Central Texas
Expwy Ste 125
J (254) 618-1050
Clinic Affiliation: Lhp Texas MD Services
Inc
Board Certified Specialties: Family
Practice
" Lengefeld, Robbye K, MD
Hamilton
Gender: Female
# PCP # 8R983101
NPI: 1659360949
400 N Brown St
(254) 386-1700
Hospital Affiliation: Hamilton General
Hospital
Clinic Affiliation: Hamilton General Hospital
Board Certified Specialties: Family
Practice
" Rudolph, Timothy N, MD
Hamilton
Gender: Male
# PCP # 8R983401
NPI: 1982777975
400 N Brown St
Bldg 2
J (254) 386-1700
Hospital Affiliation: Hamilton General
Hospital
Clinic Affiliation: Hamilton General Hospital
Board Certified Specialties: Family
Practice
" Stegemoller, Kristen L, MD
" Killian, Luke M, MD
Gender: Male
# PCP # 8R983001
NPI: 1417946708
400 N Brown St
(254) 386-1700
Hospital Affiliation: College Station Medical
Center, Hamilton General Hospital, St
Joseph Regional Health Center
Clinic Affiliation: Hamilton General Hospital
Board Certified Specialties: Family
Practice
" Hubert, Jeffrey K, DO
Hark er Heights
Gender: Male
PCP # 8AP83403
NPI: 1821139221
5702 E Central Texas
Expwy
(254) 680-7300
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Kindle, Kenneth R, MD
Hark er Heights
Gender: Male
PCP # 86J23001
NPI: 1467412395
907 Mountain Lion Cir
J (254) 680-1100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Nichols, Steven L, MD
Hamilton
Hark er Heights
Gender: Female
# PCP # 8DE02102
NPI: 1992038400
400 N Brown St
Bldg 2
J (254) 386-1700
Hospital Affiliation: Hamilton General
Hospital
Clinic Affiliation: Hamilton General Hospital
Board Certified Specialties: Family
Practice
Gender: Male
PCP # 8B045501
NPI: 1972575249
907 Mountain Lion Circle
J (254) 953-7700
Hospital Affiliation: Coryell Memorial
Hospital, Hillcrest Baptist Medical Center
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
Tan, Ping N, MD
Gender: Male
PCP # 8DK00301
NPI: 1528173754
302 N Brown St
(254) 386-8136
Hospital Affiliation: Hamilton General
Hospital
Clinic Affiliation: Ping N Tan MD Inc
Board Certified Specialties: None
Hamilton
INTERNAL MEDICINE
Tan, Ping N, MD
Gender: Male
PCP # 00HK1101
NPI: 1528173754
302 N Brown
J (254) 386-8136
Hospital Affiliation: Hamilton General
Hospital
Board Certified Specialties: None
HARKER HEIGHTS
FAMILY PRACTICE
Hamilton
PEDIATRICS
Hark er Heights
Gender: Male
# PCP # 82X02301
NPI: 1982695797
400 N Brown St Bldg 2
J (254) 386-1700
Hospital Affiliation: Hamilton General
Hospital
Clinic Affiliation: Hamilton General Hospital
Board Certified Specialties: Family
Practice
Hamilton
Gender: Male
# PCP # 8CW35201
NPI: 1902132988
400 N Brown St
Bldg 2
(254) 386-1700
Hospital Affiliation: Hamilton General
Hospital
Clinic Affiliation: Hamilton General Hospital
Board Certified Specialties: Family
Practice
" Eneli, Kenechukwu O, MD
Hamilton
" Perry, Robert R, MD
Hark er Heights
Gender: Male
PCP # 8CV07901
NPI: 1841272481
880 Prospector Trl
Ste 200
(254) 690-1475
Hospital Affiliation: Metroplex Hospital,
Rollins Brook Community Hospital
Clinic Affiliation: Metroplex Clinic
Physicians Inc
Board Certified Specialties: Family
Practice
" Polkowski, Cheryl A, MD
Hark er Heights
Gender: Female
PCP # 8X405201
NPI: 1194882241
880 Prospector Trl
Ste 200
J (254) 690-1475
Hospital Affiliation: Metroplex Hospital
Clinic Affiliation: Marsh III William S DO
Board Certified Specialties: Family
Practice
" Swain, Jeremy L, DO
Hark er Heights
" Elemuren, Iyabo A, MD
Harker Heights
J
Gender: Female
PCP # 8G887001
NPI: 1326113218
740 S Amy Ln
(254) 699-8521
Hospital Affiliation: Metroplex Hospital
Clinic Affiliation: Family Medicine Clinic
Board Certified Specialties: Family
Practice
Gender: Male
PCP # 8DE48801
NPI: 1417160417
300 W Central Texas
Expwy Ste 117
(254) 340-0042
Clinic Affiliation: Modoc Family Medicine
PLLC
Board Certified Specialties: Family
Practice
J - Wheelchair Access
31
HARKER HEIGHTS
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Whitman, Christine M, MD
Harker Heights
HARKER HEIGHTS Cont
INTERNAL MEDICINE
Marchessault, Michelle E, MD
Gender: Female
PCP # 8DV39901
NPI: 1598909657
800 W Central Texas Expwy
Ste 390
(254) 915-1152
Clinic Affiliation: Lhp Texas MD Services
Inc
Board Certified Specialties: None
Harker Heights
Zegarra, Nancy G, MD
Gender: Female
PCP # 8DW02301
NPI: 1366768715
800 W Central Texas
Expwy Ste 390
(254) 618-4330
Clinic Affiliation: Lhp Texas MD Services
Inc
Board Certified Specialties: None
Harker Heights
PEDIATRICS
" Ali, Yasmeen, MD
Harker Heights
Gender: Female
PCP # 8DA15201
NPI: 1356359814
200 Nola Ruth Blvd
(254) 698-6629
Hospital Affiliation: Metroplex Hospital,
Rollins Brook Community Hospital
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: Pediatrics
" Habib, Ramla A, MD
Harker Heights
J
Gender: Female
PCP # 8CD76402
NPI: 1720166291
581 Pan American Dr
Ste 1
(254) 213-4052
Hospital Affiliation: Metroplex Hospital
Clinic Affiliation: Killeen Pediatric Care
Clinic
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
J
" Van Benthuysen, Suzanne L, MD
Harker Heights
Gender: Female
# PCP # 8CQ17202
NPI: 1962673301
775 Indian Trl Ste 200
J (877) 800-5722
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Lone Star Circle of Care
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Craig, William S, MD
Hico
Gender: Male
# PCP # 8R983502
NPI: 1417132192
104 S Walnut St
J (254) 796-4424
Hospital Affiliation: Hamilton General
Hospital
Clinic Affiliation: Hamilton General Hospital
Board Certified Specialties: Family
Practice
HEARNE
" Nurnberg, Jason T, DO
Hearne
" Horne, Monte H, MD
Hico
Gender: Male
PCP # 8W698702
NPI: 1013955533
104 S Magnolia St
J (979) 280-0022
Hospital Affiliation: Little River Healthcare
Clinic Affiliation: Little River Healthcare
Family Ca
Board Certified Specialties: Family
Practice
Gender: Male
# PCP # 8R983202
NPI: 1184613473
104 S Walnut St
J (254) 796-4224
Hospital Affiliation: Hamilton General
Hospital
Clinic Affiliation: Hamilton General Hospital
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
HEWITT
FAMILY PRACTICE
" Johnson, Charles F, MD
Hico
" Cooney, Edward, MD
Gender: Male
PCP # 82466K02
NPI: 1568422400
510 N Hewitt Dr
J (254) 420-5000
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Killian, Luke M, MD
Hico
Gender: Male
# PCP # 8R983002
NPI: 1417946708
104 S Walnut St
(254) 796-4224
Hospital Affiliation: College Station Medical
Center, Hamilton General Hospital, St
Joseph Regional Health Center
Clinic Affiliation: Hamilton General Hospital
Board Certified Specialties: Family
Practice
" Kitson, Sandra, MD
Hewitt
Gender: Female
PCP # 8S190602
NPI: 1720048614
510 N Hewitt Dr
(254) 420-5000
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
HILLSBORO
FAMILY PRACTICE
" Ebert Blackburn, Didi E, DO
Hillsboro
" Truong, Thao M, MD
Hillsboro
Gender: Male
PCP # 8DC83101
NPI: 1740202910
117 Jane Ln
(254) 582-8006
Hospital Affiliation: Kimble Hospital
Clinic Affiliation: Timberland Medical Group
Board Certified Specialties: Family
Practice
HORSESHOE BAY
INTERNAL MEDICINE
Jones, Shirley F, MD
Gender: Female
PCP # 8CS30202
NPI: 1750304200
201 Bay W Blvd
(830) 598-5968
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Hospital
Llano
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Horseshoe Bay
" Lee, James R, MD
Gender: Male
# PCP # 82X02302
NPI: 1982695797
104 S Walnut St
J (254) 796-4224
Hospital Affiliation: Hamilton General
Hospital
Clinic Affiliation: Hamilton General Hospital
Board Certified Specialties: Family
Practice
Gender: Male
PCP # 82463K02
NPI: 1194787598
510 N Hewitt Dr
J (254) 420-5000
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
HUTTO
FAMILY PRACTICE
Hutto
" Lengefeld, Robbye K, MD
Hico
" Vo, Thu P, DO
Hewitt
Gender: Female
# PCP # 8R983102
NPI: 1659360949
104 S Walnut St
(254) 796-4224
Hospital Affiliation: Hamilton General
Hospital
Clinic Affiliation: Hamilton General Hospital
Board Certified Specialties: Family
Practice
Gender: Female
PCP # 8CC97703
NPI: 1932186319
510 N Hewitt Dr
J (254) 420-5000
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Chang, Franklin, MD
" Rudolph, Timothy N, MD
Gender: Male
# PCP # 8R983402
NPI: 1982777975
104 S Walnut St
J (254) 796-4224
Hospital Affiliation: Hamilton General
Hospital
Clinic Affiliation: Hamilton General Hospital
Board Certified Specialties: Family
Practice
Castillo, Cathy A, MD
Gender: Female
PCP # 8U684901
NPI: 1295787778
151 Exchange Blvd
Ste 500
(512) 846-1244
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids
Georgetown Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Hutto
Hico
Vathada, Murali, MD
Gender: Male
PCP # 8EC40201
NPI: 1639121072
200 Nola Ruth
(877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Gender: Female
PCP # 8CU82201
NPI: 1649596305
1323 E Franklin St
Ste 105
(254) 582-7481
Hospital Affiliation: Plaza Medical Center
Fort Worth
Clinic Affiliation: Family Diagnostic Medical
Center LLP
Board Certified Specialties: Family
Practice
J
Hico
" Sharp, James, MD
Hewitt
Harker Heights
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Female
# PCP # 8DE02101
NPI: 1992038400
104 S Walnut St
J (254) 796-4224
Hospital Affiliation: Hamilton General
Hospital
Clinic Affiliation: Hamilton General Hospital
Board Certified Specialties: Family
Practice
Gender: Male
# PCP # 8CW35203
NPI: 1902132988
104 S Walnut St
(254) 796-4224
Hospital Affiliation: Hamilton General
Hospital
Clinic Affiliation: Hamilton General Hospital
Board Certified Specialties: Family
Practice
Hewitt
" Homsi, Omar, MD
Gender: Male
PCP # 8A329102
NPI: 1912945551
581 Pan American Dr
Ste 1
(254) 213-4052
Hospital Affiliation: Metroplex Hospital,
Rollins Brook Community Hospital
Clinic Affiliation: Killeen Pediatric Care
Clinic
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
FAMILY PRACTICE
FAMILY PRACTICE
Harker Heights
" Stegemoller, Kristen L, MD
Hico
HICO
Gender: Female
PCP # 8DZ80001
NPI: 1821295783
200 Nola Ruth
(877) 800-5722
Hospital Affiliation: Seton Medical Ctr
Harker Heights
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: Pediatrics
J
Gender: Male
PCP # 80439K04
NPI: 1285694265
120 Ed Schmidt Blvd
Ste B
(512) 509-9500
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
J - Wheelchair Access
32
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
KILLEEN
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Griffin, Violeta V, MD
" Elemuren, Iyabo A, MD
Hutto
HUTTO Cont
FAMILY PRACTICE Cont
" Fiedler, Benjamin P, MD
Hutto
Gender: Male
PCP # 8M008901
NPI: 1811947948
123 Ed Schmidt Blvd
Ste 140
J (877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: Family
Practice
" Luttrell, Brady L, MD
" Mathew, Asha, MD
J
" Morgan, Jessica A, MD
Gender: Female
PCP # 8CV71901
NPI: 1972794162
123 Ed Schmidt Blvd
Ste 140
(877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Mahale, Radha S, MD
Hutto
Nguyen, Chau H, DO
Gender: Male
PCP # 8BS42404
NPI: 1619041407
120 Ed Schmidt Blvd
(512) 509-9500
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
PEDIATRICS
Killeen
Gender: Female
PCP # 8EH12801
NPI: 1407174063
123 Ed Schmidt Blvd
Ste 140
(877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: Pediatrics
Hutto
Hutto
Gender: Female
PCP # 8BR13302
NPI: 1053372193
120 County Rd 119
J (512) 509-0200
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Gender: Female
# PCP # 8G887002
NPI: 1326113218
4200 W Stan Schlueter
Loop Bldg C
J (254) 699-8521
Hospital Affiliation: Metroplex Hospital
Clinic Affiliation: Family Medicine Clinic
Board Certified Specialties: Family
Practice
Hutto
Hutto
Gender: Male
PCP # 8AH35101
NPI: 1790814481
151 Exchange Blvd
Ste 500
(877) 846-1244
Hospital Affiliation: Metroplex Hospital,
Seton Medical Center
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Killeen
Gender: Female
PCP # 8DW84701
NPI: 1962622159
151 Exchange Blvd
Ste 500
(512) 846-1244
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Fritz, Jed S, MD
Killeen
J
" Van Benthuysen, Suzanne L, MD
Hutto
Gender: Female
# PCP # 8CQ17201
NPI: 1962673301
123 Ed Schmidt Ste 140
J (877) 800-5722
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Lone Star Circle of Care
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Butler, Kathleen V, MD
Gender: Female
# PCP # 8BR92001
NPI: 1962490870
123 Ed Schmidt Blvd
Ste 140
(877) 800-5722
Hospital Affiliation: Mother Frances
Hospital
Clinic Affiliation: Lone Star Circle of Care
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
J
KILLEEN
" Ferrell, Angelle M, MD
Hutto
Gender: Female
PCP # 8W525401
NPI: 1124051800
151 Exchange Blvd
Ste 500
(512) 846-1244
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Guajardo, Arturo, MD
Gender: Male
PCP # 8P096001
NPI: 1376564153
3800 S W S Young
Dr Ste 103
(254) 415-7598
Hospital Affiliation: Doctors Hospital Of
Laredo
Clinic Affiliation: Arturo Guajardo MD
Board Certified Specialties: Family
Practice
" Flores-Perkins, Silvia P, MD
Gender: Female
PCP # 8EE98701
NPI: 1639289135
123 Ed Schmidt Blvd
Ste 140
(877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: Pediatrics
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Male
PCP # 86J26001
NPI: 1033179304
3801 Scott and White Dr
(254) 680-1100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Joseph II, John A, MD
Killeen
Blancarte, Gilbert, MD
Gender: Male
PCP # 8DS12901
NPI: 1265410773
3106 S W S Young Dr
Bldg D Ste 402
(512) 323-6900
Hospital Affiliation: St Davids S Austin
Medical Center
Clinic Affiliation: Greentree Health
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
J
" Kadhim, Thikra J, MD
" Cantu, Cesar E, MD
J
Gender: Male
PCP # 8J987603
NPI: 1275598187
5702 E Central Texas Expwy
(254) 780-7300
Hospital Affiliation: Metroplex Hospital,
Scott And White Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
Gender: Male
PCP # 80761901
NPI: 1558321083
3801 Scott and White Dr
(254) 680-1100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Killeen
Killeen
Hutto
Gender: Male
PCP # 80761801
NPI: 1972562395
3801 Scott and White Dr
(254) 680-1100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Killeen
" Averitt, William M, DO
Killeen
Gender: Male
PCP # 87G88301
NPI: 1730140120
1002 Wales Dr Ste 8
J (254) 501-6400
PCP # 87G88302
NPI: 1730140120
4501 S Clear Creek Rd
J (254) 501-6400
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Lejawa, Robert J, DO
Killeen
Gender: Male
PCP # 8X405301
NPI: 1265592596
2301 S Clear Creek Rd
Ste 208
(254) 519-1900
Hospital Affiliation: Shannon Medical
Center
Clinic Affiliation: Marsh III William S DO
Board Certified Specialties: Family
Practice
" Gerdes, Paul, MD
FAMILY PRACTICE
J
Gender: Male
PCP # 84W33801
NPI: 1639138035
3801 Scott and White Dr
(254) 680-1100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Kirkpatrick, Michael, MD
Killeen
Killeen
Killeen
Hutto
Fowler, Ryan C, MD
Gender: Male
PCP # 8DV30401
NPI: 1417959925
401 W Jasper Dr
(254) 298-2400
Hospital Affiliation: Little River Healthcare,
Metroplex Hospital, Seton Medical Ctr
Harker Heights
Clinic Affiliation: Little River Healthcare
Family Ca
Board Certified Specialties: None
Kim, Cheung K, MD
Gender: Male
PCP # 00R75F01
NPI: 1437132255
3106 S W S Young Dr
Ste B203
J (254) 554-8668
Hospital Affiliation: Metroplex Hospital
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Killeen
J
Gender: Female
PCP # 8U748001
NPI: 1477507077
4520 E Central Texas Expwy
Ste 101
(254) 200-9355
Hospital Affiliation: Metroplex Hospital,
Rollins Brook Community Hospital, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Killeen Family Health and
Urgent
Board Certified Specialties: Family
Practice
Lincoln, Katherine A, DO
Gender: Female
PCP # 8BQ42001
NPI: 1669538963
2300 S Clear Creek Rd
Ste 101
J (855) 963-4325
Hospital Affiliation: Baptist Health System
Clinic Affiliation: Family Care and Minor
Emergency Ctr PA
Board Certified Specialties: None
Killeen
Malave, Ernesto, MD
Gender: Male
# PCP # 00N96L01
NPI: 1609985852
2301 S Clear Creek Rd 108
J (254) 432-5735
Hospital Affiliation: Metroplex Hospital
Board Certified Specialties: None
Killeen
Martens, Thomas E, DO
Gender: Male
PCP # 8AK60905
NPI: 1144333055
2206 E Central Texas
Expwy
J (254) 213-5111
Clinic Affiliation: Union Treatment Centers
Board Certified Specialties: None
Killeen
" Maxwell, Shane R, MD
Killeen
PCP # 80373F01
NPI: 1689635740
3801 Scott and White Dr
J (254) 680-1100
PCP # 80373F02
NPI: 1689635740
5702 E Central Texas Expwy
J (254) 780-7300
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
J - Wheelchair Access
33
KILLEEN
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Whited, Everest A, MD
Gender: Male
PCP # 8BP55001
NPI: 1902899636
1002 Wales Dr
J (254) 501-6400
Enwemnwa, Nneamaka, MD
Gender: Female
PCP # 8EL85801
NPI: 1801026448
2201 S Clear Creek Rd
J (254) 526-7523
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Killeen
KILLEEN Cont
FAMILY PRACTICE Cont
Killeen
Mayabb, Trevin B, MD
Gender: Male
PCP # 8EJ61601
NPI: 1508157330
5702 E Central Texas Expwy
(254) 680-7300
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
" ONeal, Michael A, DO
Killeen
J
Gender: Male
PCP # 80755201
NPI: 1861453631
3801 Scott and White Dr
(254) 680-1100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Reddy, Rajesh, MD
Killeen
J
Gender: Male
PCP # 8DL29601
NPI: 1205029287
2207 S Clear Creek Rd
Ste 203
(254) 519-8885
Hospital Affiliation: Metroplex Hospital,
Scott And White Memorial Hospital
Clinic Affiliation: Metroplex Clinic
Physicians Inc
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
" Sanchez, Ernesto H, MD
Killeen
PCP # 8BP55002
NPI: 1902899636
4501 S Clear Creek Rd
J (254) 501-6400
Hospital Affiliation: St Davids Medical
Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
" Gruschkus, Gerhard F, MD
Gender: Male
PCP # 0009NA01
NPI: 1154415883
502 W Jasper
(254) 526-6300
Hospital Affiliation: Metroplex Hospital
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
" Wilson, Elena V, MD
Gender: Female
PCP # 8CX17901
NPI: 1841424389
1002 Wales Dr
J (254) 501-6400
PCP # 8CX17902
NPI: 1841424389
4501 S Clear Crek Rd
J (254) 501-6400
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Mirkes, Curtis R, DO
Killeen
Gender: Male
PCP # 8W064902
NPI: 1932123429
2201 S Clear Creek Rd
(254) 519-8513
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Wooldrige, Alicia L, MD
Killeen
Gender: Female
PCP # 8DT21901
NPI: 1437383387
3801 Scott and White Dr
J (254) 680-1100
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
Raju, Bindu, MD
Gender: Female
PCP # 8M799601
NPI: 1326031303
2201 S Clear Creek Rd
J (254) 519-8132
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
Killeen
J
" Smith, Steven L, MD
Killeen
J
Gender: Male
PCP # 80746701
NPI: 1477515799
3801 Scott and White Dr
(254) 680-1100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Webster, Dave E, DO
Gender: Male
# PCP # 00593G01
NPI: 1992808018
5610 E Central Texas Expwy
Ste 1
J (254) 690-8887
Hospital Affiliation: Metroplex Hospital
Practice Information: No Patients Under 1
yrs old
Board Certified Specialties: None
Thomas Jacob, Jenny, MD
Gender: Female
PCP # 8EQ48801
NPI: 1538427349
2201 S Clear Creek Rd
J (254) 526-7523
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
" White, Heath D, DO
Killeen
J
" Ralph, Stephen, MD
Gender: Male
# PCP # 8K623401
NPI: 1386726735
3816 S Clear Creek Rd
Ste E
J (254) 554-8773
Hospital Affiliation: Metroplex Hospital
Clinic Affiliation: Stillhouse Emergency
Physicians Inc
Board Certified Specialties: Internal
Medicine
" Blancarte, Gilbert, MD
" Sheth, Minesh P, MD
Killeen
Gender: Male
PCP # 8DS74401
NPI: 1265410773
3106 S WS Young Dr
Bldg D Ste 402
(512) 323-6900
Hospital Affiliation: St Davids S Austin
Medical Center
Clinic Affiliation: Union Treatment Centers
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
Gender: Male
PCP # 8CF28901
NPI: 1053421602
2201 S Clear Creek Rd
J (254) 519-8132
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Wood, Adam S, MD
J
Day Jr, Cedric T, MD
Gender: Male
PCP # 8DU67601
NPI: 1790929610
3801 Scott and White Dr
J (254) 680-1100
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Killeen
PEDIATRICS
" Avila, Jamie, MD
Killeen
Gender: Female
PCP # 8DR31802
NPI: 1295023653
2201 S Clear Creek Rd
(254) 680-1100
" Sukumar, Latha, MD
" Cheema, Yasir I, MD
Killeen
Gender: Male
PCP # 8CW96801
NPI: 1952515876
2201 S Clear Creek Rd
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
Gender: Male
PCP # 8CA35002
NPI: 1225296494
2201 S Clear Creek Rd
(254) 519-8513
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
OBSTETRICS-GYNECOLOGY
Killeen
Gender: Female
PCP # 8B937201
NPI: 1114908662
2301 S Clear Creek Rd
Ste 112
(254) 519-3131
Hospital Affiliation: Metroplex Hospital,
Seton Medical Ctr Harker Heights
Clinic Affiliation: Sukumar Sundaram MD
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
Gender: Male
PCP # 8CW55704
NPI: 1134392582
2201 S Clear Creek Rd
(254) 519-8513
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Killeen
Killeen
Killeen
Killeen
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Adiele, Jacquelene M, MD
Gender: Female
PCP # 8DL09701
NPI: 1609896497
3816 S Clear Creek Rd
Ste A
(254) 200-2748
Hospital Affiliation: Metroplex Hospital
Clinic Affiliation: Jacquelene M Adiele MD
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: None
Gender: Male
PCP # 8B937101
NPI: 1336120880
2301 S Clear Creek Rd
Ste 112
(254) 519-3131
Hospital Affiliation: Metroplex Hospital,
Seton Medical Ctr Harker Heights
Clinic Affiliation: Sukumar Sundaram MD
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: Internal
Medicine
Killeen
Killeen
INTERNAL MEDICINE
Killeen
J
Killeen
Killeen
Gender: Male
PCP # 8368NC01
NPI: 1407840259
5702 E Central Texas Expwy
(254) 680-7300
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
" Sukumar, Sundaram, MD
Killeen
PCP # 8DR31801
NPI: 1295023653
3801 Scott and
White Dr
(254) 680-1100
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Pediatrics
" Baca, Katrina M, MD
Killeen
J
Gender: Female
PCP # 8F557601
NPI: 1346209616
3801 Scott and White Dr
(254) 680-1100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
J - Wheelchair Access
34
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
KYLE
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Friday, Renee Y, MD
" Nickel, Susan P, MD
Killeen
KILLEEN Cont
PEDIATRICS Cont
" Blankenship, Lilian V, MD
Killeen
Gender: Female
# PCP # 00NT7001
NPI: 1891787248
3004 S W S Young Dr
J (254) 634-7337
Hospital Affiliation: Metroplex Hospital
Practice Information: No Patients Over 16
yrs old
Board Certified Specialties: Pediatrics
Brown, Marilyn A, MD
Gender: Female
PCP # 8CX96101
NPI: 1396736823
2405 S Clear Creek Rd
J (254) 519-5250
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Killeen
" Chan, Soi Yu, MD
Killeen
Gender: Female
PCP # 8DM88804
NPI: 1700064094
2201 S Clear Creek Rd
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Pediatrics
Guptha, Sushma N, MD
Gender: Female
PCP # 8DU83401
NPI: 1710064357
3801 Scott and White Dr
J (254) 680-1100
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
" Coles, Stuart, MD
!
Killeen
Killeen
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
J
Gender: Male
PCP # 8DT15101
NPI: 1366425365
4100 Everett
Ste 400
(512) 295-1333
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Arhelger, Erik J, MD
Kyle
Gender: Male
PCP # 8DC75301
NPI: 1821291162
177 Kirkham Cir
(512) 405-0077
PCP # 8DH15201
NPI: 1518077205
4102 S Clear Creek Rd
Ste 107
(254) 526-8300
Hospital Affiliation: Metroplex Hospital,
Seton Medical Ctr Harker Heights
Clinic Affiliation: Killeen Pediatric Care
Clinic
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
PCP # 8BW45301
NPI: 1821291162
177 Kirkham Circle
J (512) 405-0077
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Central Texas Medical
Assoc, Live Oak Health Partners
Board Certified Specialties: Family
Practice
" Clampitt, David M, MD
Kyle
Gender: Male
PCP # 8CN87901
NPI: 1043430325
5103 Kyle Center Dr
Ste 104
(512) 504-0855
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Seton Family of Doctors
Board Certified Specialties: Family
Practice
FAMILY PRACTICE
" Miller, Grady F, DO
Kingsland
Gender: Male
PCP # 8CS21004
NPI: 1154303725
105 FM 2342
(325) 388-9400
Hospital Affiliation: Scott & White Hospital
Llano
Clinic Affiliation: Scott and White Hospital
Llano
Board Certified Specialties: Family
Practice
Mirkes, Curtis R, DO
Gender: Male
PCP # 8W064902
NPI: 1932123429
2201 S Clear Creek Rd
(254) 519-8513
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Russell, Kimberly A, MD
Kingsland
Gender: Female
PCP # 8CS22503
NPI: 1174505796
105 FM 2342
(325) 388-9422
Hospital Affiliation: Scott & White Hospital
Llano
Clinic Affiliation: Scott and White Hospital
Llano
Board Certified Specialties: Family
Practice
" Mitchell, Ricky D, MD
" Farooqi, Manzoor S, MD
" Amadi, Fidelis E, MD
Kyle
KINGSLAND
Gender: Male
PCP # 8A329101
NPI: 1912945551
4102 S Clear Creek Rd
Ste 107
(254) 526-8300
Hospital Affiliation: Metroplex Hospital,
Rollins Brook Community Hospital
Clinic Affiliation: Killeen Pediatric Care
Clinic
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Killeen
Killeen
Gender: Male
# PCP # 0038AC01
NPI: 1821098534
3004 S WS Young Dr
J (254) 634-7337
Hospital Affiliation: Metroplex Hospital
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
J
" Homsi, Omar, MD
Killeen
Drigalla, Jessica W, MD
Gender: Female
PCP # 8X205103
NPI: 1770641706
3801 Scott and White Dr
J (254) 680-1100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
Gender: Female
PCP # 8CD76401
NPI: 1720166291
4102 S Clear Creek Rd
Ste 107
(254) 526-8300
Hospital Affiliation: Metroplex Hospital
Clinic Affiliation: Killeen Pediatric Care
Clinic
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Killeen
J
Ward, Erica L, MD
Gender: Female
PCP # 8W232001
NPI: 1992711956
3801 Scott and White Dr
(254) 680-1100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
Wright, Daphne G, MD
Gender: Female
PCP # 8DH15202
NPI: 1518077205
2301 S Clear Creek Rd
Ste 226
J (254) 526-8300
" Habib, Ramla A, MD
" Coleman Jr, Ronald, DO
Gender: Male
PCP # 87G89101
NPI: 1326007964
3801 Scott and White Dr
J (254) 680-1100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
Killeen
KYLE
FAMILY PRACTICE
Killeen
Killeen
J
Gender: Female
PCP # 80752802
NPI: 1821058215
3801 Scott and White Dr
(254) 680-1100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
J
Killeen
Killeen
Gender: Male
PCP # 8DA15301
NPI: 1841304540
2300 S Clear Creek Rd
Ste 105
(254) 554-3494
Hospital Affiliation: Metroplex Hospital,
Rollins Brook Community Hospital
Clinic Affiliation: Lone Star Circle of Care
Practice Information: No Patients Over 17
yrs old
Board Certified Specialties: Pediatrics
Killeen
Gender: Female
PCP # 8DZ48201
NPI: 1275531394
4102 S Clear Creek Rd
Ste 107
(254) 526-8300
Hospital Affiliation: Clear Lake Regional
Medical Center, Doctors Hospital Of Laredo,
Houston Methodist St John Hosp, Mem
Hermann Southeast Hosp, Texas Childrens
Hospital
Clinic Affiliation: Killeen Pediatric Care
Clinic
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Gender: Male
PCP # 8K623301
NPI: 1144286980
3816 S Clear Creek Rd
Ste E
(254) 554-8773
Hospital Affiliation: Metroplex Hospital
Clinic Affiliation: Stillhouse Emergency
Physicians Inc
Practice Information: No Patients Over 17
yrs old
Board Certified Specialties: Pediatrics
" Gamble, Maryann C, MD
Kyle
Gender: Female
PCP # 8CY15701
NPI: 1295995439
4100 Everett Ste 400
(512) 295-1333
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Gilcrease, Gary L, MD
Kyle
Gender: Male
PCP # 0090KA01
PCP # 8AJ37701
NPI: 1427090893
135 Bunton Creek Rd
Ste 102
J (512) 268-2091
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Gary L Gilcrease MD
Board Certified Specialties: Family
Practice
Kyle
INTERNAL MEDICINE
" Johns, Ronald W, MD
Kingsland
J
Gender: Male
PCP # 8U427202
NPI: 1750376703
3947 Hwy 1431 W
Ste 1 and 2
(830) 693-2005
Hospital Affiliation: Seton Highland Lakes
Clinic Affiliation: Amy Van Dorfy MD
Board Certified Specialties: Internal
Medicine
Hamilton, Kaleb M, MD
Gender: Male
PCP # 8AM79601
NPI: 1508895996
4100 Everett Ste 400
(512) 295-1333
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
J - Wheelchair Access
35
KYLE
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Flinn, Jeanne E, DO
Gender: Female
# PCP # 8J046002
NPI: 1629009469
181A Kirkham Cir
J (512) 392-1700
Hospital Affiliation: Central Texas Medical
Center, Dell Childrens Med Ctr Cent Tx
Clinic Affiliation: Corridor Primary Care PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
" Edison, Flora, MD
Kyle
KYLE Cont
FAMILY PRACTICE Cont
!
" Smith, Theodore D, DO
Kyle
J
Gender: Male
PCP # 82415S01
NPI: 1114933470
4100 Everett St
Ste 400
(512) 295-1333
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Kyle
" Vazquez, Miguel A, MD
Kyle
Gender: Male
PCP # 8DT93704
NPI: 1750388450
2810 Dacy Ln
(210) 233-7000
Hospital Affiliation: Christus Santa Rosa
Hosp City Ctr, Methodist Hospital,
Metropolitan Methodist Hospital
Clinic Affiliation: Communicare Health
Centers
Board Certified Specialties: Family
Practice
" Viscardi, Marjorie E, MD
Kyle
J
Gender: Female
PCP # 8BN26004
NPI: 1710046206
135 Bunton Creek Rd
Ste 102
(512) 295-2121
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Gary L Gilcrease MD
Board Certified Specialties: Family
Practice
" Worrell, Sandra L, MD
Kyle
Gender: Female
PCP # 8BS97001
NPI: 1285841775
4100 Everett Dr Ste 400
(512) 295-1333
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
GENERAL PRACTICE
Vasquez, Hector H, MD
Gender: Male
!# PCP # 8DN63201
NPI: 1518075894
2810 Dacy Ln
(512) 268-8900
Hospital Affiliation: Christus Santa Rosa
Hsp Med Ctr, Val Verde Regional Medical
Center
Clinic Affiliation: Communicare Health
Centers
Board Certified Specialties: None
" Chanda Kim, Mousumi, MD
Kyle
J
Gender: Female
PCP # 8CN81801
NPI: 1982772901
5301 Kyle Center Dr
Ste 104
(512) 791-1224
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Internal
Medicine
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Kyle
Garcia, Patrick, MD
Gender: Male
PCP # 8CN81901
NPI: 1326112889
5103 Kyle Center Dr
Ste 104
(512) 791-1224
Hospital Affiliation: Seton Edgar B Davis,
Seton Highland Lakes, Seton Medical
Center, Seton Medical Center Hays, Seton
Southwest, University Med Ctr Brackenridge
Clinic Affiliation: Seton Family of Doctors
Board Certified Specialties: None
Fournier, Jacqueline F, MD
Gender: Female
PCP # 8BX88501
NPI: 1972693471
4100 Everett Dr
Ste 400
(512) 295-1333
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
" Grady, Michael J, MD
Kyle
Gender: Male
PCP # 8A264002
NPI: 1376574111
181A Kirkham Cir
J (512) 392-1700
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Corridor Primary Care PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Goman, Elizabeth J, MD
Kyle
Gender: Female
PCP # 8CX15001
NPI: 1114952744
5103 Kyle Center Dr
Ste 104
J (512) 791-1224
Hospital Affiliation: Seton Medical Center
Hays
Clinic Affiliation: Seton Family of Doctors
Board Certified Specialties: Internal
Medicine
" Hagen, Conor O, MD
Kyle
Gender: Male
PCP # 8DU79701
NPI: 1790006708
4100 Everett
Ste 400
(512) 295-1333
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
PEDIATRICS
" Black, Angela P, MD
Kyle
Gender: Female
PCP # 8CG16302
NPI: 1972671733
181A Kirkham Cir
J (512) 392-1700
Hospital Affiliation: Seton Edgar B Davis,
University Med Ctr Brackenridge
Clinic Affiliation: Corridor Primary Care PA
Practice Information: No Patients Over 19
yrs old
Board Certified Specialties: Pediatrics
Harrison, Sue A, MD
Gender: Female
PCP # 83Y52202
NPI: 1558392399
181A Kirkham Cir
J (512) 392-1700
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Corridor Primary Care PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
" Miller, Michelle E, MD
Kyle
Gender: Female
PCP # 8CA72102
NPI: 1346395217
181A Kirkham Cir
(512) 392-1700
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Corridor Primary Care PA
Practice Information: No Patients Over 19
yrs old
Board Certified Specialties: Pediatrics
J
Kyle
Salkar, Amit D, MD
Gender: Male
PCP # 8EL30101
NPI: 1366768376
4100 Everett
Ste 400
(512) 295-1333
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Velasquez, Theresa S, MD
Gender: Female
# PCP # 8CN27601
NPI: 1275519456
2810 Dacy Ln
(512) 268-8900
Hospital Affiliation: Central Texas Medical
Center, St Davids Georgetown Hospital
Clinic Affiliation: Communicare Health
Centers
Board Certified Specialties: None
Kyle
LA GRANGE
FAMILY PRACTICE
" Blackwell, Wess J, MD
La Grange
Gender: Male
PCP # 8F094201
NPI: 1780679662
1253 N Von Minden
(979) 968-8493
Hospital Affiliation: St Marks Medical
Center
Clinic Affiliation: McBroom Clinic PA
Board Certified Specialties: Family
Practice
Kyle
" Deschner, Rhonda W, MD
Kyle
Gender: Female
PCP # 8CB12002
NPI: 1639316698
181A Kirkham Cir
(512) 392-1700
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Corridor Primary Care PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Kyle
INTERNAL MEDICINE
Kyle
Gender: Female
PCP # 8DS75501
NPI: 1134192974
902 Rebel Dr
(512) 268-2613
Hospital Affiliation: Fisher County Hospital
District, Seton Edgar B Davis, University
Med Ctr Brackenridge
Clinic Affiliation: Wellmed Medical Group
PA
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: Internal
Medicine
Humphrey, Jill S, MD
Gender: Female
PCP # 8J046302
NPI: 1790874402
181A Kirkham Cir
J (512) 392-1700
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Corridor Primary Care PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
" Borgstedte, Thomas O, DO
La Grange
J
Kyle
Edwards, Kimberly C, MD
Gender: Female
! PCP # 8F707602
NPI: 1831297514
4100 Everett
Ste 400
J (512) 295-1333
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Kyle
" Messinger, Ivri K, MD
Kyle
Gender: Female
PCP # 8BN25802
NPI: 1114975711
181A Kirkham Cir
J (512) 392-1700
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Corridor Primary Care PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Gender: Male
PCP # 8K172001
NPI: 1295877264
1253 N Von Minden
(979) 968-8493
Hospital Affiliation: St Marks Medical
Center
Clinic Affiliation: McBroom Clinic PA
Practice Information: No Obstetrics
Board Certified Specialties: Family
Practice
Irwin, Debra S, MD
Gender: Female
PCP # 8CD26201
NPI: 1659386712
753 E Travis St
J (979) 968-2000
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Marks Medical
Center
Clinic Affiliation: Tejas Health Care
Board Certified Specialties: None
La Grange
" McBroom, William M, MD
La Grange
J
Gender: Male
PCP # 8F094001
NPI: 1407998461
1253 N Von Minden
(979) 968-8493
Hospital Affiliation: St Marks Medical
Center
Clinic Affiliation: McBroom Clinic PA
Board Certified Specialties: Family
Practice
J - Wheelchair Access
36
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
LEANDER
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Cain, Robin G, MD
Lampasas
LA GRANGE Cont
FAMILY PRACTICE Cont
" Nolen, Bill D, DO
La Grange
Gender: Male
PCP # 81Y32101
NPI: 1184626913
2 Saint Marks Pl Ste 112
J (979) 242-5878
Hospital Affiliation: St Marks Medical
Center
Clinic Affiliation: Nolen Clinic
Board Certified Specialties: Family
Practice
OBSTETRICS-GYNECOLOGY
Diclemente, Michael J, MD
Gender: Male
PCP # 8DT57201
NPI: 1639160088
753 E Travis St
(979) 968-2000
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: Tejas Health Care
Board Certified Specialties: None
LAKEWAY
FAMILY PRACTICE
" Freeland, Daniel V, DO
Lak eway
J
Gender: Male
PCP # 8BF00401
NPI: 1336258847
1008 Ranch Rd 620 S
Ste 200
(512) 263-9072
Hospital Affiliation: Lakeway Regional
Medical Ctr Llc, St Davids Medical Center
Clinic Affiliation: Daniel Freeland DO PA
Board Certified Specialties: Family
Practice
# PCP # 84951G03
NPI: 1740262377
905 N Key Ave
J (512) 556-3621
Hospital Affiliation: Metroplex Hospital,
Rollins Brook Community Hospital
Clinic Affiliation: Family Medicine Rural
Health
Board Certified Specialties: Family
Practice
" Chikkala, Subha, MD
Lampasas
INTERNAL MEDICINE
La Grange
" Bennett, Brent L, MD
Lak eway
J
PEDIATRICS
" Jamil, Samina, MD
La Grange
Gender: Female
PCP # 8DV15701
NPI: 1134249972
753 E Travis St
(979) 968-2000
Hospital Affiliation: St Marks Medical
Center
Clinic Affiliation: Tejas Health Care
Board Certified Specialties: Pediatrics
Kostur, Gregory D, MD
Gender: Male
# PCP # 8DH33001
NPI: 1447316799
Two Saint Marks Pl
Ste 104
J (979) 242-2883
Hospital Affiliation: St Marks Medical
Center
Clinic Affiliation: St Marks Medical Center
Board Certified Specialties: None
LAGO VISTA
FAMILY PRACTICE
" Kyte, Paul D, MD
Lago Vista
Gender: Male
PCP # 8DP41304
NPI: 1356352967
6502 Lohmans Ford Rd
(512) 267-3213
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Seton Northwest Hospital
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
Neal, Elizabeth S, MD
Gender: Female
PCP # 8DR13701
NPI: 1356455265
7708 Lohman Ford Rd
Ste 101 Bldg A
(512) 267-1877
Clinic Affiliation: Timberland Medical Group
Board Certified Specialties: None
J
" Franz, Charles M, DO
Gender: Male
PCP # 8EC66501
NPI: 1053320069
200 Medical Pkwy
Ste 310
(512) 654-3000
Hospital Affiliation: Lakeway Regional
Medical Ctr Llc
Clinic Affiliation: Lrmc Physician Services
Inc
Board Certified Specialties: Internal
Medicine
J
Gender: Male
PCP # 8J562304
NPI: 1912978206
1205 Central Texas Expwy
(512) 556-5362
Hospital Affiliation: Seton Highland Lakes,
The Medical Ctr Of Southeast Tx Lp
Clinic Affiliation: Seton Healthcare
Practice Information: No Obstetrics, No
Patients Under 1 yrs old
Board Certified Specialties: Family
Practice
Hay, Georgia C, MD
Gender: Female
PCP # 8DH19301
NPI: 1801024054
187 Pr 4060
J (512) 556-3621
Hospital Affiliation: John Peter Smith
Hospital, Rollins Brook Community Hospital
Clinic Affiliation: Family Medicine Rural
Health
Board Certified Specialties: None
Lampasas
" Reddy, Shobha D, MD
Lak eway
Gender: Female
# PCP # 0090NS01
NPI: 1235151523
317 Ranch Rd 620 S
Ste 100
J (512) 263-5225
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: Internal
Medicine
PEDIATRICS
" Adeni, Shubha, MD
Lak eway
J
Gender: Female
PCP # 8DV94402
NPI: 1245505254
207 W Ave E
(512) 556-3621
Hospital Affiliation: Metroplex Hospital,
Valley Baptist Medical Center
Clinic Affiliation: Family Medicine Rural
Health
Board Certified Specialties: Family
Practice
Lampasas
" Ondash, Robert J, MD
Lago Vista
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Male
PCP # 8K964001
NPI: 1871561035
2300 Lohmans Spur
Ste 106
(512) 263-7133
Hospital Affiliation: St Davids Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: Bennett Brent MD
Board Certified Specialties: Internal
Medicine
Lak eway
La Grange
" Perry, Robert R, MD
Lampasas
Gender: Female
# PCP # 84951G01
NPI: 1740262377
187 Pr 4060
J (512) 556-3621
Gender: Female
PCP # 0061JG01
NPI: 1578661468
900 S FM 620 Rd
Ste C201
(512) 328-2266
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, St Davids
Medical Center
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Gender: Male
# PCP # 89Y90001
NPI: 1174505176
187 Pr 4060
J (512) 556-3621
Hospital Affiliation: Metroplex Hospital,
Rollins Brook Community Hospital
Clinic Affiliation: Family Medicine Rural
Health
Board Certified Specialties: Family
Practice
Gender: Male
# PCP # 89Y90101
NPI: 1609858232
187 Pr 4060
J (512) 556-3621
Hospital Affiliation: Metroplex Hospital,
Rollins Brook Community Hospital
Clinic Affiliation: Family Medicine Rural
Health
Board Certified Specialties: Family
Practice
" Cain, James E, MD
Lampas as
Gender: Male
# PCP # 84950G01
NPI: 1467434464
187 Pr 4060
J (512) 556-3621
Hospital Affiliation: Metroplex Hospital,
Rollins Brook Community Hospital
Clinic Affiliation: Family Medicine Rural
Health
Board Certified Specialties: Family
Practice
" Deng, Yue, MD
Lampasas
Gender: Female
PCP # 8AK93606
NPI: 1821292483
1205 Central Texas Expwy
J (512) 556-5362
Hospital Affiliation: Seton Highland Lakes,
Seton Medical Center, Seton Northwest
Hospital
Clinic Affiliation: Seton Healthcare
Board Certified Specialties: Internal
Medicine
LEANDER
FAMILY PRACTICE
" Burnell, Elizabeth E, MD
Leander
Gender: Female
PCP # 8A890101
NPI: 1255325429
902 Crystal Falls Pkwy
J (512) 259-2222
Hospital Affiliation: River Oaks Endoscopy
Center Llp, West Houston Medical Center
Clinic Affiliation: Mansolo Ron MD
Practice Information: No Patients Under 4
yrs old
Board Certified Specialties: Family
Practice
Egelsee Jr, Luis, MD
Gender: Male
PCP # 8CJ29501
NPI: 1407969140
651 N Hwy 183
Ste 110
(512) 528-0432
Hospital Affiliation: Cedar Park Regional
Medical Ctr
Clinic Affiliation: Timberland Medical Group
Board Certified Specialties: None
Leander
" Lane, Mark S, MD
" Patteson Jr, Morris K, MD
LAMPASAS
INTERNAL MEDICINE
Lampasas
Lampasas
FAMILY PRACTICE
Gender: Male
PCP # 8CV07902
NPI: 1841272481
608 N Key Ave
(512) 564-0722
Hospital Affiliation: Metroplex Hospital,
Rollins Brook Community Hospital
Clinic Affiliation: Metroplex Clinic
Physicians Inc
Board Certified Specialties: Family
Practice
Granato, Alison C, MD
Gender: Female
PCP # 8EA72902
NPI: 1861710063
1007 S US Hwy 183
J (512) 260-4900
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Leander
" Mansolo, Ron M, MD
Leander
Gender: Male
PCP # 8A890001
NPI: 1871586933
902 Crystal Falls Pkwy
J (512) 259-2222
Hospital Affiliation: River Oaks Endoscopy
Center Llp, Round Rock Medical Center,
Seton Northwest Hospital, West Houston
Medical Center
Clinic Affiliation: Mansolo Ron MD
Practice Information: No Patients Under 4
yrs old
Board Certified Specialties: Family
Practice
!
J - Wheelchair Access
37
LEANDER
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
LEANDER Cont
PEDIATRICS
" Craig, Clark W, MD
Llano
Gender: Male
PCP # 8BP55602
NPI: 1356323935
200 W Ollie St
(325) 247-5040
Hospital Affiliation: Scott & White Hospital
Llano
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Azadi, Sohail B, MD
Leander
FAMILY PRACTICE Cont
Manthena, Swapna, MD
Gender: Female
! PCP # 8EJ93401
NPI: 1225365208
901 Crystal Falls Pkwy
Ste 150
(512) 231-5548
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Leander
Mauldin, Allen L, MD
Gender: Male
PCP # 8DD49901
PCP # 8DL91501
NPI: 1437167095
2701 S Hwy 183
Ste B
(512) 259-5111
Hospital Affiliation: Round Rock Medical
Center, St Davids Georgetown Hospital
Clinic Affiliation: Leander Healthcare
Center LLC, Wellmed Medical Group PA
Board Certified Specialties: None
Gender: Male
PCP # 8AX41001
NPI: 1154414688
709 N Bagdad Rd
J (512) 260-0101
Hospital Affiliation: St Davids Georgetown
Hospital, St Davids Medical Center
Clinic Affiliation: Avecinna Medical Center
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: Pediatrics
" Forrister, Skylar S, MD
Llano
Gender: Male
PCP # 8BE77702
NPI: 1497737969
200 W Ollie St
(254) 724-2111
Hospital Affiliation: Scott & White Hospital
Llano
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Leander
!
!
LIBERTY HILL
FAMILY PRACTICE
" Overstreet, Haley C, MD
Liberty Hill
Gender: Female
PCP # 8ED05702
NPI: 1700107323
14365 Hwy 29 W
(512) 778-5160
Hospital Affiliation: Cedar Park Regional
Medical Ctr
Clinic Affiliation: Timberland Medical Group
Board Certified Specialties: Family
Practice
" Patel, Smita C, MD
Leander
Gender: Female
PCP # 8AB53305
NPI: 1235166786
1007 S Hwy 183
(512) 260-4900
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
J
Scanlan, Lynne, MD
Gender: Female
PCP # 8CW16203
NPI: 1285898668
1007 S US Hwy 183
J (512) 260-4900
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
Leander
Gender: Male
PCP # 8EN65101
NPI: 1831129139
14365 W State Hwy 29
Ste 10
(512) 778-5160
Clinic Affiliation: Timberland Medical Group
Board Certified Specialties: Internal
Medicine
INTERNAL MEDICINE
" Azadi, Roya A, MD
Leander
Gender: Female
!# PCP # 8AX41101
NPI: 1912180084
709 N Bagdad Rd
J (512) 260-0101
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Round Rock Medical Center,
Seton Medical Center, Seton Northwest
Hospital, St Davids Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Avecinna Medical Center
Board Certified Specialties: Internal
Medicine
LLANO
FAMILY PRACTICE
Llano
OBSTETRICS-GYNECOLOGY
Montemayor, Patricia C, MD
Gender: Female
PCP # 8DR02702
NPI: 1255332037
1007 S Hwy 183
(512) 260-4900
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Leander
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Female
PCP # 8CS20203
NPI: 1467434936
102 E Young
(325) 247-4131
PCP # 8CS20202
NPI: 1467434936
200 W Ollie St
(325) 247-5040
Hospital Affiliation: Scott & White Hospital
Llano
Clinic Affiliation: Scott and White Hospital
Llano
Board Certified Specialties: Family
Practice
" Berkley, William G, MD
" Wolf, Paul M, MD
Llano
Carstens, Paul A, MD
Gender: Male
PCP # 8CS19702
NPI: 1144328766
200 W Ollie St
(325) 247-5040
Hospital Affiliation: Scott & White Hospital
Llano
Clinic Affiliation: Scott and White Hospital
Llano
Board Certified Specialties: None
Gender: Male
# PCP # 8CS20603
NPI: 1508848052
102 E Young
(325) 247-4131
PCP # 8CS20602
NPI: 1508848052
200 W Ollie St
(325) 247-5040
Hospital Affiliation: Scott & White Hospital
Llano
Clinic Affiliation: Scott and White Hospital
Llano
Board Certified Specialties: Family
Practice
" Horne, Monte H, MD
Llano
J
" Franklin Jr, Jack P, MD
Llano
Gender: Male
PCP # 8BE77102
PCP # 8CS20302
NPI: 1366426595
200 W Ollie St
J (254) 724-2111
(325) 247-5040
Hospital Affiliation: Scott & White Hospital
Llano
Clinic Affiliation: Scott and White Clinic,
Scott and White Hospital Llano
Board Certified Specialties: Family
Practice
" Meiser, William J, DO
Gender: Male
PCP # 8CS20902
NPI: 1962428482
200 W Ollie St
(325) 247-5040
Clinic Affiliation: Scott and White Hospital
Llano
Board Certified Specialties: Family
Practice
" Miller, Grady F, DO
Llano
Gender: Male
PCP # 8BE77802
PCP # 8CS21002
NPI: 1154303725
200 W Ollie St
(254) 724-2111
(325) 247-5040
Hospital Affiliation: Scott & White Hospital
Llano
Clinic Affiliation: Scott and White Clinic,
Scott and White Hospital Llano
Board Certified Specialties: Family
Practice
" Gray, Chad E, MD
Gender: Male
PCP # 8DV17902
NPI: 1134191760
200 W Ollie St
J (325) 247-5040
Hospital Affiliation: Lamb Healthcare
Center, University Medical Center
Clinic Affiliation: Scott and White Hospital
Llano
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
" Grimshaw, Randall, MD
Gender: Male
PCP # 8CS20502
NPI: 1316929961
200 W Ollie St
(325) 247-5040
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Scott and White Hospital
Llano
Board Certified Specialties: Family
Practice
Gender: Male
PCP # 8ER59601
NPI: 1184613473
102 E Young
(325) 247-4131
Hospital Affiliation: Hamilton General
Hospital
Clinic Affiliation: Scott and White Hospital
Llano
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
Llano
Llano
Llano
Copeland, Curtis R, MD
Gender: Male
PCP # 8DV74402
NPI: 1457646259
200 W Ollie St
(325) 247-5040
Clinic Affiliation: Scott and White Hospital
Llano
Board Certified Specialties: None
" Hoerster, Dan D, MD
Llano
" Forrister, Sonja L, MD
Liberty Hill
Liberty Hill
Gender: Male
PCP # 8CS30003
NPI: 1568646545
102 E Young
(325) 247-4131
Clinic Affiliation: Scott and White Hospital
Llano
Board Certified Specialties: Family
Practice
Llano
INTERNAL MEDICINE
Gender: Male
PCP # 8DD45601
NPI: 1457368730
14365 W State Hwy 29
J (512) 778-5160
Hospital Affiliation: Cedar Park Regional
Medical Ctr
Clinic Affiliation: Timberland Medical Group
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: Internal
Medicine
" Hays Jr, Robert F, MD
Llano
" Tucker, Kelly R, MD
Llano
Gender: Male
PCP # 8CS22703
NPI: 1033192166
102 E Young
(325) 247-4131
PCP # 8CS22702
NPI: 1033192166
200 W Ollie St
(325) 247-5040
Hospital Affiliation: Scott & White Hospital
Llano
Clinic Affiliation: Scott and White Hospital
Llano
Board Certified Specialties: Family
Practice
J - Wheelchair Access
38
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
MANOR
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Russell, Terri A, MD
Gender: Female
# PCP # 8BF00501
NPI: 1700985553
1105 S Medina St
J (512) 376-9700
Hospital Affiliation: St Davids Medical
Center
Clinic Affiliation: Terri Anne Russell MD
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
" Roopireddy, Sreekanth R, MD
Loc khart
LLANO Cont
INTERNAL MEDICINE
Llano
Llano
Jones, Shirley F, MD
Gender: Female
PCP # 8CS30203
NPI: 1750304200
200 W Ollie
(325) 247-5040
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Hospital
Llano
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Turner, Terry L, MD
Gender: Male
PCP # 8CS22802
NPI: 1982686481
200 W Ollie St
(325) 247-5040
Hospital Affiliation: Scott & White Hospital
Llano
Clinic Affiliation: Scott and White Hospital
Llano
Board Certified Specialties: None
Lockhart
Gender: Male
# PCP # 8BW50901
NPI: 1053535567
300 S Colorado St
Ste A
J (512) 376-9690
Hospital Affiliation: Seton Edgar B Davis
Clinic Affiliation: Seton Healthcare
Board Certified Specialties: Family
Practice
" Wheeler, Kimberly M, MD
Loc khart
J
Gender: Female
PCP # 8W620101
NPI: 1679527147
1009 W San Antonio St
(512) 376-5247
Hospital Affiliation: Central Texas Medical
Center, St Davids Medical Center, St Davids
S Austin Medical Center
Clinic Affiliation: Lockhart Family Medicine
PLLC
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: Family
Practice
Llano
Carstens, Paul A, MD
Gender: Male
PCP # 8CS19702
NPI: 1144328766
200 W Ollie St
(325) 247-5040
Hospital Affiliation: Scott & White Hospital
Llano
Clinic Affiliation: Scott and White Hospital
Llano
Board Certified Specialties: None
LOCKHART
" Jesudass, Samson W, MD
Gender: Male
# PCP # 8DC18501
NPI: 1619911385
300 S Colorado St
Ste A
J (512) 376-9690
Hospital Affiliation: Seton Edgar B Davis,
Seton Medical Center, Seton Smithville Reg
Hospital
Clinic Affiliation: Seton Healthcare
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: Internal
Medicine
" Mohandas, Arjun, MD
Loc khart
Gender: Male
PCP # 8CM95701
NPI: 1639123573
209 S Church St
Ste B
(512) 791-1224
Hospital Affiliation: Seton Edgar B Davis,
Warm Springs Spec Hosp Luling Llc
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: Internal
Medicine
FAMILY PRACTICE
" Kirtley, Randall W, MD
Lockhart
Gender: Male
PCP # 8CM95601
NPI: 1457374621
300 S Commerce St
Ste B
(512) 791-1224
Hospital Affiliation: Central Texas Medical
Center, Seton Edgar B Davis, Seton
Smithville Reg Hospital, St Davids Medical
Center
Clinic Affiliation: Seton Family of Doctors
Board Certified Specialties: Family
Practice
" Mohandas, Renu, MD
Loc khart
Gender: Female
PCP # 8CM95801
NPI: 1205949112
209 S Church St
Ste B
(512) 376-2999
Hospital Affiliation: Seton Edgar B Davis,
Warm Springs Spec Hosp Luling Llc
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: Internal
Medicine
Laurence, Charles E, MD
Gender: Male
PCP # 00SC2001
NPI: 1285641001
1301 S Medina
J (512) 398-3464
Hospital Affiliation: Central Texas Medical
Center
Board Certified Specialties: None
Lockhart
Romanek, Barton J, MD
Gender: Male
PCP # 8W620001
NPI: 1417901513
1009 W San Antonio St
J (512) 376-5247
Hospital Affiliation: Central Texas Medical
Center, St Davids Medical Center
Clinic Affiliation: Lockhart Family Medicine
PLLC
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: None
Lockhart
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
FAMILY PRACTICE
Bilir, Sule P, MD
Gender: Female
# PCP # 8CR95401
NPI: 1326112715
111 S Laurel Ave
J (830) 875-6399
Clinic Affiliation: Community Health Ctrs
So Central TX Inc
Board Certified Specialties: None
Luling
Medellin, Roland A, MD
Gender: Male
PCP # 8W715802
NPI: 1184626871
111 S Laurel Ave
J (830) 875-6399
Hospital Affiliation: Memorial Hospital,
Memorial Hospital Home Health
Clinic Affiliation: Community Health Ctrs
So Central TX Inc
Board Certified Specialties: None
Luling
INTERNAL MEDICINE
Loc khart
PEDIATRICS
LULING
Rider, James A, DO
Gender: Male
# PCP # 8DM05703
NPI: 1154640993
111 S Laurel Ave
J (830) 875-6399
Clinic Affiliation: Community Health Ctrs
So Central TX Inc
Board Certified Specialties: None
" Kim, Rebecca, MD
J
Wray, Mary J, MD
Gender: Female
# PCP # 8CA04101
NPI: 1588633499
111 S Laurel St
(830) 875-6399
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, University Med Ctr Brackenridge
Clinic Affiliation: Community Health Ctrs
So Central TX Inc
Board Certified Specialties: None
Luling
MADISONVILLE
FAMILY PRACTICE
Hubley Jr, Grover C, MD
Gender: Male
PCP # 8W731001
NPI: 1720197437
813 S State St
Ste 100
(936) 348-3515
Hospital Affiliation: Madison St Joseph
Health Center, St Joseph Regional Health
Center
Clinic Affiliation: St Joseph Regional
Health Center
Practice Information: No Obstetrics
Board Certified Specialties: None
Madisonv ille
" Tuck White, Melissa S, MD
Madisonv ille
Gender: Female
PCP # 8EA21002
NPI: 1306973979
1613 E Main St
(936) 349-0350
Clinic Affiliation: Hmh Medical Clinic
Board Certified Specialties: Family
Practice
" Stone, Jamilla C, MD
Luling
Gender: Female
PCP # 8DY74501
NPI: 1932337029
130 Hays
Ste D
(830) 875-7074
Hospital Affiliation: Seton Edgar B Davis
Clinic Affiliation: Seton Family of Doctors
Board Certified Specialties: Family
Practice
INTERNAL MEDICINE
" Edison, Flora, MD
Luling
Gender: Female
PCP # 8CB72501
NPI: 1134192974
130 Hays St Ste D
(830) 875-3445
Hospital Affiliation: Fisher County Hospital
District, Seton Edgar B Davis, University
Med Ctr Brackenridge
Clinic Affiliation: Seton Healthcare
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: Internal
Medicine
Luling
Gender: Female
PCP # 8CF70701
NPI: 1467656033
300 S Colorado St
Ste B
(512) 376-9690
Hospital Affiliation: Seton Edgar B Davis
Clinic Affiliation: Seton Healthcare
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
PEDIATRICS
Luling
PEDIATRICS
Loc khart
Price, Allan E, MD
Gender: Male
PCP # 8DM08701
NPI: 1578678298
130 Hays St Ste D
J (830) 875-3445
Hospital Affiliation: Seton Edgar B Davis
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: None
Luling
Nepustil, Ivan R, MD
Gender: Male
PCP # 8EA74401
NPI: 1407879463
130 Hays St
Ste D
(830) 875-3445
Hospital Affiliation: Seton Edgar B Davis
Clinic Affiliation: Seton Family of Doctors
Board Certified Specialties: None
MANOR
FAMILY PRACTICE
" Escamilla, David F, MD
Manor
Gender: Male
PCP # 8CY95106
NPI: 1427093434
600 W Carrie Manor St
J (512) 978-9780
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: Communitycare
Board Certified Specialties: Family
Practice
" Ruiz, Marilyn, MD
Manor
Gender: Female
PCP # 8DW80401
NPI: 1528273281
14001 Shadow Glen
Blvd Ste G
(512) 272-4451
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Manor Family Practice
PLLC
Board Certified Specialties: Family
Practice
J - Wheelchair Access
39
MANOR
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Davenport, Peter, MD
" Offutt, Amy L, MD
Marble F alls
MANOR Cont
INTERNAL MEDICINE
" Katkuri, Rajani R, MD
Manor
Gender: Female
PCP # 8CY97801
NPI: 1871607911
600 W Carrie Manor St
(512) 978-9780
Hospital Affiliation: Seton Northwest
Hospital
Clinic Affiliation: Communitycare
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
" Ramos, Alina M, MD
Manor
Gender: Female
PCP # 8CY98802
NPI: 1689606857
600 W Carrie Manor St
(512) 978-9780
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Communitycare
Board Certified Specialties: Internal
Medicine
PEDIATRICS
Manor
Lama Briseno, Tracy R, DO
Gender: Female
PCP # 8CY93607
NPI: 1558520544
600 W Carrie Manor St
(512) 978-9780
Clinic Affiliation: Communitycare
Board Certified Specialties: None
MARBLE FALLS
FAMILY PRACTICE
Carstens, Paul A, MD
Gender: Male
PCP # 8CS19703
NPI: 1144328766
706 Ave G
(830) 693-2834
Hospital Affiliation: Scott & White Hospital
Llano
Clinic Affiliation: Scott and White Hospital
Llano
Board Certified Specialties: None
Marble Falls
" Craig, Clark W, MD
Marble Falls
Gender: Male
PCP # 8CS19802
NPI: 1356323935
706 Ave G
(830) 693-8234
Hospital Affiliation: Scott & White Hospital
Llano
Clinic Affiliation: Scott and White Hospital
Llano
Board Certified Specialties: Family
Practice
" Cravey, Bruce M, MD
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Shinkawa, Sidney M, MD
Gender: Female
PCP # 8CE71501
NPI: 1689656266
700 US Hwy 281
(830) 693-2600
Hospital Affiliation: Scott & White Hospital
Llano, Seton Highland Lakes
Clinic Affiliation: Seton Healthcare
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: None
Marble Falls
Gender: Female
PCP # 8X868001
NPI: 1891777314
707 Third St
J (830) 693-7546
Hospital Affiliation: Scott & White Hospital
Llano
Clinic Affiliation: Amy L Offutt MD
Board Certified Specialties: Family
Practice
" Duperval-Brownlee, Tamarah, MD
Marble F alls
" Spaw, Raymond G, MD
Marble Falls
Gender: Female
PCP # 8CT52402
NPI: 1215047733
2510 N U S Hwy 281
Ste 120
J (877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: Family
Practice
Gender: Male
PCP # 8CP17301
NPI: 1174503163
700 US Hwy 281
(830) 693-2600
Hospital Affiliation: Round Rock Medical
Center, Seton Highland Lakes, St Davids
Georgetown Hospital
Clinic Affiliation: Seton Healthcare
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Family
Practice
" Franz, Charles M, DO
Marble F alls
Gender: Male
PCP # 8J562303
NPI: 1912978206
700 Hwy 281 N
J (830) 693-2600
Hospital Affiliation: Seton Highland Lakes,
The Medical Ctr Of Southeast Tx Lp
Clinic Affiliation: Seton Healthcare
Practice Information: No Obstetrics, No
Patients Under 1 yrs old
Board Certified Specialties: Family
Practice
Stedman Jr, Horis T, MD
Gender: Male
PCP # 87Z00101
NPI: 1285629220
2300 Hwy 281 N
J (830) 693-3621
Hospital Affiliation: Seton Highland Lakes
Clinic Affiliation: Family Wellness Center
PA
Practice Information: No Obstetrics
Board Certified Specialties: None
" Sidwani Chawla, Seema L, DO
Marble Falls
Gender: Female
PCP # 8EC46802
NPI: 1003849282
800 W Hwy 71
(830) 201-7100
Clinic Affiliation: Scott and White Hospital
Llano
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
J
OBSTETRICS-GYNECOLOGY
Marble Falls
Gosselink, Peter G, MD
Gender: Male
PCP # 8U427101
NPI: 1770503658
608 Gateway Central
Ste 100
J (830) 693-2005
Hospital Affiliation: Seton Highland Lakes
Clinic Affiliation: Amy Van Dorfy MD
Board Certified Specialties: None
Marble F alls
" Van Dorfy, Amy E, MD
Marble Falls
Gender: Female
PCP # 8U427001
NPI: 1578535787
608 Gateway Central
Ste 100
J (830) 693-2005
Hospital Affiliation: Seton Highland Lakes,
University Med Ctr Brackenridge
Clinic Affiliation: Amy Van Dorfy MD
Board Certified Specialties: Family
Practice
" Gray, Chad E, MD
Marble F alls
Gender: Male
PCP # 8DV17903
NPI: 1134191760
706 Ave G
J (830) 693-8234
Hospital Affiliation: Lamb Healthcare
Center, University Medical Center
Clinic Affiliation: Scott and White Hospital
Llano
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
Cook, Paul A, MD
Gender: Male
PCP # 8DP42303
NPI: 1568455004
800 W Hwy 71
J (830) 201-7100
Clinic Affiliation: Scott and White Hospital
Llano
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Marble Falls
PEDIATRICS
Carstens, Paul A, MD
Gender: Male
PCP # 8CS19703
NPI: 1144328766
706 Ave G
(830) 693-2834
Hospital Affiliation: Scott & White Hospital
Llano
Clinic Affiliation: Scott and White Hospital
Llano
Board Certified Specialties: None
Marble Falls
INTERNAL MEDICINE
" Cheema, Yasir I, MD
Marble Falls
" Cramer, Andrea E, MD
Marble Falls
Gender: Female
PCP # 8CZ32201
NPI: 1639129562
1123 Hwy 1431
(830) 693-3988
Hospital Affiliation: Medical Center Of
Plano, Medical City Dallas Hospital, Tx Hlth
Presbyterian Hosp Dallas, Tx Hlth
Presbyterian Hosp Plano
Clinic Affiliation: Childrens Health Center
PA
Practice Information: No Patients Over 22
yrs old
Board Certified Specialties: Pediatrics
Gender: Male
PCP # 8CW96804
NPI: 1952515876
8001 W Hwy 71
J (830) 201-7100
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
" Hays Jr, Robert F, MD
Marble F alls
Gender: Male
PCP # 8CS30002
NPI: 1568646545
706 Ave G
(830) 693-8234
Clinic Affiliation: Scott and White Hospital
Llano
Board Certified Specialties: Family
Practice
Marble Falls
Gender: Male
PCP # 8CS19902
NPI: 1487636064
706 Ave G
(830) 693-8234
Hospital Affiliation: Scott & White Hospital
Llano
Clinic Affiliation: Scott and White Hospital
Llano
Board Certified Specialties: Family
Practice
Marble Falls
Gender: Male
PCP # 8CS20002
NPI: 1134395973
706 Ave G
(830) 693-8234
Clinic Affiliation: Scott and White Hospital
Llano
Board Certified Specialties: Family
Practice
" Deng, Yue, MD
Marble Falls
Gender: Female
PCP # 8AK93604
NPI: 1821292483
700 US Hwy 281
J (830) 693-2600
Hospital Affiliation: Seton Highland Lakes,
Seton Medical Center, Seton Northwest
Hospital
Clinic Affiliation: Seton Healthcare
Board Certified Specialties: Internal
Medicine
Liggett, Scott P, MD
Gender: Male
PCP # 8CS20702
NPI: 1336121953
706 Ave G
(830) 693-8234
Hospital Affiliation: Scott & White Hospital
Llano, Seton Highland Lakes
Clinic Affiliation: Scott and White Hospital
Llano
Board Certified Specialties: None
Marble F alls
Offutt, Kelly A, MD
Gender: Female
PCP # 8CS22402
NPI: 1154303709
706 Ave G
(830) 693-8234
Hospital Affiliation: Scott & White Hospital
Llano
Clinic Affiliation: Scott and White Hospital
Llano
Board Certified Specialties: None
Marble Falls
" Johns, Ronald W, MD
Marble Falls
Gender: Male
PCP # 8U427201
NPI: 1750376703
608 Gateway Central 100
Ste 100
J (830) 693-2005
Hospital Affiliation: Seton Highland Lakes
Clinic Affiliation: Amy Van Dorfy MD
Board Certified Specialties: Internal
Medicine
" Tannous, Jeanet N, MD
Marble Falls
J
Gender: Female
PCP # 8CZ31901
NPI: 1689874240
1123 Hwy 1431
(830) 693-3988
Hospital Affiliation: Cook Childrens Medical
Center, Scott & White Hospital Llano
Clinic Affiliation: Childrens Health Center
PA
Board Certified Specialties: Pediatrics
J - Wheelchair Access
40
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
PFLUGERVILLE
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Hart, Steven B, MD
Gender: Male
PCP # 88878S01
NPI: 1952317208
15803 Windermere Dr
Ste 103
J (512) 989-2680
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Pflugerville
MARBLE FALLS Cont
PEDIATRICS Cont
Thomas, Sandra K, MD
Gender: Female
PCP # 8CZ31801
NPI: 1932152709
1123 Hwy 1431
J (830) 693-3988
Hospital Affiliation: Scott & White Hospital
Llano, Seton Highland Lakes
Clinic Affiliation: Childrens Health Center
PA
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
Marble Falls
" Thompson, Tanna M, MD
Marble Falls
Gender: Female
PCP # 8CE71601
NPI: 1528135860
700 US Hwy 281
J (830) 693-2600
Hospital Affiliation: St Davids Georgetown
Hospital
Clinic Affiliation: Seton Healthcare
Board Certified Specialties: Pediatrics
OGLESBY
FAMILY PRACTICE
Weed III, John M, MD
Gender: Male
PCP # 8W695702
NPI: 1134161359
1700 Brazos
J (512) 446-4500
Hospital Affiliation: Little River Healthcare
Clinic Affiliation: Little River Healthcare
Family Ca
Board Certified Specialties: None
Oglesby
Gender: Female
PCP # 8CZ32001
NPI: 1902968126
1123 Hwy 1431
J (830) 693-3988
Clinic Affiliation: Childrens Health Center
PA
Board Certified Specialties: Pediatrics
McGregor
FAMILY PRACTICE
PCP # 8U497002
NPI: 1194768911
18900 Limestone
Commercial Dr Ste 600
(512) 252-1505
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, St
Davids Medical Center
Clinic Affiliation: Shane Edward Keller MD
Board Certified Specialties: Family
Practice
J
Khan, Afreen, DO
Gender: Female
PCP # 8EM14901
NPI: 1942404751
15803 Windermere Dr
Ste 103
(512) 989-2680
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Pflugerville
" Chang, Franklin, MD
FAMILY PRACTICE
MEXIA
Gender: Male
PCP # 0016GG01
NPI: 1174522296
200 N Heatherwilde Blvd
(512) 989-7400
Hospital Affiliation: Round Rock Medical
Center, St Davids Medical Center
Practice Information: No Patients Under 5
yrs old
Board Certified Specialties: Family
Practice
Pflugerville
J
Gender: Male
# PCP # 8AR80401
NPI: 1710946561
500 S Johnson Dr
J (254) 313-5200
Hospital Affiliation: North Runnels Hospital,
Scott And White Memorial Hospital
Clinic Affiliation: Family Practice Center
Board Certified Specialties: Family
Practice
J
" Boyd, John R, MD
MCGREGOR
" Boles, Keith A, MD
Gender: Male
PCP # 8U497001
NPI: 1194768911
1615 Grand Ave Pkwy
Ste 112
(512) 252-1505
Pflugerville
" Valmiki, Himabindu A, MD
Gender: Male
PCP # 80439K05
NPI: 1285694265
1701 Pflugerville Pkwy
(512) 260-6000
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Kyte, Paul D, MD
Pflugerville
Gender: Male
PCP # 8DP41303
NPI: 1356352967
1701 Pfluderville Pkwy
(512) 260-6000
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Seton Northwest Hospital
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
" Escamilla, David F, MD
Pflugerville
J
Gender: Male
PCP # 8CY95109
NPI: 1427093434
15822 Foothill Farms
Loop
(512) 978-9840
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: Communitycare
Board Certified Specialties: Family
Practice
" Madabhushi, Madhuri, MD
Pflugerville
Gender: Female
PCP # 8CS42301
NPI: 1780841817
15803 Windemere Dr
Ste 103
(512) 989-2680
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Gerdelman, Brenna K, MD
Pflugerville
Gender: Female
PCP # 8U684601
NPI: 1033125380
15803 Windermere Dr
Ste 103
(512) 989-2680
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, The Hosp At
Westlake Med Ctr
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Yerger, Nathan K, MD
Mexia
Gender: Male
PCP # 8DA44501
NPI: 1609011444
514 S Bonham Ste D
(254) 562-9321
Clinic Affiliation: Texas Specialty
Physicians
Board Certified Specialties: Family
Practice
" Medrano, William, MD
Pflugerville
" Haji, Amina K, MD
Pflugerville
MOODY
FAMILY PRACTICE
" Hong, May C, MD
Moody
Gender: Female
PCP # 8CM39402
NPI: 1811933690
498 Ave E
J (254) 853-2162
Hospital Affiliation: Scott & White Hospital
Taylor
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
J
Gender: Female
PCP # 83N83801
NPI: 1326143090
1512 Town Center Dr
Ste 100
(512) 791-1224
Hospital Affiliation: Seton Medical Ctr
Williamson
Clinic Affiliation: Seton Family of Doctors
Board Certified Specialties: Family
Practice
" Keller, Shane E, MD
FAMILY PRACTICE
Marble Falls
" Parthasarathy, Urmila, DO
Pflugerv ille
Pflugerville
PFLUGERVILLE
J
Nguyen, Chau H, DO
Gender: Male
PCP # 8BS42405
NPI: 1619041407
1701 Pflugerville
(512) 260-6000
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
Pflugerv ille
Gender: Female
PCP # 8DY82502
NPI: 1235140153
1701 Pflugerville Pkwy
(512) 260-6000
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
J
Gender: Male
PCP # 84G10801
NPI: 1619083342
15803 Windermere Dr
Ste 103
(512) 989-2680
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Meshew, Catherine L, MD
Pflugerville
J
Gender: Female
PCP # 8DJ15004
NPI: 1033346382
1701 Pflugerville Pkwy
(512) 260-6000
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
" Philip, Tina J, DO
Pflugerv ille
Gender: Female
# PCP # 8U497101
NPI: 1174793970
1615 Grand Ave Pkwy
Ste 112
J (512) 252-1505
PCP # 8U497102
NPI: 1174793970
18900 Limestone
Commercial Dr Ste 600
J (512) 252-1505
Hospital Affiliation: North Austin Medical
Center
Clinic Affiliation: Shane Edward Keller MD
Board Certified Specialties: Family
Practice
" Pruitt, Enas L, MD
Pflugerv ille
Gender: Male
PCP # 8CN86601
NPI: 1073682472
1512 Town Center Dr
Ste 100
J (512) 791-1224
Hospital Affiliation: Seton Medical Ctr
Williamson
Clinic Affiliation: Seton Family of Doctors
Board Certified Specialties: Family
Practice
Russo, Anthony R, MD
Gender: Male
# PCP # 00B91R01
NPI: 1700860400
2401 Peacan St W
Ste 103
J (512) 251-5586
Hospital Affiliation: St Davids Medical
Center
Practice Information: No Patients Under 6
yrs old
Board Certified Specialties: None
Pflugerv ille
" Sherrill, Julia C, MD
Pflugerv ille
Gender: Female
PCP # 8CX72404
NPI: 1699938159
1701 Pflugerville Pkwy
J (512) 260-6000
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
" Stewart, Christopher A, MD
Pflugerv ille
Gender: Male
PCP # 86774K04
NPI: 1184686230
1701 E Pflugerville
Pkwy
J (512) 259-6000
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
J - Wheelchair Access
41
PFLUGERVILLE
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Enders, Judith W, MD
Gender: Female
PCP # 8F707801
NPI: 1992711261
15803 Windermere Dr Ste A
J (512) 989-2680
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
" Burugu, Sukanya, MD
Pflugerville
PFLUGERVILLE Cont
FAMILY PRACTICE Cont
" Stone, Mark A, MD
Pflugerville
Gender: Male
PCP # 82702N04
NPI: 1326000852
1701 Pflugerville Pkwy
(512) 260-6000
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
J
Vega, Katherine M, MD
Gender: Female
PCP # 8ED91302
NPI: 1134377849
1701 E Pflugerville Pkwy
(512) 259-6000
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Pflugerville
" Verma, Ashu, DO
Pflugerville
J
Gender: Female
PCP # 8DQ56503
NPI: 1548420011
1701 Pflugerville Pkwy
(512) 260-6000
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
Gender: Female
PCP # 8CN84201
NPI: 1770579203
1512 Town Center Dr
Ste 100
(512) 324-4875
Hospital Affiliation: Cornerstone Hosp Of
Austin, Seton Medical Center, Seton Medical
Ctr Williamson, St Davids Hospital
Clinic Affiliation: Seton Family of Doctors
Board Certified Specialties: Internal
Medicine
J
Gender: Female
PCP # 80317N05
NPI: 1609046804
1701 Pflugerville Pkwy
(512) 260-6000
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
INTERNAL MEDICINE
" Brister, Susan C, MD
Pflugerville
!
Gender: Female
PCP # 8DX39201
NPI: 1033178751
1501 Pecan St W Ste 102
(512) 421-3750
Hospital Affiliation: Scott & White Hlthcare
Round Rock, Scott And White Memorial
Hospital
Clinic Affiliation: Wellmed Medical Group
PA
Board Certified Specialties: Internal
Medicine
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
PCP # 8DU64904
NPI: 1669468039
1700 Brazos Ave
Ste B
(512) 446-4545
PCP # 8DU64902
NPI: 1669468039
602 N Main St
(512) 446-4555
Hospital Affiliation: Little River Healthcare,
Metroplex Hospital, Scott And White
Memorial Hospital, Seton Medical Ctr Harker
Heights
Clinic Affiliation: Little River Healthcare
Family Ca
Board Certified Specialties: Family
Practice
" Holliman, Anna E, MD
Gender: Female
PCP # 8G934701
NPI: 1619983954
15803 Windermere Dr Ste A
J (512) 989-2680
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Mambapoor, Viswajyothi, MD
Gender: Female
PCP # 0001HA01
PCP # 8CG28401
NPI: 1972609162
200 N Heatherwilde Blvd
Ste B
J (512) 251-7007
Hospital Affiliation: Seton Northwest
Hospital
Clinic Affiliation: Viswajyothi Mambapoor
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
!
!
Lama Briseno, Tracy R, DO
Gender: Female
PCP # 8CY93611
NPI: 1558520544
15822 Foothill Farms
Loop
(512) 978-9840
Clinic Affiliation: Communitycare
Board Certified Specialties: None
" Firer, Daniel J, MD
Rockdale
J
Pflugerv ille
" Ramos, Alina M, MD
Pflugerville
Gender: Female
PCP # 8CY98801
NPI: 1689606857
15822 Foothill Farms
Loop
(512) 978-9840
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Communitycare
Board Certified Specialties: Internal
Medicine
" Via, Lara T, MD
Gender: Male
PCP # 8DU64903
NPI: 1669468039
1700 Brazos Ave
Ste A
(512) 446-4545
Pflugerv ille
Pflugerville
Pflugerville
" Barkis, Leslie A, DO
Rockdale
Golden, Alma L, MD
Gender: Female
PCP # 8W265802
NPI: 1841370772
1701 Pflugerville
J (512) 259-6000
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
" Dao, Yen K, DO
" Ven Huizen, Vanessa, DO
ROCKDALE
FAMILY PRACTICE
Pflugerv ille
Pflugerville
Pflugerville
Gender: Female
PCP # 8DC79601
NPI: 1215113519
15803 Windermere Dr
Ste 103
(512) 989-2680
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: Family
Practice
Pflugerv ille
Gender: Female
PCP # 8CQ17804
NPI: 1992710040
104 Rex Kerwin Ct
J (512) 251-3915
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Adult Primary Care
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties: Internal
Medicine
" Nguyen, Ky Q, MD
" House, Janelle K, DO
Rockdale
Pflugerv ille
Gender: Male
PCP # 8AX34401
NPI: 1710903257
15803 Windermere Dr
Ste 103
(512) 989-2680
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
PEDIATRICS
" Azuma, Lynn M, MD
Pflugerville
Gender: Female
PCP # 8AB53605
NPI: 1295782043
1701 Pflugerville
J (512) 260-6000
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
Singh, Shaili M, MD
Gender: Female
PCP # 8EA46401
NPI: 1740260785
15803 Windermere Dr
Ste 103
(512) 989-2680
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Pflugerv ille
" Cavanagh, Andrew T, MD
Pflugerville
Gender: Male
PCP # 8R680301
NPI: 1891701173
15803 Windermere Dr
Ste A
(512) 989-2680
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Pediatrics
Gender: Male
PCP # 8DJ43901
NPI: 1093944134
1700 Brazos
(512) 446-4545
Hospital Affiliation: Little River Healthcare
Clinic Affiliation: Little River Healthcare
Family Ca
Board Certified Specialties: Family
Practice
J
Gender: Female
PCP # 8BB69101
NPI: 1356480594
1700 Brazos
(512) 446-4545
Hospital Affiliation: Little River Healthcare
Clinic Affiliation: Little River Healthcare
Family Ca
Board Certified Specialties: Family
Practice
Molina, Martin C, MD
Gender: Male
PCP # 8DN56501
NPI: 1700830338
1700 Brazos Ave
Ste B
J (512) 446-4506
Hospital Affiliation: Little River Healthcare,
North Austin Medical Center, Round Rock
Medical Center, Seton Smithville Reg
Hospital, The Hosp At Westlake Med Ctr
Clinic Affiliation: Little River Healthcare
Family Ca
Board Certified Specialties: None
Rockdale
" Nurnberg, Jason T, DO
Rockdale
J
Gender: Male
PCP # 8W698701
NPI: 1013955533
1700 Brazos
(512) 446-4500
Hospital Affiliation: Little River Healthcare
Clinic Affiliation: Little River Healthcare
Family Ca
Board Certified Specialties: Family
Practice
J - Wheelchair Access
42
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
ROUND ROCK
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Baker, Dan R, MD
Round Rock
ROCKDALE Cont
FAMILY PRACTICE Cont
!
" Oneill, Larissa K, MD
Roc kdale
Gender: Female
PCP # 8CZ73001
NPI: 1003890963
602 N Main
(512) 446-4555
Hospital Affiliation: Little River Healthcare,
Round Rock Medical Center
Clinic Affiliation: Little River Healthcare
Family Ca
Board Certified Specialties: Family
Practice
" Pettit, James C, DO
J
Roc kdale
Gender: Male
PCP # 8EJ30001
NPI: 1265450175
1700 Brazos Ave
(512) 446-4545
Hospital Affiliation: Burleson St Joseph
Health Center, Little River Healthcare
Clinic Affiliation: Little River Healthcare
Family Ca
Board Certified Specialties: Family
Practice
Thompson, Peyton L, MD
Gender: Male
PCP # 8W699001
NPI: 1861439069
1700 Brazos
(512) 430-6486
Roc kdale
PCP # 8BR44001
NPI: 1861439069
725 W Cameron Ave
(512) 522-2299
Hospital Affiliation: Little River Healthcare
Clinic Affiliation: Fallen Tree Corp, Little
River Healthcare Family Ca
Board Certified Specialties: None
Weed III, John M, MD
Gender: Male
PCP # 8W695701
NPI: 1134161359
602 N Main
J (512) 446-4555
Hospital Affiliation: Little River Healthcare
Clinic Affiliation: Little River Healthcare
Family Ca
Board Certified Specialties: None
David, Elbert R, MD
Gender: Male
! PCP # 86V63001
NPI: 1861494924
7200 Wyoming Spgs
Ste 600
J (512) 244-1995
Hospital Affiliation: Round Rock Medical
Center
Clinic Affiliation: Family Medicine Assoc of
Round Rock PA
Board Certified Specialties: None
Round Rock
Gender: Male
PCP # 8A345001
NPI: 1073613212
1 Chisholm Trl
Ste 4100
(512) 310-8883
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Medical Ctr Williamson, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Baker Dan R MD
Practice Information: No Patients Under 5
yrs old
Board Certified Specialties: Family
Practice
" Beach, Gary J, MD
" Deshazo, Flint K, MD
Round Rock
!
Round Rock
J
J
Gender: Male
PCP # 89C02901
NPI: 1700892049
940 Hesters Crossing
(512) 244-9024
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Diaz, David A, MD
Round Rock
" Bodapati, Rajeswari K, MD
J
Gender: Female
PCP # 8CY06804
NPI: 1528171196
425 University Blvd
Ste 200
(512) 509-4038
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
J
" Boyd, James A, MD
J
Esparza, Sandra A, MD
Gender: Female
# PCP # 8J843101
NPI: 1609871938
1750 Red Bud Ln
J (512) 310-9700
Hospital Affiliation: Round Rock Medical
Center, Seton Northwest Hospital
Clinic Affiliation: ABC Medical Center
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Gender: Male
PCP # 81342S01
NPI: 1629073929
7200 Wyoming Spgs
Ste 600
(512) 244-1995
Hospital Affiliation: Round Rock Medical
Center
Clinic Affiliation: Family Medicine Assoc of
Round Rock PA
Board Certified Specialties: Family
Practice
Ezekoye, Olufunke E, MD
Gender: Female
PCP # 8BG94801
NPI: 1164515631
940 Hesters Crossing
(512) 244-9024
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Center, Seton
Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Round Rock
" Calderon, April M, DO
FAMILY PRACTICE
" Anderson, Norma E, MD
Gender: Female
PCP # 8X124101
NPI: 1013953736
7700 Cat Hollow Dr
Ste 205
J (512) 218-4900
Hospital Affiliation: Mission Regional
Medical Center, Round Rock Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Matsubara and Assoc PA
Board Certified Specialties: Family
Practice
J
Gender: Female
PCP # 8CL98605
NPI: 1437475191
16420 RR 620 Ste 104
(512) 250-7000
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Hardy, Julie C, MD
Round Roc k
Gender: Female
PCP # 8964M701
NPI: 1043226392
940 Hesters Crossing
J (512) 244-9024
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Hines, Terrance S, MD
Round Roc k
Gender: Male
PCP # 8CA01403
NPI: 1588855266
302 University Blvd
J (512) 509-0200
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Hutto, Steven B, MD
Round Roc k
Gender: Male
PCP # 8DR90601
NPI: 1356588529
940 Hesters Crossing
(512) 244-9024
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Cooney, Edward, MD
" Irvin, Bryan, MD
Round Roc k
Gender: Male
PCP # 85071S01
NPI: 1831104991
940 Hesters Crossing
J (512) 244-9024
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Under 6
yrs old
Board Certified Specialties: Family
Practice
" Isaac, Dominique J, MD
Round Roc k
Gender: Female
PCP # 8U684101
NPI: 1497761761
940 Hesters Crossing
(512) 244-9024
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Round Rock
J
" Franklin Jr, Jack P, MD
Round Rock
Gender: Male
PCP # 82466K03
NPI: 1568422400
302 University Blvd
(512) 509-0200
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
J
" Daniel, Steven, DO
Gender: Male
PCP # 8BE77103
NPI: 1366426595
302 University Blvd
(512) 509-0200
Hospital Affiliation: Scott & White Hospital
Llano
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Round Rock
" Goode, Joel D, MD
Round Rock
Gender: Male
PCP # 8CX46801
NPI: 1245420108
7200 Wyoming Spgs
Ste 600
(512) 244-1995
Clinic Affiliation: Family Medicine Assoc of
Round Rock PA
Board Certified Specialties: Family
Practice
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Female
PCP # 8CE84801
NPI: 1346264561
940 Hesters Crossing
(512) 244-9024
Hospital Affiliation: Seton Medical Center,
Seton Medical Ctr Williamson, Seton
Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Round Rock
Round Rock
Round Rock
Round Rock
Gender: Male
PCP # 8M181001
NPI: 1033106380
15930 S Great Oaks Dr
Ste A200
(512) 246-3338
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Center
Clinic Affiliation: Great Oaks Family
Practice PA
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: Family
Practice
Round Rock
Roc kdale
ROUND ROCK
Gender: Male
PCP # 86V63201
NPI: 1669474623
7200 Wyoming Spgs
Ste 600
(512) 244-1995
Hospital Affiliation: Round Rock Medical
Center
Clinic Affiliation: Family Medicine Assoc of
Round Rock PA
Board Certified Specialties: Family
Practice
" Haas, Tracey A, DO
Round Roc k
Gender: Male
PCP # 8DB70601
NPI: 1649247198
4112 Links Ln
Ste 201
(512) 672-8933
Hospital Affiliation: Round Rock Medical
Center, West Houston Medical Center
Clinic Affiliation: Capital Area Primary Care
PLLC
Board Certified Specialties: Family
Practice
" Jadhav, Swati, MD
Round Roc k
Gender: Female
PCP # 8B074001
NPI: 1215943584
940 Hesters Crossing
J (512) 244-9024
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
J - Wheelchair Access
43
ROUND ROCK
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Neitsch, Deborah K, MD
" Pruitt, Enas L, MD
Round Rock
ROUND ROCK Cont
FAMILY PRACTICE Cont
" Kurunthottical, Raju Z, DO
Round Rock
Gender: Female
PCP # 8CS46701
NPI: 1184602393
301 Seton Pkwy Ste 401
(512) 324-4818
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Ctr Williamson, St
Davids Georgetown Hospital
Clinic Affiliation: Seton Family of Doctors
Board Certified Specialties: Family
Practice
Lewis, Christopher A, MD
Gender: Male
PCP # 8DB70701
NPI: 1871570895
4112 Links Ln
Ste 201
(512) 672-8933
Hospital Affiliation: Round Rock Medical
Center, West Houston Medical Center
Clinic Affiliation: Capital Area Primary Care
PLLC
Board Certified Specialties: None
Round Rock
" Lopez Gutierrez, Patricia, MD
Round Rock
J
Gender: Female
PCP # 8EK59002
NPI: 1659570208
1800 S A W Grimes Blvd
(512) 244-5700
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
" Magdamo Jr, Willie B, MD
Round Rock
!
Gender: Male
PCP # 8DD48801
NPI: 1093725384
940 Hesters Crossing
Rd
(512) 244-9024
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
J
" Meshew, Catherine L, MD
Round Rock
J
Gender: Female
PCP # 8DJ15003
NPI: 1033346382
2000 S IH 35 Ste N 5
(512) 244-3822
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
" Mills, Shane B, DO
Round Rock
J
Gender: Male
PCP # 84804K02
NPI: 1730176231
16420 R R 620 Ste 104
(512) 252-7000
Hospital Affiliation: Round Rock Medical
Center, Seton Northwest Hospital
Clinic Affiliation: Scott and White Clinic
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: Family
Practice
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Putney, Christopher G, MD
Gender: Male
PCP # 81341S01
NPI: 1295737245
7200 Wyoming Spgs
Ste 600
J (512) 244-1995
Hospital Affiliation: Round Rock Medical
Center
Clinic Affiliation: Family Medicine Assoc of
Round Rock PA
Board Certified Specialties: None
Gender: Female
PCP # 8AH81001
NPI: 1134174881
3000 Joe Dimaggio
Blvd Ste 65
(512) 733-6464
Hospital Affiliation: Round Rock Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Legends Medical Clinic
PLLC
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: Family
Practice
Round Rock
" Nguyen, Joe T, MD
Gender: Male
PCP # 83045Y01
NPI: 1447266705
940 Hesters Crossing Rd
J (512) 244-9024
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Under 6
yrs old
Board Certified Specialties: Family
Practice
" Uriegas, Rodolfo, MD
Round Rock
J
" Rangarajan, Anuradha R, MD
Round Rock
Gender: Female
# PCP # 83N83901
NPI: 1225057516
301 Seton Pkwy
Ste 401
J (512) 791-1224
Hospital Affiliation: Seton Medical Ctr
Williamson
Clinic Affiliation: Seton Family of Doctors
Board Certified Specialties: Family
Practice
" Oliver, Paul B, MD
Round Rock
Gender: Male
PCP # 8A346001
NPI: 1326059635
2000 S IH 35
Ste E1
J (512) 244-1978
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Center, Seton Medical
Ctr Williamson, Seton Northwest Hospital
Clinic Affiliation: Dragon Family Medicine
PA
Practice Information: No Obstetrics
Board Certified Specialties: Family
Practice
" Virani, Anisha, MD
Gender: Female
PCP # 8EQ17801
NPI: 1073803730
894 Summit Dr
Ste 108
(512) 244-5100
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Rogers, James W, DO
Gender: Male
PCP # 8DP87701
NPI: 1942208434
940 Hesters Crossing
(512) 244-9024
Hospital Affiliation: Memorial Medical
Center Of East Texas, Woodland Heights
Medical Center
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Parthasarathy, Urmila, DO
Gender: Female
PCP # 8EL97301
NPI: 1326143090
894 Summit St
(512) 272-4636
Hospital Affiliation: Seton Medical Ctr
Williamson
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Wettermark III, Alfred B, MD
Round Rock
Gender: Male
PCP # 8DB47301
NPI: 1720288053
940 Hesters Crossing Rd
(512) 244-9024
Hospital Affiliation: John Peter Smith
Hospital
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
" Sharma, Anuj, MD
Round Rock
Gender: Female
PCP # 8DX72902
NPI: 1407872740
302 University Blvd
J (512) 509-0200
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
" Pena, Jacobo, MD
Round Rock
Gender: Male
PCP # 8DL34802
NPI: 1467688622
120 Ed Schmidt Blvd
Ste B E F
J (512) 509-9503
" Williams II, Clarence E, MD
Round Rock
J
" Strawser, Richard T, MD
Round Rock
Gender: Male
PCP # 8DB71001
NPI: 1891762357
7200 Wyoming Spgs Dr
Ste 1500
(512) 218-8696
Hospital Affiliation: Round Rock Medical
Center, West Houston Medical Center
Clinic Affiliation: Capital Area Primary Care
PLLC
Board Certified Specialties: Family
Practice
PCP # 8DL34803
NPI: 1467688622
302 University Blvd
J (512) 509-0200
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
" Pendleton, Solomon A, MD
Round Rock
Gender: Male
PCP # 8CW07202
NPI: 1134329600
302 University Blvd
J (512) 509-0200
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Tariq, Zarlish, MD
Gender: Female
PCP # 8EC54302
NPI: 1336347723
16420 R R 620
J (512) 250-7000
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Round Rock
Gender: Male
PCP # 89C01501
NPI: 1295740363
940 Hesters Crossing
(512) 244-9024
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Round Rock
Round Rock
Round Rock
" Matsubara, Atsushi, MD
" Tran, Xuan K, MD
Round Rock
Gender: Male
PCP # 8EK52601
NPI: 1073682472
894 Summit St
(512) 272-4636
Hospital Affiliation: Seton Medical Ctr
Williamson
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Family
Practice
Round Rock
Round Rock
Gender: Male
PCP # 8X124001
NPI: 1871535195
7700 Cat Hollow Dr
Ste 205
(512) 218-4900
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Ctr Williamson, Seton
Northwest Hospital
Clinic Affiliation: Matsubara and Assoc PA
Board Certified Specialties: Family
Practice
Round Rock
Gender: Female
PCP # 8DB70801
NPI: 1881658482
4112 Links Ln
Ste 201
(512) 672-8933
Hospital Affiliation: Round Rock Medical
Center, St Davids Hospital, St Davids
Medical Center
Clinic Affiliation: Capital Area Primary Care
PLLC
Board Certified Specialties: Family
Practice
Gender: Male
PCP # 8CY86501
NPI: 1154514842
2000 S IH 35
(512) 244-3822
Hospital Affiliation: Scott & White Hlthcare
Round Rock
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
INTERNAL MEDICINE
" Chou, Yi Chun, MD
Round Rock
Gender: Female
PCP # 8ER17701
NPI: 1952535890
302 University Blvd
(512) 509-0200
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
J - Wheelchair Access
44
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
ROUND ROCK
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Miller, Gwendolyn B, MD
Gender: Female
PCP # 8CQ79004
PCP # 8ED17302
NPI: 1700812716
302 University Blvd
J (512) 509-0200
Hospital Affiliation: Doctors Hospital, North
Austin Medical Center, Round Rock Medical
Center, St Davids Medical Center
Clinic Affiliation: Scott & White Hospital
Taylor, Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Round Rock
ROUND ROCK Cont
INTERNAL MEDICINE Cont
" Coughlin, Sean J, MD
Round Rock
Gender: Male
PCP # 8CW98702
NPI: 1912911009
425 University Blvd
(512) 509-0200
Hospital Affiliation: Baptist Health System,
Christus Santa Rosa Hosp City Ctr, Seton
Medical Center, St Davids Medical Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Gender: Male
PCP # 8P911402
NPI: 1386605368
302 University Blvd
(512) 509-0200
Hospital Affiliation: Glen Rose Medical
Center, Lake Granbury Medical Center
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs, No Patients
Under 16 yrs old
Board Certified Specialties: Internal
Medicine
J
" McKenzie, Trina D, MD
Gender: Female
PCP # 8BX83702
NPI: 1326104183
302 University Blvd
(512) 509-0200
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Male
PCP # 8CW55702
NPI: 1134392582
302 University Blvd
(512) 509-0200
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
J
OBSTETRICS-GYNECOLOGY
" Edmondson, Steven R, MD
Round Rock
Gender: Male
PCP # 8DX59701
NPI: 1164429890
3950 N A W Grimes Blvd
Ste N103
(877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Practice Information: No Patients Under 14
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
Rao, Sharon N, MD
Gender: Female
PCP # 8EA36302
NPI: 1811218902
425 University Blvd
J (512) 509-0200
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Round Rock
Montemayor, Patricia C, MD
Gender: Female
PCP # 8DR02703
NPI: 1255332037
302 University Blvd
(512) 509-0200
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Round Rock
" Slavcheva, Evgenia G, MD
Round Rock
Gender: Female
PCP # 8EC46502
NPI: 1477508448
302 University Blvd
(512) 509-0200
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
J
" Marks, Lianne, MD
Round Rock
" White, Heath D, DO
Round Rock
Gender: Female
PCP # 80768701
NPI: 1740245414
425 University Blvd
(512) 509-0200
Hospital Affiliation: North Austin Medical
Center, St Davids Medical Center
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
Round Rock
Gender: Female
PCP # 8AH51503
NPI: 1114918349
302 University Blvd
J (512) 509-0200
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
J
" Nye, Diana Del D, MD
" Dluzniewski, Holly D, MD
Gender: Male
PCP # 8CL39902
NPI: 1073582029
302 University Blvd
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Gender: Male
PCP # 8CA34902
NPI: 1568615243
302 University Blvd
(512) 509-0200
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Round Rock
Round Rock
" Ladogana, Michael, MD
" Vazquez, Jacobo A, MD
Round Rock
Norton, Christine H, DO
Gender: Female
PCP # 8EM13001
NPI: 1487659157
940 Hesters Crossing
(512) 244-9024
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
" Dayal, Vivek H, MD
Round Rock
Gender: Male
PCP # 8DB71201
NPI: 1063489102
7200 Wyoming Spgs Dr
Ste 1500
(512) 218-0896
Hospital Affiliation: Round Rock Medical
Center, West Houston Medical Center
Clinic Affiliation: Capital Area Primary Care
PLLC
Board Certified Specialties: Internal
Medicine
Round Rock
Round Rock
Gender: Female
PCP # 8DB70501
NPI: 1932176492
7200 Wyoming Spgs Dr
Ste 150
(512) 218-8696
Hospital Affiliation: Round Rock Medical
Center, West Houston Medical Center
Clinic Affiliation: Capital Area Primary Care
PLLC
Board Certified Specialties: Internal
Medicine
" Turner, Trevor H, MD
Osterman Boswell, Kathleen M, MD
Gender: Female
PCP # 8EK81402
NPI: 1497070858
302 University Blvd
J (512) 509-0200
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Round Rock
Spellings, Veronica A, MD
Gender: Female
PCP # 8DB70901
NPI: 1477531978
7200 Wyoming Spgs Dr
Ste 1500
(512) 218-8696
Hospital Affiliation: Round Rock Medical
Center, West Houston Medical Center
Clinic Affiliation: Capital Area Primary Care
PLLC
Board Certified Specialties: None
Round Rock
PEDIATRICS
" Abreu Macomber, Martha B, MD
Round Roc k
Gender: Female
PCP # 8AP83803
NPI: 1609847235
425 University Blvd
(512) 509-0200
Hospital Affiliation: Scott & White Hlthcare
Round Rock, Seton Medical Center
Clinic Affiliation: Scott and White Clinic
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Round Rock
" Moffitt, Michael J, MD
" Dasgupta, Nilanjana S, MD
Gender: Male
PCP # 8M525001
NPI: 1922173137
7215 Wyoming Spgs
Ste 700 Bldg 3
J (512) 246-3344
Hospital Affiliation: Central Texas Medical
Center, North Austin Medical Center, Round
Rock Medical Center
Clinic Affiliation: North Star Family
Medicine PA
Board Certified Specialties: Internal
Medicine
Gender: Female
PCP # 8DB71101
NPI: 1700812112
4112 Links Ln
Ste 201
(512) 672-8933
Hospital Affiliation: Round Rock Medical
Center, West Houston Medical Center
Clinic Affiliation: Capital Area Primary Care
PLLC
Board Certified Specialties: Internal
Medicine
Round Rock
Round Rock
Gender: Female
PCP # 8CV70601
NPI: 1598703084
3950 N Aw Grimes Blvd
Ste N104
J (877) 800-5722
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Ctr Williamson
Clinic Affiliation: Lone Star Circle of Care
Practice Information: No patients under 50
years old
Board Certified Specialties: Internal
Medicine
" Sypniewski, Stephanie A, MD
Round Rock
" Addy, Debaroti M, MD
Round Roc k
Gender: Female
# PCP # 8P286001
NPI: 1023016235
15930 S Great Oaks Bldg B
J (512) 255-8868
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Northwest Hospital
Clinic Affiliation: Addy and Unite MD
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Agadi, Satish, MD
Round Roc k
Gender: Male
PCP # 8EB57803
NPI: 1275724585
425 University Blvd
J (512) 509-0200
Hospital Affiliation: Texas Childrens
Hospital
Clinic Affiliation: Scott and White Clinic
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Atkuri, Lakshmi V, MD
Gender: Female
PCP # 8CC83701
NPI: 1558397950
302 University Blvd
J (512) 509-0200
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
Round Roc k
" Azuma, Lynn M, MD
Round Roc k
Gender: Female
PCP # 8AB53606
NPI: 1295782043
302 University Blvd
J (512) 509-0200
PCP # 8AB53607
NPI: 1295782043
425 University Blvd
J (512) 509-0200
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
" Bacares, Edgar, MD
Round Roc k
Gender: Male
# PCP # 8AT50701
NPI: 1225021256
2120 N Mays St
Ste 430
J (877) 800-5722
Hospital Affiliation: Seton Medical Ctr
Williamson
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: Pediatrics
Berg, Bradley R, MD
Gender: Male
PCP # 8DY17002
NPI: 1871589929
302 University Blvd
(512) 509-0200
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Round Roc k
J - Wheelchair Access
45
ROUND ROCK
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
ROUND ROCK Cont
PEDIATRICS Cont
" Berhane, Rahel, MD
Round Rock
J
Gender: Female
PCP # 83501X02
NPI: 1740246743
1000 Hesters Crossing Rd
(512) 628-1810
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, St Davids Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Deharo, Rafael A, MD
Round Rock
Gender: Male
PCP # 8K665001
NPI: 1083727259
7200 Wyoming Spgs
Ste 200
J (512) 244-5959
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Northwest Hospital
Clinic Affiliation: Wyoming Springs
Pediatrics
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Gender: Male
PCP # 8B074701
NPI: 1124033287
940 Hesters Crossing
J (512) 244-9024
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Brown, Bernadette M, MD
Round Rock
J
Gender: Female
PCP # 00TK5401
NPI: 1396859435
1050 Meadows Rd Ste 307
(512) 255-6033
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Center, St Davids
Medical Center
Board Certified Specialties: Pediatrics
" Casey, Erin M, MD
Round Rock
Dluzniewski, Holly D, MD
Gender: Female
PCP # 8DB70501
NPI: 1932176492
7200 Wyoming Spgs Dr
Ste 150
(512) 218-8696
Hospital Affiliation: Round Rock Medical
Center, West Houston Medical Center
Clinic Affiliation: Capital Area Primary Care
PLLC
Board Certified Specialties: Internal
Medicine
Round Rock
" Chan, Soi Yu, MD
J
Gender: Female
PCP # 8DM88803
NPI: 1700064094
302 University Blvd
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Pediatrics
" Chang, Ting Chuan, MD
Round Rock
J
Gender: Male
PCP # 8P286201
NPI: 1194810903
15930 S Great Oaks Dr
Ste B
(512) 255-8868
Hospital Affiliation: Round Rock Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Addy and Unite MD
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Dayal, Vivek H, MD
Gender: Male
PCP # 8M525001
NPI: 1922173137
7215 Wyoming Spgs
Ste 700 Bldg 3
J (512) 246-3344
Hospital Affiliation: Central Texas Medical
Center, North Austin Medical Center, Round
Rock Medical Center
Clinic Affiliation: North Star Family
Medicine PA
Board Certified Specialties: Internal
Medicine
Gender: Female
PCP # 8AU93703
NPI: 1497933428
425 University Blvd
J (512) 509-0200
Hospital Affiliation: Scott & White Hlthcare
Round Rock
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
" Jacomides, Jenny R, MD
Round Rock
" Duble, Shannon L, MD
Gender: Female
# PCP # 8F298501
NPI: 1760526099
7700 Cat Hollow Dr
Ste 104
J (512) 733-5437
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Medical Ctr Williamson, Seton
Northwest Hospital, St Davids Georgetown
Hospital, St Davids Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Pediatric Center of Round
Rock
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Gender: Female
PCP # 8DK11902
NPI: 1457428609
4112 Links Ln
Ste 102
(512) 436-9455
Clinic Affiliation: Chisholm Trail Pediatrics
Inc PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Esparza, Ramon, MD
Gender: Male
PCP # 8J843001
NPI: 1245235647
1750 Red Bud Ln
J (512) 310-9700
Hospital Affiliation: Round Rock Medical
Center
Clinic Affiliation: ABC Medical Center
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Round Rock
Lal, Arti, MD
Gender: Female
PCP # 8CS29803
NPI: 1417047077
425 University Blvd
(512) 509-0200
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
Round Rock
" Katalenas, Marta M, MD
" Lawrence, Glenn L, MD
Round Rock
J
Gender: Female
# PCP # 8F298001
NPI: 1386741171
7700 Cat Hollow Dr
Ste 104
J (512) 733-5437
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center
Clinic Affiliation: Pediatric Center of Round
Rock
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Flachs, Lisa S, MD
Gender: Female
PCP # 8CR36102
NPI: 1366751133
4112 Links Ln
Ste 102
(512) 930-4776
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Chisholm Trail Pediatrics
Inc PA
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: Pediatrics
Kovaric, Kelly L, MD
Gender: Female
# PCP # 8DC59801
NPI: 1962623454
7700 Cat Hollow
Dr Ste 104
J (512) 733-5437
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center
Clinic Affiliation: Pediatric Center of Round
Rock
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Round Rock
" Foster, D M, MD
Round Rock
Gender: Male
PCP # 84E40703
NPI: 1104886571
302 University Blvd
J (512) 509-0200
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
Gender: Male
PCP # 81X06503
NPI: 1073574216
302 University Dr
(512) 509-0200
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
" Marroquin, Jaclyn T, MD
Round Rock
J
Gender: Female
PCP # 8V904801
NPI: 1912102583
2120 N Mays St Ste 430
(512) 255-5120
Clinic Affiliation: Lone Star Circle of Care
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Marshall, Erin E, MD
Round Rock
J
Round Rock
Round Rock
Round Rock
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
" Helmcamp, Jennifer M, MD
Round Rock
Round Rock
Gender: Female
PCP # 8V911601
NPI: 1346358108
940 Hesters Crossing
(512) 244-9024
Hospital Affiliation: North Austin Medical
Center, Seton Northwest Hospital, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Pediatrics
Round Rock
Gender: Female
PCP # 87J39401
NPI: 1861408114
940 Hesters Crossing
J (512) 244-9024
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Gender: Female
PCP # 8AB76502
NPI: 1043437940
302 University Blvd
(512) 509-0200
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
Gender: Male
PCP # 89775101
NPI: 1356357693
940 Hesters Crossing
(512) 244-9024
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
J
" Harvey, Kristi, MD
" Dieterich, Samantha E, MD
" Bhatti, Meenu S, MD
" Kuhl, Walter B, MD
Round Rock
Round Rock
Round Rock
Round Rock
Gender: Female
# PCP # 8CA95201
NPI: 1093786394
3950 N Aw Grimes Blvd
Ste N201
J (877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: Pediatrics
" Gritzka, Boris A, MD
Round Rock
Gender: Female
PCP # 8K665201
NPI: 1982717179
7200 Wyoming Spgs
Ste 200
(512) 244-5959
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Northwest Hospital
Clinic Affiliation: Wyoming Springs
Pediatrics
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Millar, Jose Gabriel C, MD
Round Rock
J
Gender: Male
PCP # 0086KL03
NPI: 1386732675
16010 Park Valley Dr
Ste 300
(512) 255-7337
# PCP # 0086KL01
NPI: 1386732675
16040 Park Valley Dr
Ste 227
J (512) 255-7337
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Northwest Hospital
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Owens, Nancy E, MD
Round Rock
J
Gender: Female
PCP # 83047Y01
NPI: 1821004185
940 Hesters Crossing
(512) 244-9024
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
J - Wheelchair Access
46
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
SAN MARCOS
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Scranton, Maria C, MD
Round Rock
ROUND ROCK Cont
PEDIATRICS Cont
" Pankratz, Natacha R, MD
Round Rock
Gender: Female
# PCP # 8M008701
NPI: 1710936307
2120 N Mays St
Ste 430
J (877) 800-5722
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, St Davids Georgetown Hospital
Clinic Affiliation: Lone Star Circle of Care
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Pautler, Denise L, MD
Round Rock
Gender: Female
PCP # 8BR92701
NPI: 1447489547
3950 N Aw Grimes Blvd
Ste 201
J (512) 524-9282
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: Pediatrics
" Piatt, Guadalupe R, MD
Round Rock
Gender: Female
PCP # 8EF20801
NPI: 1952397077
2120 N Mays St
Ste 430
(877) 800-5722
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, St Davids S
Austin Medical Center
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: Pediatrics
" Pickens, Steven G, MD
Round Rock
Gender: Male
PCP # 8R749202
NPI: 1932293016
4112 Links Ln
Ste 102
J (512) 436-9455
Hospital Affiliation: St Davids Georgetown
Hospital
Clinic Affiliation: Chisholm Trail Pediatrics
Inc PA
Board Certified Specialties: Pediatrics
Ramsey, David A, MD
Gender: Male
PCP # 88280Y02
NPI: 1861586943
4112 Links Ln
Ste 102
J (512) 436-9455
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, St Davids Georgetown Hospital
Clinic Affiliation: Chisholm Trail Pediatrics
Inc PA
Board Certified Specialties: None
J
Shah, Amy H, MD
Gender: Female
PCP # 8DX72301
NPI: 1225022734
940 Hesters Crossing
(512) 244-9024
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Rashid, Alan, MD
Gender: Male
PCP # 8EK40901
NPI: 1922059948
940 Hesters Crossing
(512) 244-9024
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
" Salinas, Crystal M, MD
Round Rock
Gender: Female
PCP # 8DW24101
NPI: 1740417872
7700 Cat Hollow Dr
Ste 104
(512) 733-5437
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Pediatric Center of Round
Rock
Board Certified Specialties: Pediatrics
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
" White, Alan, MD
Round Rock
Round Rock
J
Spellings, Veronica A, MD
Gender: Female
PCP # 8DB70901
NPI: 1477531978
7200 Wyoming Spgs Dr
Ste 1500
(512) 218-8696
Hospital Affiliation: Round Rock Medical
Center, West Houston Medical Center
Clinic Affiliation: Capital Area Primary Care
PLLC
Board Certified Specialties: None
Round Rock
Sypniewski, Stephanie A, MD
Gender: Female
PCP # 8DB71101
NPI: 1700812112
4112 Links Ln
Ste 201
(512) 672-8933
Hospital Affiliation: Round Rock Medical
Center, West Houston Medical Center
Clinic Affiliation: Capital Area Primary Care
PLLC
Board Certified Specialties: Internal
Medicine
" Tomkins, Amy C, DO
Round Rock
Gender: Female
PCP # 8S554701
NPI: 1134135494
940 Hesters Crossing
(512) 244-9024
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Pediatrics
Gender: Male
PCP # 87J44801
NPI: 1861408122
940 Hesters Crossing
(512) 244-9024
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Zibdeh Lough, Hana I, DO
Round Rock
Gender: Female
PCP # 8EM55501
NPI: 1326294257
940 Hesters Crossing Rd
(512) 244-9024
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: Children
Board Certified Specialties: Pediatrics
Round Rock
Round Rock
Round Rock
Unite III, Anselmo G, MD
Gender: Male
# PCP # 8P286101
NPI: 1366440646
15930 B Great Oaks Dr
J (512) 255-8868
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center
Clinic Affiliation: Addy and Unite MD
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Round Rock
Gender: Female
PCP # 83036Y01
NPI: 1285640540
940 Hesters Crossing
(512) 244-9024
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
SALADO
FAMILY PRACTICE
Warren, Cheryl L, MD
Gender: Female
PCP # 8CD06801
NPI: 1770549172
3525 FM 2484
J (254) 947-7500
Hospital Affiliation: Tx Hlth Presbyterian
Hosp Wnj, University Medical Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
Salado
SAN MARCOS
FAMILY PRACTICE
Anderson, Charles P, MD
Gender: Male
# PCP # 00SH4601
NPI: 1992735500
1400 N Hwy 123
J (512) 396-3663
Hospital Affiliation: Central Texas Medical
Center
Board Certified Specialties: None
San Marcos
" Travis, Wade R, MD
Round Rock
Gender: Male
# PCP # 8P286301
NPI: 1558452961
15930 S Great Oaks Dr
J (512) 255-8868
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, St
Davids Georgetown Hospital, St Marks
Medical Center
Clinic Affiliation: Addy and Unite MD
Board Certified Specialties: Pediatrics
" Castoldi, Thomas A, DO
San Marcos
Turner, Trevor H, MD
Gender: Male
PCP # 8DB71201
NPI: 1063489102
7200 Wyoming Spgs Dr
Ste 1500
(512) 218-0896
Hospital Affiliation: Round Rock Medical
Center, West Houston Medical Center
Clinic Affiliation: Capital Area Primary Care
PLLC
Board Certified Specialties: Internal
Medicine
Round Rock
!
!
J
Gender: Male
PCP # 00K07501
PCP # 8CR64101
NPI: 1073605093
310 Stagecoach Trl
Ste 200B
(512) 396-5300
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Dr Thomas A Castoldi and
Assocs
Practice Information: No Obstetrics, No
Patients Under 2 yrs old
Board Certified Specialties: Family
Practice
Clogston, Curtis P, MD
Gender: Male
# PCP # 8P232001
NPI: 1174543524
1348 Hwy 123
Ste A
J (512) 392-5556
Hospital Affiliation: Seton Medical Center,
Southwest General Hospital
Clinic Affiliation: Curtis P Clogston MD
Board Certified Specialties: None
San Marc os
" Garrett, James S, MD
San Marc os
Gender: Male
PCP # 00A97Q01
NPI: 1538166491
1601-B Redwood Rd
J (512) 754-6622
Hospital Affiliation: Central Texas Medical
Center, Seton Medical Center, St Davids S
Austin Medical Center
Practice Information: No Obstetrics
Board Certified Specialties: Family
Practice
!
" Kowalik, Jenifer R, MD
San Marc os
Gender: Female
PCP # 8AJ26801
NPI: 1679507180
1999 Medical Pkwy
Ste A
J (512) 351-4541
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Jenifer Kowalik MD
Board Certified Specialties: Family
Practice
Laue, Richard R, MD
Gender: Male
# PCP # 8J935001
NPI: 1154353548
2406 Hunter Rd Ste 106
J (512) 396-7686
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: San Marcos Family
Medicine
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: None
San Marc os
Lee, Alan L, MD
Gender: Male
# PCP # 87860X01
NPI: 1336164425
2406 Hunter Rd
Ste 106
J (512) 396-7686
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: San Marcos Family
Medicine
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: None
San Marc os
Mangalick, Vip, MD
Gender: Male
# PCP # 8J935301
NPI: 1437347697
2406 Hunter Rd
Ste 106
J (512) 396-7686
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: San Marcos Family
Medicine
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: None
San Marc os
J - Wheelchair Access
47
SAN MARCOS
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Smith, Grayson, MD
Gender: Male
PCP # 8R596001
NPI: 1740224567
1305 Wonder World
Dr Ste 206
J (512) 353-8666
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: San Marcos Diagnostics
PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
" Vanshaar, Jason R, MD
San Marcos
SAN MARCOS Cont
FAMILY PRACTICE Cont
Mossburg, Patricia T, MD
Gender: Female
# PCP # 8J935101
NPI: 1477578565
2406 Hunter Rd Ste 106
J (512) 396-7686
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: San Marcos Family
Medicine
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: None
San Marcos
" Vazquez, Miguel A, MD
San Marcos
Gender: Male
PCP # 8DT93705
NPI: 1750388450
1340 Wonder World Dr
Ste 4201
(210) 233-7000
Hospital Affiliation: Christus Santa Rosa
Hosp City Ctr, Methodist Hospital,
Metropolitan Methodist Hospital
Clinic Affiliation: Communicare Health
Centers
Board Certified Specialties: Family
Practice
" Richardson, Stephen G, MD
San Marcos
J
Gender: Male
PCP # 8EM91401
NPI: 1992020440
401 Broadway St
Ste A
(512) 393-5018
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Live Oak Health Partners
Board Certified Specialties: Family
Practice
Rodriguez, Michelle C, MD
Gender: Female
PCP # 8DL35501
NPI: 1710115274
1320 Wonder World Dr
Ste 101
J (512) 396-3911
Hospital Affiliation: Central Texas Medical
Center, Mem Hermann Southwest Hospital
Clinic Affiliation: Live Oak Health Partners
Board Certified Specialties: None
" Rogers, William R, DO
J
Gender: Male
PCP # 00AF5601
NPI: 1619041415
310 Stagecoach Trl
Ste 200
(512) 396-4700
Hospital Affiliation: Central Texas Medical
Center
Practice Information: No Patients Under 4
yrs old
Board Certified Specialties: Family
Practice
" Symon, Julia B, MD
San Marcos
Gender: Female
PCP # 8EG06801
NPI: 1821035171
1320 Wonder World Dr
Ste 101
(512) 396-3911
PCP # 8AJ99101
NPI: 1821035171
1601 Redwood Rd
Ste C
J (512) 754-8500
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Julia B Symon MD, Live
Oak Health Partners
Practice Information: No Patients Under 14
yrs old
Board Certified Specialties: Internal
Medicine
" Willborn, Myriah G, DO
San Marcos
Gender: Female
PCP # 8DN05801
NPI: 1740557552
2406 Hunter Rd
Ste 206
(512) 396-7686
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: San Marcos Family
Medicine
Board Certified Specialties: Family
Practice
San Marcos
San Marcos
San Marcos
Gender: Male
PCP # 8DL35601
NPI: 1497983076
1320 Wonder World Dr
Ste 101
J (512) 396-3911
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Live Oak Health Partners
Board Certified Specialties: Family
Practice
Weng, Gladys C, DO
Gender: Female
PCP # 8AT88401
NPI: 1225094121
1320 Wonder World Dr
Ste 101
(512) 396-3911
San Marcos
INTERNAL MEDICINE
" Depagter, Lenore C, DO
San Marcos
PCP # 8U814101
NPI: 1225094121
2007 A Medical Pkwy
J (512) 396-3911
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Central Texas Medical
Assoc, Live Oak Health Partners
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Gender: Female
# PCP # 8DG07101
NPI: 1932214921
1320 Wonder World Dr
Ste 101
J (512) 396-3911
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Live Oak Health Partners
Board Certified Specialties: Internal
Medicine
PEDIATRICS
" Dolan, Donna J, MD
San Marcos
" Sanderlin, Brent W, DO
San Marcos
J
Gender: Male
PCP # 8EM90601
NPI: 1609837210
1320 Wonder World Dr
Ste 101
(512) 396-3911
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Live Oak Health Partners
Board Certified Specialties: Family
Practice
" Schneider, David L, MD
San Marcos
Gender: Male
PCP # 8EL77401
NPI: 1871542936
1601 Redwood Rd
Ste B
(512) 754-6622
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Resolute Health
Physicians Networ
Board Certified Specialties: Family
Practice
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
" Black, Angela P, MD
Gender: Female
PCP # 8726M001
NPI: 1831134824
1305 Wonder World Dr
Ste 206
J (512) 396-1525
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Dolan Donna J MD
Practice Information: No Patients Under 14
yrs old
Board Certified Specialties: Internal
Medicine
San Marcos
Gender: Female
# PCP # 8CG16301
NPI: 1972671733
601 Leah Ave
J (512) 392-1700
Hospital Affiliation: Seton Edgar B Davis,
University Med Ctr Brackenridge
Clinic Affiliation: Corridor Primary Care PA
Practice Information: No Patients Over 19
yrs old
Board Certified Specialties: Pediatrics
" Deschner, Rhonda W, MD
San Marcos
" Moore, Gregory K, MD
San Marcos
Gender: Female
# PCP # 8CB12001
NPI: 1639316698
601 Leah Ave
(512) 392-1700
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Corridor Primary Care PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Gender: Male
# PCP # 83Y52001
NPI: 1417958760
601 Leah Ave
J (512) 396-1000
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Corridor Primary Care PA
Board Certified Specialties: Internal
Medicine
Flinn, Jeanne E, DO
Gender: Female
# PCP # 8J046001
NPI: 1629009469
601 Leah Ave
J (512) 392-1700
Hospital Affiliation: Central Texas Medical
Center, Dell Childrens Med Ctr Cent Tx
Clinic Affiliation: Corridor Primary Care PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
San Marcos
" Grady, Michael J, MD
San Marcos
Gender: Male
# PCP # 8A264001
NPI: 1376574111
601 Leah Ave
J (512) 392-1700
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Corridor Primary Care PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Harrison, Sue A, MD
Gender: Female
# PCP # 83Y52201
NPI: 1558392399
601 Leah Ave
J (512) 392-1700
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Corridor Primary Care PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
San Marcos
Humphrey, Jill S, MD
Gender: Female
# PCP # 8J046301
NPI: 1790874402
601 Leah Ave
J (512) 392-1700
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Corridor Primary Care PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
San Marcos
" Messinger, Ivri K, MD
San Marcos
Gender: Female
# PCP # 8BN25801
NPI: 1114975711
601 Leah Ave
J (512) 392-1700
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Corridor Primary Care PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Velasquez, Theresa S, MD
Gender: Female
# PCP # 8CN27602
NPI: 1275519456
1340 Wonder World Dr
Ste 4201
(512) 392-1718
Hospital Affiliation: Central Texas Medical
Center, St Davids Georgetown Hospital
Clinic Affiliation: Communicare Health
Centers
Board Certified Specialties: None
San Marcos
SCHULENBURG
FAMILY PRACTICE
Kocurek, Donald J, MD
Gender: Male
# PCP # 8CF14001
NPI: 1932125622
40 E Ave
(979) 743-3520
Hospital Affiliation: St Marks Medical
Center
Clinic Affiliation: Kocurek and James Clinic
PLLC
Board Certified Specialties: None
Schulenburg
J - Wheelchair Access
48
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
TEMPLE
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
OBSTETRICS-GYNECOLOGY
" Cohen, Dinna O, MD
Taylor
SCHULENBURG Cont
FAMILY PRACTICE Cont
" Tijerina, Lindsey E, MD
Schulenburg
Gender: Female
# PCP # 8DT85701
NPI: 1225359235
40 E Ave
(979) 743-3520
Hospital Affiliation: St Marks Medical
Center
Clinic Affiliation: Kocurek and James Clinic
PLLC
Board Certified Specialties: Family
Practice
J
" Gutierrez-Macias, Rodolfo G, MD
SMITHVILLE
J
" Stone, Mark A, MD
Smithville
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
J
Gender: Male
PCP # 82702N02
NPI: 1326000852
403 Mallard Ln
(512) 509-0200
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Barkis, Leslie A, DO
Gender: Male
PCP # 8DU64901
NPI: 1669468039
1905 Southwest Hk Dodgen Loop
(254) 298-2400
Hospital Affiliation: Little River Healthcare,
Metroplex Hospital, Scott And White
Memorial Hospital, Seton Medical Ctr Harker
Heights
Clinic Affiliation: Little River Healthcare
Family Ca
Board Certified Specialties: Family
Practice
" Cohen, Nathan R, MD
Taylor
J
PCP # 83X69602
NPI: 1497715700
7556 Honeysuckle
(254) 742-7400
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
Temple
INTERNAL MEDICINE
TAYLOR
Gender: Male
PCP # 80439K02
NPI: 1285694265
403 Mallard Ln
J (512) 509-0200
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Barber, Sharon L, MD
Gender: Female
PCP # 83X69601
NPI: 1497715700
1402 W Ave H
J (254) 771-8411
Taylor
J
Gender: Male
PCP # 8CA00801
NPI: 1912983362
2401 S 31st St
(254) 724-8800
Hospital Affiliation: Heart Of Texas
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Temple
Gender: Male
PCP # 8BG56802
NPI: 1720259328
403 Mallard Ln
(512) 509-0200
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
PEDIATRICS
" Chang, Franklin, MD
J
" Smalley, Franklin J, MD
!
Taylor
" Allen Jr, James H, MD
Temple
Gender: Male
PCP # 8A336102
NPI: 1992765192
403 Mallard Ln
(512) 352-5251
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Taylor
" Yens, Diana A, MD
FAMILY PRACTICE
TEMPLE
FAMILY PRACTICE
" Holdampf, Barry J, MD
Smithville
Spears, Neal M, MD
Gender: Male
PCP # 8CV14801
NPI: 1053352294
1501 Dorthy Nichols
Ln
(512) 791-1224
Hospital Affiliation: Seton Smithville Reg
Hospital, Texas Childrens Hospital
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Over 17
yrs old
Board Certified Specialties: None
Gender: Male
PCP # 8CA01402
NPI: 1588855266
403 Mallard Ln
(512) 352-5251
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Taylor
INTERNAL MEDICINE
Gender: Female
PCP # 8DL44701
NPI: 1255394375
605 NE Ninth St
J (512) 791-1224
Hospital Affiliation: Seton Smithville Reg
Hospital
Clinic Affiliation: Seton Family of Doctors
Board Certified Specialties: Internal
Medicine
Gender: Female
# PCP # 8CQ17203
NPI: 1962673301
305A Mallard Ln
J (877) 800-5722
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Lone Star Circle of Care
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Hines, Terrance S, MD
PEDIATRICS
James, Michele L, MD
Gender: Female
# PCP # 8CF40501
NPI: 1376557520
40 E Ave
(979) 743-3520
Clinic Affiliation: Kocurek and James Clinic
PLLC
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
" Van Benthuysen, Suzanne L, MD
Tay lor
Taylor
J
Chumbley II, Clyde M, MD
Gender: Male
PCP # 8CS34002
NPI: 1417938341
403 Mallard Ln
(512) 352-5251
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
PEDIATRICS
Gender: Male
PCP # 8DU40901
NPI: 1417952003
305 Mallard Ln
(877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: Family
Practice
Schulenburg
Schulenburg
Tay lor
Taylor
INTERNAL MEDICINE
Powell, Justin W, DO
Gender: Male
PCP # 8DC97801
NPI: 1487663191
40 E Ave
J (979) 743-3520
Clinic Affiliation: Kocurek and James Clinic
PLLC
Board Certified Specialties: None
Gender: Female
PCP # 80438K02
NPI: 1376502906
403 Mallard Ln
(512) 509-0200
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Gender: Male
PCP # 80437K02
NPI: 1306806203
403 Mallard Ln
(512) 352-5251
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Blazo, Maria A, MD
Temple
Gender: Female
PCP # 8EQ85701
NPI: 1902986334
2401 S 31st St
J (254) 724-2111
Hospital Affiliation: Chi St Lukes Hlth
Baylor Coll Med, Houston Methodist
Hospital, Texas Childrens Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Brackman, Marri K, DO
Gender: Female
PCP # 8EL37101
NPI: 1609168855
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Temple
" Calderon, April M, DO
Temple
Gender: Female
PCP # 8CL98601
NPI: 1437475191
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Flory, Jennifer K, MD
Temple
Gender: Female
PCP # 8B470201
NPI: 1295795961
1402 W Ave H
J (254) 680-1100
PCP # 8B470202
NPI: 1295795961
7556 Honeysuckle
J (254) 742-7400
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Fowler, Ryan C, MD
Gender: Male
PCP # 8DV30402
NPI: 1417959925
1905 Southwest Hk Dodgen Loop
(254) 298-2480
Hospital Affiliation: Little River Healthcare,
Metroplex Hospital, Seton Medical Ctr
Harker Heights
Clinic Affiliation: Little River Healthcare
Family Ca
Board Certified Specialties: None
Temple
" Franklin Jr, Jack P, MD
Temple
Gender: Male
PCP # 8CS20303
NPI: 1366426595
2401 S 31st St
(254) 724-2111
Hospital Affiliation: Scott & White Hospital
Llano
Clinic Affiliation: Scott and White Hospital
Llano
Board Certified Specialties: Family
Practice
" Berry, Tiffany J, MD
Temple
Miller, Gwendolyn B, MD
Gender: Female
PCP # 8CQ79003
NPI: 1700812716
305 Mallard Ln
J (512) 352-7611
Hospital Affiliation: Doctors Hospital, North
Austin Medical Center, Round Rock Medical
Center, St Davids Medical Center
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Taylor
J
J
Gender: Female
PCP # 8AB19701
NPI: 1003013343
1402 W Ave H
(254) 771-8411
PCP # 8AB19702
NPI: 1003013343
7556 Honeysuckle
(254) 742-7400
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Furman, Matthew J, MD
Temple
Gender: Male
PCP # 8DU65101
NPI: 1003802109
1905 Southwest Hk Dodgen Loop
(254) 298-2480
Clinic Affiliation: Little River Healthcare
Family Ca
Board Certified Specialties: Family
Practice
J - Wheelchair Access
49
TEMPLE
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Kitson, Sandra, MD
" Sherrill, Julia C, MD
Temple
TEMPLE Cont
FAMILY PRACTICE Cont
" Graham, Loyce H, MD
Temple
Gender: Female
PCP # 8DU65701
NPI: 1265492979
1905 Southwest Hk Dodgen Loop
(254) 298-2400
Hospital Affiliation: Little River Healthcare,
Metroplex Hospital, Scott And White
Memorial Hospital, Seton Medical Ctr Harker
Heights
Clinic Affiliation: Little River Healthcare
Family Ca
Board Certified Specialties: Family
Practice
" Kylberg, Roger W, MD
" Hart, Kathryn D, MD
Gender: Female
PCP # 8DN81901
NPI: 1073876306
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
" Henry, Robert A, DO
Temple
J
J
Gender: Male
PCP # 80762901
NPI: 1740240308
1402 W Ave H
(254) 771-8411
PCP # 80762902
NPI: 1740240308
7556 Honeysuckle
(254) 742-7400
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Hong, May C, MD
Temple
J
Gender: Female
PCP # 8CM39403
NPI: 1811933690
1402 W Ave H
(254) 771-8411
Hospital Affiliation: Scott & White Hospital
Taylor
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Gender: Male
PCP # 8DU68901
NPI: 1356338412
1905 Southwest Hk Dodgen Loop
(254) 298-2400
Hospital Affiliation: Little River Healthcare,
Metroplex Hospital
Clinic Affiliation: Little River Healthcare
Family Ca
Board Certified Specialties: Family
Practice
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
J
" Aslam, Waqas, MD
Temple
Gender: Male
PCP # 8EL37001
NPI: 1841509320
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
Gender: Female
PCP # 8CD84701
NPI: 1811055049
1402 W Ave H
J (254) 771-8411
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Via, Lara T, MD
Temple
Gender: Female
PCP # 80317N03
NPI: 1609046804
937 Canyon Creek Dr
J (254) 774-7680
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Manning, John L, MD
Gender: Male
PCP # 83X67101
NPI: 1588625776
1402 W Ave H
J (254) 771-8411
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Via, Robert M, MD
Temple
PCP # 80316N01
NPI: 1629030101
1402 W Ave H
J (254) 771-8411
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Mayabb, Trevin B, MD
Gender: Male
PCP # 8EJ61602
NPI: 1508157330
409 W Adams
(254) 742-3700
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Temple
" Vo, Thu P, DO
" Bhat, Ashwini, MD
Temple
Gender: Female
PCP # 8CZ84901
NPI: 1396901856
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
J
Bolanos, Karla P, MD
Gender: Female
PCP # 8CU69601
NPI: 1699766345
2401 S 31st St
J (254) 724-2111
Temple
PCP # 8CU69602
NPI: 1699766345
600 S 25th St
(254) 771-8472
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
J
Temple
Gender: Female
PCP # 8CC97701
NPI: 1932186319
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Mueller, Jessie M, MD
Temple
Gender: Female
PCP # 8CL41501
NPI: 1578721882
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Walton, William J, MD
Gender: Male
PCP # 8CB44901
NPI: 1255323861
409 W Adams Ave
J (254) 742-3700
Hospital Affiliation: Medical City Dallas
Hospital, Methodist Richardson Medical Ctr,
Tx Hlth Presbyterian Hosp Dallas
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
" Bowling, John R, MD
Temple
Gender: Male
PCP # 80748401
NPI: 1356301550
1605 S 31st St
(254) 215-0100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
J
Temple
" Pendleton, Solomon A, MD
Temple
Gender: Male
PCP # 8CW07201
NPI: 1134329600
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Broadnax, Veronica A, MD
Gender: Female
PCP # 8DY52801
NPI: 1568699718
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Temple
INTERNAL MEDICINE
" Ramm, Jason D, MD
Temple
" Aguirre, Roberto I, MD
Gender: Male
PCP # 8EQ61101
NPI: 1639161631
409 W Adams
(254) 742-3700
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
" Hopkins, Donald W, DO
Gender: Male
PCP # 8CA35301
NPI: 1851559132
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Smith, Janice K, MD
Temple
Temple
" Anderson, Robert L, MD
Temple
Temple
Gender: Male
PCP # 8DU69001
NPI: 1245226547
1905 Southwest Hk Dodgen Loop
(254) 298-2480
Hospital Affiliation: Little River Healthcare,
Metroplex Hospital
Clinic Affiliation: Little River Healthcare
Family Ca
Board Certified Specialties: Family
Practice
" Hall, Jeffrey A, DO
Temple
Gender: Female
PCP # 8CX72402
NPI: 1699938159
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Family
Practice
Temple
Temple
Gender: Male
PCP # 8U146101
NPI: 1609836311
409 W Adams Ave
(254) 742-3700
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Temple
Gender: Female
PCP # 8S190601
NPI: 1720048614
2401 S 31st St
(254) 724-2111
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Temple
Gender: Male
PCP # 83X67501
NPI: 1730149014
1605 S 31st St
J (254) 215-0100
Hospital Affiliation: Scott And White
Memorial Hospital, Tx Hlth Harris Methodist
Hosp
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Rascoe, Terry, MD
Temple
Gender: Male
PCP # 87G88501
NPI: 1649231978
409 W Adams Ave
J (254) 742-3700
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Alger, Elmer A, MD
Gender: Male
PCP # 8BS42901
NPI: 1356346563
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
Temple
" Brust, Karen B, MD
Temple
J
Gender: Female
PCP # 8W894701
NPI: 1558568717
2401 S 31st St
(254) 724-2111
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Byrd, Timothy M, MD
Temple
J
Gender: Male
PCP # 8CV42801
NPI: 1972764868
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
J - Wheelchair Access
50
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
TEMPLE
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Holleman, Vernon D, MD
Gender: Male
PCP # 80737301
NPI: 1265492896
1605 S 31st St
J (254) 215-0100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
" Gopalam, Mithula R, MD
Temple
TEMPLE Cont
INTERNAL MEDICINE Cont
" Cesani, Jose A, MD
Temple
Gender: Male
PCP # 84809F01
NPI: 1528027299
1605 S 31st St
J (254) 215-0100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Cheema, Yasir I, MD
Temple
Gender: Male
PCP # 8CW96803
NPI: 1952515876
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
J
" Goraya, Nimrit, MD
Temple
J
J
Fairweather, Morgan G, MD
Gender: Male
PCP # 8DU67501
NPI: 1215257142
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
J
J
J
J
" Jesse, Richard H, MD
Gender: Female
PCP # 8DG31401
NPI: 1811124365
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
J
Jimenez, Edgar J, MD
Gender: Male
PCP # 8EJ09101
NPI: 1912981952
2401 S 31st St
J (254) 724-2111
Hospital Affiliation: Care Regional Medical
Center, Corpus Christi Medical Center Bay
Area
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
" Havemann, David F, MD
J
Gender: Male
PCP # 80744301
NPI: 1598725053
1605 S 31st St
(254) 215-0100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Temple
Gender: Female
PCP # 86J19601
NPI: 1780644492
1605 S 31st St
(254) 215-0100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Temple
" Ghamande, Shekhar A, MD
Gender: Male
PCP # 8CW94101
NPI: 1447440912
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Temple
" Hall, Beatriz M, MD
Temple
Gender: Female
PCP # 8DE93101
NPI: 1467614958
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
" Kimmey, Kathy B, MD
Temple
Gender: Female
PCP # 80769401
NPI: 1649230574
1605 S 31st St
J (254) 215-0100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Lange, Jason K, MD
Gender: Male
PCP # 8S190301
NPI: 1275593931
2401 S 31st St
J (254) 724-2111
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
Temple
" Leyva, Astrud L, MD
Temple
Gender: Male
PCP # 8DV48001
NPI: 1275724460
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
" Issac, Tony, MD
Temple
J
Gender: Female
PCP # 8DH47001
NPI: 1669676235
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
" Kaur, Baljit, MD
Temple
Temple
Gender: Female
PCP # 8AD06701
NPI: 1619156056
2401 S 31st St
(254) 724-8800
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Haenel, Shannon, DO
" Gardner, Angela R, MD
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Female
PCP # 8AD06301
NPI: 1306851274
2401 S 31st St
(254) 724-8800
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Temple
Temple
Gender: Male
PCP # 8CY24901
NPI: 1366412090
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
" Huynh, Tran C, MD
Temple
" Guo, Jadie Y, MD
" Forrester, Lisa D, MD
Gender: Female
PCP # 8CG15401
NPI: 1245434802
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Gender: Male
PCP # 8EH50401
NPI: 1760610182
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
Gender: Female
PCP # 8CY79501
NPI: 1932314846
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
Temple
Temple
Gender: Female
PCP # 8CA35601
NPI: 1477712792
1605 S 31st St
J (254) 215-0100
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Hunt, Richmond L, MD
" Grillo, Kelly H, MD
J
Gender: Male
PCP # 8CV50401
NPI: 1891956587
1605 S 31st St
(254) 215-0100
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Temple
Temple
Temple
Temple
J
" Green, Aval Na Ree S, MD
" Dave, Bijal P, MD
Delmas, Thomas L, MD
Gender: Male
PCP # 8EH20601
NPI: 1255623492
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
" Hubble, Levi L, MD
Temple
Gender: Female
PCP # 8CM48701
PCP # 8CN06701
NPI: 1518168723
2401 S 31st St
(254) 724-2111
(254) 724-8800
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Temple
Temple
Gender: Female
PCP # 8CS54901
NPI: 1669654133
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Temple
Gender: Female
PCP # 8CE00301
NPI: 1093931974
1605 S 31st St
(254) 215-0100
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Gender: Male
PCP # 80740601
NPI: 1508826231
2401 S 31st St
(254) 724-2111
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Karanjeet, Raina, MD
Temple
J
Gender: Female
PCP # 8DX94001
NPI: 1336303270
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
" Lezama, Maybelline V, MD
Temple
Gender: Female
PCP # 8CB44201
NPI: 1467627737
1605 S 31st St
J (254) 215-0100
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Lowe, Darla G, MD
Temple
Gender: Female
PCP # 84W33501
NPI: 1528029709
1605 S 31st St
J (254) 215-0100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Malik, Mudassar M, MD
Temple
Gender: Male
PCP # 8BS02001
NPI: 1710186093
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Mansour, Paul G, MD
Temple
Gender: Male
PCP # 8BG56201
NPI: 1982863122
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
J - Wheelchair Access
51
TEMPLE
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Rouf, Emran, MD
Gender: Male
PCP # 8CV57901
NPI: 1275578825
1605 S 31st St
J (254) 215-0100
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
" Myers II, John D, MD
Temple
TEMPLE Cont
INTERNAL MEDICINE Cont
" Martin, Michael P, MD
Temple
J
Gender: Male
PCP # 80758301
NPI: 1104887256
1605 S 31st St
(254) 215-0100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" McKenzie, Trina D, MD
Temple
Gender: Female
PCP # 8BX83701
NPI: 1326104183
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" McNeal, Michael J, MD
Temple
J
Gender: Male
PCP # 8DT46001
NPI: 1093033714
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
" Mirkes, Curtis R, DO
Gender: Male
PCP # 8W064901
NPI: 1932123429
2401 S 31st St
(254) 724-2111
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Mock, Jonathan D, MD
Temple
Gender: Male
PCP # 8AB53101
NPI: 1578640884
2401 S 31st St
(254) 724-2111
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Moffitt, Michael J, MD
Temple
Gender: Male
PCP # 8P911401
NPI: 1386605368
1605 S 31st St
(254) 215-0100
Hospital Affiliation: Glen Rose Medical
Center, Lake Granbury Medical Center
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs, No Patients
Under 16 yrs old
Board Certified Specialties: Internal
Medicine
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Male
PCP # 8CF33901
NPI: 1336107549
2401 S 31st St
J (254) 724-2111
Hospital Affiliation: John Peter Smith
Hospital, Parkland Health And Hospital Sys
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Patil, Sarla R, MD
Gender: Female
PCP # 8DU70101
NPI: 1982672192
1905 Southwest Hk Dodgen Loop
J (254) 298-2480
Hospital Affiliation: Little River Healthcare,
Seton Medical Ctr Harker Heights
Clinic Affiliation: Little River Healthcare
Family Ca
Board Certified Specialties: Internal
Medicine
J
" Sibbitt, Stephen J, MD
Gender: Male
PCP # 8G841701
NPI: 1780645440
1605 S 31st St
J (254) 215-0100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Plemmons, Robert M, MD
Gender: Male
PCP # 8BW92501
NPI: 1225144009
2401 S 31st St
(254) 724-2111
PCP # 8BW92502
NPI: 1225144009
2601 Thorton Ln
(254) 724-6622
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
" Slavcheva, Evgenia G, MD
Temple
Gender: Female
PCP # 8EC46501
NPI: 1477508448
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
" Poteet Jr, Herman B, MD
Temple
Gender: Male
PCP # 8DU74601
NPI: 1598751885
1905 Southwest Hk Dodgen Loop
J (254) 298-2480
Hospital Affiliation: Little River Healthcare,
Metroplex Hospital, Scott And White
Memorial Hospital
Clinic Affiliation: Little River Healthcare
Family Ca
Board Certified Specialties: Internal
Medicine
" Velasquez Jr, Juvencio, MD
J
Vincent, Hailey M, MD
Gender: Female
PCP # 8DU68501
NPI: 1740500818
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
" Vohra, Sameera, MD
Temple
Gender: Female
PCP # 8BX83801
NPI: 1730370925
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Walker, Stephen C, MD
Temple
" Smith, Daniel J, MD
" Prince, Whitney, MD
Temple
Gender: Female
PCP # 8CW97201
NPI: 1265682181
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Stratton, Noah, DO
Gender: Male
PCP # 8EK05301
NPI: 1730472713
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
J
" Ramirez, Jonathan C, MD
Gender: Male
PCP # 8CV90101
NPI: 1184883241
1605 S 31st St
J (254) 215-0100
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Tong, Carl W, MD
Temple
Gender: Male
PCP # 8CT45801
NPI: 1992760276
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Reasoner, Brian M, MD
Temple
Gender: Male
PCP # 8BV76101
NPI: 1487663100
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Van Cleave, Holly A, MD
" Weinblatt, James S, MD
J
" Rivera, Cathleen M, MD
Temple
Gender: Female
PCP # 8CE00101
NPI: 1811971484
1605 S 31st St
J (254) 215-0100
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Gender: Male
PCP # 83X67401
NPI: 1659333565
1605 S 31st St
(254) 215-0100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Weiss, Barbara A, MD
Temple
J
Temple
Gender: Female
PCP # 81754Y01
NPI: 1629030192
1605 S 31st St
J (254) 215-0100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Gender: Male
PCP # 80759801
NPI: 1326000357
1605 S 31st St
(254) 215-0100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Temple
Temple
Temple
Gender: Male
PCP # 80434K01
NPI: 1861454878
1605 S 31st St
(254) 215-0100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Temple
Temple
Gender: Male
PCP # 80744001
NPI: 1235191545
1605 S 31st St
J (254) 724-2111
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Gender: Male
PCP # 8CA34901
NPI: 1568615243
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Temple
Temple
Temple
" McNeal, Tresa M, MD
Temple
" Schlabach, Michael R, MD
" Vazquez, Jacobo A, MD
Temple
Temple
Temple
Temple
Gender: Female
PCP # 8U149501
NPI: 1225057672
2401 S 31st St
(254) 724-2111
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Temple
Gender: Male
PCP # 8B045601
NPI: 1427019330
1605 S 31st St
J (254) 215-0100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Gender: Female
PCP # 86J21801
NPI: 1912969825
1605 S 31st St
(254) 724-2111
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Westwick, Thomas J, MD
Temple
J
Gender: Male
PCP # 86J21601
NPI: 1689636508
1605 S 31st St
(254) 215-0100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
J - Wheelchair Access
52
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
TEMPLE
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Armin, Samira, MD
" Black, D Bethany, MD
Temple
TEMPLE Cont
J
Gender: Female
PCP # 8DH66503
NPI: 1306070586
1901 Southwest H K Dodgen Loop
Bldg 300
(254) 724-5437
J
PCP # 8DH66502
NPI: 1306070586
2112 Southwest Loop 363
Ste 110
(254) 724-2111
INTERNAL MEDICINE Cont
" Win, Sonny, MD
Temple
Gender: Male
PCP # 83X68501
NPI: 1588626253
1605 S 31st St
J (254) 215-0100
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Wood, Adam S, MD
Temple
Gender: Male
PCP # 8CA35001
NPI: 1225296494
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
J
J
J
PCP # 80738402
NPI: 1093775389
2112 Southwest Loop 363
Ste 110
(254) 724-5437
" Brakemeier, Robert H, MD
J
Gender: Male
PCP # 80741101
NPI: 1760441539
2401 S 31st St
J (254) 724-2111
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties:
Obstetrics-Gynecology
" Furman, Alisa A, MD
Temple
Gephart, Laura F, MD
Gender: Female
PCP # 8EQ67301
NPI: 1568783306
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
" Agadi, Satish, MD
Temple
Gender: Male
PCP # 8EB57801
NPI: 1275724585
2401 S 31st St
J (254) 724-2111
Hospital Affiliation: Texas Childrens
Hospital
Clinic Affiliation: Scott and White Clinic
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
PCP # 80738401
NPI: 1093775389
2401 S 31st St
(254) 724-5437
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
J
PCP # 82464K02
NPI: 1275593352
2112 Southwest Loop 363
Ste 110
(254) 724-5437
Bybee, Kristy R, DO
Gender: Female
PCP # 8CV42601
NPI: 1467774943
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
" Chan, Soi Yu, MD
Temple
J
" Beharry, Meera S, MD
Temple
Gender: Female
PCP # 8DK57503
NPI: 1447403340
1901 Southwest H K Dodgen Loop
Bldg 300
(254) 724-5437
Gender: Female
PCP # 8DM88801
NPI: 1700064094
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Pediatrics
" Choe, Jessica W, MD
Temple
Gender: Female
PCP # 8BS96801
NPI: 1578722146
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
PCP # 8DK57501
NPI: 1447403340
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott & White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Pediatrics
" Colbath, Melissa S, MD
Temple
" Bierwirth, Matthew B, MD
Temple
J
PCP # 82464K01
NPI: 1275593352
2401 S 31st St
(254) 724-2111
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
Temple
Battle, Soo C, MD
Gender: Female
PCP # 8CD75201
NPI: 1417281437
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
Temple
PEDIATRICS
J
Gender: Male
PCP # 82464K03
NPI: 1275593352
1901 Southwest H K Dodgen Loop
Bldg 300
(254) 724-5437
J
Temple
Gender: Female
PCP # 8DW77001
NPI: 1710973102
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties:
Obstetrics-Gynecology
" Desai, Manish A, MD
Temple
Gender: Male
PCP # 8CW90401
NPI: 1861515843
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
" Farris, Amanda C, DO
Temple
Gender: Female
PCP # 8AB76601
NPI: 1467651554
2401 S 31st St
(254) 724-2111
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
" Burke, Robert E, MD
" Asbury, J R, MD
Birkholz, Christopher, MD
Gender: Male
PCP # 8DG31501
NPI: 1598926669
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Gender: Female
PCP # 8DU65501
NPI: 1548220718
1905 Southwest Hk Dodgen Loop
(254) 298-2400
Hospital Affiliation: Little River Healthcare,
Metroplex Hospital, Scott And White
Memorial Hospital, Seton Medical Ctr Harker
Heights
Clinic Affiliation: Little River Healthcare
Family Ca
Board Certified Specialties: Pediatrics
Temple
Temple
OBSTETRICS-GYNECOLOGY
Temple
J
PCP # 8DH66501
NPI: 1306070586
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Pediatrics
Gender: Male
PCP # 80738403
NPI: 1093775389
1901 Southwest H K Dodgen Loop
Bldg 300
(254) 724-5437
Temple
Temple
J
Gender: Male
PCP # 82335B03
NPI: 1750340568
2112 Southwest Loop 363 Ste 110
(254) 724-5437
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
J
Gender: Female
PCP # 8CL98501
NPI: 1255667499
2401 S 31st St
(254) 724-2111
PCP # 8CL98502
NPI: 1255667499
6684 W Adams Ave
(254) 899-4205
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
" Davis, Tinku, MD
Temple
J
Gender: Female
PCP # 8CB05701
NPI: 1477757037
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: No Patients Over 17
yrs old
Board Certified Specialties: Pediatrics
" Flippin, Jill M, MD
Temple
Gender: Female
PCP # 8BU45101
NPI: 1871767087
2401 S 31st St
(254) 724-8800
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
" Fuller, Allie M, MD
Temple
Gender: Female
PCP # 8CL62501
NPI: 1942461454
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
" Gibson, Jeremy, MD
Temple
Gender: Male
PCP # 8B470501
NPI: 1003876798
2401 S 31st St
J (254) 724-2111
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
Golden, Alma L, MD
Gender: Female
PCP # 8W265801
NPI: 1841370772
2401 S 31st St
J (254) 724-2111
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
Temple
" Govande, Vinayak P, MD
Temple
Gender: Male
PCP # 8EA75501
NPI: 1790707826
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Pediatrics
Guptha, Sushma N, MD
Gender: Female
PCP # 8DU83403
NPI: 1710064357
2401 S 31st St
J (254) 680-1100
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
Temple
" Hagen, Barbara T, MD
Temple
Gender: Female
PCP # 80766101
NPI: 1972837516
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
J - Wheelchair Access
53
TEMPLE
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" McCormick, Sarah M, DO
" Rai, Anuradha, MD
Temple
TEMPLE Cont
PEDIATRICS Cont
" Itkin, Philip G, MD
Temple
J
J
Gender: Male
PCP # 8CY04001
NPI: 1447322490
2401 S 31st St
(254) 724-2111
PCP # 8CY04002
NPI: 1447322490
6684 W Adams Ave
(254) 899-4200
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Pediatrics
" Kane, Javier R, MD
Temple
J
J
Gender: Male
PCP # 8CW38802
NPI: 1700999265
1901 Southwest H K Dodgen Loop
Bldg 300
(254) 724-5437
PCP # 8CW38801
NPI: 1700999265
2401 S 31st St
(254) 724-2111
Hospital Affiliation:
ChildrensHospitalSanAntonio', Christus
Santa Rosa Hosp City Ctr, University Health
System
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
" Kastner, Randy R, MD
Temple
J
J
Gender: Male
PCP # 85Z66001
NPI: 1932169331
2401 S 31st St
(254) 724-2111
PCP # 85Z66002
NPI: 1932169331
6684 W Adams Ave
(254) 899-4200
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
Konnur, Neelam, MD
Gender: Female
PCP # 8CY85202
NPI: 1972646479
1901 Southwest Hk Dodgen Loop
Bldg 300
J (254) 724-5437
Temple
J
PCP # 8CY85201
NPI: 1972646479
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
" McAllister, Daniel G, MD
Temple
J
Gender: Male
PCP # 8W033501
NPI: 1629079504
2401 S 31st St
(254) 724-2111
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
" Thompson Jr, John Q, DO
Temple
Gender: Male
PCP # 80744102
NPI: 1275595266
1901 Southwest Hk Dodgen Loop
Bldg 300
(254) 724-5437
J
PCP # 80744101
NPI: 1275595266
2401 S 31st St
(254) 724-2111
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
" Riser, Rebecca M, MD
Temple
Gender: Female
PCP # 8DU70801
NPI: 1407817067
1905 Southwest Hk Dodgen Loop
J (254) 298-2480
Hospital Affiliation: Little River Healthcare,
Metroplex Hospital, Scott And White
Memorial Hospital
Clinic Affiliation: Little River Healthcare
Family Ca
Board Certified Specialties: Pediatrics
McNeal, Tresa M, MD
Gender: Female
PCP # 8U149501
NPI: 1225057672
2401 S 31st St
(254) 724-2111
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Saenz, Paulina A, MD
Gender: Female
PCP # 8CY24701
NPI: 1184875858
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
J
Ward, Erica L, MD
Gender: Female
PCP # 8W232002
NPI: 1992711956
2401 S 31st St
(254) 724-2111
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
Temple
Temple
" Meza, Elena I, MD
Temple
Gender: Female
PCP # 8CX80202
NPI: 1710948559
2112 Southwest Loop 363
Ste 110
J (254) 724-2111
PCP # 8CX80201
NPI: 1710948559
2401 S 31st St
J (254) 724-2111
Hospital Affiliation: North Central Baptist
Hospital, Northeast Baptist Hospital
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Pediatrics
" Santema, Sharyl J, MD
" Williams, Charlie D, MD
Temple
Temple
Gender: Female
PCP # 80430K01
NPI: 1972564706
2401 S 31st St
J (254) 724-2111
PCP # 80430K02
NPI: 1972564706
6684 W Adams Ave
J (254) 899-4200
Hospital Affiliation: Scott And White
Memorial Hospital, Seton Medical Center, St
Davids Medical Center
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
Mirkes, Curtis R, DO
Gender: Male
PCP # 8W064901
NPI: 1932123429
2401 S 31st St
(254) 724-2111
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
Temple
Smith, Michael C, MD
Gender: Male
PCP # 82333B01
NPI: 1033171350
2401 S 31st St
J (254) 724-2111
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
Temple
" Newman, Trichelle A, MD
Temple
Gender: Female
PCP # 8BG56901
NPI: 1164682886
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
" Kirby Keyser, Linda J, MD
J
Gender: Female
PCP # 8CM48501
NPI: 1093712523
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
Temple
Temple
Gender: Female
PCP # 8X629601
NPI: 1417286592
2401 S 31st St
(214) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
Temple
Gender: Female
PCP # 8DX74401
NPI: 1093988297
2401 S 31st St
(254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Pediatrics
" Sosa, Jacqueline Q, MD
Temple
Gender: Female
PCP # 8DV35201
NPI: 1407021173
1905 Southwest Hk Dodgen Loop
J (254) 298-2465
Clinic Affiliation: Little River Healthcare
Family Ca
Board Certified Specialties: Pediatrics
" Okogbo, Michael E, MD
Temple
Gender: Male
PCP # 8CL53601
NPI: 1043224132
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
J
J
FAMILY PRACTICE
" Allison, Dale C, MD
Waco
Gender: Male
# PCP # 80Y50101
NPI: 1154393429
7300 Bosque Blvd
J (254) 202-2600
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Family
Practice
" Barry, Lynda J, MD
Waco
Gender: Female
PCP # 8CD50001
NPI: 1043297849
9821 China Springs Hwy
(254) 202-7400
Hospital Affiliation: Driscoll
ChildrensHospital', Hillcrest Baptist Medical
Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Family
Practice
" Sullivan, Lisa S, MD
Gender: Female
PCP # 8BS42102
NPI: 1922254309
2112 Southwest Loop 363
Ste 110
J (254) 724-2111
" Olufs, Richard D, MD
Gender: Male
PCP # 8DU74501
NPI: 1467448746
1905 Southwest Hk Dodgen Loop
J (254) 298-2480
Hospital Affiliation: Little River Healthcare,
Metroplex Hospital, Seton Medical Ctr
Harker Heights
Clinic Affiliation: Little River Healthcare
Family Ca
Board Certified Specialties: Pediatrics
PCP # 8BS42101
NPI: 1922254309
2401 S 31st St
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
PCP # 86J25602
NPI: 1629030549
6684 W Adams Ave
(254) 899-4200
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
WACO
Temple
Temple
Gender: Male
PCP # 86J25601
NPI: 1629030549
2401 S 31st St
(254) 724-2111
Bull, Brian D, MD
Gender: Male
# PCP # 80Y49601
NPI: 1023089679
851 N Loop 340
J (254) 202-7500
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: None
Waco
J - Wheelchair Access
54
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
WACO
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Guerra, Carlos A, MD
" NIX, Anastacia J, MD
Wac o
WACO Cont
FAMILY PRACTICE Cont
" Carl, Leighton H, MD
Waco
Gender: Male
# PCP # 8AA48201
NPI: 1922075225
7300 Bosque Blvd
J (254) 202-2600
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Family
Practice
Waco
Delue, Sean D, MD
Gender: Male
PCP # 8BV76802
NPI: 1477525004
7700 Fish Pond Rd
(254) 741-4444
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
" George, Saramma, MD
Waco
Gender: Female
PCP # 8W735501
NPI: 1215035845
2201 MacArthur Dr
Ste 2205
(254) 202-6580
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Baptist Medical
Ct
Board Certified Specialties: Family
Practice
" Gill, John H, MD
Waco
Gender: Male
# PCP # 8H907401
NPI: 1578540183
1600 Providence Dr
J (254) 313-4200
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Family Practice Center
Board Certified Specialties: Family
Practice
" Goebel, Gregg, MD
Waco
Gender: Male
PCP # 80769703
NPI: 1194784439
7700 Fishpond Rd
J (254) 741-4444
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Graham Jr, James T, MD
Waco
Gender: Male
# PCP # 88X54802
NPI: 1508839515
3301 Westminister
J (254) 202-7800
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Family
Practice
" Grant, Christopher R, MD
Waco
Gender: Male
PCP # 84196K02
NPI: 1891755500
7700 Fishpond Rd
J (254) 741-4444
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Waco
Gender: Male
# PCP # 81514G01
NPI: 1952373227
7300 Bosque Blvd
J (254) 202-2600
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Family
Practice
Gender: Female
PCP # 8DV41201
NPI: 1508151309
851 N Loop 340
(254) 202-7500
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Family
Practice
" Hinds, William M, MD
" Petty, Michael K, DO
Wac o
Waco
Gender: Male
# PCP # 8W096201
NPI: 1932169695
50 Hillcrest Medical Blvd
Ste 104
J (254) 202-7300
Hospital Affiliation: Hillcrest Baptist
Medical Center, Scott And White Memorial
Hospital
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Family
Practice
Gender: Male
# PCP # 8A889001
NPI: 1700850682
7300 Bosque Blvd
J (254) 202-2600
Hospital Affiliation: Columbus Community
Hospital, Hillcrest Baptist Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Family
Practice
" Raley, Stephen P, MD
Waco
Gender: Male
PCP # 8AA48101
NPI: 1649360421
7300 Bosque Blvd
(254) 202-2600
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Family
Practice
" Reis, Michael, MD
Waco
" Jensen, Randall D, MD
Wac o
J
Gender: Male
PCP # 80757102
NPI: 1639139231
7700 Fishpond Rd
(254) 741-4444
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
J
Waco
" Jernigan, Floyd, MD
Wac o
J
Gender: Male
PCP # 86J22302
NPI: 1831151166
7700 Fishpond Rd
J (254) 741-4444
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Talbert, Amy L, MD
Waco
Gender: Female
PCP # 8A889601
NPI: 1659399798
9821 China Sprig Rd
J (254) 202-7400
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Family
Practice
" Tipton, Reagan E, DO
Waco
Gender: Male
PCP # 8H367501
NPI: 1487622544
50 Hillcrest Medical
Blvd Ste 1
(254) 202-7300
Hospital Affiliation: Coryell Memorial
Hospital, Hillcrest Baptist Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Family
Practice
Gender: Male
# PCP # 80Y49301
NPI: 1336111996
1001 Hewitt Dr
J (254) 202-7800
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Family
Practice
" Hulme, Kyle L, MD
Wac o
J
" Stern, Charles, MD
Waco
Gender: Male
PCP # 84191K02
NPI: 1891755088
7700 Fishpond Rd
(254) 761-4444
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Gender: Male
PCP # 80765202
NPI: 1568423218
7700 Fishpond Rd
(254) 741-4444
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
Roth, Stephanie D, MD
Gender: Female
PCP # 8DX37201
NPI: 1528022472
851 N Loop 340
(254) 202-7500
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: None
" Ryman, James L, MD
Waco
" Kirk, Lisa J, DO
Wac o
Gender: Female
PCP # 8CT95201
NPI: 1578562146
318 Richland W Cir
Ste B
(254) 776-8008
Clinic Affiliation: Brazos Integrative
Medicine
Board Certified Specialties: Family
Practice
J
Gender: Male
PCP # 8CG85203
NPI: 1841352424
7700 Fish Pond Rd
(254) 761-4444
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
" Schiller, Timothy W, DO
Waco
Gender: Male
# PCP # 84591X01
NPI: 1063483618
851 N Loop 340
J (254) 202-7500
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Family
Practice
" Lejawa, Robert J, DO
Wac o
Gender: Male
PCP # 8X405303
NPI: 1265592596
7030 New Sanger Ave
(254) 519-1900
Hospital Affiliation: Shannon Medical
Center
Clinic Affiliation: Marsh III William S DO
Board Certified Specialties: Family
Practice
Waco
Trevino, Mandy L, MD
Gender: Female
PCP # 8EJ61801
NPI: 1861784340
7700 Fish Pond Rd
(254) 761-4444
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
" Turnage, Elizabeth B, MD
Waco
Gender: Female
# PCP # 8A889301
NPI: 1154393890
7300 Bosque Blvd
J (254) 202-2600
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Family
Practice
" Wehmeyer, Van A, MD
Waco
Gender: Male
PCP # 8X959203
NPI: 1376617076
7700 Fishpond Dr
J (254) 741-4444
PCP # 8X959202
NPI: 1376617076
7700 Fishpond Rd
J (254) 741-4444
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Family
Practice
J - Wheelchair Access
55
WACO
Independent Provider Network (IPN)
bmk_pin_pcp
OCTOBER 15, 2014
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
WACO Cont
INTERNAL MEDICINE
" Bhat, Ashwini, MD
Wac o
J
Gender: Female
PCP # 8CZ84902
NPI: 1396901856
100 Hillcrest Medical
Blvd
(254) 202-5800
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
" Cheema, Yasir I, MD
Wac o
J
Gender: Male
PCP # 8CW96802
NPI: 1952515876
100 Hillcrest Medical
Blvd
(254) 202-5800
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
" Gupta, Sandeep S, MD
Wac o
J
Gender: Male
PCP # 8CV85001
NPI: 1194990945
100 Hillcrest Medical
Blvd
(254) 202-5800
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
" Headrick, Jennifer L, MD
Wac o
J
Gender: Female
PCP # 8EK81301
NPI: 1336334739
100 Hillcrest Medical
Blvd
(254) 202-5800
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Internal
Medicine
" Karan, Shobha, MD
Wac o
Gender: Female
PCP # 8AW76101
NPI: 1720222524
2201 MacArthur Dr
(254) 202-6500
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Baptist Medical
Ct
Board Certified Specialties: Internal
Medicine
" White, Heath D, DO
Wac o
J
Gender: Male
PCP # 8CW55703
NPI: 1134392582
100 Hillcrest Medical
Blvd
(254) 202-5800
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Internal
Medicine
PEDIATRICS
" Beharry, Meera S, MD
Wac o
" Bierwirth, Matthew B, MD
" Dewbre, Jacquelin D, DO
Waco
Waco
Gender: Male
PCP # 82335B04
NPI: 1750340568
2201 MacArthur Dr
Ste 103
J (254) 756-6836
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
Gender: Female
# PCP # 8H367801
NPI: 1346211893
2201 MacArthur Dr
J (254) 202-6100
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Brown, Marilyn A, MD
Gender: Female
PCP # 8CX96102
NPI: 1396736823
120 Hillcrest Medical
Blvd 200 and 201
J (254) 297-0400
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Waco
" Ferguson, James W, MD
Waco
Gender: Male
PCP # 00FZ0901
NPI: 1558310839
405 Londonderry Ste 300
J (254) 772-2722
Hospital Affiliation: Hillcrest Baptist
Medical Center
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: Pediatrics
" Burns, Rebeckah J, MD
Waco
Gender: Female
PCP # 8CY80601
NPI: 1649294851
120 Hillcrest Medical
Blvd
J (254) 202-6100
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Pediatrics
" Gamble, Charles E, MD
Waco
Gender: Male
# PCP # 80Y50401
NPI: 1720059272
2201 MacArthur Dr
J (254) 202-6100
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Pediatrics
Chakmakjian, Stephen S, MD
Gender: Male
PCP # 8S052001
NPI: 1770566333
601 W Hwy 6
Ste 102
J (254) 399-8364
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Heart of TX Pediatrics PA
Board Certified Specialties: None
Waco
" Hecox, Celeste D, MD
Waco
Gender: Female
PCP # 8DS17801
NPI: 1306040415
120 Hillcrest Medical
Blvd Ste 100
J (254) 202-6100
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: Pediatrics
" Chan, Soi Yu, MD
Waco
Gender: Female
PCP # 8DM88802
NPI: 1700064094
100 Hillcrest Medical
Blvd
J (254) 724-2111
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Pediatrics
" Kemper, Karen C, MD
Waco
Gender: Female
# PCP # 8A889201
NPI: 1689645236
120 Hillcrest Medical
Blvd Ste 1
J (254) 202-6100
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Pediatrics
Clark, Samuel D, DO
Gender: Male
PCP # 8CF27102
NPI: 1346391752
120 Hillcrest Medical
Blvd Ste 200 201
J (254) 297-0400
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
Waco
" Marsellus, Cessley D, MD
Waco
Gender: Female
PCP # 8P237502
NPI: 1285694885
7700 Fishpond Rd
(254) 741-4444
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: Pediatrics
" Conner, Catherine S, MD
Waco
Gender: Female
PCP # 8CK51101
NPI: 1669676227
601 W State Hwy 6
Ste 102
(254) 399-8364
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Heart of TX Pediatrics PA
Board Certified Specialties: Pediatrics
" McDonald, Andrew W, MD
Waco
Gender: Male
# PCP # 84593X01
NPI: 1720050081
2201 MacArthur Dr
Pediatric Pavillion
J (254) 202-6100
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Practice Information: No Patients Over 16
yrs old
Board Certified Specialties: Pediatrics
Gender: Female
PCP # 8DK57502
NPI: 1447403340
100 Hillcrest Medical
Blvd
(254) 202-5800
Clinic Affiliation: Scott & White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Pediatrics
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Waco
Myers, Anna C, MD
Gender: Female
PCP # 8U149002
NPI: 1568422939
7700 Fish Pond Rd
(254) 741-4444
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Scott and White Clinic
Board Certified Specialties: None
Nesmith, William R, MD
Gender: Male
PCP # 8P629001
NPI: 1962485516
601 W Hwy 6
Ste 102
J (254) 399-8364
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Heart of TX Pediatrics PA
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
Waco
" Popejoy, Vicki V, MD
Waco
Gender: Female
# PCP # 8W096001
NPI: 1588625990
2201 MacArthur Dr
Ste 103
J (254) 202-6100
Hospital Affiliation: Hillcrest Baptist
Medical Center, Scott And White Memorial
Hospital
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Pediatrics
" Spark, Harvey, MD
Waco
J
Gender: Male
PCP # 8DE84901
NPI: 1992986863
2201 McArthur Dr
(254) 730-2600
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs, No Patients
Over 18 yrs old, Specialized in Pediatrics
Board Certified Specialties: Pediatrics
" Srinivasan, Priyadarshini, MD
Waco
Gender: Female
PCP # 8DU01501
NPI: 1083693691
120 Hillcrest Medical
Blvd
(254) 297-0400
Clinic Affiliation: Scott and White Clinic
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Pediatrics
Stanko, Sue E, MD
Gender: Female
PCP # 0066GQ01
NPI: 1740246909
1201 Hewitt Dr
Ste 204
J (254) 741-9933
Board Certified Specialties: None
Waco
" Thaller, Katherine E, MD
Waco
Gender: Female
PCP # 8EK20801
NPI: 1144632530
120 Hillcrest Medical
Blvd Ste 100
(254) 202-6100
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Pediatrics
J - Wheelchair Access
56
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmki_pn_pcp
WOODWAY
Primary Care Physicians
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Rasor, Daniel L, MD
Gender: Male
PCP # 8DN20401
NPI: 1043211329
912 S Capital of Texas
Hwy Ste 100
(512) 892-7076
Hospital Affiliation: St Davids S Austin
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: South Austin Family
Practiceclinic LLP
Practice Information: No Patients Under 1
yrs old
Board Certified Specialties: None
" Smith, Kristina B, MD
Wes t Lake Hills
WEST
FAMILY PRACTICE
" Chudej, Eric, MD
West
Gender: Male
PCP # 8CY15401
NPI: 1053620013
401 Meadow Dr
J (254) 826-3073
Clinic Affiliation: Family Diagnostic Medical
Center LLP
Board Certified Specialties: Family
Practice
WEST LAKE HILLS
" Angerstein, Jacqueline, DO
Blair, Stephen, MD
Gender: Male
PCP # 8DN18601
NPI: 1962404244
912 Capital of Texas Hwy
Ste 100
(512) 892-7076
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: South Austin Family
Practiceclinic LLP
Board Certified Specialties: None
Lifshen, Michael S, MD
Gender: Male
PCP # 8DN19701
NPI: 1982605234
912 Capital of Texas Hwy
Ste 100
(512) 892-7076
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: South Austin Family
Practiceclinic LLP
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: None
" Patel, Sadhana S, MD
Gender: Female
PCP # 8DN20301
NPI: 1316948755
912 Capital of Texas Hwy
Ste 100
(512) 306-8360
Hospital Affiliation: St Davids S Austin
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: South Austin Family
Practiceclinic LLP
Board Certified Specialties: Family
Practice
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
" Ebert Blackburn, Didi E, DO
Whitney
J
" Christensen, Jennifer C, MD
Wes t Lake Hills
Gender: Female
PCP # 8CU82202
NPI: 1649596305
1314 N Brazos St
(254) 694-6997
Hospital Affiliation: Plaza Medical Center
Fort Worth
Clinic Affiliation: Family Diagnostic Medical
Center LLP
Board Certified Specialties: Family
Practice
" Henderson, Randall D, DO
Gender: Female
# PCP # 8DQ23801
NPI: 1790974632
4201 Bee Caves Rd
Ste C100
(512) 327-1155
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Schoolhouse Pediatrics
Board Certified Specialties: Pediatrics
Whitney
Gender: Male
PCP # 8EJ36701
NPI: 1700879848
1314 N Brazos St
(254) 694-3621
Clinic Affiliation: Whitney Family Medicine
Board Certified Specialties: Family
Practice
" Gallagher, Ava W, MD
Wes t Lake Hills
WIMBERLEY
Gender: Female
PCP # 8DS62301
NPI: 1396975397
925 Westbank Dr
Ste 100
(512) 327-0411
Hospital Affiliation: Houston Methodist St
John Hosp
Clinic Affiliation: 411 Pediatrics
Board Certified Specialties: Pediatrics
West Lake Hills
West Lake Hills
WHITNEY
FAMILY PRACTICE
Brown, Ari A, MD
Gender: Female
PCP # 8DS62201
NPI: 1396850525
925 Westbank Dr
Ste 100
(512) 327-0411
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: 411 Pediatrics
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Wes t Lake Hills
West Lake Hills
West Lake Hills
Gender: Female
# PCP # 8DS62401
NPI: 1730325754
925 Westbank Dr
Ste 100
J (512) 327-0411
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, St
Davids Medical Center
Clinic Affiliation: 411 Pediatrics
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
PEDIATRICS
FAMILY PRACTICE
Gender: Female
PCP # 8AJ08701
NPI: 1750367629
3530 Bee Caves Rd
Ste 110
J (512) 328-3311
Hospital Affiliation: St Davids S Austin
Medical Center
Clinic Affiliation: J Angerstein DO
Board Certified Specialties: Family
Practice
West Lake Hills
FAMILY PRACTICE
" Price, Eric W, MD
Wimberley
Gender: Male
PCP # 8DC74801
NPI: 1558378893
950 FM 2325
Ste B
(512) 847-3434
" Hamilton, Elaine L, MD
Wes t Lake Hills
J
Gender: Female
PCP # 8A529001
NPI: 1215036173
5656 Bee Caves Rd
Ste C 104
(512) 327-1177
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, Seton Southwest,
St Davids Medical Center
Clinic Affiliation: Westlake Pediatrics
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Reidy, Elizabeth T, MD
Gender: Female
# PCP # 8X160001
NPI: 1063483147
4201 Bee Caves Rd
Ste C100
J (512) 327-1155
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Schoolhouse Pediatrics
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Wes t Lake Hills
J
PCP # 8CQ27001
NPI: 1558378893
950 FM 2325 Ste B
(512) 847-3434
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Central Texas Medical
Assoc, Live Oak Health Partners
Board Certified Specialties: Family
Practice
Ramirez, Juan I, MD
Gender: Male
PCP # 8AJ05001
NPI: 1205835071
9670 Ranch Rd 12
J (512) 847-6789
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Juan I Ramirez MD
Board Certified Specialties: None
Wimberley
Sebring, Lane, MD
Gender: Male
PCP # 82246Z01
NPI: 1902833908
16811 Ranch Rd 12
J (512) 847-5618
Hospital Affiliation: Central Texas Medical
Center
Clinic Affiliation: Sebring Clinic PA
Board Certified Specialties: None
Wimberley
WOODWAY
FAMILY PRACTICE
" Graham Jr, James T, MD
Woodway
Gender: Male
# PCP # 88X54801
NPI: 1508839515
1001 Hewitt Dr
J (254) 202-7800
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Family
Practice
" Hinson III, Horace G, MD
Woodway
Gender: Male
PCP # 88X54901
NPI: 1699747253
1001 Hewitt Dr
J (254) 202-7800
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Family
Practice
" James, Kyle D, MD
Woodway
Gender: Male
PCP # 8CV76401
NPI: 1497745426
1001 Hewitt Dr
J (254) 202-7800
Hospital Affiliation: East Texas Medical
Center, Hillcrest Baptist Medical Center,
University Of Texas Health Center At Tyler
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Family
Practice
" Kosarek, John D, MD
Woodway
Gender: Male
# PCP # 80Y50501
NPI: 1538132840
7702 Central Park Dr
J (254) 202-2770
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Family
Practice
" Myers, David S, MD
Woodway
Gender: Male
# PCP # 8W096101
NPI: 1902961493
7702 Central Park Dr
J (254) 202-7800
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Family
Practice
" Salinas, Gerald, MD
Woodway
Gender: Male
# PCP # 80Y50601
NPI: 1821061136
7702 Central Park Dr
J (254) 202-7700
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: Family
Practice
J - Wheelchair Access
57
WOODWAY
Independent Provider Network (IPN)
bmk_pin_pcp
Primary Care Physicians
OCTOBER 15, 2014
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
WOODWAY Cont
FAMILY PRACTICE Cont
Speckmiear, John W, MD
Gender: Male
# PCP # 80Y50701
NPI: 1912979659
7702 Central Park Dr
J (254) 202-7700
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Hillcrest Family Health
Ctrs
Board Certified Specialties: None
Woodway
Trippe, Karl M, MD
Gender: Male
PCP # 8CX08101
NPI: 1285615674
7100 Old McGregor Rd
(254) 399-6545
Hospital Affiliation: Hillcrest Baptist
Medical Center
Clinic Affiliation: Waco Primary Care PA
Board Certified Specialties: None
Woodway
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
J - Wheelchair Access
58
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
INDEPENDENT
October
15, 2014PROVIDER NETWO RK (IPN)
Aus tin
AUSTIN
ACUPUNCTURE
" Bangs, Jessie A, LAC
Austin
#
Gender: Female
NPI: 1134540438
2111 Dickson Dr
Ste 10
(832) 248-4884
Board Certified Specialties: Acupuncture
Banuelos, Ronald W, LAC
Gender: Male
NPI: 1295902864
# 8701 Shoal Creek Blvd
Ste 302
J(512) 619-2224
Practice Information: No Patients Under 7
yrs old
Board Certified Specialties: None
Austin
" Cao, Haitao, LAC
Austin
#
Gender: Female
NPI: 1720221799
1707 Fortview Rd
J(512) 707-8828
Clinic Affiliation: Austin Acupuncture Clinic
Practice Information: No Patients Under 1
yrs old
Board Certified Specialties: Acupuncture
" Cazares, Anna M, LAC
Austin
#
Gender: Female
NPI: 1356622526
1000 E Seventh St Ste 203
(512) 228-9158
Board Certified Specialties: Acupuncture
" Chang, PO H, LAC
Austin
Gender: Male
NPI: 1194976977
1702 Shag Bark Trl
(512) 797-1314
Board Certified Specialties: Acupuncture
#
#
Forcier, Julianne M, LAC
Gender: Female
NPI: 1750399366
# 1708 Walnut Ave
J(512) 296-1541
Board Certified Specialties: None
" Foreman, Brooke C, LAC
Aus tin
#
Aus tin
" Chu, Yien Long, LAC
#
Austin
Gender: Male
NPI: 1346448909
8700 Manchaca Rd
Ste 505
J(512) 825-4979
Clinic Affiliation: Dragon Acupuncture
Clinic
Board Certified Specialties: Acupuncture
Gender: Female
NPI: 1992097133
411 E 45th St
J(512) 451-5726
Board Certified Specialties: Acupuncture
NPI: 1659678092
8015 Shoal Creek Blvd
Ste 110
J(512) 788-4743
Clinic Affiliation: Hausman Chiropractic
and Acupunct, Premier Gynecology
Board Certified Specialties: Acupuncture
Hsiao, Mu-Fan, LAC
Gender: Male
NPI: 1548506322
# 127 E Riverside Dr
Ste 111
(512) 775-6228
Board Certified Specialties: None
Austin
Gomes, Elizabete A, LAC
Gender: Female
NPI: 1679703102
2525 Wallingwood Dr
Bldg 12
J(512) 771-0005
Board Certified Specialties: None
Hsu, Shing Jane C, LAC
Gender: Female
NPI: 1295911576
# 1702 Shag Bark Tr
(512) 339-9202
Board Certified Specialties: None
Dollar, Jonathan D, LAC
Gender: Male
NPI: 1558670554
4220 W William Cannon Dr
Ste 130
J(512) 892-3434
Clinic Affiliation: Texas Chiropractic and
Therapy
Board Certified Specialties: None
Gong, Guoji, LAC
Gender: Male
NPI: 1518086610
# 13010 Research Blvd
Ste 103
J(512) 219-0903
Clinic Affiliation: S Tct Health Inc
Practice Information: No Patients Under 6
yrs old
Board Certified Specialties: None
Huynh, Ann, LAC
Gender: Female
NPI: 1326293242
# 1221 W Ben White Blvd
Ste 210A
J(512) 731-3363
Clinic Affiliation: Acuherbia LLC
Board Certified Specialties: None
Austin
Kettering, Yvonne P, LAC
Gender: Female
NPI: 1629374301
# 8701 Shoal Creek
Ste 302
J(512) 801-2453
Board Certified Specialties: None
Gu, Jingyu, LAC
Gender: Male
NPI: 1083702872
# 1502 W Koenig Ln
J(512) 452-5757
Clinic Affiliation: Wellspring Acupuncture
and Holist
Board Certified Specialties: None
Duncan, Dianne, LAC
Gender: Female
NPI: 1811024284
# 5609 Adams Ave Ste B
J(512) 374-9800
Practice Information: No Patients Under 6
yrs old
Board Certified Specialties: None
" Kung, Phyllis, LAC
" Fan, Yong Xin, LAC
Austin
#
Gender: Male
NPI: 1528236528
2700 W Anderson Ln
Ste 512
J(512) 467-0370
Clinic Affiliation: Aoma Academy LP
Board Certified Specialties: Acupuncture
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
#
Gender: Female
NPI: 1427377795
1502 W Sixth St Ste A
(512) 650-8880
Board Certified Specialties: Acupuncture
Laguna, Jose R, LAC
Gender: Male
NPI: 1265671713
# 2700 W Anderson Ln
Ste 512
J(512) 467-0370
Austin
NPI: 1629223268
4701 W Gate Blvd
J(512) 693-4373
Clinic Affiliation: Aoma Academy LP
Board Certified Specialties: None
#
" Han, Qiuxia, LAC
Aus tin
Gender: Female
NPI: 1083702468
2500 W William Cannon Dr
Ste 201
J(512) 217-3855
Clinic Affiliation: Mother Nature’s Accup &
Chin
Board Certified Specialties: Acupuncture
" Liu, Yuxing, LAC
Austin
#
NPI: 1265671713
4701 W Gate Blvd
J(512) 693-4373
Clinic Affiliation: Aoma Academy LP
Board Certified Specialties: None
Lee, Sherry H, LAC
Gender: Female
NPI: 1215013685
# 4131 Spicewood Springs Rd
Ste G1
J(512) 342-9125
Practice Information: No Patients Under 3
yrs old
Board Certified Specialties: None
" He, Yan, LAC
Gender: Female
NPI: 1144498148
11651 Jollyville Rd
Ste 150
(512) 331-3866
Clinic Affiliation: Acupuncture Healing Art
Ctr Inc
Board Certified Specialties: Acupuncture
Lentfer, J Nicole, LAC
Gender: Female
NPI: 1730226903
# 3809 S Second St Ste D100
J(512) 892-3366
Clinic Affiliation: Natural Healthcare
Alliance PLLC
Board Certified Specialties: None
Austin
Gender: Male
NPI: 1982886057
8711 Burnet Rd
Ste A18 A20
(512) 374-4988
Clinic Affiliation: Honeysuckle Acupuncture
Clinic
Board Certified Specialties: Acupuncture
Luo, Song, LAC
Gender: Male
NPI: 1740458645
# 2700 W Anderson Ln
Ste 512
J(512) 467-0370
Austin
#
NPI: 1740458645
4701 W Gate Blvd
J(512) 693-4373
Clinic Affiliation: Aoma Academy LP
Board Certified Specialties: None
" Luo, Wen Chiang K, LAC
Austin
#
Gender: Male
NPI: 1740318088
4131 Spicewood Springs I1
J(512) 795-8021
Board Certified Specialties: Acupuncture
McCarthy, Moira J, LAC
Gender: Female
NPI: 1376690123
# 2525 Wallingwood Dr
Ste 1500
J(512) 328-5200
(512) 453-6555
Clinic Affiliation: Ulery Chiropractic Health
Center PA
Practice Information: No Patients Under 10
yrs old
Board Certified Specialties: None
Austin
" Merritt, Marlene A, LAC
Austin
#
Austin
Aus tin
#
Lin, Paul C, LAC
Gender: Male
NPI: 1578650560
# 1707 Fortview Rd
J(512) 445-2222
Clinic Affiliation: Austin Acupuncture Clinic
Board Certified Specialties: None
Austin
Austin
Hamilton, Lesley H, LAC
Gender: Female
NPI: 1629223268
# 2700 W Anderson Ln
Ste 512
J(512) 467-0370
Austin
Lin, Lisa P, LAC
Gender: Female
NPI: 1831286392
# 1707 Fortview Rd
(512) 707-8828
Clinic Affiliation: Austin Acupuncture Clinic,
TX Health and Science University
Board Certified Specialties: None
Austin
Austin
Aus tin
#
Li, Shaozhi, LAC
Gender: Male
NPI: 1649571886
# 1707 Fortview Rd
J(512) 445-2222
Clinic Affiliation: Austin Acupuncture Clinic
Board Certified Specialties: None
Austin
Austin
Aus tin
#
NPI: 1194906198
8303 Shoal Creek Blvd
(512) 419-7355
Clinic Affiliation: Acupuncture and Chinese
Medical
Practice Information: No Patients Under 1
yrs old
Board Certified Specialties: Acupuncture
" Henderson, Tamara A, LAC
Aus tin
Austin
Gender: Male
NPI: 1194906198
10601 Pecan Park Blvd
(512) 250-8940
Austin
Gender: Female
NPI: 1659678092
1010 W Ninth St
(512) 459-4405
" Castillo, Laura E, LAC
#
" He, Yuxin, LAC
Austin
Aus tin
Austin
Gender: Female
NPI: 1578878997
4220 W William Cannon Dr
Ste 130
J(512) 892-3434
Clinic Affiliation: Texas Chiropractic and
Therapy
Board Certified Specialties: Acupuncture
Finnell, John, LAC
Gender: Male
NPI: 1114172194
4701 Westgate Blvd
J(512) 693-4373
Clinic Affiliation: Aoma Academy LP
Board Certified Specialties: None
Gender: Female
NPI: 1073631834
5750 Balcones Dr
Ste 106
J(512) 495-9015
Clinic Affiliation: Merritt Acupuncture
Wellness
Board Certified Specialties: Acupuncture
" Moose, Elizabeth S, LAC
Austin
#
Gender: Female
NPI: 1255647590
12741 Research Blvd
Ste 505
(512) 419-1076
Clinic Affiliation: Balcones Acupuncture Inc
Board Certified Specialties: Acupuncture
J - Wheelchair Access
59
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Rutkowski, Vanessa M, LAC
Gender: Female
NPI: 1972719466
# 2111 Dickson Dr
Ste 26
J(512) 899-8996
Clinic Affiliation: Tigerlily Wellness &
Acupuncture
Board Certified Specialties: None
" Tan, Shengyan, LAC
Austin
AUSTIN Cont
ACUPUNCTURE Cont
Morris, William R, LAC
Gender: Male
NPI: 1174769491
# 2700 W Anderson Ln
Ste 512
J(512) 467-0370
Aus tin
#
NPI: 1174769491
4701 W Gate Blvd
J(512) 693-4373
Clinic Affiliation: Aoma Academy LP
Board Certified Specialties: None
" Nunley, Karen E, LAC
Aus tin
#
Gender: Female
NPI: 1780891952
3933 Spicewood Spgs
Rd Ste E400
J(512) 338-8810
Board Certified Specialties: Acupuncture
Pryne, Rama C, OT
Gender: Female
NPI: 1164530192
# 2312 Western Trails Blvd
Ste 401
(512) 293-5388
Clinic Affiliation: Acupuncture and Rehab
Clinic of A
Board Certified Specialties: None
Schutz, Izumi Z, LAC
Gender: Female
NPI: 1578899100
# 300 Beardsley Ln
Ste E
J(512) 293-1311
Board Certified Specialties: None
Austin
#
Gender: Female
NPI: 1144357260
4131 Spicewood
Springs Rd Ste C
J(512) 921-7699
NPI: 1144357260
4131 Spicewood Springs Rd
Ste C2
J(512) 921-7699
Clinic Affiliation: Acupuncture and Chinese
Medicine
Board Certified Specialties: Acupuncture
" Raymond, Rhonda K, LAC
Russell, Pearl C, LAC
Gender: Female
NPI: 1376987511
# 8009 Nairn Dr
(512) 289-6277
Board Certified Specialties: None
Gender: Male
NPI: 1730402587
7423 Burnet Rd
J(512) 450-1595
Board Certified Specialties: Acupuncture
Wang, Guoen E, LAC
Gender: Male
NPI: 1235296757
# 11851 Jollyville Rd
Ste 102
(512) 453-5352
Clinic Affiliation: Acupuncture Plus
Board Certified Specialties: None
Gender: Female
NPI: 1447545124
2700 W Anderson Ln
Ste 512
J(512) 467-0370
Clinic Affiliation: Aoma Academy LP
Board Certified Specialties: Acupuncture
Warner Hindman, Rebecca S, LAC
Gender: Female
NPI: 1740308402
# 2520 Longview St
Ste 313
(512) 363-2756
Board Certified Specialties: None
Austin
Gender: Female
NPI: 1992093694
1807 W Slaughter Ln
Ste 450
J(512) 522-7450
Rutkowski, Paul D, LAC
Gender: Male
NPI: 1639385123
# 2111 Dickson Dr
Ste 26
J(512) 899-8996
Clinic Affiliation: Tigerlily Wellness &
Acupuncture
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
" Zheng, Guili, LAC
Gender: Male
NPI: 1558443218
4005 Manchaca Rd
(512) 444-8082
#
Gender: Female
NPI: 1366619934
1518 W Koenig Ln
J(512) 431-5576
Board Certified Specialties: Acupuncture
" Zhou, Ziyang, LAC
#
Zhu, Bindi, LAC
Gender: Male
NPI: 1801062609
# 1008 Mo Pac Cir
Ste 201
J(512) 457-0886
Clinic Affiliation: Acupuncture and Herb
Health Center
Board Certified Specialties: None
" Zou, Ming, LAC
Austin
#
" Wu, Qian Z, LAC
Su, Shiqiang, LAC
Gender: Male
NPI: 1023190725
# 4207 James Casey St
Ste 115
(512) 383-1881
Board Certified Specialties: None
#
Tachibana, Sachiko, LAC
Gender: Female
NPI: 1730401076
# 2312 Western Trails
Blvd Ste 401
J(512) 796-2997
Board Certified Specialties: None
Austin
Austin
" Tan, Lin Y, LAC
Gender: Male
NPI: 1508034505
11651 Jollyville Rd
Ste 150
(512) 331-3866
Clinic Affiliation: Acupuncture Healing Art
Ctr Inc
Board Certified Specialties: Acupuncture
Xu, Chelsea Q, LAC
Gender: Female
NPI: 1972724730
4701 W Gate Blvd
J(512) 693-4373
Clinic Affiliation: Aoma Academy LP
Board Certified Specialties: None
Zachary, William J, LAC
Gender: Male
NPI: 1134278260
# 3203 Larry Ln
J(512) 825-3305
Practice Information: No Patients Under 1
yrs old
Board Certified Specialties: None
Austin
Austin
Gender: Female
NPI: 1194161968
1707 Fortview Rd
(512) 905-5948
Clinic Affiliation: TX Health and Science
University
Board Certified Specialties: Acupuncture
Gender: Male
NPI: 1154516821
711 W 38th St
Ste G3
J(512) 478-7112
Clinic Affiliation: Pine Mtn Chinese Accup
& Herb PC
Board Certified Specialties: Acupuncture
Austin
Austin
Austin
NPI: 1558443218
4029 S Capital of Texas
Hwy Ste 105
(512) 657-8117
Clinic Affiliation: Actual Acupuncture and
Chinese Me, TX Health and Science
University
Board Certified Specialties: Acupuncture
Austin
" Welden, Lisa C, LAC
NPI: 1992093694
4111 Marathon Blvd
Ste 110
J(512) 522-7405
Clinic Affiliation: Body Evolution
Acupuncture & Well
Board Certified Specialties: Acupuncture
Gender: Female
NPI: 1790953792
2700 W Anderson Ln
Ste 512
J(512) 467-0370
Clinic Affiliation: Aoma Academy LP
Board Certified Specialties: Acupuncture
Austin
Austin
Aus tin
Aus tin
#
Austin
" Stang, Jennifer L, LAC
Aus tin
Gender: Female
NPI: 1366683278
6836 Bee Cave Rd
Ste 262
(512) 348-8943
Board Certified Specialties: Acupuncture
Gender: Female
NPI: 1790081735
8700 Manchaca Rd
Ste 505
J(512) 825-4979
Clinic Affiliation: Dragon Acupuncture
Clinic
Board Certified Specialties: Acupuncture
Austin
#
" Zhang, Zhong L, LAC
" Wang, Chiufen, LAC
" Song, Yaoping, LAC
#
Gender: Female
NPI: 1326119686
12335 Hymeadow Dr
Ste 300
J(512) 585-3268
Board Certified Specialties: Acupuncture
Gender: Female
NPI: 1942482005
8711 Burnet Rd
Ste A18 A20
(512) 374-4988
Clinic Affiliation: Honeysuckle Acupuncture
Clinic
Board Certified Specialties: Acupuncture
Austin
Austin
Austin
Aus tin
#
#
" Siu, Yen K, LAC
#
#
" Wada, Masako, LAC
Austin
#
" Zeng, Zheng, LAC
Austin
Austin
Shen, Xiaotian, LAC
Gender: Male
NPI: 1114053675
2700 W Anderson Ln
Ste 512
(512) 467-0370
Clinic Affiliation: Aoma Academy LP
Board Certified Specialties: None
Aus tin
" Qin, Shuangzhu, LAC
Uppena, Megumi T, LAC
Gender: Female
NPI: 1275783987
# 4422 Pack Saddle Pass
Ste 105
J(512) 431-7997
Clinic Affiliation: Bamboo Field
Acupuncture and Herb
Practice Information: No Patients Under 1
yrs old
Board Certified Specialties: None
Gender: Female
NPI: 1497960322
5828 Balcones Dr Ste 205
(512) 743-6321
Board Certified Specialties: Acupuncture
Austin
Gender: Female
NPI: 1902150808
2700 W Anderson Ln
Ste 512
J(512) 467-0370
Clinic Affiliation: Aoma Academy LP
Board Certified Specialties: Acupuncture
Austin
" Schnyer, Rosa N, LAC
Pan, Zimei, LAC
Gender: Female
NPI: 1801077748
# 10601 Pecan Park Blvd
J(512) 419-7355
#
#
Austin
Aus tin
NPI: 1801077748
8303 Shoal Creek Blvd
J(512) 419-7355
Clinic Affiliation: Acupuncture and Chinese
Medical
Board Certified Specialties: None
Austin
Gender: Female
NPI: 1972672459
2911 Medical Arts St
Ste 1B
J(512) 476-3505
Clinic Affiliation: Snow Lily Holistic Health
Clinic
Board Certified Specialties: Acupuncture
ALLERGY-IMMUNOLOGY
Austin
#
Albertson, Gary R, DO
Gender: Male
NPI: 1225063951
3003 Bee Caves Rd
Ste 201
(512) 462-3627
NPI: 1225063951
4303 Victory Dr
(512) 462-3627
Hospital Affiliation: Round Rock Medical
Center, Ward Memorial Hospital
Clinic Affiliation: Victory Medical & Family
Care
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: None
J - Wheelchair Access
60
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Gaglani, Binaca, MD
" Howland III, William C, MD
Aus tin
AUSTIN Cont
ALLERGY-IMMUNOLOGY Cont
" Barstow Jr, Douglas G, MD
Austin
#
Gender: Male
NPI: 1326166273
3410 Far West Blvd
Ste 146
J(512) 349-0777
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids S Austin
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Allergy & Asthma Asso
Ciatespllc
Board Certified Specialties:
Allergy-Immunology
" Gutierrez, Maria G, MD
Gender: Female
NPI: 1679678213
720 W 34th St
Ste 200
J(512) 454-5821
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, St Davids S
Austin Medical Center
Clinic Affiliation: Gutierrez Maria G MD
Board Certified Specialties:
Allergy-Immunology
" Cook, Robert D, MD
#
Gender: Male
NPI: 1962404699
11770 Jollyville Rd
(512) 732-2774
" Dice, John P, MD
Gender: Male
NPI: 1437140506
720 W 34th St
Ste 200
(512) 454-5821
Hospital Affiliation: Baptist Health System,
Seton Medical Center, Southwest General
Hospital
Clinic Affiliation: John P Dice MD
Board Certified Specialties:
Allergy-Immunology
" Dyer, Philip D, MD
Austin
#
Gender: Male
NPI: 1205050267
3303 Northland Dr Ste 301
J(512) 458-9191
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Allergy Assoc
Board Certified Specialties:
Allergy-Immunology
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Male
NPI: 1760420582
11623 Angus Rd Ste 11
J(512) 338-1366
NPI: 1225035363
1927 Lohmans Crossing
Rd Ste 200
(512) 610-3110
Hospital Affiliation: Conroe Regional
Medical Center, Houston Northwest Medical
Center, Mem Hermann The Woodlands
Hosp, North Austin Medical Center, Seton
Medical Center, St Lukes The Woodlands
Hospital, Tomball Regional Hospital
Clinic Affiliation: Hill Country Allergy &
Asthma
Board Certified Specialties:
Allergy-Immunology
Gender: Male
NPI: 1497767420
3410 Far West Blvd
Ste 146
J(512) 349-0777
Hospital Affiliation: Scott & White Hlthcare
Round Rock
Clinic Affiliation: Allergy & Asthma Asso
Ciatespllc
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties:
Allergy-Immunology
" Miller, Brian T, DO
Austin
#
" Legere III, Henry J, MD
Austin
Gender: Male
NPI: 1669464723
11770 Jollyville Rd
J(512) 732-2774
NPI: 1669464723
5656 Bee Caves Rd
Ste G201
J(512) 732-2774
" Henry, Anthony R, MD
Gender: Male
NPI: 1245232487
6600 S Mo Pac Expwy
Ste 2180
J(512) 892-3336
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Center, Seton Medical
Ctr Williamson, St Davids Georgetown
Hospital
Clinic Affiliation: Allergy and Asthma of
Central Texas
Board Certified Specialties:
Allergy-Immunology
" Navarro, Maritza, MD
Gender: Female
NPI: 1346212180
11714 Wilson Parke Ave
Ste 150
(512) 272-4636
" Hollander, Seth M, MD
Aus tin
Gender: Male
NPI: 1255451886
11770 Jollyvile Rd
(512) 732-2774
NPI: 1255451886
5625 Eiger Rd
Ste 200
(512) 892-7076
#
NPI: 1669464723
6611 Riverplace Blvd
Ste 305
J(512) 732-2774
NPI: 1669464723
7900 FM 1826
Ste 1-260
J(512) 732-2774
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Medical Ctr Williamson, Seton Northwest
Hospital, St Davids Medical Center, The
Hosp At Westlake Med Ctr, University Med
Ctr Brackenridge
Clinic Affiliation: Henry Joseph Legere III
MD, Total Mens Physicians Group LLC
Board Certified Specialties:
Allergy-Immunology
Lieberman, Allen K, MD
Gender: Male
NPI: 1922075787
# 10801 N Mo Pac Expwy
Bldg 2 Ste 150
J(512) 345-7635
Hospital Affiliation: St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Allergy & Asthma Center
of Austin
Board Certified Specialties: None
NPI: 1255451886
7900 FM 1826
Bldg 1 Ste 260
J(512) 732-2774
" Otto, William, MD
Gender: Male
NPI: 1912913278
6811 Austin Center Blvd
Ste 300
J(512) 346-8888
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties:
Allergy-Immunology
" Reddy, Uday K, MD
Austin
#
Austin
NPI: 1255451886
7900 FM 1826
Ste 1-260
(512) 732-2774
Hospital Affiliation: Seton Medical Center,
The Hosp At Westlake Med Ctr
Clinic Affiliation: Seth M Hollander MD,
South Austin Family Practiceclinic LLP
Board Certified Specialties:
Allergy-Immunology
NPI: 1346212180
12414 Alderbrook Dr
Ste 201
J(512) 873-7468
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, St Davids Medical Center
Clinic Affiliation: Austin Regional Clinic PA,
Maritza Navarro MD
Board Certified Specialties:
Allergy-Immunology
Austin
Austin
NPI: 1255451886
6611 Riverplace Blvd
Ste 305
(512) 732-2774
Gender: Male
NPI: 1790882108
6600 S Mo Pac Expwy
Ste 2180
J(512) 892-3336
Hospital Affiliation: Metroplex Hospital,
Round Rock Medical Center
Clinic Affiliation: Allergy and Asthma of
Central Texas
Board Certified Specialties:
Allergy-Immunology
Austin
NPI: 1669464723
12717 Shops Pkwy
Ste 500
(512) 222-8667
Aus tin
NPI: 1962404699
7900 FM 1826
Ste 1-260
(512) 732-2774
Hospital Affiliation: Little River Healthcare,
Scott & White Hlthcare Round Rock, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, The Hosp At
Westlake Med Ctr
Clinic Affiliation: Ronald L Cox MD Inc
Board Certified Specialties:
Allergy-Immunology
Austin
#
NPI: 1760420582
4207 James Casey St
Ste 306
J(512) 338-1366
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Board Certified Specialties:
Allergy-Immunology
" Cox, Ronald L, MD
Gender: Male
NPI: 1225035363
10815 RR 2222
Bldg 3A Ste 202
(512) 610-3110
" Leath, Thomas M, MD
" Harden, Roger A, MD
#
" Mery, Amin G, MD
Austin
Gender: Male
NPI: 1770550535
10801 N Mo Pac Expwy
Ste 150 Bldg 2
J(512) 345-7635
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Allergy & Asthma Center
of Austin
Practice Information: No Patients Under 4
yrs old
Board Certified Specialties:
Allergy-Immunology
Austin
Aus tin
Austin
NPI: 1962404699
6611 Riverplace Blvd
Ste 305
(512) 732-2774
#
Aus tin
Austin
Gender: Male
NPI: 1407813645
4150 N Lamar
J(512) 467-0978
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Heart Hospital Of Austin, North
Austin Medical Center, Seton Medical
Center, Seton Northwest Hospital, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Central Texas Allergy &
Asthma Center
Board Certified Specialties:
Allergy-Immunology
Austin
Gender: Female
NPI: 1831194240
2312 Western Trails Blvd
Ste A101
J(512) 804-0000
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center
Clinic Affiliation: Binaca Gaglani MD
Board Certified Specialties:
Allergy-Immunology
Gender: Male
NPI: 1730185711
6600 S Mo Pac Expwy
Ste 2180
J(512) 892-3336
Hospital Affiliation: Houston Methodist
Hospital, Round Rock Medical Center, Seton
Southwest, St Davids S Austin Medical
Center, Texas Childrens Hospital
Clinic Affiliation: Allergy and Asthma of
Central Texas
Board Certified Specialties:
Allergy-Immunology
Reshamwala, Neha, MD
Gender: Female
NPI: 1780874578
11770 Jollyville Rd
(512) 732-2774
NPI: 1780874578
6611 Riverplace Blvd
Ste 305
(512) 732-2774
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Neha Reshamwala MD
Board Certified Specialties: None
J - Wheelchair Access
61
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Austin
AUSTIN Cont
ALLERGY-IMMUNOLOGY Cont
" Rodriguez Ramos, Juan L, MD
Aus tin
Gender: Male
NPI: 1891801528
3816 S First St
(512) 443-1311
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties:
Allergy-Immunology
Aus tin
Schultz, Eric D, DO
Gender: Male
NPI: 1578774980
5625 Eiger Rd
Ste 200
(512) 892-7076
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Medical Ctr Williamson, The Hosp At
Westlake Med Ctr, University Med Ctr
Brackenridge
Clinic Affiliation: South Austin Family
Practiceclinic LLP
Board Certified Specialties: None
Austin
Austin
Austin
" Smith, Thomas F, MD
Aus tin
Gender: Male
NPI: 1346207917
11770 Jollyville Rd
J(512) 732-2774
NPI: 1346207917
7900 FM 1826
Ste 1-260
J(512) 732-2774
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Greater Austin Allergy
Asthma and
Board Certified Specialties:
Allergy-Immunology
#
Gender: Female
NPI: 1528311297
2559 Western Trails
Blvd Ste 200
(512) 899-2028
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Allen, Thresia J, APN
Gender: Female
NPI: 1245422203
6811 Austin Center Blvd
(512) 346-8888
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Bane, Ginger R, APN
Gender: Female
NPI: 1801076948
1221 W Ben White Blvd
Ste B100 300
J(877) 800-5722
" Calais, Laura, APN
Austin
Gender: Female
NPI: 1952618704
1301 W 38th St
Ste 705
(512) 791-1224
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Austin
Gender: Female
NPI: 1144652751
7610 W Hwy 71
Ste F
(512) 288-0859
Clinic Affiliation: National House Call
Practitioners
Board Certified Specialties: Anp/Cert/Clnp
Austin
" Booth, Heidi, APN
Austin
Gender: Female
NPI: 1144512070
408 W 45th St
(512) 451-5800
Clinic Affiliation: Austin Kidney Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Austin
Austin
NPI: 1245241066
3706 S First St
(512) 324-4930
Clinic Affiliation: Seton Community Health
Centers
Board Certified Specialties: None
Austin
Gender: Female
NPI: 1013102599
1600 W 38th St
Ste 308
(512) 324-3540
Clinic Affiliation: Seton Brain and Spine
Institute
Board Certified Specialties: Anp/Cert/Clnp
" Bonsall, Diane P, APN
Barry, Shanna B, APN
Gender: Female
NPI: 1245241066
# 2811 E Second St
(512) 324-4930
" Adams, Rhonda, APN
" Butrum, Kimberly C, APN
Austin
#
Borgstrand, Stephanie M, APN
Gender: Female
NPI: 1659529931
2200 Park Bend Dr
Ste 201 Bldg 1
J(512) 416-7246
Clinic Affiliation: Austin Pain Assoc
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Borich, Karen L, APN
Gender: Female
NPI: 1154651636
1807 Slaughter Ln Ste 490
(512) 282-8967
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
" Burg, Brianna L, APN
Austin
Gender: Female
NPI: 1629203476
1301 Barbara Jordan
Blvd Ste 4
J(512) 708-1234
Clinic Affiliation: Austin Pediatric Surgery
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Bayliss, Lawrence S, APN
Gender: Male
NPI: 1316164163
928 Blackson Ave
(512) 978-9740
Clinic Affiliation: Communitycare
Board Certified Specialties: None
Cardenas, Jo Ann, APN
Gender: Female
NPI: 1518997121
7610 W Hwy 71
Ste F
(512) 288-0859
Clinic Affiliation: National House Call
Practitioners
Board Certified Specialties: None
" Carper, Elise, APN
Gender: Female
NPI: 1699835009
4544 S Lamar
Ste 700
J(512) 834-4141
Clinic Affiliation: Balcones Pain
Consultants
Board Certified Specialties: Anp/Cert/Clnp
Austin
Carr, Amy J, APN
Gender: Female
NPI: 1720293012
7610 W Hwy 71
Ste F
(512) 288-0859
Clinic Affiliation: National House Call
Practitioners
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
" Casey, Karen E, APN
Austin
Gender: Female
NPI: 1609877042
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
" Brown, Rebecca E, APN
Gender: Female
NPI: 1154619344
13435 N US Hwy 183
Ste 302
(512) 250-5300
Clinic Affiliation: Ageless Mens Health
Holding Inc
Board Certified Specialties: Anp/Cert/Clnp
Calloway, Susan K, APN
Gender: Female
NPI: 1043236383
6835 Austin Center Blvd
(512) 346-6611
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Austin
Austin
Batista, Edwin A, APN
Gender: Male
NPI: 1871788018
1301 Barbara Jordan Blvd
Ste 400
(512) 708-1234
Clinic Affiliation: Austin Pediatric Surgery
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Burr, Lisa L, APN
Gender: Female
NPI: 1962413716
3706 S First St
J(512) 324-4930
Clinic Affiliation: Seton Community Health
Centers
Board Certified Specialties: None
Austin
" Bollock, Heidi A, APN
Austin
Austin
Austin
Austin
Gender: Male
NPI: 1558601211
7610 Hwy 71 W Ste F
(512) 288-0859
Clinic Affiliation: National House Call
Practitioners
Board Certified Specialties: Anp/Cert/Clnp
Aus tin
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Allegretti, Christina M, APN
Gender: Female
NPI: 1992901961
1301 Barbara Jordan Blvd
Ste 401
J(512) 628-1900
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
" Banks, Christopher, APN
ANP/CERT/CLNP
Gender: Female
NPI: 1336321876
7610 Hwy 71 W
Ste F
(515) 288-0859
Clinic Affiliation: National House Call
Practitioners
Board Certified Specialties: Anp/Cert/Clnp
Gender: Female
NPI: 1619201134
5508 Parkcrest Dr
Ste 310
J(512) 420-9900
Clinic Affiliation: Sleep Medicine
Consultants, Sleep Medicine Consultants of
Cen
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Austin
" Vaughan, Thurman R, MD
Gender: Male
NPI: 1083838015
3303 Northland Dr
Ste 301
J(512) 458-9191
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Austin Allergy Assoc
Board Certified Specialties:
Allergy-Immunology
" Blakley, Karen H, APN
NPI: 1801076948
2802 Webberville Rd
(512) 978-9500
Clinic Affiliation: Communitycare, Lone
Star Circle of Care
Board Certified Specialties: None
Aus tin
Blackburn, Mary Z, APN
Gender: Female
NPI: 1699930628
6811 Austin Ctr Blvd
Ste 300
(512) 346-8888
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Austin
Alexander, Christopher H, APN
Gender: Male
NPI: 1013149954
! 3801 N Lamar Blvd
(512) 447-2211
Clinic Affiliation: Capitol Emergency Assoc
PA
Board Certified Specialties: None
" Scibielski, Paul, MD
NPI: 1346207917
6611 Riverplace Blvd
Ste 305
J(512) 732-2774
Austin
Austin
Aus tin
Gender: Male
NPI: 1609070291
11770 Jollyville Rd
(512) 732-2774
Hospital Affiliation: Christus Spohn
Hospital-South, Coryell Memorial Hospital,
Hillcrest Baptist Medical Center
Clinic Affiliation: Paul Scibielski MD
Board Certified Specialties:
Allergy-Immunology
Albert, Suzanne S, APN
Gender: Female
NPI: 1104994607
3705 Medical Pkwy
Ste 540
J(512) 452-8888
Clinic Affiliation: Balcones Obstetrics and
Gynecolog
Board Certified Specialties: None
Austin
Casey, Sarah B, APN
Gender: Female
NPI: 1780960401
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1820
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
J - Wheelchair Access
62
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Aus tin
AUSTIN Cont
ANP/CERT/CLNP Cont
" Chapman, Allison W, APN
Austin
Gender: Female
NPI: 1316218423
4007 James Casey
Ste B200
J(512) 441-9799
Clinic Affiliation: Austin Pulmonary
Consultants PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Austin
Austin
Chedville, Judith J, APN
Gender: Female
NPI: 1336497650
10401 Anderson Mill Rd
Ste 110-B
(512) 250-5571
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Cheung Gan, Meng Lan, APN
Gender: Female
NPI: 1366686362
800 W Fifth St
Apt 201
J(901) 261-4848
Clinic Affiliation: Texas Phs Professional
Assoc
Board Certified Specialties: None
Clifton, Truett B, APN
Gender: Male
NPI: 1902027386
11111 Research Blvd
Ste 310
J(512) 828-3300
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: None
" Coffey, Michelle, APN
Gender: Female
NPI: 1023392461
11211 Taylor Draper Ln
Ste 202
(512) 477-4088
Clinic Affiliation: Russell Peggy M DO
Practice Information: No patients under 50
years old
Board Certified Specialties: Anp/Cert/Clnp
" Concepcion, Shane C, APN
Gender: Female
NPI: 1962510248
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Aus tin
#
Austin
Dach, Brandi M, APN
Gender: Female
NPI: 1417162025
1301 Barbara Jordan Blvd
Ste 401
J(512) 628-1900
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Austin
#
Gender: Female
NPI: 1366771321
1211 Taylor Draper Ln
Ste 202
(512) 477-4088
Clinic Affiliation: Austin Geriatric Spec
Practice Information: No patients under 50
years old
Board Certified Specialties: Anp/Cert/Clnp
#
Donaghey, Heather D, APN
Gender: Female
NPI: 1871896258
1301 Barbara Jordan Blvd
Ste 401
J(512) 628-1900
Clinic Affiliation: Specially For Children
Board Certified Specialties: None
Ebo, Paula Y, APN
Gender: Female
NPI: 1831489947
7610 W Hwy 71
Ste F
(512) 288-0859
Clinic Affiliation: National House Call
Practitioners
Board Certified Specialties: None
Gender: Female
NPI: 1992077127
11111 Research Blvd
Ste 310
(877) 800-5722
Gender: Female
NPI: 1356423842
5301 Duval Rd
Ste A500
(512) 222-0000
Clinic Affiliation: Austin Adult Primary Care
Board Certified Specialties: Anp/Cert/Clnp
Austin
" Dayal, Melani I, APN
Aus tin
Farley, Jennifer G, APN
Gender: Female
NPI: 1427331842
1301 Barbara Jordan
Blvd Ste 307
J(512) 324-0907
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Pediatric Surgical
Subspecialists
Board Certified Specialties: None
" Fauth, Jaime, APN
Austin
Gender: Female
NPI: 1396098455
2200 Park Bend Dr
Bldg 1 Ste 201
J(512) 416-7246
Clinic Affiliation: Austin Pain Assoc
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Flesher, Shannon J, APN
Gender: Female
NPI: 1174802169
12319 N Mopac Expwy
Ste 200
J(512) 973-8276
Clinic Affiliation: Austin Urology Institue PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Frank, Jill R, APN
Gender: Female
NPI: 1982905758
# 2811 E Second St
(512) 324-4930
Clinic Affiliation: Seton Community Health
Centers
Board Certified Specialties: None
" Gann, Amy J, APN
Austin
Gender: Female
NPI: 1730380700
1301 Barbara Jordan
Blvd Ste 400
J(512) 708-1234
Clinic Affiliation: Austin Pediatric Surgery
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
" Garcia, Cordelia A, APN
Austin
Gender: Female
NPI: 1831523158
1301 Barbara Jordan Blvd
Ste 200
(512) 628-1830
Clinic Affiliation: Specially For Children
Board Certified Specialties: Anp/Cert/Clnp
Austin
Austin
" Fagner, Karin S, APN
NPI: 1992077127
1313 Red River
Ste 320
(512) 978-8870
Clinic Affiliation: Communitycare, Lone
Star Circle of Care
Board Certified Specialties: Anp/Cert/Clnp
Gender: Female
NPI: 1659687416
4007 James Casey St
Ste B200
J(512) 441-9799
Clinic Affiliation: Austin Pulmonary
Consultants PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Gender: Female
NPI: 1417231069
1600 W 38th St
Ste 420
(512) 261-4800
Clinic Affiliation: Innovative Infusions LLC
Board Certified Specialties: Anp/Cert/Clnp
Fisher, Latronica T, APN
Gender: Female
NPI: 1821190539
7610 W Hwy 71
Ste F
(512) 288-0859
Clinic Affiliation: National House Call
Practitioners
Board Certified Specialties: None
Austin
Austin
" Davenport, Abigail B, APN
" Croce, Emily A, APN
NPI: 1285756734
2909 N IH 35
J(512) 478-4939
Clinic Affiliation: Peoples Community Clinic
Inc
Board Certified Specialties: None
Austin
" Eichler, Edna E, APN
Aus tin
Austin
Austin
Austin
" Daniel, Melinda G, APN
Aus tin
Gender: Female
NPI: 1982943015
4100 Duval Rd Bldg 3
Ste 200
J(512) 485-7200
Clinic Affiliation: Central Texas Pain
Institute PA
Board Certified Specialties: Anp/Cert/Clnp
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Cruz, Victoria L, APN
Gender: Female
NPI: 1174715775
3755 S Capital of Texas
Hwy Ste 160
J(512) 439-1105
Divin-Cosgrove, Christine A, APN
Gender: Female
NPI: 1285756734
# 1515 Grove Blvd
J(512) 267-7233
Austin
NPI: 1174715775
4700 Seton Center Pkwy
Ste 200
J(512) 439-1000
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: None
Austin
Gender: Female
NPI: 1871792317
1301 Barbara Jordan Blvd
Ste 200
(512) 628-1920
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Gender: Female
NPI: 1316957582
1600 W 38th St
Ste 304
(512) 324-3540
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: Seton Brain and Spine
Institute
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Anp/Cert/Clnp
" Cross Anuar, Carissa A, APN
Austin
#
" Dietz, Maryetta, APN
Aus tin
Aus tin
Diaz, Oralia, APN
Gender: Female
NPI: 1205122892
3307 Northland Dr
Ste 300
J(866) 872-8060
Clinic Affiliation: Mbs Integrated Care
Board Certified Specialties: None
Austin
Cross, Holly S, APN
Gender: Female
NPI: 1811292212
! 601 E 15th St
(972) 791-1224
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: None
" Clendennen, Kristi R, APN
Austin
Austin
Aus tin
Austin
Gender: Female
NPI: 1811170269
7610 W Hwy 71
Ste F
(512) 288-0859
Clinic Affiliation: National House Call
Practitioners
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Cross, Elizabeth M, APN
Gender: Female
NPI: 1215217906
1301 Barbara Jordan
Blvd Ste 200
(512) 628-1850
Clinic Affiliation: Pediatric Surgical
Subspecialists
Board Certified Specialties: None
Garrison, Rachel D, APN
Gender: Female
NPI: 1710284849
7610 W Hwy 71
Ste F
(512) 288-0859
Clinic Affiliation: National House Call
Practitioners
Board Certified Specialties: None
Geller, Barbara L, APN
Gender: Female
NPI: 1235395344
1010 W 40th St
(512) 459-8753
Clinic Affiliation: Cardiothoracic and
Vascular Surge
Board Certified Specialties: None
" Gilluly, Debra T, APN
Austin
Gender: Female
NPI: 1972935195
408 W 45th St
(512) 451-5800
Clinic Affiliation: Austin Kidney Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
" Goldshtrom, Sarah B, APN
Austin
Gender: Female
NPI: 1730414673
1301 Barbara Jordan Blvd
Ste 400
(512) 708-1234
Clinic Affiliation: Austin Pediatric Surgery
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
J - Wheelchair Access
63
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Hodgkiss, Christina M, APN
Austin
AUSTIN Cont
ANP/CERT/CLNP Cont
" Granger, Sarah N, APN
Aus tin
Gender: Female
NPI: 1023388725
711 F W 38th St
J(512) 458-6121
Clinic Affiliation: Austin Neurological Clinic
Board Certified Specialties: Anp/Cert/Clnp
Aus tin
Austin
Grimes, Darla A, APN
Gender: Female
NPI: 1164737961
1807 Slaughter Ln
Ste 490
(512) 282-8967
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Guerra, Maria, APN
Gender: Female
NPI: 1417235623
# 2811 E Second St
(512) 324-4930
Aus tin
Austin
Hamilton, Maura, APN
Gender: Female
NPI: 1396932893
1301 Barbara Jordan
Blvd Ste 307
J(512) 324-0907
Clinic Affiliation: Pediatric Surgical
Subspecialists
Board Certified Specialties: None
Hamilton, Stacey D, APN
Gender: Female
NPI: 1801810767
# 11211 Taylor Draper Ln
Ste 202
(512) 477-4088
Clinic Affiliation: Russell Peggy M DO
Practice Information: No patients under 50
years old
Board Certified Specialties: None
Aus tin
Haydon, Sybil M, APN
Gender: Female
NPI: 1023023181
! 3828 S First St
(512) 443-1311
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Austin
Aus tin
Aus tin
Aus tin
Hemmen, Margaret L, APN
Gender: Female
NPI: 1285909739
6835 Austin Center
Blvd
(512) 346-6611
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Hicks, Linda A, APN
NPI: 1871549956
1210 W Braker Ln
(512) 978-9300
NPI: 1871549956
2901 N IH 35
Ste 101
(512) 232-3900
Clinic Affiliation: Communitycare
Board Certified Specialties: None
Aus tin
Higginbotham, Nicole H, APN
Gender: Female
NPI: 1902828759
1301 Barbara Jordan
Blvd Ste 307
J(512) 324-0907
Clinic Affiliation: Pediatric Surgical
Subspecialists
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Austin
Holub, Kate L, APN
Gender: Female
NPI: 1366698995
4007 James Casey St
(512) 451-5800
Austin
Jordan, Annaliese M, APN
Gender: Female
NPI: 1760674246
1301 W 38th St
Ste 514
J(512) 791-1224
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
Austin
Austin
" Kacerguis, Teresa A, APN
Gender: Female
NPI: 1043575806
3000 N IH 35
Ste 635
(512) 451-5800
Clinic Affiliation: Austin Kidney Assoc PA
Board Certified Specialties: Anp/Cert/Clnp
" Keefe, Marcy L, APN
Austin
#
Hull, Thomas N, APN
Gender: Male
NPI: 1881634897
3828 S First
(512) 443-1311
Gender: Female
NPI: 1245230234
408 W 23rd St Ste 300
J(512) 735-2300
Clinic Affiliation: Peoples Community Clinic
Inc
Board Certified Specialties: Anp/Cert/Clnp
Gender: Female
NPI: 1326134024
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1830
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Hurt, Lori L, APN
Gender: Female
NPI: 1679848394
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1810
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
" Kreifels, Erika L, APN
Gender: Female
NPI: 1104152057
1301 Barbara Jordan Blvd
Ste 400
J(512) 708-1234
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Austin Pediatric Surgery
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Austin
" Kelner, Margaret M, APN
Austin
" Hurtado, Cheryl L, APN
Gender: Female
NPI: 1790786044
3801 N Lamar Blvd 300
J(512) 206-3600
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Austin
Jatinen, Ellen B, APN
NPI: 1003821166
1301 W 38th St Ste 205
J(512) 451-0161
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Gender: Female
NPI: 1366786394
1600 W 38th St Ste 420
(512) 261-4800
Clinic Affiliation: Innovative Infusions LLC
Board Certified Specialties: Anp/Cert/Clnp
Kennedy, Christine E, APN
Gender: Female
NPI: 1073883781
1301 Barbara Jordan
Ste 302
J(512) 472-6134
Clinic Affiliation: Pediatric Urology of
Central Texas
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Koneski, Rose M, APN
Gender: Female
NPI: 1275530123
3307 Northland Dr
Ste 300
(866) 872-8060
Clinic Affiliation: Mbs Integrated Care
Board Certified Specialties: None
Austin
Austin
#
Koelker, Gail, APN
Gender: Female
NPI: 1902801756
6801 S IH 35
Ste 1 E
(512) 978-9960
Clinic Affiliation: Communitycare
Board Certified Specialties: None
Kraft, Kathleen L, APN
Gender: Female
NPI: 1447482161
! 3816 S First St
(512) 443-1311
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
" Keeler, Claire, APN
NPI: 1881634897
4614 N IH 35
(512) 978-9100
Clinic Affiliation: Austin Regional Clinic PA,
Communitycare
Board Certified Specialties: None
Kirorei, Seleina, APN
Gender: Female
NPI: 1427390442
7610 Hwy 71 W Ste F
J(512) 288-0859
Clinic Affiliation: National House Call
Practitioners
Board Certified Specialties: None
Austin
Austin
Austin
Austin
Austin
Austin
Hopper, Emily S, APN
Gender: Female
NPI: 1841342078
1301 Barbara Jordan
Blvd Ste 307
(512) 324-0907
Clinic Affiliation: Pediatric Surgical
Subspecialists
Board Certified Specialties: None
#
Kirkland, Stephanie A, APN
Gender: Female
NPI: 1083813661
! 3801 N Lamar Blvd
(512) 476-7111
Clinic Affiliation: Capitol Emergency Assoc
PA
Board Certified Specialties: None
Austin
Austin
NPI: 1366698995
408 W 45th St
(512) 451-5800
Clinic Affiliation: Austin Kidney Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Austin
Johnson, Kimberly R, APN
Gender: Female
NPI: 1689830804
12701 FM 620
(713) 285-1730
Clinic Affiliation: Baylor Internal Medicine
Consultants
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Jones, Anita A, APN
Gender: Female
NPI: 1225210958
# 1515 Grove Blvd
J(512) 267-7233
Clinic Affiliation: Peoples Community Clinic
Inc
Board Certified Specialties: None
Hoffman, Kelly D, APN
Gender: Female
NPI: 1437426327
1301 Barbara Jordan Blvd
Ste 400
J(512) 708-1234
Clinic Affiliation: Austin Pediatric Surgery
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
NPI: 1417235623
3706 S First St
(512) 324-4930
Clinic Affiliation: Seton Community Health
Centers
Board Certified Specialties: None
Aus tin
Austin
Gender: Female
NPI: 1528389558
3801 N Lamar Blvd
Ste 300
(512) 206-3600
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Austin
Kubaney, Holly R, APN
Gender: Female
NPI: 1083679419
1301 Barbara Jordan Blvd
Ste 401
J(512) 628-1900
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Kuehn, Morganna L, APN
Gender: Female
NPI: 1659503969
1301 Barbara Jordan
Blvd Ste 307
J(512) 324-0907
Clinic Affiliation: Pediatric Surgical
Subspecialists
Board Certified Specialties: None
King, Rebecca A, APN
Gender: Female
NPI: 1255648259
3307 Northland Dr
Ste 300
(866) 872-8060
Clinic Affiliation: Mbs Integrated Care
Board Certified Specialties: None
J - Wheelchair Access
64
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Aus tin
AUSTIN Cont
ANP/CERT/CLNP Cont
" Kypke, Patricia J, APN
Austin
!
!
Gender: Female
NPI: 1326088287
12221 N Mopac Expwy
(512) 901-1000
Aus tin
NPI: 1326088287
3801 N Lamar Blvd
(512) 901-1000
NPI: 1326088287
3801 N Lamar Blvd
Ste 300
(512) 206-3600
Malicoat, Deanna, APN
Gender: Female
NPI: 1699944124
3307 Northland Dr
Ste 300
J(866) 872-8060
Clinic Affiliation: Mbs Integrated Care
Board Certified Specialties: None
Austin
Austin
Manakatt, Bushra M, APN
Gender: Female
NPI: 1245661958
800 W Fifth St Ste 201
(877) 260-4747
Clinic Affiliation: Texas Phs Professional
Assoc
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Mann, Mary N, APN
Gender: Female
NPI: 1164446035
# 11211 Taylor Draper Ln
Ste 202
(512) 477-4088
Clinic Affiliation: Russell Peggy M DO
Practice Information: No patients under 50
years old
Board Certified Specialties: None
Austin
Aus tin
!
NPI: 1326088287
919 E 32nd St
(512) 476-7111
Clinic Affiliation: Austin Heart PLLC,
Capitol Emergency Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
" Leitera, James F, APN
Austin
Gender: Male
NPI: 1386939452
4316 James Casey Blvd
Bldg B Ste 200
(512) 498-1029
Clinic Affiliation: Eric J Miller MD
Board Certified Specialties: Anp/Cert/Clnp
Liu, Haiyan, APN
Gender: Female
NPI: 1144481003
# 11211 Taylor Draper Ln
Ste 202
(512) 477-4088
Clinic Affiliation: Austin Geriatric Spec
Board Certified Specialties: None
" Marroquin, Belissa Z, APN
Aus tin
Gender: Female
NPI: 1194819326
3000 N Interstate 35
Ste 700
(512) 807-3180
Clinic Affiliation: Texas Cardiac Arrhythmia
PLLC
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Austin
Austin
Austin
Maa, Matthew, APN
Gender: Male
NPI: 1225463458
1221 W Ben White Blvd
Ste B300
J(877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Practice Information: No Patients Under 5
yrs old
Board Certified Specialties: None
Mabe, Melanie E, APN
Gender: Female
NPI: 1861614513
1301 Barbara Jordan
Blvd Ste 200
(512) 628-1850
NPI: 1861614513
1301 Barbara Jordan Blvd
Ste 200
(512) 628-1850
Clinic Affiliation: Pediatric Surgical
Subspecialists, Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Austin
Maclaurin, Valerie G, APN
Gender: Female
NPI: 1003054735
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1810
Clinic Affiliation: Specially For Children
Board Certified Specialties: None
" Macpherson, Jill N, APN
Austin
Gender: Female
NPI: 1568502078
901 W Ben White Blvd
J(512) 447-2211
Clinic Affiliation: Methodist Physician
Practices PLL
Board Certified Specialties: Anp/Cert/Clnp
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Austin
Aus tin
McCray, Sarah M, APN
Gender: Female
NPI: 1073764494
7112 Ed Bluestein
Blvd Ste 155
(512) 978-9300
Clinic Affiliation: Communitycare
Board Certified Specialties: None
Mellard, Tandy A, APN
Gender: Female
NPI: 1427138833
4900 Mueller Blvd
J(512) 324-0197
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
!
!
Austin
Gender: Female
NPI: 1124014089
800 W Fifth St
Apt 201
(800) 260-4747
Clinic Affiliation: Texas Phs Professional
Assoc
Practice Information: No patients under 50
years old
Board Certified Specialties: Anp/Cert/Clnp
#
Austin
Austin
" Nash, Lorin C, APN
Austin
Gender: Female
NPI: 1922311810
1301 W 38th St
Ste 400
(512) 791-1224
Clinic Affiliation: Seton Family of Doctors
Board Certified Specialties: Anp/Cert/Clnp
" Neal, Erin E, APN
Austin
Gender: Female
NPI: 1083615132
2559 Western Trails Blvd
Ste 100
(512) 899-2028
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Gender: Female
NPI: 1437424306
1600 W 38th St
Ste 420
J(512) 261-4800
Clinic Affiliation: Innovative Infusions LLC
Board Certified Specialties: Anp/Cert/Clnp
Mishra, Amanda L, APN
Gender: Female
NPI: 1497828693
3828 S First St
(512) 443-1311
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Moczygemba, Daryl R, APN
Gender: Male
NPI: 1780730770
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1900
Clinic Affiliation: Specially For Children
Board Certified Specialties: None
Austin
Austin
" Morgan, Nancy S, APN
Austin
" McKeon, Toshia M, APN
Aus tin
Gender: Female
NPI: 1568677052
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1850
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
McMahon, Shannon L, APN
Gender: Female
NPI: 1033532932
1221 W Ben White
Ste B100
(877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: None
Murillo, Miriam E, APN
Gender: Female
NPI: 1588905541
1301 Barbara Jordan Blvd
Ste 200
(512) 628-1850
Clinic Affiliation: Specially For Children
Board Certified Specialties: None
Gender: Female
NPI: 1932304540
3801 N Lamar Blvd
Ste 300
J(512) 206-3601
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
" Miller, Kellie, APN
McGwier, Sarah E, APN
Gender: Female
NPI: 1578994950
1301 Barbara Jordan Blvd
Ste 200
(512) 628-1830
Clinic Affiliation: Specially For Children
Board Certified Specialties: None
NPI: 1710085063
6012 W William Cannon Dr
Ste D102
J(512) 440-5757
Clinic Affiliation: Texas Sleep Medicine
Board Certified Specialties: Anp/Cert/Clnp
" Murphy, Meghan M, APN
Austin
Gender: Female
NPI: 1528371234
1301 Barbara Jordan Blve
Ste 200
(512) 628-1850
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Gender: Female
NPI: 1710085063
1301 W 38th St
Ste 605
J(512) 440-5757
Austin
Meredith, Linda A, APN
NPI: 1093798167
1108 Lavaca St
Ste 110-320
(512) 477-4088
Clinic Affiliation: Russell Peggy M DO
Board Certified Specialties: None
" Michael, Sara C, APN
" McElvain, Dawn K, APN
Aus tin
Medina, Maria S, APN
Gender: Female
NPI: 1346278199
2529 S First St
(512) 978-9500
Clinic Affiliation: Communitycare
Board Certified Specialties: None
" Mulvany, Monique D, APN
Austin
Austin
Aus tin
Aus tin
Meadows, Robin C, APN
NPI: 1528253739
10401 Anderson Mills Rd
Ste 110-B
(512) 250-5571
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Gender: Female
NPI: 1568465581
2501 W William
Cannon Dr Ste 401
J(512) 416-7246
Clinic Affiliation: Austin Pain Assoc
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Norris, Patricia J, APN
Gender: Female
NPI: 1871512483
7610 W Hwy 71
Ste F
(512) 288-0859
Clinic Affiliation: National House Call
Practitioners
Board Certified Specialties: None
Odozynski, Sharon T, APN
Gender: Female
NPI: 1780854000
1301 Barbara Jordan Blvd
Ste 402
(512) 628-1900
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
" Omori, Caroline K, APN
Austin
Gender: Female
NPI: 1699022061
7610 W Hwy 71
Ste F
(512) 288-0859
Clinic Affiliation: National House Call
Practitioners
Board Certified Specialties: Anp/Cert/Clnp
Austin
Oneill, Shannon K, APN
Gender: Female
NPI: 1588960819
2200 Park Bend Dr
Ste 201 Bldg 1
J(512) 416-7246
Clinic Affiliation: Austin Pain Assoc
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
J - Wheelchair Access
65
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Phillips, Suzanne N, APN
Austin
AUSTIN Cont
ANP/CERT/CLNP Cont
" Papermaster, Amy E, APN
Aus tin
Gender: Female
NPI: 1417200429
911 W 38th St
Ste 202
J(512) 324-9650
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Anp/Cert/Clnp
Paskiewicz, Kate, APN
Gender: Female
NPI: 1194155689
! 5339 IH 35 N
(877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties: None
Gender: Female
NPI: 1225030489
1301 Barbara Jordan Ste 302
J(512) 472-6134
Clinic Affiliation: Pediatric Urology of
Central Texas
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Austin
" Pena, Angela M, APN
Perez, Suzanne B, APN
Gender: Female
NPI: 1780904862
1034 Liberty Park Dr
(512) 452-2100
Clinic Affiliation: Chudleigh PA
Board Certified Specialties: None
Austin
Austin
" Perkins, Ryleigh R, APN
Aus tin
Gender: Female
NPI: 1861783946
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1850
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Aus tin
Peschon, Shana S, APN
Gender: Female
NPI: 1093903270
7610 W Hwy 71
Ste F
J(512) 288-0859
Clinic Affiliation: National House Call
Practitioners
Practice Information: No Patients Under 1
yrs old
Board Certified Specialties: None
Peterson, Dawn E, APN
Gender: Female
NPI: 1235570888
3307 Northland Dr
(512) 323-1633
NPI: 1235570888
3307 Northland Dr
Ste 300
(866) 872-8060
Clinic Affiliation: Mbs Integrated Care
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Retz, Polly A, APN
Gender: Female
NPI: 1023130911
6835 Austin Center Blvd
J(512) 346-6611
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Gender: Female
NPI: 1629093067
1301 W 38th St Ste 400
J(512) 324-3440
Clinic Affiliation: Seton Brain and Spine
Institute
Board Certified Specialties: Anp/Cert/Clnp
" Solnek, Barbara L, APN
Austin
Gender: Female
NPI: 1699706481
3801 N Lamar Blvd
Ste 300
(512) 206-3600
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
" Sondgeroth, Jordan M, APN
Austin
Gender: Female
NPI: 1417211970
1108 Lavaca St
Ste 110-320
(512) 482-0390
" Samoson, Deborah A, APN
Austin
Gender: Female
NPI: 1801804430
408 W 45th St
(512) 451-5800
Clinic Affiliation: Austin Kidney Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Richards, Roberta J, APN
Gender: Female
NPI: 1891796967
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
NPI: 1417211970
11211 Taylor Draper Ln
Ste 202
(512) 477-4088
Clinic Affiliation: Russell Peggy M DO
Board Certified Specialties: Anp/Cert/Clnp
" Saulsgiver, Lindsay T, APN
Austin
Gender: Female
NPI: 1184055410
11851 Jollyville Rd
Ste 202
(512) 249-5583
Clinic Affiliation: Physical Medicne and
Neurotoxin
Board Certified Specialties: Anp/Cert/Clnp
Ringer, Patricia R, APN
Gender: Female
NPI: 1821247990
2200 Park Bend Dr
Bldg 1 Ste 201
(512) 416-7246
Clinic Affiliation: Austin Pain Assoc
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Austin
" Rodriguez, Ruth M, APN
Gender: Female
NPI: 1417210840
4007 James Casey St
Ste A230
(512) 451-5800
Schindler Wooley, Beverly A, APN
Gender: Female
NPI: 1518291137
3307 Northland Dr
Ste 300
(866) 872-8060
Clinic Affiliation: Mbs Integrated Care
Board Certified Specialties: None
" Seoanes, Esther M, APN
Austin
#
NPI: 1417210840
408 W 45th St
(512) 451-5800
Clinic Affiliation: Austin Kidney Assoc PA,
Central Texas Kidney Assoc PA
Board Certified Specialties: Anp/Cert/Clnp
Gender: Female
NPI: 1730498213
1600 W 38th St
Ste 420
J(512) 261-4800
Clinic Affiliation: Innovative Infusions LLC
Board Certified Specialties: Anp/Cert/Clnp
Austin
#
Gender: Female
NPI: 1073806287
1301 Barbara Jordan
Blvd Ste 4
(512) 708-1234
Clinic Affiliation: Austin Pediatric Surgery
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Gender: Female
NPI: 1144452129
3801 N Lamar Blvd
Ste 300
J(512) 458-1006
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Austin
" Rohlich, Elizabeth M, APN
Austin
Gender: Female
NPI: 1942531348
1313 Red River
Ste 200
(512) 391-1751
Sharp, Kendall L, APN
Gender: Female
NPI: 1952639650
7020 Easy Wind Dr
Ste 130 Bldg V
J(512) 628-1898
Clinic Affiliation: Specially For Children
Board Certified Specialties: None
" Shirley, Kathryn R, APN
Austin
Gender: Female
NPI: 1639500465
11111 Research Blvd
Ste 450
(512) 505-5500
NPI: 1942531348
1313 Red River St Ste 200
(512) 391-1751
Clinic Affiliation: Austin Skeletal Trauma
Specialists, Institute of Reconstructive Plast
Board Certified Specialties: Anp/Cert/Clnp
NPI: 1639500465
12221 N Mopac Expwy
(512) 505-5500
Clinic Affiliation: Austin Cancer Centers
Georgetown
Board Certified Specialties: Anp/Cert/Clnp
NPI: 1992716724
8913 Collinfield Dr
(512) 324-5801
Clinic Affiliation: Seton Community Health
Centers
Board Certified Specialties: None
" Stegic, Jasenka, APN
#
Austin
" Seris, Laura A, APN
" Roesler, Emlyn P, APN
Steffano, Catherine E, APN
Gender: Female
NPI: 1992716724
2811 E Second St
(512) 324-4930
Austin
Austin
Austin
" Peters, Josephine C, APN
Aus tin
Rush, Barbara S, APN
Gender: Female
NPI: 1154661239
! 901 W Ben White Blvd
(512) 447-2211
Clinic Affiliation: Methodist Physician
Practices PLL
Board Certified Specialties: None
" Smith, Marcy L, APN
Austin
Austin
Austin
Aus tin
Gender: Female
NPI: 1861835613
7610 Hwy 71 W
Ste F
J(512) 288-0859
Clinic Affiliation: National House Call
Practitioners
Board Certified Specialties: Anp/Cert/Clnp
NPI: 1174577126
7112 Ed Bluestein
Blvd Ste 155
(512) 978-9300
Clinic Affiliation: Communitycare
Board Certified Specialties: None
" Ramos-Hodge, Amanda, APN
Aus tin
Aus tin
Rohlich, Gloria A, APN
Gender: Female
NPI: 1174577126
1210 W Braker Ln
(512) 978-9300
Austin
Aus tin
Gender: Female
NPI: 1528309739
11111 Research Blvd
Ste 450
(512) 343-2103
Clinic Affiliation: Austin Cancer Centers
Georgetown
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Austin
Gender: Female
NPI: 1245532084
3307 Northland Dr
J(512) 323-1633
Clinic Affiliation: Mbs Integrated Care
Board Certified Specialties: Anp/Cert/Clnp
Gender: Female
NPI: 1932346434
1600 W 38th St
Ste 420
(512) 261-4800
Clinic Affiliation: Innovative Infusions LLC
Board Certified Specialties: Anp/Cert/Clnp
Stellitano, Emily H, APN
Gender: Female
NPI: 1245679893
14101 Hwy 290 W
Ste 200A
J(512) 301-6400
Clinic Affiliation: Lewis Family Medicine
Board Certified Specialties: None
" Stiriss, Sarah S, APN
Austin
Gender: Female
NPI: 1467756940
12319 N Mopac Expwy
Ste 200 Bldg C
J(512) 973-8276
Clinic Affiliation: Austin Urogynecology
PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Austin
Strother, Sara J, APN
Gender: Female
NPI: 1154634970
711 W 38th St
Ste F3
J(512) 416-7246
Clinic Affiliation: Austin Pain Assoc
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
J - Wheelchair Access
66
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Vanderveen, Kristen K, APN
Aus tin
AUSTIN Cont
ANP/CERT/CLNP Cont
#
" Sullivan, Jennifer N, APN
Austin
Gender: Female
NPI: 1992130272
1301 Barbara Jordan Blvd
Ste 200
(512) 628-1850
Clinic Affiliation: Specially For Children
Board Certified Specialties: Anp/Cert/Clnp
Austin
Austin
Austin
Austin
Thomas, Jenilea K, APN
Gender: Female
NPI: 1811122526
1301 Barbara Jordan
Blvd Ste 307
J(512) 324-0907
Hospital Affiliation: Texas Childrens
Hospital
Clinic Affiliation: Pediatric Surgical
Subspecialists
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Thomas, Valerie B, APN
Gender: Female
NPI: 1093713505
1301 W 38th St
Ste 400
(512) 791-1224
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Thompson, Emily C, APN
Gender: Female
NPI: 1689015216
1301 Barbara Jordan Blvd
Ste 200
(512) 628-1850
Clinic Affiliation: Specially For Children
Board Certified Specialties: None
Turner, Jacki L, APN
Gender: Female
NPI: 1700897550
2811 E Second St
(512) 324-4930
" Watkins, April, APN
Vadakkan, Litty R, APN
Gender: Female
NPI: 1477807774
5301 Duval Rd
Ste A500
J(512) 222-0000
Clinic Affiliation: Austin Adult Primary Care
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Female
NPI: 1720422504
1301 Barbara Jordan Blvd
Ste 200
(512) 628-1830
Clinic Affiliation: Specially For Children
Board Certified Specialties: Anp/Cert/Clnp
Austin
Aus tin
Gender: Female
NPI: 1659689941
1301 W 38th St
Ste 400
(512) 324-3440
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Weaver, Vanessa R, APN
Gender: Female
NPI: 1194005173
7610 Hwy 71 W
Ste F
J(512) 288-0859
Clinic Affiliation: National House Call
Practitioners
Board Certified Specialties: None
Wynn, Sara S, APN
Gender: Female
NPI: 1225207913
2200 Park Bend Dr Bldg
2-202
(512) 836-0900
Clinic Affiliation: Austin Neurosurgical
Institute
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Yeager, Kristin M, APN
Gender: Female
NPI: 1831189281
# 1600 W 38th St
Ste 420
J(512) 261-4800
Clinic Affiliation: Innovative Infusions LLC
Board Certified Specialties: None
Austin
Austin
" Wedberg, Elizabeth A, APN
Gender: Female
NPI: 1497056113
1600 W 38th St
Ste 308
(512) 324-3540
Clinic Affiliation: Seton Brain and Spine
Institute
Board Certified Specialties: Anp/Cert/Clnp
Austin
Bowers, Norah S, AUDIO
Gender: Female
NPI: 1053530485
# 1611 Headway Cir
Bldg 2
J(512) 478-2581
Clinic Affiliation: Capital Area Easter Seals
Society
Practice Information: No Patients Under 3
yrs old
Board Certified Specialties: None
Austin
Austin
Austin
" Youngwith, Mary E, APN
Gender: Female
NPI: 1396719282
5508 Parkcrest Dr
Ste 310
J(512) 420-9900
Clinic Affiliation: Sleep Medicine
Consultants, Sleep Medicine Consultants of
Cen
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties: Anp/Cert/Clnp
" Wells, Adonica B, APN
Gender: Female
NPI: 1093099525
7610 W Hwy 71
Ste F
(512) 288-0859
Clinic Affiliation: National House Call
Practitioners
Board Certified Specialties: Anp/Cert/Clnp
Aus tin
" Zaydel, Kimberly A, APN
NPI: 1457352569
900 W 38th St Ste 420
J(512) 206-3653
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
" Wilson, Paula C, APN
Aus tin
Gender: Female
NPI: 1205140977
711 F W 35th St
J(512) 458-6121
Clinic Affiliation: Austin Neurological Clinic
Board Certified Specialties: Anp/Cert/Clnp
Gender: Female
NPI: 1669737268
4544 N Lamar Blvd
Ste 700
(512) 834-4141
Clinic Affiliation: Balcones Pain
Consultants
Board Certified Specialties: Anp/Cert/Clnp
" Zedlitz, Doris K, APN
Austin
Gender: Female
NPI: 1225090129
3000 N Interstate 35
Ste 700
(512) 807-3150
Clinic Affiliation: Texas Cardiac Arrhythmia
PLLC
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Carey, Angela A, AUDIO
Gender: Female
NPI: 1962675173
2504 Whitis Ave
Unit A
J(512) 471-3841
Clinic Affiliation: University of Texas
Speech and Hearing Center
Board Certified Specialties: None
Estes, Soriya M, AUDIO
Gender: Female
NPI: 1487652574
1206 W 38th St
Ste 3101
J(512) 900-8888
Clinic Affiliation: Estes Audiology PA
Board Certified Specialties: None
Franklin, Allan L, AUDIO
Gender: Male
NPI: 1790814507
3003 Bee Caves Rd Ste 200
J(512) 443-3500
Clinic Affiliation: Victory Hearing & Balance
Center PC
Practice Information: No Patients Under 5
yrs old
Board Certified Specialties: None
Gensler, Amy L, AUDIO
Gender: Female
NPI: 1821275504
# 6027 Roxbury Ln
J(512) 636-8227
Clinic Affiliation: The Listening Center of
Austin
Board Certified Specialties: None
Austin
Austin
Austin
Gender: Female
NPI: 1457352569
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
Balash, Joan M, AUDIO
Gender: Female
NPI: 1952330854
2504 Whitis Ave
Ste A
J(512) 471-3841
Clinic Affiliation: University of Texas
Speech and Hearing Center
Board Certified Specialties: None
Austin
Austin
Aus tin
" Whitehill, Jennifer E, APN
Yeomans, Nancy S, APN
Gender: Female
NPI: 1477568541
6835 Austin Ctr Blvd
J(512) 346-6611
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Zinser, Kristina D, APN
Gender: Female
NPI: 1619133816
1301 Barbara Jordan
Blvd Ste 307
J(512) 324-0907
Clinic Affiliation: Pediatric Surgical
Subspecialists
Board Certified Specialties: None
AUDIOLOGY
Austin
Aus tin
NPI: 1700897550
3706 S First St
(512) 324-4940
Clinic Affiliation: Seton Community Health
Centers
Board Certified Specialties: None
Austin
Austin
Gender: Female
NPI: 1386850667
1301 Barbara Jordan Blvd
Ste 400
(512) 708-1234
Clinic Affiliation: Austin Pediatric Surgery
Board Certified Specialties: Anp/Cert/Clnp
" Tiller, Jennifer L, APN
Austin
#
Gender: Female
NPI: 1740588623
11211 Taylor Draper Ln
Ste 202
(512) 477-4088
Clinic Affiliation: Austin Geriatric Spec
Practice Information: No patients under 50
years old
Board Certified Specialties: Anp/Cert/Clnp
" Wolfe, Emily C, APN
" Warren, Tammie, APN
Aus tin
Austin
Gender: Female
NPI: 1144324666
1301 Barbara Jordan Blvd
Ste 401
(512) 628-1900
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Austin
Gender: Female
NPI: 1023432051
2315 W Ben White Blvd
(512) 326-5440
Clinic Affiliation: Spine Diagnostic and
Treatment Center
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Aus tin
Wilson, Sarah A, APN
Gender: Female
NPI: 1841397486
1301 Barbara Jordan Blvd
Ste 400
(512) 708-1234
Clinic Affiliation: Austin Pediatric Surgery
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
" Wing, Wendy W, APN
" Velasquez, Cynthia E, APN
Aus tin
Tagoilelagi, Maisha D, APN
Gender: Female
NPI: 1255689998
3307 Northland Dr
(512) 323-1633
NPI: 1255689998
3307 Northland Dr
Ste 300
(866) 872-8060
Clinic Affiliation: Mbs Integrated Care
Board Certified Specialties: None
Austin
Gender: Female
NPI: 1285987115
11111 Research Blvd
Ste 230
J(877) 800-5722
Clinic Affiliation: Lone Star Circle of Care
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Anp/Cert/Clnp
Austin
House, Kelli, AUDIO
Gender: Female
NPI: 1689620486
1206 W 38th St
Ste 3101
(512) 900-8888
Clinic Affiliation: Estes Audiology PA
Board Certified Specialties: None
Keener, Kristen D, AUDIO
Gender: Female
NPI: 1164786158
5608 Parkcrest Dr
Ste 100
(512) 345-4664
Clinic Affiliation: Texas Balance Therapy
Board Certified Specialties: None
J - Wheelchair Access
67
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Canby, Robert C, MD
" Hranitzky, Patrick M, MD
Austin
AUSTIN Cont
AUDIOLOGY Cont
Aus tin
Aus tin
Langham, Amanda H, AUDIO
Gender: Female
NPI: 1912022583
3202 W Anderson Ln
Ste 208
(512) 879-3993
Clinic Affiliation: Central Texas Hearing
Center
Practice Information: No Patients Under 1
yrs old
Board Certified Specialties: None
" Al Ahmad, Amin, MD
Aus tin
Gender: Male
NPI: 1790826923
3000 N IH 35
Ste 700
(512) 807-3150
Hospital Affiliation: St Davids Medical
Center
Clinic Affiliation: St Davids Cardiology
PLLC
Board Certified Specialties: Cardiac
Electrophysiology
Aus tin
Bailey, Shane M, MD
Gender: Male
NPI: 1437213337
3000 N IH 35
Ste 700
(512) 807-3150
NPI: 1437213337
3000 N Interstate 35
Ste 700
(512) 807-3150
Hospital Affiliation: Christus Spohn
Hospital Shoreline, Heart Hospital Of Austin,
Hillcrest Baptist Medical Center, Seton
Medical Center, Seton Northwest Hospital,
Seton Southwest, St Davids Georgetown
Hospital, St Davids Medical Center, St
Joseph Regional Health Center, University
Med Ctr Brackenridge
Clinic Affiliation: St Davids Cardiology
PLLC, Texas Cardiac Arrhythmia PLLC
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties:
Cardiovascular Disease
Aus tin
Burkhardt Jr, John D, MD
Gender: Male
NPI: 1356306815
3000 N IH 35
Ste 700
(512) 807-3150
Clinic Affiliation: St Davids Cardiology
PLLC
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties:
Cardiovascular Disease
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
#
NPI: 1518968411
3000 N Interstate 35
Ste 700
(512) 807-3150
Hospital Affiliation: College Station Medical
Center, Hillcrest Baptist Medical Center,
Lakeway Regional Medical Ctr Llc, Seton
Medical Center, Seton Northwest Hospital,
Seton Southwest, Shannon Medical Center,
St Davids Medical Center, St Joseph
Regional Health Center, University Med Ctr
Brackenridge
Clinic Affiliation: St Davids Cardiology
PLLC, Texas Cardiac Arrhythmia PLLC
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties: Cardiac
Electrophysiology, Cardiovascular Disease
Woodall, Ashley, AUDIO
Gender: Female
NPI: 1891129904
5608 Parkcrest Dr
Ste 100
(512) 345-4664
Clinic Affiliation: Texas Balance Therapy
Board Certified Specialties: None
CARDIAC ELECTROPHYSIOLOGY
Austin
Gender: Male
NPI: 1518968411
3000 N IH 35
Ste 700
(512) 807-3150
Austin
Gallinghouse Jr, Gerald J, MD
Gender: Male
NPI: 1497730980
# 3000 N Interstate 35
Ste 700
(512) 807-3150
Hospital Affiliation: Baptist St Anthonys
Health System, Baptist St Anthonys Hospital
Rehab Services Unit, College Station
Medical Center, Hillcrest Baptist Medical
Center, Seton Medical Center, Shannon
Medical Center, St Davids Medical Center, St
Joseph Medical Center, University Med Ctr
Brackenridge, West Houston Medical Center
Clinic Affiliation: Texas Cardiac Arrhythmia
PLLC
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties: None
Austin
Austin
Austin
Kessler, David J, MD
Gender: Male
NPI: 1447251178
3801 N Lamar Blvd
Ste 300
J(512) 206-3601
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Central Texas Rehab Hospital
Llc, Heart Hospital Of Austin, North Austin
Medical Center, Seton Medical Center, St
Davids Medical Center, St Davids S Austin
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
Natale, Andrea, MD
Gender: Male
NPI: 1841382421
3000 N IH 35
Ste 700
(512) 807-3150
#
Heinzman, Kristopher M, MD
Gender: Male
NPI: 1669640892
1301 W 38th St
Ste 400
(512) 791-1224
Hospital Affiliation: Seton Medical Center,
Vibra Specialty Hospital
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties:
Cardiovascular Disease
Austin
Austin
NPI: 1841382421
3000 N Interstate 35
Ste 700
(512) 807-3150
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids
Hospital, St Davids Medical Center
Clinic Affiliation: St Davids Cardiology
PLLC, Texas Cardiac Arrhythmia PLLC
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Price, Larry D, DO
Gender: Male
NPI: 1689659385
3000 N IH 35
Ste 700
(512) 807-3150
" Hong, Mauricio F, MD
Gender: Male
NPI: 1073710067
1301 W 38th St Ste 400
(512) 324-3449
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Cardiac
Electrophysiology
#
Horton, Rodney P, MD
Gender: Male
NPI: 1346225596
3000 N Interstate 35
Ste 700
(512) 807-3180
Hospital Affiliation: Baptist St Anthonys
Health System, College Station Medical
Center, Hillcrest Baptist Medical Center,
Mother Frances Hospital, Seton Medical
Center, Seton Northwest Hospital, Shannon
Medical Center, St Davids Medical Center, St
Joseph Regional Health Center, University
Med Ctr Brackenridge
Clinic Affiliation: Texas Cardiac Arrhythmia
PLLC
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties:
Cardiovascular Disease
NPI: 1689659385
3000 N Interstate 35
Ste 700
(512) 807-3150
Hospital Affiliation: Hillcrest Baptist
Medical Center, Metroplex Hospital, Scott
And White Memorial Hospital, Seton Medical
Center, Seton Northwest Hospital, Shannon
Medical Center, St Davids Georgetown
Hospital, St Davids Medical Center, St
Joseph Regional Health Center, University
Med Ctr Brackenridge
Clinic Affiliation: St Davids Cardiology
PLLC, Texas Cardiac Arrhythmia PLLC
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties: Cardiac
Electrophysiology, Cardiovascular Disease
Sanchez, Javier E, MD
Gender: Male
NPI: 1518942226
1301 W 38th St
Ste 400
(512) 791-1224
NPI: 1518942226
3000 N Interstate 35
Ste 700
(512) 807-3180
Hospital Affiliation: College Station Medical
Center, Hillcrest Baptist Medical Center,
Metroplex Hospital, Round Rock Medical
Center, Seton Medical Center, Seton
Northwest Hospital, Shannon Medical
Center, St Davids Medical Center, St Joseph
Regional Health Center, University Med Ctr
Brackenridge
Clinic Affiliation: Seton Family of Doctors,
Texas Cardiac Arrhythmia PLLC
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties:
Cardiovascular Disease
Austin
Austin
Austin
Austin
Gender: Male
NPI: 1982786083
3000 N IH 35 Ste 700
J(512) 807-3150
Hospital Affiliation: Baylor University
Medical Center, Kindred Hospital Tarrant
County Fort Worth Sowe Ca, St Davids
Medical Center
Clinic Affiliation: St Davids Cardiology
PLLC
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties: Cardiac
Electrophysiology
Austin
Tschopp Jr, David R, MD
Gender: Male
NPI: 1285679431
3801 N Lamar Blvd
Ste 300
J(512) 206-3601
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Whitehill, Jeffrey N, MD
Gender: Male
NPI: 1568446292
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, St Davids Medical Center, St
Davids S Austin Medical Center, University
Med Ctr Brackenridge, West Houston
Medical Center
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
Zagrodzky, Jason D, MD
Gender: Male
NPI: 1912982018
1301 W 38th St
Ste 400
(512) 791-1224
NPI: 1912982018
3000 N Interstate 35
Ste 700
(512) 807-3150
Hospital Affiliation: College Station Medical
Center, Seton Medical Center, Seton
Northwest Hospital, Shannon Medical
Center, St Davids Medical Center, St Joseph
Regional Health Center, University Med Ctr
Brackenridge
Clinic Affiliation: Seton Family of Doctors,
Texas Cardiac Arrhythmia PLLC
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties:
Cardiovascular Disease
J - Wheelchair Access
68
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Aus tin
AUSTIN Cont
CARDIAC THORACIC SURGERY
Austin
Austin
Austin
Baptiste, Reginald C, MD
Gender: Male
NPI: 1649202979
6500 N Mopac Expwy
Ste 2207
J(512) 494-9985
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, St
Davids Medical Center, St Davids S Austin
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Capital Cardiothoracic
Surgeons PA
Board Certified Specialties: General
Vascular Surgery, Thoracic Surgery
Dewan, Stephen J, MD
Gender: Male
NPI: 1245254515
1010 W 40th St
J(512) 459-8753
Hospital Affiliation: Heart Hospital Of
Austin, North Austin Medical Center, Seton
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Cardiothoracic and
Vascular Surge
Practice Information: Specialized in
Pediatrics
Board Certified Specialties: Thoracic
Surgery
Dilling, Emery W, MD
Gender: Male
NPI: 1073527008
1010 W 40th St
J(512) 459-8753
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Cardiothoracic and
Vascular Surge
Board Certified Specialties: Thoracic
Surgery
Felger, Mark C, MD
Gender: Male
NPI: 1770507030
# 1010 W 40th St
J(512) 459-8753
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Cardiothoracic and
Vascular Surge
Board Certified Specialties: Thoracic
Surgery
Austin
Austin
Austin
Fox, Kenneth A, MD
Gender: Male
NPI: 1235153552
1010 W 40th St
J(512) 459-8753
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Cardiothoracic and
Vascular Surge
Board Certified Specialties: Thoracic
Surgery
Gotvald, Joel G, MD
Gender: Male
NPI: 1184683013
12319 N Mopac Expwy
Ste 250
J(512) 339-9100
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton Medical
Ctr Williamson, The Hosp At Westlake Med
Ctr
Clinic Affiliation: Joel Gotvald PA
Board Certified Specialties: General
Surgery, Thoracic Surgery
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
CARDIOVASCULAR DISEASE
Hoenicke, Eric M, MD
Gender: Male
NPI: 1356313043
1010 W 40th St
J(512) 459-8753
Clinic Affiliation: Cardiothoracic and
Vascular Surge
Board Certified Specialties: Thoracic
Surgery
Kessler, William F, MD
Gender: Male
NPI: 1013925585
# 1010 W 40th St
J(512) 459-8753
Hospital Affiliation: Heart Hospital Of
Austin, North Austin Medical Center, Seton
Medical Center, St Davids Medical Center, St
Davids S Austin Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Cardiothoracic and
Vascular Surge
Board Certified Specialties: Thoracic
Surgery
Gender: Male
NPI: 1326049230
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
Hospital Affiliation: Central Texas Medical
Center, Heart Hospital Of Austin, Scott &
White Hospital Llano, Seton Medical Center,
Seton Northwest Hospital, Seton Smithville
Reg Hospital, St Davids Georgetown
Hospital, St Davids Medical Center, St Marks
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
Aus tin
" Canby, Robert C, MD
Gender: Male
NPI: 1518968411
3000 N IH 35
Ste 700
(512) 807-3150
Hospital Affiliation: College Station Medical
Center, Hillcrest Baptist Medical Center,
Lakeway Regional Medical Ctr Llc, Seton
Medical Center, Seton Northwest Hospital,
Seton Southwest, Shannon Medical Center,
St Davids Medical Center, St Joseph
Regional Health Center, University Med Ctr
Brackenridge
Clinic Affiliation: St Davids Cardiology
PLLC
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties:
Cardiovascular Disease
Gender: Male
NPI: 1437213337
3000 N IH 35
Ste 700
(512) 807-3150
NPI: 1437213337
3000 N Interstate 35
Ste 700
(512) 807-3150
Hospital Affiliation: Christus Spohn
Hospital Shoreline, Heart Hospital Of Austin,
Hillcrest Baptist Medical Center, Seton
Medical Center, Seton Northwest Hospital,
Seton Southwest, St Davids Georgetown
Hospital, St Davids Medical Center, St
Joseph Regional Health Center, University
Med Ctr Brackenridge
Clinic Affiliation: St Davids Cardiology
PLLC, Texas Cardiac Arrhythmia PLLC
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Cauthen, Clay A, MD
Austin
Gender: Male
NPI: 1730396862
1301 W 38th St
Ste 514
(512) 681-0500
Hospital Affiliation: Seton Medical Center,
Seton Medical Center Hays, Seton Medical
Ctr Williamson, University Med Ctr
Brackenridge
Clinic Affiliation: Seton Family of Doctors
Board Certified Specialties:
Cardiovascular Disease
" Baldacchino, Thomas C, MD
Austin
Gender: Male
NPI: 1720057631
4207 James Casey
St Ste 215
J(512) 445-5998
New, Ronald B, MD
Gender: Male
NPI: 1912019019
1010 W 40th St
J(512) 459-8753
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Cardiothoracic and
Vascular Surge
Board Certified Specialties: Thoracic
Surgery
NPI: 1720057631
4207 James Casey St
Ste 215
(512) 445-5998
Hospital Affiliation: Lakeway Regional
Medical Ctr Llc, Seton Medical Center, Seton
Medical Center Hays, Seton Northwest
Hospital, Seton Southwest, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Capital Cardiovascular
Specialist, Lrmc Cardiology Inc
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
Oswalt, John D, MD
Gender: Male
NPI: 1174547509
1010 W 40th St
J(512) 459-8753
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Cardiothoracic and
Vascular Surge
Board Certified Specialties: Thoracic
Surgery
" Bhatt, Kunjan A, MD
" Chafizadeh, Edward R, MD
Austin
#
Austin
Gender: Male
NPI: 1770668758
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
Hospital Affiliation: Central Texas Rehab
Hospital Llc, Seton Medical Center, Seton
Northwest Hospital, St Davids Georgetown
Hospital, St Davids Medical Center
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
NPI: 1356306815
3000 N Interstate 35
Ste 700
(512) 807-3150
Clinic Affiliation: St Davids Cardiology
PLLC, Texas Cardiac Arrhythmia PLLC
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties:
Cardiovascular Disease
Austin
" Bailey, Shane M, MD
Kirkland, Hunter Q, MD
Gender: Male
NPI: 1942214788
1010 W 40th St
J(512) 459-8753
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Cardiothoracic and
Vascular Surge
Board Certified Specialties: Thoracic
Surgery
Mueller, Michael C, MD
Gender: Male
NPI: 1952315707
# 1010 W 40th St
J(512) 459-8753
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Cardiothoracic and
Vascular Surge
Board Certified Specialties: Thoracic
Surgery
#
Austin
Aus tin
Aus tin
Gender: Male
NPI: 1356306815
3000 N IH 35
Ste 700
(512) 807-3150
" Abrams, David S, MD
Austin
Aus tin
Aus tin
" Burkhardt Jr, John D, MD
Austin
Gender: Male
NPI: 1023019924
1015 E 32nd St
Ste 508
(512) 807-3140
Hospital Affiliation: Heart Hospital Of
Austin, North Austin Medical Center, Round
Rock Medical Center, Seton Highland Lakes,
Seton Medical Center, Seton Northwest
Hospital, St Davids Hospital, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: St Davids Cardiology
PLLC
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties:
Cardiovascular Disease
Chalkias, Fotini M, MD
Gender: Female
NPI: 1518065317
# 11111 Research Blvd
Ste 360
(512) 617-1916
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
Austin
J - Wheelchair Access
69
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Desai, Parul M, MD
" Frischhertz, Eric J, MD
Austin
AUSTIN Cont
CARDIOVASCULAR DISEASE Cont
" Chauhan, Manish S, MD
Aus tin
Gender: Male
NPI: 1245215516
2200 Park Bend Dr
Bldg 1 Ste 401
(512) 807-3160
NPI: 1245215516
2200 Park Bend Dr
Ste 401 Bldg 1
(512) 807-3160
Hospital Affiliation: Cornerstone Hosp Of
Austin, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge, West
Houston Medical Center
Clinic Affiliation: Cardiovascular Specialists
of Tex, St Davids Cardiology PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
Gender: Male
NPI: 1427059310
4316 James Casey St
Ste A & C
(512) 623-5300
Hospital Affiliation: North Austin Medical
Center, Seton Highland Lakes, Seton
Medical Center, Seton Northwest Hospital,
South Austin Surgery Center, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: St Davids Cardiology
PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
Gender: Male
NPI: 1023079613
11149 Research Blvd
Ste 125
(512) 338-0492
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Little River Healthcare, North
Austin Medical Center, Round Rock Medical
Center, Scott & White Hospital Taylor, Seton
Medical Center, Seton Northwest Hospital,
St Davids Georgetown Hospital, St Davids S
Austin Medical Center, West Houston
Medical Center
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Demaio Jr, Samuel J, MD
Gender: Male
NPI: 1649239872
200 Medical Pkwy
Ste 270
J(512) 263-0123
Hospital Affiliation: East El Paso Phys Med
Ctr Llc, Lakeway Regional Medical Ctr Llc,
Seton Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Star State Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease, Interventional
Cardiology
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Female
NPI: 1700898905
7900 FM 1826
Ste 170
(512) 791-1224
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Medical Center Hays,
St Davids Medical Center, St Davids S
Austin Medical Center, The Hosp At
Westlake Med Ctr
Clinic Affiliation: Seton Family of Doctors
Board Certified Specialties:
Cardiovascular Disease
" Goswami, Vivek, MD
Austin
Gender: Male
NPI: 1689734113
11149 Research
Ste 125 Bldg 1
J(512) 338-0492
Hospital Affiliation: Heart Hospital Of
Austin, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
Gallinghouse Jr, Gerald J, MD
Gender: Male
NPI: 1497730980
3000 N IH 35
Ste 700
J(512) 807-3150
#
" Dixon, Frederick E, MD
" Coffeen, Paul R, MD
Aus tin
Austin
Austin
Aus tin
Gender: Male
NPI: 1699775627
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
Hospital Affiliation: Metroplex Hospital,
North Austin Medical Center, Round Rock
Medical Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
NPI: 1982658589
4207 James Casey St
Ste 317
(512) 324-3447
Hospital Affiliation: Seton Medical Center,
Seton Medical Center Hays, St Davids S
Austin Medical Center
Clinic Affiliation: Capital Cardiovascular
Specialist, Lrmc Cardiology Inc, Seton Brain
and Spine Institute
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Dieck Jr, John A, MD
" Cishek, Mary B, MD
" Giesler, Caitlin M, MD
Austin
Gender: Male
NPI: 1982658589
4207 James Casey St
Ste 215
(512) 445-5998
Austin
Aus tin
Gender: Female
NPI: 1821073305
1301 W 38th St
Ste 400
(512) 791-1224
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Center, Seton Medical
Ctr Williamson, Seton Northwest Hospital, St
Davids Medical Center, St Davids S Austin
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties:
Cardiovascular Disease
Austin
Gender: Female
NPI: 1922009976
3801 N Lamar Blvd
Ste 300
J(512) 206-3618
Hospital Affiliation: Central Texas Medical
Center, North Austin Medical Center,
Northwest Hills Surgical Hospital, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
NPI: 1497730980
3000 N Interstate 35
Ste 700
(512) 807-3150
Hospital Affiliation: Baptist St Anthonys
Health System, Baptist St Anthonys Hospital
Rehab Services Unit, College Station
Medical Center, Hillcrest Baptist Medical
Center, Seton Medical Center, Shannon
Medical Center, St Davids Medical Center, St
Joseph Medical Center, University Med Ctr
Brackenridge, West Houston Medical Center
Clinic Affiliation: St Davids Cardiology
PLLC, Texas Cardiac Arrhythmia PLLC
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties: None
" Grad, Michael S, MD
Austin
Gender: Male
NPI: 1386629012
2200 Park Bend Dr
Bldg 1 Ste 401
(512) 807-3160
#
" Gammon, Roger S, MD
Austin
Gender: Male
NPI: 1366435810
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
NPI: 1366435810
900 W 38th St
Ste 420
J(512) 407-8346
Hospital Affiliation: Heart Hospital Of
Austin, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, Seton Southwest,
St Davids Georgetown Hospital, St Davids
Medical Center, St Davids S Austin Medical
Center, West Houston Medical Center
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Ekery, Deborah L, MD
Austin
Gender: Female
NPI: 1912908807
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
Hospital Affiliation: Central Texas Rehab
Hospital Llc, North Austin Medical Center,
Seton Medical Center, Seton Northwest
Hospital, Seton Smithville Reg Hospital,
Seton Southwest, St Marks Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Garza, David A, MD
Austin
Gender: Male
NPI: 1659466092
2911 Medical Arts St
Ste 10
J(512) 474-5551
Hospital Affiliation: Seton Medical Center,
Seton Smithville Reg Hospital, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Heart of Texas Cardiology
PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
NPI: 1386629012
2200 Park Bend Dr
Ste 401
(512) 807-3160
Hospital Affiliation: Cornerstone Hosp Of
Austin, Cornerstone Regional Hospital Llc,
North Austin Medical Center, Round Rock
Medical Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge, West
Houston Medical Center
Clinic Affiliation: Cardiovascular Specialists
of Tex, St Davids Cardiology PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Haeusslein, Ernest A, MD
Austin
Gender: Male
NPI: 1780617571
1301 W 38th St
Ste 514
J(512) 791-1224
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Hayes, David W, MD
Austin
Gender: Male
NPI: 1093801581
2911 Medical Arts St
Ste 10
J(512) 474-5551
Hospital Affiliation: Heart Hospital Of
Austin, Seton Medical Center, Seton
Smithville Reg Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Heart of Texas Cardiology
PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
J - Wheelchair Access
70
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Levy, Gerald V, MD
" Narra, Subrahmanyam, MD
Aus tin
AUSTIN Cont
CARDIOVASCULAR DISEASE Cont
" Heinzman, Kristopher M, MD
Austin
Gender: Male
NPI: 1669640892
1301 W 38th St
Ste 400
(512) 791-1224
Hospital Affiliation: Seton Medical Center,
Vibra Specialty Hospital
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Horton, Rodney P, MD
Austin
Gender: Male
NPI: 1346225596
3000 N Interstate 35
Ste 700
(512) 807-3180
Hospital Affiliation: Baptist St Anthonys
Health System, College Station Medical
Center, Hillcrest Baptist Medical Center,
Mother Frances Hospital, Seton Medical
Center, Seton Northwest Hospital, Shannon
Medical Center, St Davids Medical Center, St
Joseph Regional Health Center, University
Med Ctr Brackenridge
Clinic Affiliation: Texas Cardiac Arrhythmia
PLLC
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties:
Cardiovascular Disease
" McMinn, Thomas R, MD
Aus tin
Gender: Male
NPI: 1871669564
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Center, Seton Medical
Ctr Williamson, Seton Northwest Hospital, St
Davids S Austin Medical Center
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Kessler, David J, MD
Gender: Male
NPI: 1447251178
3801 N Lamar Blvd
Ste 300
J(512) 206-3601
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Central Texas Rehab Hospital
Llc, Heart Hospital Of Austin, North Austin
Medical Center, Seton Medical Center, St
Davids Medical Center, St Davids S Austin
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
Gender: Male
NPI: 1841382421
3000 N IH 35
Ste 700
(512) 807-3150
#
Gender: Male
NPI: 1952341034
1301 W 38th St
Ste 400
(512) 791-1224
NPI: 1952341034
6811 Far West Blvd
Ste 410
(512) 324-2705
Hospital Affiliation: Little River Healthcare,
Seton Edgar B Davis, Seton Highland Lakes,
Seton Medical Center, Seton Medical Center
Hays, Seton Northwest Hospital, Seton
Smithville Reg Hospital, Seton Southwest, St
Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties:
Cardiovascular Disease
Gender: Male
NPI: 1396746343
3801 N Lamar Blvd
Ste 300
J(512) 458-1006
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, West Houston
Medical Center
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Pagley Jr, Paul R, MD
Gender: Male
NPI: 1790786812
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
Hospital Affiliation: River Oaks Endoscopy
Center Llp, Seton Medical Center, Seton
Northwest Hospital, Seton Southwest, St
Davids Hospital, St Davids Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Pandya, Sanjay, MD
Austin
Gender: Male
NPI: 1639277353
900 W 38th St
Ste 420
J(512) 407-8346
Hospital Affiliation: Metroplex Hospital,
Seton Medical Ctr Harker Heights, St Davids
S Austin Medical Center
Clinic Affiliation: Austin Heart PLLC
Board Certified Specialties:
Cardiovascular Disease
" Nguyen, Vu D, MD
Austin
#
Gender: Male
NPI: 1093755357
1301 W 38th St
Ste 400
(512) 791-1224
NPI: 1093755357
6811 Austin Center
Blvd Ste 410
(512) 324-2705
Hospital Affiliation: Cornerstone Hosp Of
Austin, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
Seton Southwest, St Davids Medical Center,
St Davids S Austin Medical Center
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties:
Cardiovascular Disease
Gender: Male
NPI: 1548245798
4316 James Casey St
Ste A
(512) 623-5300
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Highland Lakes, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
St Marks Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: St Davids Cardiology
PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
Austin
NPI: 1952341034
6811 Austin Center
Blvd Ste 410
(512) 324-2705
Gender: Male
NPI: 1295970820
4207 James Casey St
Ste 215
(512) 445-5998
" Morris, David L, MD
#
" Nguyen, Tuan D, MD
" Mehta, Sachin, MD
NPI: 1295970820
4207 James Casey St
Ste 317
(512) 324-3447
Hospital Affiliation: St Davids S Austin
Medical Center
Clinic Affiliation: Lrmc Cardiology Inc,
Seton Brain and Spine Institute
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
NPI: 1841382421
3000 N Interstate 35
Ste 700
(512) 807-3150
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids
Hospital, St Davids Medical Center
Clinic Affiliation: St Davids Cardiology
PLLC, Texas Cardiac Arrhythmia PLLC
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Ozdil, Erol H, MD
Austin
Austin
Aus tin
Aus tin
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
" Natale, Andrea, MD
Gender: Male
NPI: 1316947344
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Center, Seton
Northwest Hospital, Seton Smithville Reg
Hospital, Seton Southwest, St Davids
Medical Center, St Davids S Austin Medical
Center, St Marks Medical Center, University
Med Ctr Brackenridge, West Houston
Medical Center
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Karha, Juhana K, MD
Gender: Male
NPI: 1851376008
1015 E 32nd St
Ste 508
(512) 480-3147
Hospital Affiliation: Cornerstone Hosp Of
Austin, North Austin Medical Center, Seton
Highland Lakes, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: St Davids Cardiology
PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
Austin
" Lewitton, Steven, MD
Gender: Male
NPI: 1487828521
1015 E 32nd St
Ste 508
(512) 480-3147
Hospital Affiliation: St Davids Hospital, St
Davids Medical Center
Clinic Affiliation: St Davids Cardiology
PLLC
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties:
Cardiovascular Disease, Internal Medicine
" Otero, Francisco J, MD
Austin
Gender: Male
NPI: 1154313013
12411 Hymeadow Dr Ste 3E
J(512) 331-5321
Hospital Affiliation: Northwest Hills Surgical
Hospital, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Georgetown Hospital
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties:
Cardiovascular Disease
Aus tin
Austin
Austin
Austin
Gender: Male
NPI: 1154306306
4316 James Casey St
Ste A
(512) 623-5300
Hospital Affiliation: Park Plaza Hospital,
Round Rock Medical Center, Seton Highland
Lakes, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
The Hosp At Westlake Med Ctr, University
Med Ctr Brackenridge, West Houston
Medical Center
Clinic Affiliation: St Davids Cardiology
PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Pirwitz, Mark J, MD
Austin
Gender: Male
NPI: 1063436152
1301 W 38th St
Ste 400
(512) 791-1224
NPI: 1063436152
6811 Austin Center
Blvd Ste 410
(512) 324-2705
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Edgar B Davis, Seton Highland Lakes, Seton
Medical Center, Seton Northwest Hospital,
St Davids S Austin Medical Center
Clinic Affiliation: Seton Family of Doctors
Board Certified Specialties:
Cardiovascular Disease
J - Wheelchair Access
71
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Sanchez, Javier E, MD
" Terreson, David W, MD
Austin
AUSTIN Cont
CARDIOVASCULAR DISEASE Cont
" Price, Larry D, DO
Aus tin
Gender: Male
NPI: 1689659385
3000 N IH 35
Ste 700
(512) 807-3150
Hospital Affiliation: Hillcrest Baptist
Medical Center, Metroplex Hospital, Scott
And White Memorial Hospital, Seton Medical
Center, Seton Northwest Hospital, Shannon
Medical Center, St Davids Georgetown
Hospital, St Davids Medical Center, St
Joseph Regional Health Center, University
Med Ctr Brackenridge
Clinic Affiliation: St Davids Cardiology
PLLC
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Risinger Jr, Norman E, MD
Aus tin
Gender: Male
NPI: 1063406692
2559 Western Trails
Blvd Ste 200
J(512) 899-2028
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids S
Austin Medical Center
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
NPI: 1316990922
900 W 38th St
Ste 420
J(512) 407-8346
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids
Hospital, St Davids Medical Center
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Wetherold, Suzanne C, MD
Austin
Gender: Female
NPI: 1710993431
2559 Western Trails Blvd
Ste 200
J(512) 899-2028
Hospital Affiliation: Seton Smithville Reg
Hospital, St Davids Medical Center, St Marks
Medical Center, University Health System
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Whitehill, Jeffrey N, MD
Austin
Gender: Male
NPI: 1568446292
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, St Davids Medical Center, St
Davids S Austin Medical Center, University
Med Ctr Brackenridge, West Houston
Medical Center
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Tracey, Thomas N, MD
Austin
Gender: Male
NPI: 1780669499
4316 James Casey St
Ste A
J(512) 623-5300
Hospital Affiliation: North Austin Medical
Center, River Oaks Endoscopy Center Llp,
Seton Medical Center, Seton Northwest
Hospital, Seton Southwest, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: St Davids Cardiology
PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Smith, Arthur M, MD
Austin
Gender: Male
NPI: 1043211444
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Georgetown Hospital, St Davids
Medical Center, St Davids S Austin Medical
Center, St Marks Medical Center, University
Med Ctr Brackenridge, West Houston
Medical Center
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
Gender: Male
NPI: 1487646667
1210 W Braker Ln
(512) 978-9300
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Male
NPI: 1649241803
901 W 38th St
Ste 400
J(512) 206-2988
Hospital Affiliation: Heart Hospital Of
Austin, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Dr Eric Tiblier PA
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties:
Cardiovascular Disease
Gender: Male
NPI: 1316990922
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
" Rodgers, George P, MD
Gender: Male
NPI: 1558323733
1301 W 38th St
Ste 400
(512) 791-1224
Hospital Affiliation: Seton Medical Center,
St Davids S Austin Medical Center
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Tiblier, Eric S, MD
" Selmon, Matthew R, MD
Aus tin
" Watkins, Michael G, MD
Austin
Austin
Austin
" Roach, Paul J, MD
NPI: 1487646667
6811 Austin Center
Blvd Ste 410
(512) 791-1224
Hospital Affiliation: Central Texas Medical
Center, North Austin Medical Center
Clinic Affiliation: Communitycare, Seton
Family of Doctors
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties:
Cardiovascular Disease
Gender: Male
NPI: 1417932120
1015 E 32nd St
Ste 508
(512) 807-3140
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
Seton Smithville Reg Hospital, Seton
Southwest, St Davids Medical Center, St
Davids S Austin Medical Center, University
Med Ctr Brackenridge, West Houston
Medical Center
Clinic Affiliation: St Davids Cardiology
PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
NPI: 1518942226
3000 N Interstate 35
Ste 700
(512) 807-3180
Hospital Affiliation: College Station Medical
Center, Hillcrest Baptist Medical Center,
Metroplex Hospital, Round Rock Medical
Center, Seton Medical Center, Seton
Northwest Hospital, Shannon Medical
Center, St Davids Medical Center, St Joseph
Regional Health Center, University Med Ctr
Brackenridge
Clinic Affiliation: Seton Family of Doctors,
Texas Cardiac Arrhythmia PLLC
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties:
Cardiovascular Disease
Aus tin
Gender: Male
NPI: 1760467468
1301 W 38th St
Ste 400
(512) 791-1224
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Highland Lakes, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties:
Cardiovascular Disease
Austin
Gender: Male
NPI: 1518942226
1301 W 38th St
Ste 400
(512) 791-1224
" Wozniak, Robert J, MD
Austin
Gender: Male
NPI: 1063408128
2200 Park Bend Dr
Bldg 1 Ste 401
(512) 807-3160
#
" Venegoni, Paolo V, MD
Austin
Gender: Male
NPI: 1790771814
2200 Park Bend Dr
Bldg 1 Ste 401
(512) 807-3160
Hospital Affiliation: Cornerstone Hosp Of
Austin, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, St Davids
Georgetown Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge, West
Houston Medical Center
Clinic Affiliation: St Davids Cardiology
PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Stahlman, Matthew B, MD
Austin
Gender: Male
NPI: 1548230212
1301 W 38th St
Ste 400
(512) 791-1224
NPI: 1548230212
6811 Austin Center
Blvd Ste 410
(512) 324-2705
Hospital Affiliation: Cornerstone Hosp Of
Austin, North Austin Medical Center, Seton
Highland Lakes, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties:
Cardiovascular Disease, Interventional
Cardiology
" Wang, Stanley S, MD
Austin
#
Gender: Male
NPI: 1962592071
2559 Western Trails
Blvd Ste 200
J(512) 899-2028
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, Seton Smithville Reg
Hospital, St Davids Medical Center, St
Davids S Austin Medical Center, St Marks
Medical Center
Clinic Affiliation: Austin Heart PLLC
Board Certified Specialties:
Cardiovascular Disease
NPI: 1063408128
2200 Park Bend Dr
Ste 401
(512) 807-3180
Hospital Affiliation: North Austin Medical
Center, Seton Southwest, St Davids
Georgetown Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge, West
Houston Medical Center
Clinic Affiliation: Cardiovascular Specialists
of Tex, St Davids Cardiology PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Zagrodzky, Jason D, MD
Austin
Gender: Male
NPI: 1912982018
1301 W 38th St
Ste 400
(512) 791-1224
NPI: 1912982018
3000 N Interstate 35
Ste 700
(512) 807-3150
Hospital Affiliation: College Station Medical
Center, Seton Medical Center, Seton
Northwest Hospital, Shannon Medical
Center, St Davids Medical Center, St Joseph
Regional Health Center, University Med Ctr
Brackenridge
Clinic Affiliation: Seton Family of Doctors,
Texas Cardiac Arrhythmia PLLC
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties:
Cardiovascular Disease
J - Wheelchair Access
72
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Reardon, Michael S, MD
Gender: Male
NPI: 1053363366
# 1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1850
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Driscoll ChildrensHospital', North
Austin Medical Center, Round Rock Medical
Center, Seton Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Neurology
Aus tin
AUSTIN Cont
CARDIOVASCULAR DISEASE Cont
" Zeineddin, Mohamad, MD
Austin
Gender: Male
NPI: 1912982885
7900 FM 1826
Ste 170
(512) 791-1224
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
Seton Southwest, St Davids Medical Center,
St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Zidar, Francis J, MD
Austin
Gender: Male
NPI: 1972580652
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
Hospital Affiliation: Seton Medical Center,
Seton Medical Ctr Williamson, Seton
Northwest Hospital, St Davids Georgetown
Hospital, St Davids Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
CHIROPRACTIC
Austin
Kane, Jeffrey S, MD
Gender: Male
NPI: 1851343271
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1850
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Austin
Kerr, Jeffrey S, MD
Gender: Male
NPI: 1669424263
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1850
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Austin
Alvarado, David, DC
Gender: Male
NPI: 1114900222
# 429 W Ben White Blvd
Ste B
J(512) 444-6636
Board Certified Specialties: None
Aus tin
Aus tin
Anderson, Ben J, DC
Gender: Male
NPI: 1295858801
1600 W 38th St
Ste 312
(512) 371-7246
Clinic Affiliation: Century Medical Services
Board Certified Specialties: None
Andrade, Michelle N, DC
Gender: Female
NPI: 1164742201
# 5555 N Lamar Blvd
Ste C121
J(512) 371-1886
Clinic Affiliation: Rosewood Chiropractic
PC
Board Certified Specialties: None
Aus tin
Aus tin
Aus tin
Bockmann, Daniel P, DC
Gender: Male
NPI: 1841207040
7756 Northcross Dr
Ste 203
J(512) 386-1876
Board Certified Specialties: None
Boecking, Neil O, DC
Gender: Male
NPI: 1023198629
# 1015 W 39 1/2 St
J(512) 371-7478
Clinic Affiliation: Pro Care Medical Center
Board Certified Specialties: None
Bomben, Ross M, DC
Gender: Male
NPI: 1326069444
# 2714 Bee Caves Rd
Ste 100
J(512) 330-9965
Clinic Affiliation: Performance Health
Austin, Performance Therapy Group PLLC
Practice Information: No Patients Under 5
yrs old
Board Certified Specialties: None
Austin
Austin
Anyatonwu, Blessing U, DC
Gender: Female
NPI: 1699094672
223 W Anderson Ln
Ste B500
(512) 481-2682
NPI: 1699094672
225 W Anderson Ln
Ste B 500
J(512) 481-2682
Clinic Affiliation: Earnest Holistic Health
LLC
Board Certified Specialties: None
Aus tin
NPI: 1386654887
4308 N Quinlana Park Rd
Ste 200
(512) 329-5500
Clinic Affiliation: Pinnacle Sports
Performance and R
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties: None
Austin
Aus tin
Keough, Karen C, MD
Gender: Female
NPI: 1538147707
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1850
NPI: 1538147707
3724 Executive Ctr Dr
Ste 163
(512) 687-3119
Clinic Affiliation: Hill Country Monitoring
LLC, Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Neurology
Bhatt, Michael A, DC
Gender: Male
NPI: 1386654887
# 300 Beardsley Ln Bldg B
(512) 329-5500
#
Alton II, Michael D, DC
Gender: Male
NPI: 1285681551
# 12414 Alderbrook Dr
Ste 250
(512) 346-2225
Clinic Affiliation: Alton Chiropractic
Board Certified Specialties: None
Bellonzi, Vincent C, DC
Gender: Male
NPI: 1194813675
1700 S Lamar Blvd
Ste 240
J(512) 473-8900
Clinic Affiliation: Austin Wellness Clinic
Board Certified Specialties: None
Austin
Aus tin
CHILD NEUROLOGY
Austin
Austin
Austin
Atencio, Bart, DC
Gender: Male
NPI: 1548335359
1500 W 38th St
Ste 38
J(512) 219-8999
Board Certified Specialties: None
Botts, Trevor J, DC
Gender: Male
NPI: 1184900359
13740 Research Blvd
Ste L4
(512) 257-3627
Clinic Affiliation: Austin Chiropractic and
Wellness
Board Certified Specialties: None
Boudreaux, Bryan G, DC
Gender: Male
NPI: 1770546038
5000 W Slaughter Ln
Ste 100 Bldg G
J(800) 404-6050
Clinic Affiliation: Airrosti Rehab Center LLC
Board Certified Specialties: None
Brown, Jeffrey L, DC
Gender: Male
NPI: 1578565065
# 7800 N Mopac Expwy
Ste 340
J(512) 346-5567
Clinic Affiliation: American Chiropractic
Clinic Aust
Board Certified Specialties: None
Austin
Baker, Russell E, DC
Gender: Male
NPI: 1982750550
4419 Frontier Trail
Ste 106
J(512) 989-8111
Board Certified Specialties: None
Austin
Becerra, Angelica B, DC
Gender: Female
NPI: 1851637987
15004 Avery Ranch Blvd
Bldg A-200
(512) 255-5252
Clinic Affiliation: Salus Chiropractic
Board Certified Specialties: None
Bryson, Jeremy T, DC
Gender: Male
NPI: 1114942042
12701 Research Blvd 309
(512) 250-9799
Board Certified Specialties: None
Burgett, Robert O, DC
Gender: Male
NPI: 1801212527
# 9009 Mountain Ridge Dr
Ste 140
J(512) 394-2496
Clinic Affiliation: Remedy Chiropractic &
Family Well
Board Certified Specialties: None
Austin
Butera, Rosanne, DC
Gender: Female
NPI: 1205836178
# 1803 W 35th St
Ste A
(512) 323-6767
Austin
#
NPI: 1205836178
1803-A W 35th St
J(512) 323-6767
Clinic Affiliation: Butera Chiropractic LLC
Board Certified Specialties: None
Calhoun, George W, DC
Gender: Male
NPI: 1588720767
# 7208 McNeil Dr
Ste 201
J(512) 258-6317
Clinic Affiliation: Harrill Calhoun
Chiropracticcentre PC
Board Certified Specialties: None
Austin
Cantu, Daniel D, DC
Gender: Male
NPI: 1417095787
# 4220 W Wm Cannon
Ste 130
(512) 892-3434
Clinic Affiliation: Texas Chiropractic and
Therapy
Board Certified Specialties: None
Austin
Austin
Carlson, John D, DC
Gender: Male
NPI: 1497773253
6905 W Gate Blvd Ste A
(512) 447-9093
#
NPI: 1497773253
6905 Westgate Blvd Ste A
J(512) 447-9093
Clinic Affiliation: Carlson Chiropractic
Center
Board Certified Specialties: None
Chicoine, James A, DC
Gender: Male
NPI: 1508974049
# 112 E Oltorf
J(512) 443-9396
Clinic Affiliation: Chicoine Chiropractic LLC
Board Certified Specialties: None
Austin
Chicoine, Jon K, DC
Gender: Male
NPI: 1881736080
# 112 E Oltorf
J(512) 443-9396
Austin
#
NPI: 1881736080
2005 Airport Blvd
J(512) 472-3557
#
NPI: 1881736080
3407 Wells Branch Pkwy
Ste 625
J(512) 255-1777
#
Austin
NPI: 1881736080
9515 N Lamar Blvd
Ste 168
J(512) 339-9888
Clinic Affiliation: Chicoine Chiropractic LLC
Board Certified Specialties: None
Chow, Doris W, DC
Gender: Female
NPI: 1285713651
1211 Baylor St
Ste 100
J(512) 351-1070
Board Certified Specialties: None
J - Wheelchair Access
73
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Duggan, Christine L, DC
Gender: Female
NPI: 1346350253
# 4100 Duval Rd
Bldg 4 Ste 203
J(512) 833-7700
Clinic Affiliation: Christine Duggan Dcpa
Board Certified Specialties: None
Fluitt, Jeffrey W, DC
Gender: Male
NPI: 1194721829
# 4316 James Casey St
Ste F 201
(512) 442-2727
Austin
AUSTIN Cont
CHIROPRACTIC Cont
Clark, Brian A, DC
Gender: Male
NPI: 1023296977
# 4634 W Gate Blvd
J(512) 288-7000
Board Certified Specialties: None
Aus tin
Aus tin
Clinton, Kristy L, DC
Gender: Female
NPI: 1639186737
3951 Parmer Ln
Ste 300
J(512) 339-2653
Board Certified Specialties: None
Cone, Joel D, DC
Gender: Male
NPI: 1871788182
# 2312 Western Trails Blvd
Ste A103b
J(512) 577-7234
Board Certified Specialties: None
Aus tin
Crawford, Brandon L, DC
Gender: Male
NPI: 1245540004
# 8701 W Parmer Ln
Ste 2121
(512) 258-8880
Board Certified Specialties: None
Aus tin
Aus tin
Deily, Sylvia E, DC
Gender: Female
NPI: 1861436933
# 3724 Executive Center
Dr Ste G10
J(512) 345-5925
NPI: 1861436933
4029 S Capital of
Texas Hwy Ste 1
(512) 845-5925
#
NPI: 1861436933
4029 S Capital of Texas
Hwy Ste 111
J(512) 345-5925
Clinic Affiliation: Seton Brain and Spine
Institute, The Spine Center
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Dierdorff, Daniel J, DC
Gender: Male
NPI: 1497988463
# 2941 W Anderson Ln
(512) 419-1367
Clinic Affiliation: Austin Hillside Family
Chiropract
Board Certified Specialties: None
Aus tin
Ding, Jay C, DC
Gender: Male
NPI: 1902926025
# 3407 Jefferson St
J(512) 451-3257
Board Certified Specialties: None
Aus tin
Aus tin
Edwards, James D, DC
Gender: Male
NPI: 1497721435
# 2500 W William Cannon
Dr Ste 205
J(512) 445-3366
Clinic Affiliation: Austin Chiropractic Ctr PC
Board Certified Specialties: None
Doyle, Mary E, DC
Gender: Female
NPI: 1538296645
1007 S Congress
Ste B11
(512) 326-5333
Clinic Affiliation: Koala Sports Medicine
Centers
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
NPI: 1194721829
4701 Westgate Blvd
D401
(512) 467-1100
Clinic Affiliation: Art Medical Alliance,
Austin Preferred Chiropractic and
Practice Information: Wheelchair
Accessibility
Board Certified Specialties: None
Austin
Edwards, Nicole C, DC
Gender: Female
NPI: 1427193754
# 3407 Wells Branch Pkwy
Ste 625
J(512) 255-1777
Clinic Affiliation: Chicoine Chiropractic LLC
Board Certified Specialties: None
Austin
Eledge, Stephen R, DC
Gender: Male
NPI: 1174684005
# 6836 Bee Caves Rd
(800) 404-6050
Clinic Affiliation: Airrosti Rehab Center LLC
Board Certified Specialties: None
Austin
Austin
De La Rosa, Diana A, DC
Gender: Female
NPI: 1336150663
2700 Via Fortuna
Ste 300
J(512) 762-5880
Board Certified Specialties: None
Aus tin
Austin
Ellspermann, Brian E, DC
Gender: Male
NPI: 1497899017
3200 Red River St
Ste 201
J(800) 404-6050
Clinic Affiliation: Airrosti Rehab Center LLC
Board Certified Specialties: None
English, William J, DC
Gender: Male
NPI: 1972660546
# 11149 Research Blvd
Ste 200
J(512) 694-6933
Clinic Affiliation: Aloha Wellness and
Healthcare
Board Certified Specialties: None
Austin
Austin
Fourie, Nicolaas J, DC
Gender: Male
NPI: 1538113766
# 1000 E 41st St Ste 915
J(512) 467-2225
Clinic Affiliation: Back N Place Chiropractic
Board Certified Specialties: None
Austin
Austin
Fuller, Jason P, DC
Gender: Male
NPI: 1164537387
13201 N FM 620
Ste 206 Bldg U
J(512) 345-5925
NPI: 1164537387
300 Beardsley Ln
Bldg B
J(512) 345-5925
Clinic Affiliation: The Spine Center
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
Gaddis, Kristie A, DC
Gender: Female
NPI: 1801154869
# 8500 Shoal Creek Blvd
Bldg 4 Ste 106
J(512) 784-9701
Board Certified Specialties: None
Austin
Estes, Stephen B, DC
Gender: Male
NPI: 1902893548
# 7800 N Mopac Expwy
Ste 340
J(512) 346-5567
Clinic Affiliation: Estes Chiropractic Clinic
PC
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Austin
Grosch, Kelly A, DC
Gender: Female
NPI: 1598080301
# 4006 S Lamar Blvd
Ste 650
J(512) 474-5433
Clinic Affiliation: Active Life Chiropractic
Clinic
Board Certified Specialties: None
Austin
Fisher, Merrick A, DC
Gender: Female
NPI: 1013248350
# 7800 N Mopac Expwy
Ste 340
(512) 346-5567
Clinic Affiliation: American Chiropractic
Clinic Aust
Board Certified Specialties: None
Austin
Harrington, Timothy S, DC
Gender: Male
NPI: 1851463319
# 1600 W 38th St
Ste 120
(512) 892-4445
Clinic Affiliation: Barton Creek Chiropractic
LLC
Board Certified Specialties: None
Forster, Simon J, DC
Gender: Male
NPI: 1811997364
# 12414 Alderbrook Dr
Ste 250
J(512) 834-2355
Clinic Affiliation: Forster Healthcare Assoc
PA
Board Certified Specialties: None
#
Esparza, Evelina, DC
Gender: Female
NPI: 1396014320
# 13915 N Burnet Rd
Ste 204
J(512) 238-9355
Clinic Affiliation: North Austin Chiropractic
Clinic
Board Certified Specialties: None
Harper, Thomas M, DC
Gender: Male
NPI: 1316986870
# 10625 W Parmer Ln
Ste D100
J(512) 341-7335
Clinic Affiliation: Avery Ranch Chiropractic
Board Certified Specialties: None
Austin
Austin
Hall, Curtis J, DC
Gender: Male
NPI: 1235175084
# 2407 S Congress Ave
J(512) 442-2777
Austin
#
NPI: 1235175084
914 W Anderson Ln
J(512) 454-4072
Clinic Affiliation: Hall Chiropractic Inc
Board Certified Specialties: None
Harkleroad, Zeke S, DC
Gender: Male
NPI: 1740297555
248 Addie Roy Rd
Ste C102
J(512) 327-5311
Board Certified Specialties: None
Austin
Fluitt, Kevin J, DC
Gender: Male
NPI: 1871880252
# 3005 S Lamar Blvd
Ste D112
J(512) 441-1240
Clinic Affiliation: Kapsner Chiropractic
Centerspa
Board Certified Specialties: None
Austin
Austin
Austin
Austin
Hausman, Robert W, DC
Gender: Male
NPI: 1801048442
# 8015 Shoal Creek Blvd
Ste 110
J(512) 419-1000
Clinic Affiliation: Hausman Chiropractic
and Acupunct
Board Certified Specialties: None
Hays, Casey P, DC
Gender: Male
NPI: 1558691931
3951 W Parmer Ln
Ste 300
(512) 339-2663
Board Certified Specialties: None
Hendrikz, Earl F, DC
Gender: Male
NPI: 1144520735
# 6448 E Hwy 290
Ste B111
(512) 374-1955
Clinic Affiliation: The Hendrikz Clinic
Board Certified Specialties: None
Austin
Henry, Michael P, DC
Gender: Male
NPI: 1831411719
# 4601 Southwest Pkwy
Ste 101
J(512) 899-2228
Clinic Affiliation: Texstar Chiropractic Clinic
PLLC
Board Certified Specialties: None
Austin
Hilliard, Charles C, DC
Gender: Male
NPI: 1003828401
# 12233 FM 620 N
Ste 107
J(512) 331-9999
Clinic Affiliation: Elite Chiropractic PLLC
Board Certified Specialties: None
Austin
Hoffman, Robert B, DC
Gender: Male
NPI: 1437145380
# 8727 Shoal Creek Blvd
J(512) 346-5164
Board Certified Specialties: None
Austin
Hogan, Shelly C, DC
Gender: Female
NPI: 1194850347
# 3407 Wells Branch Pkwy
Ste 625
J(512) 255-1777
Clinic Affiliation: Chicoine Chiropractic LLC
Board Certified Specialties: None
Austin
J - Wheelchair Access
74
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Kapsner, Michael A, DC
Gender: Male
NPI: 1487655890
# 3005 S Lamar Blvd
Ste D112
J(512) 441-1240
Lane, Dennis D, DC
Gender: Male
NPI: 1316194194
# 4029 S Capital of Texas
Hwy Ste 111
J(512) 345-5925
Aus tin
AUSTIN Cont
CHIROPRACTIC Cont
Holden, Bradley G, DC
Gender: Male
NPI: 1851323216
# 5815 W William Cannon Dr
Ste 101
J(512) 301-5996
Clinic Affiliation: Healthfirst Chiropractic PC
Board Certified Specialties: None
Austin
Holden, Nicole M, DC
Gender: Female
NPI: 1518242551
# 5815 W William Cannon Dr
Ste 101
J(512) 301-5996
Clinic Affiliation: Healthfirst Chiropractic PC
Board Certified Specialties: None
#
Austin
Jackson, Sheneaka B, DC
Gender: Female
NPI: 1538301106
# 5775 Airport Blvd
Ste 300
(512) 451-0115
Clinic Affiliation: Whitehead Chiropractic
Board Certified Specialties: None
Aus tin
Austin
Austin
Austin
Austin
Jepson, Russell D, DC
Gender: Male
NPI: 1932430782
11420 Bee Cave Rd
Ste A 100
J(512) 263-9961
Clinic Affiliation: Integrative Sports
Wellness Med C
Board Certified Specialties: None
Johnson, Marcus J, DC
Gender: Male
NPI: 1215187034
6836 Bee Caves Rd Ste 103
J(800) 404-6050
Clinic Affiliation: Airrosti Rehab Center LLC
Board Certified Specialties: None
Jones, Martin R, DC
Gender: Male
NPI: 1952618100
3200 Red River St
Ste 201
(800) 404-6050
Clinic Affiliation: Airrosti Rehab Center LLC
Board Certified Specialties: None
Jones, Patrick, DC
Gender: Male
NPI: 1639180383
# 2438 W Anderson Ln
Ste A2
J(512) 377-2663
Clinic Affiliation: P & C Chiropractic PC
Board Certified Specialties: None
Austin
Jones III, Ian L, DC
Gender: Male
NPI: 1407904899
# 1015 W 39th 1/2
J(512) 371-7478
Austin
NPI: 1407904899
7900 FM 1826 Ste 120
Bldg 1
(800) 404-6060
Clinic Affiliation: Airrosti Rehab Center
LLC, Pro Care Medical Center
Board Certified Specialties: None
Kanz, Kevin D, DC
Gender: Male
NPI: 1750327656
# 1111 W 24th St Ste B
J(512) 480-8889
Clinic Affiliation: University Chiropratic PC
Board Certified Specialties: None
Austin
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Austin
NPI: 1487655890
8440 Burnet Rd
Ste 118
J(512) 459-4014
Clinic Affiliation: Kapsner Chiropractic
Centerspa
Board Certified Specialties: None
NPI: 1316194194
4301 W William Cannon Dr
Ste 300 Bldg B
J(512) 949-3633
Clinic Affiliation: Lane Chiropractic and
Rehabilitat, The Spine Center
Board Certified Specialties: None
Kearns, Michael R, DC
Gender: Male
NPI: 1316017239
1106 Clayton Ln
Ste 102W
(800) 404-6050
Clinic Affiliation: Airrosti Rehab Center LLC
Board Certified Specialties: None
Kellerman, Nicolas L, DC
Gender: Male
NPI: 1669559993
# 13343 N Hwy 183
Ste 290
(512) 258-9355
Board Certified Specialties: None
Aus tin
Aus tin
Lara, Cynthia L, DC
Gender: Female
NPI: 1417012139
# 4006 S Lamar Blvd
Ste 650
J(512) 474-5433
Clinic Affiliation: Active Life Chiropractic
Clinic
Board Certified Specialties: None
Austin
Lawson, William M, DC
Gender: Male
NPI: 1043205735
# 9701 Brodie Ln
Ste 202
J(512) 326-2520
Clinic Affiliation: Lawson Chiropractic
Center
Board Certified Specialties: None
Austin
Kieke, Edwin, DC
Gender: Male
NPI: 1730214560
1007 S Congress Ste B11
(512) 326-5333
Clinic Affiliation: Koala Sports Medicine
Centers
Board Certified Specialties: None
Lay, James M, DC
Gender: Male
NPI: 1518075373
# 816 Congress Ave
Ste 980
J(512) 499-0366
Clinic Affiliation: San Jacinto Chiropractic
Inc
Board Certified Specialties: None
Austin
King, Alberto W, DC
Gender: Male
NPI: 1508109927
# 1007 S Congress
Ste B11
J(512) 326-5333
Aus tin
Leach, Brandie L, DC
Gender: Female
NPI: 1710062708
# 6500 N Mo Pac Expwy
Ste 3101
J(512) 491-7772
Clinic Affiliation: Performance Wellness
Centerslcc
Board Certified Specialties: None
Austin
NPI: 1508109927
7756 Northcross Dr
Ste 203
(512) 910-7005
Clinic Affiliation: Austin Align Chiropractic
and Reh, Koala Sports Medicine Centers
Board Certified Specialties: None
Lebeouf, Anice M, DC
Gender: Female
NPI: 1447360219
# 1007 S Congress Ste B11
J(512) 326-5333
Austin
Kjar, Sherrie L, DC
Gender: Female
NPI: 1598776775
# 1106 Clayton Ln
Ste 110W
J(512) 371-7119
Clinic Affiliation: Kjar Chiropractic Clinic PC
Board Certified Specialties: None
Aus tin
Kolenda, Thomas M, DC
Gender: Male
NPI: 1396752184
# 3818 Far West Blvd
Ste 110 Kolenda Chiro
J(512) 231-9002
Board Certified Specialties: None
#
#
Aus tin
Lewis, Cash W, DC
Gender: Male
NPI: 1891925012
# 3700 FM 620 S
J(512) 297-2288
Clinic Affiliation: Elite Wellness
Chiropractic and A
Board Certified Specialties: None
Austin
Logan, Roy A, DC
Gender: Male
NPI: 1073520227
# 11601 N Lamar Blvd Ste A
J(512) 215-3256
Board Certified Specialties: None
Austin
Lones, Joseph H, DC
Gender: Male
NPI: 1639381833
# 10102 N Lamar Blvd
Ste 100
J(512) 835-1955
Clinic Affiliation: Joseph H Lones III DC
Board Certified Specialties: None
Austin
Austin
Landers, Leonora, DC
Gender: Female
NPI: 1144392689
# 1600 W 38th St
Ste 120
(512) 892-4445
Clinic Affiliation: Barton Creek Chiropractic
LLC
Board Certified Specialties: None
Mason, Mary S, DC
Gender: Female
NPI: 1245338011
1108 Blanco St
J(512) 947-5517
Board Certified Specialties: None
Maxwell, Leslie C, DC
Gender: Female
NPI: 1013268283
# 5625 Eiger Rd
Ste 160
J(512) 326-1400
Clinic Affiliation: Capital of TX Chiropractic
Center
Board Certified Specialties: None
Austin
Maxwell, William A, DC
Gender: Male
NPI: 1043576028
# 500 N Capital of Texas
Hwy Bldg 6 Ste 125
(512) 201-4042
Clinic Affiliation: Choices Wellness
Board Certified Specialties: None
Austin
McClaugherty, Dwayne G, DC
Gender: Male
NPI: 1063558104
# 7800 N Mopac Expwy
Ste 340
J(512) 346-5567
Clinic Affiliation: American Chiropractic
Clinic Aust
Board Certified Specialties: None
NPI: 1447360219
500 San Marcos St
(512) 467-1100
NPI: 1447360219
911 W Anderson Ln
Ste 103
(512) 467-1100
Clinic Affiliation: Advanced Rehabilitation
PC, Koala Sports Medicine Centers
Board Certified Specialties: None
Lee, Byoung C, DC
Gender: Male
NPI: 1982705240
# 12505 Rampart St
Ste B
J(512) 339-1888
Clinic Affiliation: Ace Chiropractic PLLC
Board Certified Specialties: None
Austin
Austin
Aus tin
Lesko, Mark C, DC
Gender: Male
NPI: 1578598918
2013 Wells Branch Pkwy
Ste 103
J(512) 835-6077
Clinic Affiliation: Community Health and
Rehab Centre
Board Certified Specialties: None
Austin
NPI: 1447360219
4701 Westgate Blvd
Ste D401
(512) 467-1100
Aus tin
Kramer, Sandi M, DC
Gender: Female
NPI: 1699018267
# 6500 N Mopac Expwy
Bldg 3 Ste 3101
J(512) 491-7772
Clinic Affiliation: Performance Wellness
Centerslcc
Board Certified Specialties: None
Austin
McCormick, William R, DC
Gender: Male
NPI: 1205920774
4303 Victory Dr
(512) 462-3627
Clinic Affiliation: Victory Medical & Family
Care
Board Certified Specialties: None
McKinley, Donald, DC
Gender: Male
NPI: 1902949001
# 5625 Eiger Rd
Ste 160
J(512) 326-1400
Clinic Affiliation: Capital of TX Chiropractic
Center
Board Certified Specialties: None
Austin
J - Wheelchair Access
75
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Owen, Jack H, DC
Gender: Male
NPI: 1669577789
# 7739 Northcross Dr
Ste J
J(512) 380-9808
Clinic Affiliation: First Wellness Inc
Board Certified Specialties: None
Salyer, Don A, DC
Gender: Male
NPI: 1366528580
# 4825 E Riverside Dr
J(512) 442-4357
Clinic Affiliation: Capital Chiropractic
Center PC
Board Certified Specialties: None
Paris, Michelle, DC
Gender: Female
NPI: 1649416546
# 4600 Mueller Blvd
Ste 1009
J(512) 505-8500
Clinic Affiliation: Whole Family
Chiropractors
Board Certified Specialties: None
Sanders, Joshua S, DC
Gender: Male
NPI: 1598073686
# 3600 N Capital of Texas
Hwy Ste A-160
J(512) 334-9648
Clinic Affiliation: Healthsource of Austin
Westlake
Board Certified Specialties: None
Pellien, Jordan T, DC
Gender: Male
NPI: 1629358155
# 4701 Westgate Blvd
Ste D401
J(512) 467-1100
Savedra, Daphne D, DC
Gender: Female
NPI: 1275664773
# 12129 FM 620 N
Ste 430
(512) 250-0025
Clinic Affiliation: Careplus Chiropractic PA
Board Certified Specialties: None
Austin
AUSTIN Cont
CHIROPRACTIC Cont
Aus tin
Millan, Miguel A, DC
Gender: Male
NPI: 1255669578
12319 N Mopac
Ste 260
(512) 673-8152
Clinic Affiliation: Clinica Millan
Board Certified Specialties: None
Miller III, Gibbs D, DC
Gender: Male
NPI: 1114951985
# 1910 Justin Ln
J(512) 451-0846
Practice Information: No Patients Under 5
yrs old
Board Certified Specialties: None
Aus tin
Moore, Michele M, DC
Gender: Female
NPI: 1972521607
# 8301 Shoal Creek
J(512) 459-5523
Board Certified Specialties: None
Aus tin
Aus tin
Aus tin
Morris, Tara J, DC
Gender: Female
NPI: 1306957238
5301 W Duvall Rd
Ste A500
J(800) 404-6050
Clinic Affiliation: Airrosti Rehab Center LLC
Board Certified Specialties: None
Mullen, Kimberly A, DC
Gender: Female
NPI: 1538307764
12611 Hymeadow Dr
(503) 516-5844
NPI: 1538307764
700B S Lamar Blvd
(512) 516-5844
Board Certified Specialties: None
Aus tin
Austin
Nietsche McKirdy, Tria, DC
Gender: Female
NPI: 1942239470
# 4422 Pack Saddle Pass 103
J(512) 444-2227
Board Certified Specialties: None
Aus tin
Oberle, Tony L, DC
Gender: Male
NPI: 1144315235
# 5815 W William Cannon
Dr Ste 101
J(512) 301-5996
Clinic Affiliation: Healthfirst Chiropractic PC
Board Certified Specialties: None
Aus tin
Olson, Christopher M, DC
Gender: Male
NPI: 1386978690
# 6500 N Mopac Expwy
Ste 101 Bldg 3
J(512) 491-7772
Clinic Affiliation: Performance Wellness
Centerslcc
Board Certified Specialties: None
Aus tin
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Austin
Austin
Austin
NPI: 1629358155
500 San Marcos St
J(512) 467-1100
Perez, Daniel N, DC
Gender: Male
NPI: 1487989299
# 1701 W Ben White Blvd
Ste 157
J(512) 826-5141
Clinic Affiliation: Abundant Life Chiropractic
Board Certified Specialties: None
Austin
Austin
Schade, Cynthia J, DC
Gender: Female
NPI: 1669414959
# 4006 S Lamar Blvd
Ste 650
J(512) 474-5433
Clinic Affiliation: Active Life Chiropractic
Clinic
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: None
Austin
NPI: 1629358155
911 W Anderson Ln
Ste 103
J(512) 467-1100
Clinic Affiliation: Advanced Rehabilitation
PC
Board Certified Specialties: None
Mullins, Roy C, DC
Gender: Male
NPI: 1467518548
1515 S Capital of Texas
Hwy Ste 202
J(512) 327-2729
NPI: 1467518548
4304 Victory Dr
(512) 462-3627
Clinic Affiliation: Austin Total Rehab,
Victory Medical & Family Care
Board Certified Specialties: None
Austin
Reynolds, Austin L, DC
Gender: Male
NPI: 1154679264
2714 Bee Cave Rd
Ste 100
(512) 330-9965
Clinic Affiliation: Performance Therapy
Group PLLC
Board Certified Specialties: None
Schmidt, Robert E, DC
Gender: Male
NPI: 1235383852
# 1015 W Lynn St
(512) 850-6979
Clinic Affiliation: Restoration Chiropractic
LLC
Board Certified Specialties: None
Austin
Austin
Schwab, Tracie L, DC
Gender: Female
NPI: 1043362858
12101 W Parmer Ln
Ste 200
J(512) 363-5178
Board Certified Specialties: None
Schwartz, Adam L, DC
Gender: Male
NPI: 1225028905
# 7212 W Hwy 71
Ste B
J(512) 288-7100
Board Certified Specialties: None
Austin
Richard, Al D, DC
Gender: Female
NPI: 1184608424
# 1613 W Sixth St Ste C
J(512) 542-9031
Clinic Affiliation: Richard Family
Chiropractic PA
Board Certified Specialties: None
Austin
Sellers, Chris L, DC
Gender: Male
NPI: 1356427470
# 6500 N Mo Pac Expwy 3 101
J(512) 491-7772
Clinic Affiliation: Performance Wellness
Centerslcc
Board Certified Specialties: None
Austin
Richardson, Craig E, DC
Gender: Male
NPI: 1013012889
# 1619 W Sixth St
J(512) 472-1116
Board Certified Specialties: None
Austin
Robin, James A, DC
Gender: Male
NPI: 1811998941
# 11645 Angus Rd
Ste 2
J(512) 231-8822
Board Certified Specialties: None
Austin
Shaner, Jonathan R, DC
Gender: Male
NPI: 1932440476
# 6500 N Mopac Expwy
Bldg 3 Ste 3101
(512) 491-7772
Clinic Affiliation: Performance Wellness
Centerslcc
Board Certified Specialties: None
Austin
Shannan, George M, DC
Gender: Male
NPI: 1801808431
# 5840 Balcones Dr
Ste 100
J(512) 452-9469
Clinic Affiliation: George M Shannon DC
Board Certified Specialties: None
Austin
Shaw, James C, DC
Gender: Male
NPI: 1962547562
# 12034 Research Blvd
Ste 1
(512) 250-1099
Board Certified Specialties: None
Austin
Shepard, Kirsten K, DC
Gender: Female
NPI: 1760526925
# 4101 Marathon Blvd
(512) 323-9222
Clinic Affiliation: Longevity Wellness Group
Inc
Board Certified Specialties: None
Austin
Sheppard, Gregory B, DC
Gender: Male
NPI: 1053387118
# 2500 W William Cannon
Dr Ste 205
(512) 445-3366
Clinic Affiliation: Austin Chiropractic Ctr PC
Practice Information: No Patients Under 1
yrs old
Board Certified Specialties: None
Austin
Shigley, Diane E, DC
Gender: Female
NPI: 1558348797
# 13552 Hwy 183 N Ste D
J(512) 331-3833
Clinic Affiliation: Advanced Chiropractic
Center
Board Certified Specialties: None
Austin
Simmons, Jonathan W, DC
Gender: Male
NPI: 1598772303
# 7010 Hwy 71 W Ste 360
J(512) 288-5322
Board Certified Specialties: None
Austin
Snow, Michael J, DC
Gender: Male
NPI: 1295736601
# 8440 Burnet Rd
Ste 118
J(512) 459-4014
Clinic Affiliation: Kapsner Chiropractic
Centerspa
Board Certified Specialties: None
Austin
Austin
Shaddock, Daniel A, DC
Gender: Male
NPI: 1073818936
# 1807 W Slaughter Ln
Ste 450
(512) 280-6103
Austin
Rodriguez, Alexia, DC
Gender: Female
NPI: 1891822334
# 1714 Fortview Rd
Ste 102
(512) 326-5700
Clinic Affiliation: Fortview Chiropractic
Clinic LLC
Board Certified Specialties: None
NPI: 1073818936
2800 S IH 35
Ste 220
(512) 707-1700
Board Certified Specialties: None
Austin
Shaffer, Richard B, DC
Gender: Male
NPI: 1669550703
# 1510 W 34th St Ste 203
J(512) 374-1677
Board Certified Specialties: None
Austin
#
Starkey, David R, DC
Gender: Male
NPI: 1497978787
4220 W William Cannon
Ste 130
(512) 892-3434
NPI: 1497978787
4220 W Wm Cannon Dr
Ste 130
J(512) 892-3434
Hospital Affiliation: Umc Home Health
Clinic Affiliation: Texas Chiropractic and
Therapy
Board Certified Specialties: None
J - Wheelchair Access
76
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Vaughn, Cynthia S, DC
Gender: Female
NPI: 1114993375
# 2500 W William Cannon
Dr Ste 205
J(512) 445-3366
Clinic Affiliation: Austin Chiropractic Ctr PC
Board Certified Specialties: None
Aus tin
AUSTIN Cont
CHIROPRACTIC Cont
Stephenson, Johanna R, DC
Gender: Female
NPI: 1265434518
# 7301 Burnet Rd
Ste 104
(512) 419-0330
Clinic Affiliation: Total Health Chiropractic
PC
Board Certified Specialties: None
Austin
Summers, Stephen L, DC
Gender: Male
NPI: 1255456232
# 3907 Medical Pkwy Ste 102
J(512) 458-5880
Board Certified Specialties: None
Austin
Swanson, Justin M, DC
Gender: Male
NPI: 1750531042
# 6101 Balcones Dr
Ste 102
J(512) 452-2525
Clinic Affiliation: Austin Chiropractic and
Acupunctu
Board Certified Specialties: None
Austin
Sweney, Roxanne R, DC
Gender: Female
NPI: 1538339007
# 3823 Airport Blvd
Ste A
J(512) 743-6421
Clinic Affiliation: Sunflower Wellness Assoc
PLL
Board Certified Specialties: None
Austin
Ude, Kristen, DC
Gender: Female
NPI: 1720087331
# 1600 W 38th St
Ste 412
J(512) 970-8883
Clinic Affiliation: Integrated Chiropractic
Wellness
Board Certified Specialties: None
Wagner, David R, DC
Gender: Male
NPI: 1255444345
# 3107 Slaughter Ln
J(512) 280-6212
Clinic Affiliation: Slaughter Lane
Chiropractic
Board Certified Specialties: None
Vacula, Dorothy D, DC
Gender: Female
NPI: 1487705083
# 4131 Spicewood Sprgs I 2
(512) 524-8551
Board Certified Specialties: None
Austin
Vandewalle, Alexander C, DC
Gender: Male
NPI: 1326141581
# 11824 Jollyville Rd
Ste 500
(512) 343-0700
Austin
#
#
NPI: 1326141581
3624 N Hills Dr
Ste A101
(512) 474-0700
NPI: 1326141581
3624 N Hills Dr A101
(512) 343-0700
Clinic Affiliation: Alex Vandewalle PA,
Michael F Vandewalle PC
Board Certified Specialties: None
Vandewalle, Audrey A, DC
Gender: Female
NPI: 1831412014
# 11824 Jollyville Rd
Ste 500
(512) 343-0700
Clinic Affiliation: Michael F Vandewalle PC
Board Certified Specialties: None
Vandewalle, Michael F, DC
Gender: Male
NPI: 1013925007
# 11824 Jollyville Rd
Ste 500
J(512) 343-0700
Clinic Affiliation: Michael F Vandewalle PC
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Wu, Eric, DC
Gender: Male
NPI: 1235489568
# 13740 Research Blvd
Ste L4
J(512) 436-3798
Board Certified Specialties: None
Austin
Welch, Jonathan B, DC
Gender: Male
NPI: 1124399647
!# 2630 Exposition Blvd
Ste G02
(512) 514-5150
Clinic Affiliation: The Adjustment Bureau
Board Certified Specialties: None
Austin
Wells, Jack A, DC
Gender: Male
NPI: 1659619583
1015 W 39 1/2 St
(512) 371-7478
#
NPI: 1659619583
4220 W Wm Cannon Dr
Ste 130
J(512) 892-3434
Clinic Affiliation: Pro Care Medical Center,
Texas Chiropractic and Therapy
Board Certified Specialties: None
Austin
Whipple, Todd O, DC
Gender: Male
NPI: 1770622748
# 4701 Westgate Blvd
A102
J(512) 448-0900
Board Certified Specialties: None
Aus tin
White, Kenneth S, DC
Gender: Male
NPI: 1497715106
# 3410 Far West Blvd
Ste 100
J(512) 346-5735
Board Certified Specialties: None
Austin
NPI: 1851735534
7801 N Lamar Blvd
Ste B174
J(512) 371-7273
Clinic Affiliation: Austin Physical Therapy
Specialis, Koala Sports Medicine Centers
Board Certified Specialties: None
Austin
Whitehead, Wendee R, DC
Gender: Female
NPI: 1205932324
# 5775 Airport Blvd
Ste 300
(512) 451-0115
#
#
NPI: 1205932324
5775 Airport Blvd Ste 300
Whitehead Chiro Ctr
J(512) 451-0115
Clinic Affiliation: Whitehead Chiropractic
Board Certified Specialties: None
" Cline, Robert W, MD
Austin
Gender: Male
NPI: 1689645194
4106 Medical Pkwy
(512) 418-1979
Hospital Affiliation: Bailey Square Surgery
Center, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
Seton Southwest, St Davids Medical Center,
St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Colon & Rectal
Clinicassoc
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties: Colon-Rectal
Surgery
Wylie, Bryan M, DC
Gender: Male
NPI: 1043599699
4600 Mueller Blvd
Ste 1009
(512) 505-8500
Clinic Affiliation: Whole Family
Chiropractors
Board Certified Specialties: None
" Fleeger, David C, MD
Austin
Gender: Male
NPI: 1073597688
4007 James Casey D150
J(512) 445-5484
Hospital Affiliation: Bailey Square Surgery
Center, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, Surgicare Of South
Austin, University Med Ctr Brackenridge
Clinic Affiliation: Austin Colon & Rectal
Clinicassoc
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Colon-Rectal
Surgery
NPI: 1285628644
500 San Marcos St
Ste 104
(512) 467-1100
NPI: 1285628644
911 W Anderson Ln
Ste 103
(512) 467-1100
Clinic Affiliation: Advanced Rehabilitation
PC
Board Certified Specialties: None
Zygmont, Colette Y, DC
Gender: Female
NPI: 1326171927
# 4036 S Lamar Blvd
Ste 600
J(512) 442-7400
Clinic Affiliation: Zygmont Chiropractic
Center
Board Certified Specialties: None
Austin
Wilder, Dorea L, DC
Gender: Female
NPI: 1366670853
# 4701 Westgate Blvd
Ste D401
J(512) 467-1100
Aus tin
NPI: 1366670853
911 W Anderson Ln
Ste 103
J(512) 467-1100
Clinic Affiliation: Advanced Rehabilitation
PC
Board Certified Specialties: None
York, Jennifer A, MD
Gender: Female
NPI: 1194728535
5750 Balcones Dr
Ste 110
J(512) 744-0015
Hospital Affiliation: Seton Medical Center,
St Davids S Austin Medical Center
Clinic Affiliation: Texas Neurology Center
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Neurology,
Sleep Medicine
COLON-RECTAL SURGERY
Austin
Aus tin
Immken, Ladonna L, MD
Gender: Female
NPI: 1053363531
6811 Austin Center Blvd
Ste 400
J(512) 628-1918
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Northwest Hospital, University Med Ctr
Brackenridge
Clinic Affiliation: Esoterix Genetic
Counseling LLC
Board Certified Specialties: None
CLINICAL NEUROPHYSIOLOGY
Wunnenberg, Steven K, DC
Gender: Male
NPI: 1851735534
1007 S Congress
Ste B11
(512) 326-5333
Zelinski, Adam J, DC
Gender: Male
NPI: 1285628644
# 4701 Westgate Blvd
Ste D401
(512) 467-1100
Aus tin
#
CLINICAL GENETICS
Worley, Richard R, DC
Gender: Male
NPI: 1831374909
# 15004 Avery Ranch Blvd
Bldg A-200
(512) 255-5252
Clinic Affiliation: Salus Chiropractic
Board Certified Specialties: None
Aus tin
#
Zygmont, Greg D, DC
Gender: Male
NPI: 1932282522
# 5900 W Slaughter Ln
Ste 470
J(512) 288-5502
Clinic Affiliation: Zygmont Family
Chiropractic
Board Certified Specialties: None
Austin
Austin
Watson, Amber D, DC
Gender: Female
NPI: 1063844181
# 4220 W William Cannon Dr
Ste 130
J(512) 892-3434
Clinic Affiliation: Texas Chiropractic and
Therapy
Board Certified Specialties: None
Austin
Austin
Austin
Aus tin
Austin
Williams, Aaron S, DC
Gender: Male
NPI: 1447258579
1007 S Congress Ste B11
(512) 326-5333
Clinic Affiliation: Koala Sports Medicine
Centers
Board Certified Specialties: None
Woods, Wesley B, DC
Gender: Male
NPI: 1801823356
# 2501 W William Cannon 208
J(512) 442-9595
Clinic Affiliation: Cole Chiropractic PC
Board Certified Specialties: None
Aus tin
Aus tin
Austin
" Fox, April W, MD
Austin
Gender: Female
NPI: 1134323926
4106 Medical Pkwy
J(512) 418-1979
Clinic Affiliation: Austin Colon & Rectal
Clinicassoc
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Colon-Rectal
Surgery
J - Wheelchair Access
77
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
AUSTIN Cont
DENTISTRY
" Cabrera, Elizabeth, MD
Austin
Gender: Female
NPI: 1245242262
7801 N Lamar Blvd
Ste D8182
J(512) 868-3376
Hospital Affiliation: North Austin Medical
Center, St Davids Georgetown Hospital
Clinic Affiliation: Vitalogy PA
Board Certified Specialties: Dermatology
Reinhardt, Gary D, DDS
Gender: Male
NPI: 1477684256
# 12201 Renfert Way
Ste 345
(512) 836-3074
Clinic Affiliation: Carus Dental
Board Certified Specialties: None
Austin
COLON-RECTAL SURGERY Cont
" Graves III, Ernest D, MD
Aus tin
Gender: Male
NPI: 1578547188
4007 James Casey D150
J(512) 447-8911
#
NPI: 1578547188
4208 Medical Parkway
J(512) 452-9551
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Colon & Rectal
Clinicassoc
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: Colon-Rectal
Surgery
" Lakshman, Thiru V, MD
Aus tin
Gender: Male
NPI: 1427187350
4208 Medical Pkwy
(512) 452-9551
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Colon & Rectal
Clinicassoc
Board Certified Specialties: Colon-Rectal
Surgery
DERMATOLOGY
" Robertson III, William G, MD
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
NPI: 1760650428
8825 Bee Cave Rd
Ste 100
(512) 328-3376
Clinic Affiliation: Westlake Dermatology &
Cosmet
Board Certified Specialties: Dermatology
" Cooper, Amanda N, MD
Austin
Gender: Female
NPI: 1588808562
7800 N Mopac Expwy
Ste 315
(512) 459-4869
Clinic Affiliation: Balcones Dermatology
Assoc P
Board Certified Specialties: Dermatology
NPI: 1982716783
5000 Davis Ln
Ste 200
J(512) 615-2730
Aranda, Jennifer, MD
Gender: Female
NPI: 1902875453
1510 W 34th St Ste 100
(512) 533-9900
" Diven, Dayna G, MD
Austin
NPI: 1982716783
601 E 15th St
(512) 324-7000
#
Gender: Female
NPI: 1740214675
313 E 12th St
Ste 103
J(512) 324-9650
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center Hays,
University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Dermatology
NPI: 1982716783
8825 Bee Cave Rd
Ste 100
J(512) 328-3376
Clinic Affiliation: University Physicians
Group, Westlake Dermatology & Cosmet
Board Certified Specialties: Dermatology
" Coleman, Kyle M, MD
Austin
" Bhatt, Roopal K, MD
Austin
Gender: Male
NPI: 1588777361
12201 Renfert Way
Ste 305
J(512) 279-3376
Gender: Female
NPI: 1649253279
1801 E 51st St
Ste 320 Bldg C
J(512) 478-3376
NPI: 1588777361
327 E Cesar Chavez St
J(512) 615-3280
NPI: 1649253279
6618 Sitio Del Rio
Blvd Ste D101
J(512) 478-3376
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Four Points Dermatology
Board Certified Specialties: Dermatology
Austin
NPI: 1760650428
5000 Davis Ln
Ste 200
(512) 615-2730
NPI: 1982716783
327 E Cesar Chavez St
J(512) 615-3280
Austin
" Solis, Ricardo L, MD
Gender: Male
NPI: 1891802732
4007 James Casey D150
(512) 447-8911
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Colon & Rectal
Clinicassoc
Practice Information: No Patients Under 10
yrs old
Board Certified Specialties: Colon-Rectal
Surgery
Gender: Female
NPI: 1982716783
12201 Renfert Way
Ste 305
J(512) 279-3376
NPI: 1902875453
313 E 12th St
Ste 104
(512) 324-9650
Hospital Affiliation: Parkland Health And
Hospital Sys, St Davids Medical Center
Clinic Affiliation: Renee Snyder MD,
University Physicians Group
Board Certified Specialties: None
Aus tin
NPI: 1558345793
3705 Medical Pkwy
Ste 340
J(512) 454-3781
Hospital Affiliation: Houston Methodist St
John Hosp
Clinic Affiliation: Austin Derm Assoc
Board Certified Specialties: Dermatology
Austin
Gender: Male
NPI: 1245421429
313 E 12th St
Ste 103
J(512) 324-9699
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center Hays,
University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Dermatology
Gender: Male
NPI: 1780869271
4106 Medical Pkwy
J(512) 418-1755
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Colon & Rectal
Clinicassoc
Board Certified Specialties: Colon-Rectal
Surgery
NPI: 1760650428
327 E Cesar Chavez St
(512) 615-3280
" Chern, Peggy L, MD
" Ahmed, Ammar, MD
Austin
Gender: Male
NPI: 1437195724
4106 Medical Pkwy
J(512) 418-1979
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Colon & Rectal
Clinicassoc
Board Certified Specialties: Colon-Rectal
Surgery
Aus tin
#
NPI: 1194766444
912 S Capital of TX Hwy
Ste 100
J(512) 930-3909
Clinic Affiliation: Vitalogy PA
Board Certified Specialties: Dermatology
" Mangione, John S, MD
Gender: Female
NPI: 1760650428
12201 Renfert Way
Ste 305
(512) 279-3376
Gender: Male
NPI: 1558345793
14101 Hwy 290 W
Bldg 500A
J(512) 454-3781
Gender: Male
NPI: 1194766444
7801 N Lamar Blvd
Ste D8182
J(512) 868-3376
Aus tin
" Conroy, Melinda D, DO
" Carrasco, Daniel A, MD
" Adelman, Eric A, DO
Collins, Kristina M, MD
Gender: Female
NPI: 1881895118
5625 Eiger Rd
Ste 105
(512) 763-3760
Clinic Affiliation: Vitalogy PA
Board Certified Specialties: None
Austin
Austin
Austin
Austin
Austin
NPI: 1588777361
5000 Davis Ln
Ste 200
J(512) 615-2730
#
Bushore, David A, MD
Gender: Male
NPI: 1568461036
7800 N Mopac Expwy
Ste 315
(512) 459-4869
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, Seton Southwest,
University Med Ctr Brackenridge
Clinic Affiliation: Balcones Dermatology
Assoc P
Board Certified Specialties: None
NPI: 1588777361
8825 Bee Cave Rd
Ste 100
J(512) 328-3376
Clinic Affiliation: Westlake Dermatology &
Cosmet
Board Certified Specialties: Dermatology
" Collins, Christopher D, MD
Austin
Gender: Male
NPI: 1477636975
6811 Austin Center
Blvd Ste 300
(512) 346-8888
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Dermatology
Dozier, Susan E, MD
Gender: Female
NPI: 1023033883
8240 N Mopac Expwy
Ste 355
J(512) 527-9020
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Susan E Dozier MD
Board Certified Specialties: None
" Evans, Colby C, MD
Austin
Gender: Male
NPI: 1588766810
3508 S Lamar Blvd
Ste 300
J(512) 280-3939
NPI: 1588766810
9701 Brodie Ln A106
J(512) 280-3939
Hospital Affiliation: Seton Southwest, St
Davids S Austin Medical Center
Clinic Affiliation: Colby Evans MD
Board Certified Specialties: Dermatology
J - Wheelchair Access
78
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Aus tin
AUSTIN Cont
DERMATOLOGY Cont
" Flynn, Kevin J, MD
Austin
Gender: Male
NPI: 1689640633
12201 Renfert Way
Ste 305
(512) 279-3376
Gender: Male
NPI: 1013122753
7801 N Lamar Blvd
Ste D8182
(512) 868-3376
Clinic Affiliation: Vitalogy PA
Board Certified Specialties: Dermatology
Gender: Male
NPI: 1487766937
6811 Austin Center Blvd
Ste 300
(512) 346-0312
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Dermatology
NPI: 1528030392
8825 Bee Cave Rd
Ste 100
J(512) 328-3376
Hospital Affiliation: St Davids Medical
Center
Clinic Affiliation: Westlake Dermatology &
Cosmet
Board Certified Specialties: Dermatology
" Lain, Edward L, MD
Austin
#
" Hanson, Miriam L, MD
NPI: 1437353091
5000 Davis Ln
Ste 200
(512) 615-2730
Gender: Female
NPI: 1619047339
12319 N Mopac Expwy
Ste 100 Bldg C
J(512) 837-3376
Hospital Affiliation: North Austin Medical
Center
Clinic Affiliation: Sanova Dermatology
PLLC
Board Certified Specialties: Dermatology
Gender: Male
NPI: 1326200569
12201 Renfert Way
Ste 305
(512) 279-3376
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Male
NPI: 1013097419
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1920
Hospital Affiliation: Chi St Lukes Hlth
Baylor Coll Med, Dell Childrens Med Ctr Cent
Tx, Houston Methodist Hospital, Texas
Childrens Hospital, The Womans Hospital Of
Texas
Clinic Affiliation: Specially For Children
Board Certified Specialties: Dermatology
NPI: 1982863510
327 E Cesar Chavez St
J(512) 615-3280
" Mamelak, Adam J, MD
Austin
#
NPI: 1982863510
5000 Davis Ln
Ste 200
J(512) 615-2730
" Ghidoni, John J, MD
#
#
NPI: 1033181813
327 E Cesar Chavez St
J(512) 615-3280
NPI: 1033181813
5000 Davis Ln
Ste 200
J(512) 615-2730
NPI: 1033181813
8825 Bee Cave Rd
Ste 100
J(512) 328-3376
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Westlake Dermatology &
Cosmet
Practice Information: No Patients Under 21
yrs old
Board Certified Specialties: Dermatology
Austin
" Levy, Moise L, MD
Gender: Female
NPI: 1982863510
12201 Reinfert Way
Ste 305
J(512) 279-3376
Austin
Gender: Male
NPI: 1033181813
12201 Renfert Way
Ste 305
J(512) 279-3376
Austin
" Jackson, Julie E, MD
NPI: 1326200569
8825 Bee Caves Rd Ste 200
(512) 328-3376
Clinic Affiliation: Westlake Dermatology &
Cosmet
Board Certified Specialties: Dermatology
Gender: Male
NPI: 1003829920
8229 Shoal Creek Blvd
Ste 101
J(512) 371-7400
Hospital Affiliation: Seton Medical Center,
St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Board Certified Specialties: Dermatology
NPI: 1710159140
327 E Cesar Chavez St
J(512) 615-3280
Clinic Affiliation: Westlake Dermatology &
Cosmet
Board Certified Specialties: Dermatology
Aus tin
NPI: 1326200569
5000 Davis Ln
Ste 200
(512) 615-2730
#
Gender: Female
NPI: 1710159140
12201 Renfert Way
Ste 305
J(512) 279-3376
Gender: Male
NPI: 1851304380
720 W 34th St
Ste 210
J(512) 450-1001
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Central Austin
Dermatology PA
Board Certified Specialties: Dermatology
" Friedmann, Daniel P, MD
" Nikolaidis, Gregory A, MD
Austin
" Lankerani, Lela, DO
" Hendrix, Jay A, MD
Austin
Gender: Male
NPI: 1124079306
4300 N Quinlan Park Rd
Ste 225
J(512) 266-0007
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center
Clinic Affiliation: Steiner Ranch
Dermatology PA
Board Certified Specialties: Dermatology
NPI: 1033372586
9701 Brodie Ln Ste A106
(512) 280-3939
Clinic Affiliation: Colby Evans MD
Board Certified Specialties: Dermatology
Austin
Aus tin
NPI: 1437353091
8825 Bee Cave Rd
Ste 100
(512) 328-3376
Clinic Affiliation: Westlake Dermatology &
Cosmet
Board Certified Specialties: Dermatology
Gender: Female
NPI: 1033372586
3508 S Lamar Blvd
Ste 300
(512) 280-3939
" Kennedy, Bobby J, DO
Aus tin
#
" McClung, Amy A, MD
Austin
Austin
NPI: 1528030392
5000 Davis Ln
Ste 200
J(512) 615-2730
" Fridlington, Julie L, MD
Gender: Female
NPI: 1831242585
6811 Austin Center Blvd
Ste 300
(512) 346-8888
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Dermatology
" Jones Jr, Christopher R, MD
NPI: 1528030392
327 E Cesar Chavez St
J(512) 615-3280
#
" Mason, Amy R, MD
Austin
Austin
Gender: Female
NPI: 1528030392
12201 Renfert Way
Ste 305
J(512) 279-3376
Austin
NPI: 1437353091
327 E Cesar Chavez St
(512) 615-3280
Gender: Female
NPI: 1396728309
13642 N Hwy 183
Bldg 2 Ste 100
J(512) 331-7300
Clinic Affiliation: Spicewood Dermatology
PA
Board Certified Specialties: Dermatology
" Hanft, Valerie N, MD
" Fox, Matthew C, MD
Gender: Female
NPI: 1437353091
12201 Renfert Way
Ste 305
(512) 583-3376
" Jeng, Dana C, MD
Gender: Female
NPI: 1356532543
13642 N Hwy 183
Bldg 2 Ste 100
(512) 331-7300
Clinic Affiliation: Spicewood Dermatology
PA
Board Certified Specialties: Dermatology
Austin
Aus tin
Austin
" Martin, Julie E, MD
Austin
Gender: Female
NPI: 1801072855
7801 N Lamar Blvd
Ste D8182
J(512) 868-3376
Clinic Affiliation: Vitalogy PA
Board Certified Specialties: Dermatology
NPI: 1073748281
5000 Davis Ln
Ste 200
(512) 328-3376
Clinic Affiliation: Westlake Dermatology &
Cosmet
Board Certified Specialties: None
NPI: 1689640633
8825 Bee Cave Rd
Ste 100
(512) 328-3376
Hospital Affiliation: North Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Westlake Dermatology &
Cosmet
Board Certified Specialties: Dermatology
Gender: Male
NPI: 1740471929
1400 N IH 35
Ste C2-450
J(512) 324-7468
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Dermatology
" Jan, Mollie M, DO
Austin
NPI: 1073748281
327 E Cesar Chavez St
(512) 615-3280
NPI: 1689640633
327 E Cesar Chavez St
(512) 615-3280
NPI: 1689640633
5000 Davis Ln
Ste 200
(512) 615-2730
Gordon, Jennifer R, MD
Gender: Female
NPI: 1073748281
12201 Renfert Way
Ste 305
(512) 279-3376
NPI: 1982863510
8825 Bee Caves Rd
Ste 200
J(512) 328-3376
Clinic Affiliation: Westlake Dermatology &
Cosmet
Board Certified Specialties: Dermatology
Gender: Male
NPI: 1174663835
12319 N Mopac Expwy
Ste 100 Bldg C
J(512) 837-3376
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Northwest Hospital
Clinic Affiliation: Sanova Dermatology
PLLC
Board Certified Specialties: Dermatology
Pena Robichaux, Venessa, MD
Gender: Female
NPI: 1851611164
3508 S Lamar Blvd
Ste 300
J(512) 280-3939
NPI: 1851611164
9701 Brodie Ln
Ste A106
J(512) 280-3939
Clinic Affiliation: Colby Evans MD
Board Certified Specialties: None
Austin
Rains, Michael L, MD
Gender: Male
NPI: 1275851032
3508 S Lamar Blvd
Ste 300
J(512) 280-3939
NPI: 1275851032
9701 Brodie Ln A106
J(512) 280-3939
Clinic Affiliation: Colby Evans MD
Board Certified Specialties: None
J - Wheelchair Access
79
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Smetanick, Matthew T, DO
" Viernes, Jay L, MD
Austin
AUSTIN Cont
DERMATOLOGY Cont
" Rasmussen, Steven E, MD
Aus tin
Gender: Male
NPI: 1679567937
1717 W Sixth St Ste 120R
(512) 482-9344
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Dermatology
" Reichenberg, Jason S, MD
" Rhodes, Lisa M, MD
" Snavely, Nicholas R, MD
Gender: Male
NPI: 1801099460
10815 RR 2222 Bldg 3A
Ste 200
(512) 767-7546
Board Certified Specialties: Dermatology
Gender: Female
NPI: 1942281639
1510 W 34th St Ste 100
J(512) 533-9900
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Renee Snyder MD
Board Certified Specialties: Dermatology
NPI: 1326011859
8825 Bee Caves Rd
Ste 100
J(512) 328-3376
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Southwest, St Davids Medical Center,
St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Westlake Dermatology &
Cosmet
Board Certified Specialties: Dermatology
" Richardson, Blakely S, DO
" Speck, Laura M, MD
Gender: Female
NPI: 1760644785
12201 Renfert Way
Ste 305
(512) 279-3376
" Schulze, Thomas, MD
" Thrash, Candace M, MD
Austin
Gender: Female
NPI: 1093764664
3705 Medical Pkwy
Ste 340
(512) 454-3781
Clinic Affiliation: Austin Derm Assoc
Board Certified Specialties: Dermatology
" Townsend, Bryan L, MD
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Female
NPI: 1689016685
5555 N Lamar Blvd
Ste D-125
(512) 324-1891
Clinic Affiliation: Seton Medical Group
Board Certified Specialties: Dietician
" Truehill Devoil, Tiffany D, RD
Austin
Gender: Female
NPI: 1023435005
1210 W Braker
(512) 978-9300
Clinic Affiliation: Communitycare
Board Certified Specialties: Dietician
ENDOCRINOLOGY
Austin
Bunker, Stephen R, MD
Gender: Male
NPI: 1427014117
2712 Bee Caves Rd
Ste 122
(512) 726-0599
Hospital Affiliation: Arise Austin Medical
Center
Clinic Affiliation: Austin Imaging and Vein
Center
Board Certified Specialties: None
McKinney, James A, DO
Gender: Male
NPI: 1861571614
6633 Hwy 290
Ste 101
J(512) 314-3834
Board Certified Specialties: None
" Bledsoe, Maya, MD
Austin
Gender: Female
NPI: 1194730242
11111 Research Blvd
Ste 485
J(512) 338-8181
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Endocrinology,
Diabetes & Metabolism
" Blevins, Thomas, MD
Austin
Gender: Male
NPI: 1114992088
6500 N Mopac
Ste 200 Bldg 3
J(512) 458-8400
Hospital Affiliation: Heart Hospital Of
Austin, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Texas Diabetes &
Endocrinology
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Endocrinology,
Diabetes & Metabolism
Gender: Female
NPI: 1144481037
408 W 45th St
(512) 451-5800
Clinic Affiliation: Austin Kidney Assoc PA
Board Certified Specialties: Dietician
" Brookshire, Kristin A, RD
Austin
Gender: Female
NPI: 1386061315
2802 Webberville Rd
(512) 978-9400
Clinic Affiliation: Communitycare
Board Certified Specialties: Dietician
Gender: Male
NPI: 1619056827
8500 Bluffstone Cv
Ste A101
J(512) 328-2102
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Medical
Center
Clinic Affiliation: Zoltan Trizna MD
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: Dermatology
" Ebert, Kathryn L, RD
Austin
Gender: Female
NPI: 1689005001
3724 Jefferston St
Ste 104
(512) 547-9274
Clinic Affiliation: I Live Well Nutrition
Therapy LLC
Board Certified Specialties: Dietician
" Vickers, Jennifer, MD
Austin
Gender: Female
NPI: 1184859225
313 E 12th St
Ste 101
(512) 324-9650
Clinic Affiliation: Seton Brain and Spine
Institute
Board Certified Specialties: Dermatology
Hall, Katherine E, RD
Gender: Female
NPI: 1902177942
# 1221 Barton Hills Dr
J(512) 815-3438
Clinic Affiliation: Katilean LLC
Board Certified Specialties: None
Austin
Dubois, Susan K, MD
Gender: Female
NPI: 1114091675
2901 N IH 35
Ste 101
(512) 232-3900
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: Communitycare
Board Certified Specialties: None
ENDOCRINOLOGY, DIABETES &
METABOLISM
" Ashley, Laura, RD
" Trizna, Zoltan, MD
#
" Seagren, Beverly K, RD
Austin
Austin
" Singletary, Holly L, MD
Townsend, Bryan L, MD
Gender: Male
NPI: 1174508147
8044 Shoal Creek
(512) 459-1269
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Bryan L Townsend MD
Practice Information: Skin Cancer
Referrals
Board Certified Specialties: Dermatology
DIETICIAN
Gender: Male
NPI: 1174508147
8044 Shoal Creek
(512) 459-1269
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Bryan L Townsend MD
Practice Information: Skin Cancer
Referrals
Board Certified Specialties: Dermatology
Aus tin
Gender: Female
NPI: 1225203433
5625 Eiger Rd
Ste 105
(512) 930-3909
Clinic Affiliation: Vitalogy PA
Board Certified Specialties: Dermatology
Austin
Austin
Aus tin
Gender: Male
NPI: 1073675625
720 W 34th St
Ste 210
J(512) 450-1001
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, St Davids
Medical Center
Clinic Affiliation: Central Austin
Dermatology PA
Board Certified Specialties: Dermatology
Austin
NPI: 1760644785
5000 Davis Ln
Ste 200
(512) 615-2730
Clinic Affiliation: Westlake Dermatology &
Cosmet
Board Certified Specialties: Dermatology
Gender: Female
NPI: 1659697431
2559 Western Trails Blvd
Ste 301
(512) 815-2559
Clinic Affiliation: Westgate Skin & Cancer
PLLC
Board Certified Specialties: Dermatology
Fox, Matthew C, MD
Gender: Male
NPI: 1740471929
1400 N IH 35
Ste C2-450
J(512) 324-7468
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Dermatology
Paff, Julie A, RD
Gender: Female
NPI: 1700982469
5555 N Lamar Blvd
Ste D-125
(512) 324-1891
Clinic Affiliation: Seton Medical Group
Board Certified Specialties: None
Austin
DIAGNOSTIC RADIOLOGY
NPI: 1760644785
327 E Cesar Chavez St
(830) 693-4800
Aus tin
#
Austin
Austin
NPI: 1326011859
5000 Davis Ln
Ste 200
J(512) 615-2730
#
Austin
" Snyder, Renee R, MD
NPI: 1326011859
327 E Cesar Chavez St
J(512) 615-3280
Austin
DERMATOLOGY MICROGRAPHIC
SURGERY
Austin
Aus tin
Gender: Female
NPI: 1326011859
12201 Renfert Way
Ste 305
J(512) 279-3376
Gender: Male
NPI: 1053399477
6811 Austin Ctr Blvd
(512) 346-8888
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Dermatology
Austin
Aus tin
Gender: Male
NPI: 1396715280
313 E 12th St
Ste 103
J(512) 324-9650
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Dermatology
Austin
Gender: Male
NPI: 1306023114
7801 N Lamar Blvd
Ste D8182
J(512) 868-3376
Clinic Affiliation: Vitalogy PA
Board Certified Specialties: Dermatology
" Casaubon, Luis, MD
Austin
Gender: Male
NPI: 1447225495
6500 N Mopac
Ste 200 Bldg 3
J(512) 458-8400
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center
Clinic Affiliation: Texas Diabetes &
Endocrinology
Board Certified Specialties: Endocrinology,
Diabetes & Metabolism
J - Wheelchair Access
80
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Kumar, Pratima V, MD
Aus tin
AUSTIN Cont
Austin
Gender: Female
NPI: 1972558658
313 E 12th St
Ste 103
J(512) 324-9650
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Endocrinology,
Diabetes & Metabolism
ENDOCRINOLOGY, DIABETES &
METABOLISM Cont
" Chaicha-Brom, Tira, MD
Austin
Gender: Female
NPI: 1548434756
5000 Davis Ln
Ste 200
(512) 458-8400
" Ozer, Kerem, MD
Aus tin
NPI: 1548434756
6500 N Mopac Expwy
Bldg 3 Ste 200
(512) 458-8400
Clinic Affiliation: Texas Diabetes &
Endocrinology
Board Certified Specialties: Endocrinology,
Diabetes & Metabolism
Gender: Male
NPI: 1982878617
6500 N Mopac
Ste 200 Bldg 3
J(512) 458-8400
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center
Clinic Affiliation: Texas Diabetes &
Endocrinology
Board Certified Specialties: Endocrinology,
Diabetes & Metabolism
" Dubois, Susan K, MD
Austin
Gender: Female
NPI: 1114091675
2105 Parker Ln
(512) 797-5169
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: Auxanomen A Texas
Nonprofit Corp
Board Certified Specialties: Endocrinology,
Diabetes & Metabolism
" Espinosa, Valerie D, MD
Gender: Female
NPI: 1649245697
6500 N Mo Pac Expwy
Ste 200 Bldg 3
J(512) 458-8400
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Texas Diabetes &
Endocrinology
Board Certified Specialties: Endocrinology,
Diabetes & Metabolism
" Harrison, Lindsay B, MD
Gender: Female
NPI: 1598964702
5000 Davis Ln
Ste 200
J(512) 458-8400
" Horvit, Padma K, MD
Austin
Gender: Female
NPI: 1215949169
12501 Hymeadow Dr
Bldg 1 Ste C
J(512) 258-2556
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Endocrinology,
Diabetes & Metabolism
Kulkarni, Mrinalini N, MD
Gender: Female
NPI: 1568434694
! 313 E 12th St
Ste 102
J(512) 324-9650
Hospital Affiliation: Seton Edgar B Davis,
Seton Highland Lakes, Seton Medical
Center, Seton Medical Center Hays, Seton
Medical Ctr Williamson, Seton Northwest
Hospital, University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: None
Austin
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Aus tin
Austin, John R, MD
Gender: Male
NPI: 1740251057
3705 Medical Pkwy Ste 310
J(512) 458-6391
Hospital Affiliation: Bailey Square Surgery
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin ENT Assoc
Board Certified Specialties:
Otolaryngology
Leeman, Daniel J, MD
Gender: Male
NPI: 1508849696
1015 E 32nd St Ste 205
J(512) 478-2273
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Comprehensive ENT
Center of Texas PA
Board Certified Specialties:
Otolaryngology
Gender: Male
NPI: 1497908495
11814 Jollyville Rd
Ste 103
(512) 250-9202
Clinic Affiliation: Low-T Physicians
Professional Mbr
Practice Information: Male Patients only
Board Certified Specialties: Family
Practice
FEMALE PELVIC MED &
RECONSTRUCTIVE SURGERY
Austin
" Hutchens, Mark H, MD
Gender: Male
NPI: 1467461293
3200 Red River St
Ste 201
J(512) 473-0201
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Texas Sports and Family
Medicine PLLC
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: Family
Practice
Austin
FACIAL PLASTIC SURGERY
Aus tin
" Williams, Kynan D, MD
Austin
" Taylor, Steven A, MD
Austin
NPI: 1598964702
6500 N Mopac Expwy
Ste 200 Bldg 3
J(512) 458-8400
Clinic Affiliation: Texas Diabetes &
Endocrinology
Board Certified Specialties: Endocrinology,
Diabetes & Metabolism
Gender: Male
NPI: 1790941995
11814 Jollyville Rd
Ste 103
(512) 250-9202
Clinic Affiliation: Low-T Physicians
Professional Mbr
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Family
Practice
" Alam, Imtiaz, MD
Austin
Gender: Male
NPI: 1619064284
1210 W Braker Ln
(512) 978-9300
NPI: 1619064284
2200 Park Bend Dr
Bldg 1 Ste 300
(512) 719-4370
NPI: 1619064284
2200 Park Bend Dr
Ste 300 Bldg 1
(512) 719-4370
Hospital Affiliation: North Austin Medical
Center, Seton Northwest Hospital
Clinic Affiliation: Communitycare, Imtiaz
Alam MD, University Physicians Group
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties:
Gastroenterology
Austin
" McCarty, Robyn E, MD
Austin
!
Gender: Female
NPI: 1730293929
3200 Red River St
Ste 201
J(512) 473-0201
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Texas Sports and Family
Medicine PLLC
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: Family
Practice
Aguilar, Vivian D, MD
Gender: Female
NPI: 1144286014
911 W 38th St
Ste 202
(512) 324-8670
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Urology
GASTROENTEROLOGY
Kalpaxis, James G, MD
Gender: Male
NPI: 1063594281
4005 Spicewood Spgs
Ste C600
J(512) 346-6421
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Board Certified Specialties: None
Kouri, Jason A, MD
Gender: Male
NPI: 1649276965
! 11814 Jollyville Rd
Ste 103
(512) 250-9202
Clinic Affiliation: Low-T Physicians
Professional Mbr
Board Certified Specialties: None
Gender: Female
NPI: 1184667123
13805 Research Blvd
Ste 150
(512) 257-2500
Clinic Affiliation: Medicine In Motion Martha
Pyron M
Board Certified Specialties: Family
Practice
Austin
" Huber, Lawrence E, DO
Aus tin
Gender: Male
NPI: 1912052812
313 E 12th St
Ste 103
(512) 324-9650
Hospital Affiliation: Seton Medical Center
Hays, University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Endocrinology,
Diabetes & Metabolism
#
Austin
" Scumpia, Simona M, MD
Austin
" Pyron, Martha I, MD
Austin
FAMILY PRACTICE
Aus tin
Gender: Female
NPI: 1689778946
2200 Park Bend Dr BLD3
Ste 300
J(512) 467-2727
Hospital Affiliation: North Austin Medical
Center, St Davids Georgetown Hospital, St
Davids Medical Center, St Davids S Austin
Medical Center, The Hosp At Westlake Med
Ctr, University Med Ctr Brackenridge
Clinic Affiliation: Simona M Scumpia MD
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Endocrinology,
Diabetes & Metabolism
Thompson, Christopher P, MD
Gender: Male
NPI: 1548234842
12309 N Mopac Expwy
Ste 100
J(512) 339-4040
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Scott &
White Hospital Taylor, Seton Medical Center,
Seton Medical Center Hays, St Davids
Medical Center, Texan Surgery Center, The
Hosp At Westlake Med Ctr
Clinic Affiliation: Capital Otolaryngology
Head & Neck Surgeons PA
Board Certified Specialties:
Otolaryngology
" Alcocer, Eduardo, MD
Austin
Gender: Male
NPI: 1932184512
1111 W 34th St Ste 200
J(512) 454-4588
Hospital Affiliation: Central Texas Rehab
Hospital Llc, Heart Hospital Of Austin, North
Austin Medical Center, Northwest Hills
Surgical Hospital, Round Rock Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Georgetown
Hospital, St Davids Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Gastroenterology
PA
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties:
Gastroenterology
J - Wheelchair Access
81
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Gagneja, Harish K, MD
" Kumbum, Kavitha, MD
Austin
AUSTIN Cont
GASTROENTEROLOGY Cont
" Becker, Scott D, MD
Aus tin
Gender: Male
NPI: 1912982596
1015 E 32nd St Ste 300
J(512) 448-4588
NPI: 1912982596
4310 James Casey St
Ste 4A
J(512) 448-4588
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Gastroenterology
PA
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties:
Gastroenterology
!
Gender: Male
NPI: 1477651982
4310 James Casey St
Ste 4A
J(512) 420-0186
Hospital Affiliation: Seton Southwest, St
Davids Medical Center, St Davids
Rehabilitation Center, St Davids S Austin
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Gastroenterology
PA
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties:
Gastroenterology
" Frachtman, Robert L, MD
Aus tin
Gender: Male
NPI: 1922083039
1111 W 34th St
Ste 200
J(512) 420-0186
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Austin Gastroenterology
PA
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties:
Gastroenterology
" Frank, Carl D, MD
Aus tin
Gender: Male
NPI: 1962455105
8015 Shoal Creek Blvd
Ste 109
J(512) 420-0186
Clinic Affiliation: Austin Gastroenterology
PA
Board Certified Specialties:
Gastroenterology, Internal Medicine
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
" Lubin, Craig H, MD
Gender: Male
NPI: 1033194634
1111 W 34th St
Ste 200
J(512) 485-5889
Hospital Affiliation: Heart Hospital Of
Austin, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Gastroenterology
PA
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties:
Gastroenterology
NPI: 1154347870
4310 James Casey St
Ste 4A
J(512) 448-4588
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Austin Gastroenterology
PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Gastroenterology
" Pham, Binh V, MD
Gender: Male
NPI: 1558371559
1111 W 34th St Ste 200
(512) 420-0186
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Gastroenterology
PA
Board Certified Specialties:
Gastroenterology
" Reddy, Sridhar P, MD
Austin
Gender: Male
NPI: 1134123938
2911 Medical Arts St
Ste 9B
J(512) 474-6321
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, St Davids Medical Center,
Texas Neurorehab Center, University Med
Ctr Brackenridge
Clinic Affiliation: Sridhar P Reddy MD
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Gastroenterology
" Mank III, Gerald W, MD
Austin
Gender: Male
NPI: 1821309592
1111 W 34th St
Ste 200
J(512) 454-4588
" Hsu, Chia Wen, MD
Austin
NPI: 1821309592
8015 Shoal Creek Blvd
Ste 109
(512) 371-1519
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Gastroenterology
PA, University Physicians Group
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Gastroenterology
Gender: Male
NPI: 1568447670
4310 James Casey St
Ste 4A
J(512) 420-0186
Hospital Affiliation: St Davids Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: Austin Gastroenterology
PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Gastroenterology
" Rice, Dan C, MD
Austin
Gender: Male
NPI: 1669457719
4310 James Casey St
Ste 4A
J(512) 420-0186
Hospital Affiliation: Austin Endoscopy
Center Ii Llc, Cornerstone Hosp Of Austin,
Healthsouth Rehabilitation Hospital Of
Austin, Lakeway Regional Medical Ctr Llc,
Seton Edgar B Davis, Seton Medical Center,
Seton Southwest, St Davids Medical Center,
St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Gastroenterology
PA
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties:
Gastroenterology
" Mansour, Lilah, MD
Austin
Gender: Female
NPI: 1467467985
6811 Austin Center Blvd
Ste 300
(512) 346-8888
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties:
Gastroenterology
" Kumar, Pradeep, MD
Austin
Gender: Male
NPI: 1093790537
1015 E 32nd St Ste 300
J(512) 448-4588
NPI: 1093790537
4310 James Casey St
Ste 4A
J(512) 420-0186
Hospital Affiliation: Cornerstone Hosp Of
Austin, Lakeway Regional Medical Ctr Llc,
Northwest Hills Surgical Hospital, Round
Rock Medical Center, Seton Edgar B Davis,
Seton Medical Center, Seton Southwest, St
Davids Medical Center, St Davids S Austin
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Gastroenterology
PA
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties:
Gastroenterology
" Matteer, Nancy P, MD
Austin
Gender: Female
NPI: 1568615136
4007 James Casey St
Ste C210
J(512) 447-8466
Hospital Affiliation: St Davids Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: Nancy P Matteer MD
Board Certified Specialties:
Gastroenterology
" Ridgeway, Mona L, MD
Austin
Gender: Female
NPI: 1811972367
1111 W 34th St
Ste 200
J(512) 420-0186
Hospital Affiliation: Austin Endoscopy
Center I Llc, Austin Endoscopy Center Ii Llc,
Seton Medical Center
Clinic Affiliation: Austin Gastroenterology
PA
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties:
Gastroenterology
" McHorse, Tom S, MD
Austin
Gender: Male
NPI: 1083614523
6811 Austin Center Blvd
Ste 300
(512) 346-8888
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Highland Lakes, Seton
Medical Center, St Davids Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties:
Gastroenterology
Mehta, Rajesh M, MD
Gender: Male
NPI: 1255414157
4007 James Casey St
Ste C210
J(512) 368-5294
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: Lonestar
Gastroenterology
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: Internal
Medicine
Austin
Austin
Gender: Male
NPI: 1154347870
10815 RR 2222
Ste 202 Bldg 3a1
J(512) 279-2000
Gender: Male
NPI: 1174508758
1111 W 34th St Ste 200
J(512) 454-4588
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Gastroenterology
PA
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties:
Gastroenterology
" Emmett, Daniel S, MD
NPI: 1508079302
313 E 12th St
Ste 101
(512) 324-9650
Clinic Affiliation: Austin Gastroenterology
PA, University Physicians Group
Board Certified Specialties:
Gastroenterology
" Havemann, Benjamin D, MD
" Dabaghi, Rashad E, MD
Austin
Gender: Female
NPI: 1508079302
1111 W 34th St
Ste 200
(512) 454-4588
Austin
Aus tin
Aus tin
Austin
Gender: Male
NPI: 1235114786
1015 E 32nd St
Ste 300
J(512) 469-9966
Hospital Affiliation: Cornerstone Hosp Of
Austin, Lakeway Regional Medical Ctr Llc,
North Austin Medical Center, Seton Edgar B
Davis, Seton Medical Center, Seton
Northwest Hospital, Seton Southwest, St
Davids Medical Center, St Davids S Austin
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Gastroenterology
PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Gastroenterology
" Singh, Inder M, MD
Austin
Gender: Male
NPI: 1447456736
313 E 12th St Ste 101
(512) 324-9650
NPI: 1447456736
601 E 15th St
(512) 485-5889
Clinic Affiliation: Austin Gastroenterology
PA, University Physicians Group
Board Certified Specialties:
Gastroenterology
J - Wheelchair Access
82
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Willeford III, George, MD
" Askew Jr, Robert E, MD
Aus tin
AUSTIN Cont
GASTROENTEROLOGY Cont
" Sperling, Richard M, MD
Austin
Gender: Male
NPI: 1881679959
1111 W 34th St Ste 200
J(512) 454-4588
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Austin Gastroenterology
PA
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties:
Gastroenterology
" Spindel, Enrique, MD
Austin
Gender: Male
NPI: 1467424267
4007 James Casey St
Ste C210
J(512) 447-8466
" Srygley, Fletcher D, MD
" Anderson, Brady E, MD
Gender: Female
NPI: 1912946484
1111 W 34th St Ste 200
(512) 454-4588
" Utts, Stephen J, MD
#
Gender: Male
NPI: 1285619262
4310 James Casey St
Ste 4A
J(512) 485-5889
Hospital Affiliation: Heart Hospital Of
Austin, Lakeway Regional Medical Ctr Llc,
Seton Edgar B Davis, Seton Southwest, St
Davids Georgetown Hospital, St Davids
Medical Center, St Davids S Austin Medical
Center
Clinic Affiliation: Austin Gastroenterology
PA
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties:
Gastroenterology
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
" Coombs Skiles, Caroline H, MD
Austin
Gender: Female
NPI: 1144438136
6500 N Mopac Ste 2205
Bldg 2
(512) 505-5500
NPI: 1144438136
900 E 30th St Ste 100
(512) 334-2777
Hospital Affiliation: Arise Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center
Clinic Affiliation: Austin Cancer Centers
Georgetown
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: General
Surgery
" Brown, Carlos V, MD
Austin
Gender: Male
NPI: 1235251075
313 E 12th St
Ste 104
J(512) 324-9650
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: General
Surgery
" Cherico, Felix W, MD
Austin
" Esquivel, Alejandro, MD
Austin
Gender: Male
NPI: 1093813925
4007 James Casey St
Ste A220
(512) 447-4993
Hospital Affiliation: Bailey Square Surgery
Center, Seton Northwest Hospital, Seton
Southwest, South Austin Surgery Center, St
Davids Medical Center, St Davids S Austin
Medical Center, Surgicare Of South Austin
Clinic Affiliation: Surgical Assoc of Austin
PA
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties: General
Surgery
Gender: Male
NPI: 1851320246
1015 E 32nd St
Ste 308
J(512) 472-1381
Gender: Male
NPI: 1871661124
200 Medical Pkwy Ste 360
J(512) 879-0111
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Lakeway Regional Medical Ctr
Llc, North Austin Medical Center, Oakwood
Surgery Center, Round Rock Medical
Center, Seton Medical Ctr Williamson, St
Davids Georgetown Hospital, The Hosp At
Westlake Med Ctr
Clinic Affiliation: Central Texas Surgical
Assoc
Practice Information: No Patients Under 5
yrs old
Board Certified Specialties: General
Surgery
" Trevino, Jessica M, MD
Austin
Gender: Male
NPI: 1063493039
1400 N IH 35 Ste 300
(512) 324-7873
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: General
Surgery
Aus tin
Austin
NPI: 1912946484
313 E 12th St Ste 101
J(512) 324-9650
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center Hays, Seton
Medical Ctr Williamson, Seton Northwest
Hospital, Seton Southwest, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Gastroenterology
PA, University Physicians Group
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Gastroenterology
" Aydelotte, Jayson D, MD
" Abikhaled, John A, MD
Austin
Gender: Male
NPI: 1265659106
12319 N Mopac Expwy
Ste 350
J(512) 491-6542
Hospital Affiliation: Cedar Park Regional
Medical Ctr, North Austin Medical Center,
Round Rock Medical Center, Scott & White
Hlthcare Round Rock, Seton Northwest
Hospital, Seton Southwest, St Davids
Georgetown Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Northstar Surgery
Specialists PA
Board Certified Specialties: General
Surgery
Austin
Aus tin
Gender: Male
NPI: 1639108731
3901 Medical Pkwy
Ste 200
J(512) 458-3279
Hospital Affiliation: Arise Austin Medical
Center, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
Seton Southwest, St Davids Medical Center,
St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Surgeons P L L C
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: General
Surgery
" Choudhry, Vineet, MD
Austin
Gender: Male
NPI: 1194754317
3901 Medical Pkwy
Ste 200
J(512) 467-7151
Hospital Affiliation: Bailey Square Surgery
Center, Central Park Surgery Center, North
Austin Medical Center, Seton Medical
Center, St Davids Medical Center
Clinic Affiliation: Austin Surgeons P L L C
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: General
Surgery
GENERAL SURGERY
NPI: 1467424267
900 E 30th St
Ste 201
J(512) 447-8466
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Gastroenterology
Gender: Male
NPI: 1124290416
4310 James Casey St
Ste 4A
(512) 448-4588
Clinic Affiliation: Austin Gastroenterology
PA
Board Certified Specialties:
Gastroenterology
Austin
Gender: Male
NPI: 1225013758
1111 W 34th St
Ste 200
J(512) 420-0186
Hospital Affiliation: Austin Endoscopy
Center I Llc, Bailey Square Surgery Center,
Cornerstone Hosp Of Austin, Healthsouth
Rehabilitation Hospital Of Austin, North
Austin Medical Center, Northwest Surgery
Center Llp, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Gastroenterology
PA
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties:
Gastroenterology
NPI: 1851320246
12201 Renfert Way
Ste 335
J(512) 472-1381
Hospital Affiliation: Bailey Square Surgery
Center, North Austin Medical Center, Seton
Medical Center, St Davids Medical Center, St
Davids S Austin Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Surgical Assoc of Austin
PA
Practice Information: No Patients Under 14
yrs old
Board Certified Specialties: General
Surgery
" Ashworth, Rodney B, MD
Aus tin
Gender: Male
NPI: 1356377907
12201 Renfert Way
Ste 335
J(512) 472-1381
" Fielder, W Drew, MD
Austin
Gender: Male
NPI: 1972500866
1313 Red River
Ste 305
J(512) 324-7789
" Ching, Peter V, MD
Austin
Gender: Male
NPI: 1669465282
1015 E 32nd St
Ste 308
J(512) 472-1381
NPI: 1356377907
4007 James Casey St
Ste 230
J(512) 447-4993
Hospital Affiliation: North Austin Medical
Center, North Austin Surgery Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center
Clinic Affiliation: Surgical Assoc of Austin
PA
Board Certified Specialties: General
Surgery
NPI: 1669465282
4007 James Casey St
Ste A220
J(512) 472-1381
Hospital Affiliation: Bailey Square Surgery
Center, North Austin Medical Center, Seton
Medical Center, St Davids Medical Center, St
Davids S Austin Medical Center, Surgicare
Of South Austin
Clinic Affiliation: Surgical Assoc of Austin
PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: General
Surgery
NPI: 1972500866
1400 N IH 35
Ste 300
J(512) 324-7873
Hospital Affiliation: Seton Northwest
Hospital, University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: General
Surgery
" Fleming, Richard Y, MD
Austin
Gender: Male
NPI: 1881623114
1015 E 32nd St
Ste 308
J(512) 472-1381
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Surgical Assoc of Austin
PA
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: General
Surgery
J - Wheelchair Access
83
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Garcia, Joseph, MD
" Hawthorne, Andy L, MD
Austin
AUSTIN Cont
GENERAL SURGERY Cont
" Folkers, David C, MD
Aus tin
Gender: Male
NPI: 1538265442
4007 James Casey St
Ste B130
J(512) 402-5806
Hospital Affiliation: North Austin Medical
Center, Seton Smithville Reg Hospital, Seton
Southwest, St Davids Medical Center, St
Davids S Austin Medical Center
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: General
Surgery
" Garcia, Nilda M, MD
Gender: Female
NPI: 1407815533
1301 Barbara Jordan Blvd
Ste 400
(512) 708-1234
Hospital Affiliation: Childrens Medical
Center Of Dallas, Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center,
Parkland Health And Hospital Sys, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Pediatric Surgery
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: General
Surgery
" Forage, Jean P, MD
Gender: Male
NPI: 1396789764
11111 Research Blvd
Ste 210
J(512) 443-5954
" Gambarin, Semyon, MD
" Ganta, Sashidhar V, MD
Aus tin
Gender: Male
NPI: 1821060807
11851 Jollyville Rd
Ste 104
J(512) 257-2425
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
Seton Southwest, St Davids Medical Center,
St Davids S Austin Medical Center
Clinic Affiliation: Sashidhar V Ganta MD
Board Certified Specialties: General
Surgery
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
" Livingston, Charles D, MD
Austin
Gender: Male
NPI: 1073545760
3901 Medical Pkwy
Ste 200
J(512) 467-7151
Hospital Affiliation: Central Park Surgery
Center, North Austin Medical Center, Seton
Medical Center, St Davids Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Surgeons P L L C
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: General
Surgery
" Markus, Robert M, MD
Austin
Gender: Male
NPI: 1386675213
1015 E 32nd St
Ste 308
J(512) 472-1381
" Johnson, Jeff L, MD
Austin
Gender: Male
NPI: 1235115064
7900 FM 1826
Ste 180
(512) 615-3574
Hospital Affiliation: Arise Austin Medical
Center, Seton Medical Center, Seton Medical
Center Hays, Seton Northwest Hospital,
Seton Southwest, Stonegate Surgery Center
Lp, The Hosp At Westlake Med Ctr, Tx Hlth
Harris Methodist Hosp Heb, University Med
Ctr Brackenridge
Clinic Affiliation: Jeff L Johnson MD
Board Certified Specialties: General
Surgery
NPI: 1386675213
4007 James Casey St
Ste A230
J(512) 472-1381
Hospital Affiliation: Bailey Square Surgery
Center, Seton Medical Center, St Davids
Medical Center, St Davids S Austin Medical
Center, Surgicare Of South Austin,
University Med Ctr Brackenridge
Clinic Affiliation: Surgical Assoc of Austin
PA
Practice Information: No Patients Under 14
yrs old
Board Certified Specialties: General
Surgery
" Jones Jr, Harry L, MD
Guleserian, Kristine J, MD
Gender: Female
NPI: 1023070109
1201 W 37th St
(214) 456-5000
Austin
Gender: Male
NPI: 1871525550
3901 Medical Pkwy
Ste 200
J(512) 467-7151
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Austin Surgeons P L L C
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: General
Surgery
NPI: 1023070109
4900 Mueller Blvd
(512) 324-1000
Aus tin
Gender: Male
NPI: 1871508937
6811 Austin Center Blvd
Ste 300
J(512) 346-8888
Hospital Affiliation: Bailey Square Surgery
Center, Central Park Surgery Center, Seton
Medical Center, Seton Northwest Hospital,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: General
Surgery
Gender: Male
NPI: 1699710665
6633 E Hwy 290
Ste 101
J(956) 992-9161
Hospital Affiliation: Lifecare Hospitals
South Tx-South, South Texas Health System
Clinic Affiliation: All In Veins LLC
Board Certified Specialties: General
Surgery, Preventive Medicine
Gender: Male
NPI: 1184683013
12319 N Mopac Expwy
Ste 250
J(512) 339-9100
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton Medical
Ctr Williamson, The Hosp At Westlake Med
Ctr
Clinic Affiliation: Joel Gotvald PA
Board Certified Specialties: General
Surgery, Thoracic Surgery
Austin
Gender: Male
NPI: 1003848789
3901 Medical Pkwy Ste 200
J(512) 467-7151
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Austin Surgeons P L L C
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: General
Surgery
" Hovorka, John W, MD
" Gotvald, Joel G, MD
" Freer, Rebecca, MD
" Lindsey, Mark R, MD
Austin
Austin
Austin
Aus tin
Gender: Female
NPI: 1750397022
6811 Austin Center Blvd
Ste 300
J(512) 346-8888
Hospital Affiliation: Bailey Square Surgery
Center, Seton Medical Center, Seton
Northwest Hospital, Seton Southwest,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: General
Surgery
Gender: Male
NPI: 1801919881
200 Medical Pkwy
Ste 360
J(512) 879-0111
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Lakeway Regional Medical Ctr
Llc, North Austin Medical Center, Oakwood
Surgery Center, Round Rock Medical
Center, Seton Medical Center, Seton Medical
Ctr Williamson, Seton Northwest Hospital, St
Davids Georgetown Hospital, The Hosp At
Westlake Med Ctr
Clinic Affiliation: Central Texas Surgical
Assoc
Board Certified Specialties: General
Surgery
Austin
Aus tin
NPI: 1396789764
4101 James Casey St
Ste 340
J(512) 443-5954
Hospital Affiliation: Bailey Square Surgery
Center, Scott & White Hospital Llano, Seton
Medical Center, Seton Northwest Hospital,
Seton Southwest, St Davids Medical Center,
St Davids S Austin Medical Center
Clinic Affiliation: Assoc In General Surger
Practice Information: No Patients Under 7
yrs old
Board Certified Specialties: General
Surgery
Austin
Gender: Male
NPI: 1174639801
6811 Austin Center Blvd
Ste 300
J(512) 346-8888
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: General
Surgery
NPI: 1023070109
601 E 15th St
(512) 324-7000
Clinic Affiliation: UT Southwestern Medical
Center
Board Certified Specialties: None
" Martinez, Kelly, MD
Austin
Gender: Female
NPI: 1972560274
901 W 38th St Ste 200
(512) 421-4100
Hospital Affiliation: Arise Austin Medical
Center, Northwest Hills Surgical Hospital,
Seton Medical Center, St Davids Medical
Center
Clinic Affiliation: Texas Oncology PA
Board Certified Specialties: General
Surgery
" Kimbrough II, Birch D, MD
Austin
" Hanschen, Stephen, MD
Austin
#
Gender: Male
NPI: 1225044571
6811 Austin Center Blvd
Ste 300
J(512) 346-8888
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: General
Surgery
Gender: Male
NPI: 1558319400
5700 W Slaughter Ln
Ste 260
J(512) 268-3824
Hospital Affiliation: St Davids S Austin
Medical Center
Clinic Affiliation: Capital City Emergency
Staffing
Board Certified Specialties: General
Surgery
" Mayer, William D, MD
Austin
Gender: Male
NPI: 1841221686
1015 E 32nd St
Ste 308
J(512) 472-1381
Hospital Affiliation: Bailey Square Surgery
Center, North Austin Medical Center, Seton
Medical Center, St Davids Medical Center, St
Davids S Austin Medical Center, The Hosp
At Westlake Med Ctr
Clinic Affiliation: Surgical Assoc of Austin
PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: General
Surgery
" Kocay, Dean A, MD
Austin
Gender: Male
NPI: 1659373744
4007 James Casey Ste B130
J(512) 912-0480
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
Seton Southwest, St Davids Medical Center,
St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: General
Surgery
" McKenzie, Shaun, MD
Austin
Gender: Male
NPI: 1114189933
1015 E 32nd St Ste 308
(512) 499-8823
Hospital Affiliation: Seton Medical Center,
St Davids S Austin Medical Center
Clinic Affiliation: Surgical Assoc of Austin
PA
Board Certified Specialties: General
Surgery
J - Wheelchair Access
84
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Aus tin
AUSTIN Cont
GENERAL SURGERY Cont
" Meynig, Jeffrey T, MD
Austin
Gender: Male
NPI: 1164454724
3901 Medical Pkwy
Ste 200
J(512) 467-7151
Hospital Affiliation: Central Park Surgery
Center, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Surgeons P L L C
Practice Information: No Patients Under 6
yrs old
Board Certified Specialties: General
Surgery
" Rios Jr, Oscar, MD
Gender: Male
NPI: 1467453621
!# 9701 Brodie Ln
Ste 206
J(512) 263-0024
Hospital Affiliation: Baptist Health System,
Methodist Hospital, Methodist Specialty And
Transplant Hospital, Southwest General
Hospital
Clinic Affiliation: Devika Surgical Assoc
PLLC
Board Certified Specialties: General
Surgery
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
NPI: 1558469452
4101 James Casey St
Ste 340
(512) 443-5954
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, Seton Southwest, St
Davids S Austin Medical Center
Clinic Affiliation: Hyon Christopher Shin
MD
Practice Information: No Patients Under 4
yrs old
Board Certified Specialties: General
Surgery
" Runyan, Bratcher L, MD
Gender: Male
NPI: 1730300211
200 Medical Pkwy
Ste 360
(512) 879-0111
Clinic Affiliation: Central Texas Surgical
Assoc
Board Certified Specialties: General
Surgery
" O’Farrell, Kevin P, MD
" Patel, Nilesh A, MD
Gender: Male
NPI: 1558469452
11111 Research Blvd
Ste 210
(512) 443-5954
Aus tin
Austin
Austin
" Shin, Hyon Ho, MD
Austin
NPI: 1346377066
1400 N IH 35
Ste 300
J(512) 324-7873
Hospital Affiliation: Houston Methodist
Hospital, Seton Medical Ctr Williamson,
University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: General
Surgery
" Nelson, Jane C, MD
Gender: Male
NPI: 1003822362
6811 Austin Center Blvd
Ste 300
J(512) 346-8888
Hospital Affiliation: Bailey Square Surgery
Center, Central Park Surgery Center, Seton
Medical Center, Seton Northwest Hospital,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: General
Surgery
NPI: 1609830645
4007 James Casey St
Ste A220
J(512) 472-1381
Hospital Affiliation: Bailey Square Surgery
Center, North Austin Medical Center, North
Austin Surgery Center, Round Rock Medical
Center, Seton Medical Center, St Davids
Medical Center, St Davids S Austin Medical
Center
Clinic Affiliation: Surgical Assoc of Austin
PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: General
Surgery
Aus tin
Austin
Gender: Male
NPI: 1508889205
1313 Red River
Ste 305
J(512) 324-7789
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: General
Surgery
NPI: 1609830645
12201 Renfert Way
Ste 335
J(512) 472-1381
Gender: Male
NPI: 1871508945
6811 Austin Center Blvd
Ste 300
J(512) 344-0368
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: General
Surgery
Gender: Male
NPI: 1346377066
1313 Red River
Ste 305
J(512) 324-7789
" Uecker, John M, MD
Austin
Gender: Male
NPI: 1609830645
1015 E 32nd St
Ste 308
J(512) 472-1381
" Regan, Michael, MD
" Morrison, Patricia J, MD
Gender: Female
NPI: 1699735670
6500 N Mopac Ste 2205
Bldg 2
(512) 505-5500
Hospital Affiliation: Arise Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Cancer Centers
Georgetown
Board Certified Specialties: General
Surgery
" Sankar, Aravind B, MD
Austin
Aus tin
Austin
Gender: Female
NPI: 1215047402
12201 Renfert Way
Ste 100
(512) 338-5201
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: General
Surgery
Payne, Thomas N, MD
Gender: Male
NPI: 1710904388
12221 Renfert Way
Ste 220
(512) 719-5224
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center
Clinic Affiliation: St Davids OB Hospitalist
PLLC
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties: None
" Victor, Brant E, MD
Austin
Gender: Male
NPI: 1184653321
3901 Medical Pkwy Ste 200
J(512) 467-7151
Hospital Affiliation: Bailey Square Surgery
Center, Central Park Surgery Center, Heart
Hospital Of Austin, North Austin Medical
Center, Seton Medical Center, St Davids
Medical Center
Clinic Affiliation: Austin Surgeons P L L C
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: General
Surgery
GENERAL VASCULAR SURGERY
" Apple, Jeffrey M, MD
Austin
Gender: Male
NPI: 1750354924
1010 W 40th St
J(512) 459-8753
Hospital Affiliation: St Davids S Austin
Medical Center
Clinic Affiliation: Cardiothoracic and
Vascular Surge
Board Certified Specialties: General
Vascular Surgery
" Baptiste, Reginald C, MD
Austin
Gender: Male
NPI: 1649202979
6500 N Mopac Expwy
Ste 2207
J(512) 494-9985
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, St
Davids Medical Center, St Davids S Austin
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Capital Cardiothoracic
Surgeons PA
Board Certified Specialties: General
Vascular Surgery, Thoracic Surgery
" Smith, Clyde D, MD
Austin
Gender: Male
NPI: 1104917202
2911 Medical Arts St
Ste 6
(512) 478-9900
" Sabra, John P, MD
Aus tin
Gender: Male
NPI: 1093738791
1313 Red River
Ste 305
J(512) 324-7789
NPI: 1104917202
2911 Medical Arts Ste 6
(512) 914-2628
Hospital Affiliation: Little River Healthcare,
Scott & White Hospital Taylor, Scott And
White Memorial Hospital, Seton Medical
Center, Seton Northwest Hospital, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Board Certified Specialties: General
Surgery
NPI: 1093738791
1400 N IH 35
Ste 300
J(512) 324-7873
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: General
Surgery
Austin
Truumees, Eeric, MD
Gender: Male
NPI: 1356322630
1600 W 38th St
Ste 200
(512) 324-3560
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Medical Center Hays, Seton Medical Ctr
Williamson, Seton Northwest Hospital, St
Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Seton Brain and Spine
Institute
Board Certified Specialties: None
GYNECOLOGIC ONCOLOGY
Austin
Crozier, Mark A, MD
Gender: Male
NPI: 1376586271
1313 Red River
Ste 305
(512) 324-7789
NPI: 1376586271
911 W 38th St
Ste 202
(512) 324-9650
Hospital Affiliation: Bailey Square Surgery
Center, Seton Medical Center, Seton
Northwest Hospital, Seton Southwest, St
Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: University Physicians
Group
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
J - Wheelchair Access
85
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
AUSTIN Cont
HAND SURGERY
Austin
Foster, Robert A, MD
Gender: Male
NPI: 1437153210
# 4700 Seton Center Pkwy
Ste 200
J(512) 439-1000
Hospital Affiliation: Arise Austin Medical
Center, Healthsouth Rehabilitation Hospital
Of Austin, North Austin Medical Center,
Round Rock Medical Center, Seton Medical
Center, Seton Northwest Hospital, St Davids
Medical Center, St Davids S Austin Medical
Center, The Hosp At Westlake Med Ctr,
University Med Ctr Brackenridge
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: Orthopedic
Surgery
Austin
GYNECOLOGIC ONCOLOGY Cont
" Knowles, Lynne M, MD
Aus tin
Gender: Female
NPI: 1568561397
4101 James Casey St
Ste 100
J(512) 447-2202
NPI: 1568561397
6204 Balcones Dr
J(512) 427-9400
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Gynecologic
Oncology
Aus tin
Austin
Loar III, Paul V, MD
Gender: Male
NPI: 1063488617
12221 Renfert Way
Ste 300
(512) 873-8900
NPI: 1063488617
901 W 38th St Ste 300
(512) 421-4100
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Texas Oncology PA
Board Certified Specialties: None
Austin
" Smith, Ellen B, MD
Aus tin
#
Aus tin
Gender: Female
NPI: 1558305490
901 W 38th St
Ste 200
(512) 421-4100
Hospital Affiliation: Bailey Square Surgery
Center, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: Gynecologic
Oncology
Teneriello, Michael G, MD
Gender: Male
NPI: 1801834809
4101 James Casey St
Ste 100
J(512) 447-2202
NPI: 1801834809
6204 Balcones Dr
J(512) 427-9400
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Austin
Austin
Austin
Pearce, Stephen M, MD
Gender: Male
NPI: 1922000504
1015 E 32nd St
Ste 101
J(512) 477-6341
NPI: 1922000504
3001 Bee Caves Rd
Ste 220
J(512) 795-8812
Hospital Affiliation: Arise Austin Medical
Center, Seton Medical Center, St Davids
Medical Center, The Hosp At Westlake Med
Ctr, University Med Ctr Brackenridge
Clinic Affiliation: Austin Bone & Joint Clinic
Board Certified Specialties: Orthopedic
Surgery
Austin
Austin
HEMATOLOGY
Gadaria, Umeshchandra G, MD
Gender: Male
NPI: 1154301208
1015 E 32nd Ste 208
J(512) 478-0993
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Board Certified Specialties: Plastic
Surgery
Austin
Castillo, Rene A, MD
Gender: Male
NPI: 1134186166
4101 James Casey St
Ste 100
J(512) 447-2202
NPI: 1134186166
901 W 38th St Ste 200
J(512) 421-4100
Hospital Affiliation: Central Texas Medical
Center, North Austin Medical Center,
Northwest Surgery Center Llp, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
Hardy, Brian T, MD
Gender: Male
NPI: 1730382193
911 W 38th St
Ste 300
J(512) 439-1002
Hospital Affiliation: Texas Orthopedics
Surgery Center
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: Orthopedic
Surgery
Austin
Holzman, Steven, MD
Gender: Male
NPI: 1255443974
6818 Austin Center Blvd
Ste 206
J(512) 338-4404
Hospital Affiliation: Bailey Square Surgery
Center, Cedar Park Regional Medical Ctr,
North Austin Medical Center, Northwest Hills
Surgical Hospital, Seton Medical Center,
Seton Northwest Hospital, Seton Southwest,
St Davids Medical Center, University Med Ctr
Brackenridge
Board Certified Specialties: Plastic
Surgery
Austin
Johnson, Don E, MD
Gender: Male
NPI: 1609974955
3705 Medical Pkwy
Ste 530
J(512) 443-3933
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Board Certified Specialties: Orthopedic
Surgery
Chadha, Punit, MD
Gender: Male
NPI: 1497778229
4101 James Casey St
Ste 100
J(512) 447-2202
Hospital Affiliation: Cornerstone Hosp Of
Austin, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Oncology
Doner, Kevin T, MD
Gender: Male
NPI: 1336115880
12221 Renfert Way
Ste 300
(512) 873-8900
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, St Davids
Medical Center
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Oncology
Fain, Jerry D, MD
Gender: Male
NPI: 1447293840
# 901 W 38th St
Ste 200
(512) 421-4100
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, St Davids S
Austin Medical Center
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
Austin
Patel, Manish V, MD
Gender: Male
NPI: 1114031929
2500 W Wm Cannon Dr
Ste 401
J(512) 451-1969
Hospital Affiliation: Arise Austin Medical
Center, North Austin Medical Center, Round
Rock Medical Center, Scott & White Hospital
Taylor, Seton Medical Center, Seton
Northwest Hospital, St Davids Georgetown
Hospital, St Davids Medical Center, St
Davids S Austin Medical Center
Clinic Affiliation: Southwest Orthopaedic
Group
Board Certified Specialties: None
George, David W, MD
Gender: Male
NPI: 1164465563
901 W 38th St Ste 200
J(512) 421-4100
Hospital Affiliation: Cornerstone Hosp Of
Austin, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Georgetown Hospital, St Davids
Medical Center
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Oncology
Hellerstedt, Beth A, MD
Gender: Female
NPI: 1215975487
6101 Balcones Dr
Ste 101
J(512) 406-5150
NPI: 1215975487
6204 Balcones Dr
J(512) 427-9400
Hospital Affiliation: Cornerstone Hosp Of
Austin, Heart Hospital Of Austin, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, St Davids
Georgetown Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
Helmer III, Richard E, MD
Gender: Male
NPI: 1447293899
# 901 W 38th St
Ste 200
J(512) 421-4100
Hospital Affiliation: Scott & White Hospital
Llano, Seton Medical Center
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
Austin
Austin
Hoverman, John R, MD
Gender: Male
NPI: 1508808494
4101 James Casey St
Ste 100
J(512) 447-2202
NPI: 1508808494
6101 Balcones Dr
Ste 101
J(512) 406-5150
NPI: 1508808494
6204 Balcones Dr
J(512) 302-1771
Hospital Affiliation: Cornerstone Hosp Of
Austin, North Austin Medical Center, Seton
Medical Center, St Davids Medical Center
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
Austin
Kocs, Darren M, MD
Gender: Male
NPI: 1972541357
6204 Balcones Dr
J(512) 302-1771
Hospital Affiliation: Cornerstone Hosp Of
Austin, Round Rock Medical Center, Scott &
White Hospital Taylor, Seton Medical Center,
St Davids Georgetown Hospital, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
J - Wheelchair Access
86
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Aus tin
AUSTIN Cont
HEMATOLOGY Cont
Austin
Loukas, Demetrius F, MD
Gender: Male
NPI: 1154369775
11111 Research Blvd
Ste 400
J(512) 349-0081
NPI: 1154369775
901 W 38th St Ste 200
J(512) 421-4100
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old, Practice Limited to Hematology,
Practice Limited to Oncology
Board Certified Specialties: Oncology
Austin
Patt, Debra A, MD
Gender: Female
NPI: 1003839820
12201 Renfert Way
Ste 370
J(512) 302-1771
Aus tin
Aus tin
NPI: 1003839820
4101 James Casey St
Ste 100
J(512) 447-2202
Austin
Sandbach, John F, MD
Gender: Male
NPI: 1376585505
6101 Balcones Dr
Ste 101
(512) 406-5150
NPI: 1376585505
6204 Balcones Dr
(512) 427-9400
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
St Marks Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old, Practice Limited to Oncology
Board Certified Specialties: Oncology
Austin
Tweedy, Dennis A, MD
Gender: Male
NPI: 1205874948
4101 James Casey St
Ste 100
(512) 440-7888
Hospital Affiliation: Central Texas Medical
Center, Cornerstone Hosp Of Austin, Seton
Medical Center, Seton Medical Ctr
Williamson, Seton Northwest Hospital, Seton
Southwest, St Davids Medical Center, St
Davids S Austin Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Austin
Aus tin
Aus tin
Chawla, Jane S, MD
Gender: Female
NPI: 1487863304
6204 Balcones Dr
(512) 427-9400
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Medical Ctr
Williamson, St Davids Medical Center, St
Davids S Austin Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Texas Oncology PA
Board Certified Specialties: None
Austin
Kampe, Carsten E, MD
Gender: Male
NPI: 1912944521
4101 James Casey St
Ste 100
J(512) 447-2202
NPI: 1275571879
6204 Balcones Dr
J(512) 302-1771
HOSPICE & PALLIATIVE MEDICINE
" Hurwitz, Craig A, MD
Austin
Gender: Male
NPI: 1669567178
4900 Mueller Blvd
J(512) 324-0197
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center
Clinic Affiliation: Specially For Children
Board Certified Specialties: Hospice &
Palliative Medicine, Pediatrics
Austin
Maxwell, Mary S, MD
Gender: Female
NPI: 1669469235
4107 Spicewood Springs Rd
Ste 100
(512) 397-3360
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Central Texas Palliative
Care Assoc
Board Certified Specialties: None
INFECTIOUS DISEASES
" Bagwell, John T, MD
Austin
#
NPI: 1275571879
901 W 38th St Ste 200
J(512) 421-4100
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Oncology
Austin
Austin
NPI: 1912944521
6204 Balcones Dr
J(512) 302-1771
Hospital Affiliation: Cornerstone Hosp Of
Austin, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Oncology
Rubin De Celis, Carlos, MD
Gender: Male
NPI: 1275571879
12201 Renfert Way
Ste 325
J(512) 302-1771
NPI: 1275571879
4101 James Casey St
J(512) 447-2202
Cruz, Jose C, MD
Gender: Male
NPI: 1720043524
901 W Ben White Blvd
J(512) 447-2211
Hospital Affiliation: Covenant Medical
Center, Covenant Medical Center Lakeside,
University Medical Center
Clinic Affiliation: Methodist Physician
Practices PLL
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Gorrebeeck, Allison E, MD
Gender: Female
NPI: 1467548628
12221 N Mopac Expwy
(512) 505-5500
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center
Clinic Affiliation: Austin Cancer Centers
Georgetown
Board Certified Specialties: Oncology
Kasper, Michael L, MD
Gender: Male
NPI: 1669414652
6101 Balcones Dr
Ste 101
J(512) 302-1771
NPI: 1669414652
6204 Balcones Dr
J(512) 302-1771
Hospital Affiliation: Cornerstone Hosp Of
Austin, Heart Hospital Of Austin, North
Austin Medical Center, Round Rock Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Oncology
HEMATOLOGY-ONCOLOGY
NPI: 1003839820
2911 Medical Arts St
Ste 13
J(512) 478-9990
NPI: 1003839820
6204 Balcones Dr
J(512) 302-1771
Hospital Affiliation: Md Anderson Cancer
Center, Seton Medical Center, St Davids
Georgetown Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old, Practice Limited to Oncology
Board Certified Specialties: Oncology
Uyeki, James V, MD
Gender: Male
NPI: 1124187927
4101 James Casey St
Ste 100
(512) 447-2202
Hospital Affiliation: Central Texas Medical
Center, Md Anderson Cancer Center, Seton
Medical Center, St Davids Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old, Practice Limited to Oncology
Board Certified Specialties: None
Austin
Smith, Jason L, MD
Gender: Male
NPI: 1114137064
4101 James Casey St
Ste 100
J(512) 447-2202
Hospital Affiliation: Central Texas Medical
Center, Seton Medical Center
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Oncology
Wright, Jennifer A, MD
Gender: Female
NPI: 1568624831
4101 James Casey St
Ste 100
J(512) 447-2202
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Medical Center Hays,
Seton Northwest Hospital, Seton Southwest,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
Yorio, Jeffrey T, MD
Gender: Male
NPI: 1215197314
6204 Balcones Dr
(512) 427-9400
Hospital Affiliation: Md Anderson Cancer
Center, North Austin Medical Center, Seton
Medical Center, St Davids Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: Practice Limited to
Oncology
Board Certified Specialties: None
Gender: Male
NPI: 1598783128
1301 W 38th St
Ste 403
J(512) 459-0301
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Infectious Disease
Consultants PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Infectious
Diseases
Bissett, Jack D, MD
Gender: Male
NPI: 1407874027
# 1301 W 38th St
Ste 403
J(512) 459-0301
Hospital Affiliation: Heart Hospital Of
Austin, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Infectious Disease
Consultants PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Austin
" De Marco, Brendan M, MD
Austin
#
Austin
Gender: Male
NPI: 1083632459
4614 N IH 35
(512) 978-9100
Hospital Affiliation: Parkland Health And
Hospital Sys
Clinic Affiliation: Communitycare
Board Certified Specialties: Infectious
Diseases
Douglass, Elizabeth T, MD
Gender: Female
NPI: 1073675401
313 E 12th St
Ste 102
J(512) 324-8880
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Internal
Medicine
J - Wheelchair Access
87
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Shuford, Jennifer A, MD
Austin
AUSTIN Cont
INFECTIOUS DISEASES Cont
" Ellis, Lisa C, MD
Aus tin
#
Aus tin
Gender: Female
NPI: 1497774020
1301 W 38th St
Ste 403
J(512) 459-0301
Hospital Affiliation: Heart Hospital Of
Austin, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Infectious Disease
Consultants PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Infectious
Diseases
Evans, James S, MD
Gender: Male
NPI: 1396769543
1301 W 38th St
Ste 403
J(512) 459-0301
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Infectious Disease
Consultants PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
" Sriram, Padmam M, MD
Austin
Austin
Mondy, Kristin E, MD
Gender: Female
NPI: 1265459762
! 313 E 12th St
Ste 101
(512) 324-9650
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Internal
Medicine
" Gogineni, Sireesha, MD
Austin
Gender: Female
NPI: 1801974423
4007 James Casey Ste B200
(512) 441-9799
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Seton Medical Center, Seton
Medical Center Hays, Seton Medical Ctr
Williamson, Seton Northwest Hospital, Warm
Springs Spec Hosp Luling Llc
Clinic Affiliation: Austin Pulmonary
Consultants PA
Board Certified Specialties: Internal
Medicine
" Grossmann, Alicia W, MD
Austin
Gender: Female
NPI: 1225296320
6301 W Parmer Ln
Ste 102
(512) 568-3565
Hospital Affiliation: North Austin Medical
Center
Clinic Affiliation: Alicia W Grossmann MD
Board Certified Specialties: Internal
Medicine
" Douglass, Elizabeth T, MD
Gender: Female
NPI: 1073675401
313 E 12th St
Ste 102
J(512) 324-8880
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Internal
Medicine
" Burugu, Sukanya, MD
Gender: Female
NPI: 1992710040
11615 Angus Rd Ste 108
(512) 372-4400
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties: Internal
Medicine
Austin
Austin
Cervantes, Cecilia M, MD
Gender: Female
NPI: 1114022753
5114 Balcones Woods Dr
Ste 307-347
J(512) 466-2621
Hospital Affiliation: North Austin Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: Cecilia M Cervantes MD,
Cervantes Healthcare LLP
Practice Information: No Patients Under 10
yrs old
Board Certified Specialties: None
" Hayden, Shailaja J, MD
Austin
Gender: Female
NPI: 1427226224
1305 W 34th St
Ste 400
J(512) 459-6599
Hospital Affiliation: St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Pulmonary and Critical
Care Consultants of Aus
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: Internal
Medicine
Dubois, Susan K, MD
Gender: Female
NPI: 1114091675
2901 N IH 35
Ste 101
(512) 232-3900
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: Communitycare
Board Certified Specialties: None
Fisher, H Kenneth, MD
Gender: Male
NPI: 1063517506
5508 Parkcrest Dr
Ste 310
(512) 420-9900
Clinic Affiliation: Sleep Medicine
Consultants
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
" Lewis, Richard M, MD
Austin
Gender: Male
NPI: 1598726408
12221 N Mo Pac Expwy
J(512) 901-2504
Hospital Affiliation: Central Texas Medical
Center, North Austin Medical Center,
Northwest Hills Surgical Hospital, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, St Davids
Georgetown Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Capital Area Surgeons
PLLC
Board Certified Specialties: Internal
Medicine, Urology
" Frank, Carl D, MD
Austin
Gender: Male
NPI: 1962455105
8015 Shoal Creek Blvd
Ste 109
J(512) 420-0186
Clinic Affiliation: Austin Gastroenterology
PA
Board Certified Specialties:
Gastroenterology, Internal Medicine
" Cheruku, Sunil R, MD
Austin
Gender: Male
NPI: 1235173345
5508 Parkcrest Dr
Ste 310
(512) 420-9900
Hospital Affiliation: Healthsouth
Rehabilitation Hospital Of Austin, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Sleep Medicine
Consultants of Cen
Board Certified Specialties: Internal
Medicine
Gheewala, Raeeda M, MD
Gender: Female
NPI: 1851507115
4007 James Casey St
Ste A230
J(512) 451-5800
NPI: 1851507115
408 W 45th St
J(512) 459-1399
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Cornerstone Hosp Of Austin,
Seton Highland Lakes, Seton Medical
Center, Seton Medical Center Hays, Seton
Medical Ctr Williamson, Seton Northwest
Hospital, St Davids Medical Center
Clinic Affiliation: Central Texas Kidney
Assoc PA
Board Certified Specialties: Nephrology
Austin
Austin
" Robinson, Matthew C, MD
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Male
NPI: 1255362448
4101 Marathon Blvd
(512) 323-9222
Hospital Affiliation: University Medical
Center
Clinic Affiliation: Longevity Wellness Group
Inc
Board Certified Specialties: Internal
Medicine
Gender: Male
NPI: 1952359952
5700 W Slaughter Ln
Ste 260
(512) 268-3824
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Center, St Davids
Georgetown Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Capital City Emergency
Staffing
Board Certified Specialties: Internal
Medicine
Aus tin
Dailey, Jimmy W, MD
Gender: Male
NPI: 1073598199
11814 Jollyville Rd
Ste 103
(512) 250-9202
Hospital Affiliation: Tx Hlth Presbyterian
Hosp Kaufman
Clinic Affiliation: Low-T Physicians
Professional Mbr
Board Certified Specialties: None
Austin
" Davis, Gregory T, MD
" Boone, Arthur R, MD
Austin
Cruz, Jose C, MD
Gender: Male
NPI: 1720043524
901 W Ben White Blvd
J(512) 447-2211
Hospital Affiliation: Covenant Medical
Center, Covenant Medical Center Lakeside,
University Medical Center
Clinic Affiliation: Methodist Physician
Practices PLL
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Austin
Austin
Aus tin
Gender: Male
NPI: 1063437838
1301 W 38th St Ste 403
J(512) 459-0301
Hospital Affiliation: Heart Hospital Of
Austin, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Medical Ctr Williamson, Seton
Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Infectious Disease
Consultants PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Infectious
Diseases
Zachary, James A, MD
Gender: Male
NPI: 1457350290
4614 N IH 35
(512) 978-9100
Clinic Affiliation: Communitycare
Board Certified Specialties: None
INTERNAL MEDICINE
" Metzger, Brian S, MD
Gender: Male
NPI: 1538306899
1301 W 38th St Ste 403
J(512) 459-0301
Hospital Affiliation: Heart Hospital Of
Austin, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: Austin Infectious Disease
Consultants PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Infectious
Diseases
Austin
Gender: Female
NPI: 1659325181
4614 N IH 35
(512) 978-9100
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Communitycare
Board Certified Specialties: Infectious
Diseases
Aus tin
#
Austin
Gender: Female
NPI: 1295880813
1301 W 38th St Ste 403
(512) 459-0301
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, Texas Neurorehab Center
Clinic Affiliation: Austin Infectious Disease
Consultants PA
Board Certified Specialties: Infectious
Diseases
" Lewitton, Steven, MD
Austin
Gender: Male
NPI: 1487828521
1015 E 32nd St
Ste 508
(512) 480-3147
Hospital Affiliation: St Davids Hospital, St
Davids Medical Center
Clinic Affiliation: St Davids Cardiology
PLLC
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties:
Cardiovascular Disease, Internal Medicine
J - Wheelchair Access
88
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Mondy, Kristin E, MD
Aus tin
AUSTIN Cont
INTERNAL MEDICINE Cont
!
" Liu, Sharon, DO
Austin
Gender: Female
NPI: 1497981625
3828 S First St
(512) 443-1311
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Internal
Medicine
" MacKay, Daniel A, MD
Austin
#
" Monge, Maria C, MD
Aus tin
Gender: Female
NPI: 1851567556
1600 W 38th
Ste 212
J(877) 800-5722
Gender: Male
NPI: 1962450916
5700 W Slaughter Ln
Ste 260
J(512) 268-3824
Hospital Affiliation: Round Rock Medical
Center
Clinic Affiliation: Capital City Emergency
Staffing
Board Certified Specialties: Internal
Medicine
" Marroquin, James C, MD
" Naik, Seema G, MD
Gender: Female
NPI: 1245460575
901 W Ben White Blvd
(512) 447-2211
Hospital Affiliation: Methodist Specialty
And Transplant Hospital
Clinic Affiliation: Methodist Physician
Practices PLL
Board Certified Specialties: Internal
Medicine
" Masters Jr, Matthew, MD
Gender: Male
NPI: 1255414157
4007 James Casey St
Ste C210
J(512) 368-5294
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: Lonestar
Gastroenterology
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: Internal
Medicine
" Middleton, Ellen A, MD
Austin
Gender: Female
NPI: 1215132881
1210 Braker Ln
(512) 978-9300
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: Communitycare
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Austin
Punjabi, Narendra S, MD
Gender: Male
NPI: 1295740751
11615 Angus Rd
Ste 106
(512) 346-8652
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center
Clinic Affiliation: Narendra Punjabi MD
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Austin
" Ramos, Alina M, MD
Aus tin
!
" Tran, Phuong H, MD
Austin
Gender: Male
NPI: 1710197678
4450 Frontier Trl
(512) 373-8475
Clinic Affiliation: Low-T Physicians
Professional Mbr
Board Certified Specialties: Internal
Medicine
Rowder, Nicholas J, MD
Gender: Male
NPI: 1942230164
408 W 45th St
J(512) 451-5800
Austin
Austin
Gender: Female
NPI: 1912014812
3708 Jefferson St
(512) 459-6503
Hospital Affiliation: North Central Baptist
Hospital
Clinic Affiliation: Wellmed Networks Inc
Board Certified Specialties: Internal
Medicine
Gender: Male
NPI: 1942362520
1210 Braker Ln
(512) 978-9300
Hospital Affiliation: Seton Medical Ctr
Williamson
Clinic Affiliation: Communitycare
Board Certified Specialties: Internal
Medicine
" Mehta, Rajesh M, MD
Gender: Male
NPI: 1518052224
12335 Hymeadow Dr
Ste 150
J(512) 977-8300
Hospital Affiliation: North Austin Medical
Center, St Davids Medical Center
Clinic Affiliation: Leo Toupin MD
Practice Information: No Patients Under 14
yrs old
Board Certified Specialties: Internal
Medicine
" Schaefer, Jessica M, DO
" Naik, Shantanu S, MD
Austin
" Toupin, Leo R, MD
Austin
Austin
Aus tin
Aus tin
Reddy, Sridhar P, MD
Gender: Male
NPI: 1134123938
2911 Medical Arts St
Ste 9B
J(512) 474-6321
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, St Davids Medical Center,
Texas Neurorehab Center, University Med
Ctr Brackenridge
Clinic Affiliation: Sridhar P Reddy MD
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Gastroenterology
NPI: 1942230164
8620 Burnet Rd Ste 400
J(512) 334-1810
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Cornerstone Hosp Of Austin,
Heart Hospital Of Austin, Seton Medical
Center, Seton Medical Center Hays, Seton
Medical Ctr Williamson, Seton Northwest
Hospital, St Davids Medical Center, St
Davids S Austin Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Central Texas Kidney
Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Nephrology
Aus tin
Austin
Gender: Male
NPI: 1568453934
1705 Lost Creek Blvd
J(512) 329-0435
Hospital Affiliation: Cornerstone Hosp Of
Austin, Seton Medical Center, Seton
Northwest Hospital, South Austin Surgery
Center, St Davids Medical Center, St Davids
S Austin Medical Center, University Med Ctr
Brackenridge
Practice Information: No Patients Under 18
yrs old, Practice Limited to Addiction
Therapy
Board Certified Specialties: Internal
Medicine
Austin
NPI: 1851567556
1600 W 38th St
Ste 212
J(877) 800-5722
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Lone Star Circle of Care
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Internal
Medicine
Austin
Gender: Male
NPI: 1902014392
4107 Spicewood Springs Rd
(512) 342-4731
Hospital Affiliation: Heart Hospital Of
Austin, Seton Medical Center
Clinic Affiliation: Central Texas Palliative
Care Assoc
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties: Internal
Medicine
Austin
Gender: Female
NPI: 1265459762
313 E 12th St
Ste 101
(512) 324-9650
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Internal
Medicine
Gender: Female
NPI: 1689606857
601 E 15th St
(512) 324-7000
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Internal
Medicine
Shetty, Rajesh A, MD
Gender: Male
NPI: 1255374641
1210 W Braker Ln
(512) 978-9300
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Seton Edgar B Davis, Seton
Medical Ctr Williamson, Seton Northwest
Hospital, Seton Southwest
Clinic Affiliation: Communitycare
Board Certified Specialties: None
Soubra, Said H, MD
Gender: Male
NPI: 1548219751
1210 W Braker Ln
(512) 978-9300
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Dell Childrens Med Ctr Cent Tx,
Seton Medical Center, Seton Medical Ctr
Williamson, Seton Northwest Hospital
Clinic Affiliation: Communitycare
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
" Thatikonda, Srivani, MD
Austin
Gender: Female
NPI: 1881631356
805 W 37th St
(512) 421-4280
Hospital Affiliation: Cedar Park Regional
Medical Ctr, North Austin Medical Center,
Seton Medical Center, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Texas Oncology PA
Board Certified Specialties: Internal
Medicine, Radiation Oncology
Vidacic, Aleksandra, MD
Gender: Female
NPI: 1629272224
210 Lee Barton Dr
Unit 206
(210) 787-6621
Clinic Affiliation: Dr Av PLLC
Board Certified Specialties: None
Vinta, Malavika, MD
Gender: Female
NPI: 1518903525
408 W 45th St
J(512) 451-5800
Hospital Affiliation: Cornerstone Hosp Of
Austin, Heart Hospital Of Austin, Round
Rock Medical Center, Seton Medical Center,
Seton Medical Center Hays, Seton Medical
Ctr Williamson, Seton Northwest Hospital, St
Davids Medical Center, St Davids S Austin
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Central Texas Kidney
Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Nephrology
" Westbrook Jr, Raymond R, DO
Austin
Gender: Male
NPI: 1437103520
11814 Jollyville Rd
Ste 103
(512) 250-6202
Hospital Affiliation: Kindred Hospital
Tarrant County Arlington Campus, Medical
Center Of Arlington, Tx Hlth Arlington
Memorial Hosp
Clinic Affiliation: Low-T Physicians
Professional Mbr
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties: Internal
Medicine
" Zhou, Chen, MD
Austin
Gender: Female
NPI: 1851595458
13376 N Hwy 183
Ste 110
(512) 219-0129
Hospital Affiliation: Heart Hospital Of
Austin, Scott And White Memorial Hospital,
St Davids Georgetown Hospital, St Davids
Medical Center
Clinic Affiliation: Wellmed Medical Group
PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Internal
Medicine
J - Wheelchair Access
89
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Austin
AUSTIN Cont
INTERVENTIONAL CARDIOLOGY
" Amjadi, Nima, MD
Aus tin
#
Aus tin
Gender: Male
NPI: 1114974011
4316 James Casey St
Ste A
(512) 623-5300
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, Seton Southwest,
St Davids Medical Center, St Davids S
Austin Medical Center, Transitional Learning
Ctr Lubbock, University Med Ctr
Brackenridge
Clinic Affiliation: St Davids Cardiology
PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Interventional
Cardiology
Carlson, Thomas A, MD
Gender: Male
NPI: 1861453458
3801 N Lamar
Ste 300
J(512) 206-3600
Hospital Affiliation: Little River Healthcare,
Round Rock Medical Center, Scott & White
Hospital Taylor, Seton Medical Center, Seton
Northwest Hospital, St Davids S Austin
Medical Center, West Houston Medical
Center
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Chafizadeh, Edward R, MD
Gender: Male
NPI: 1023019924
# 1015 E 32nd St
Ste 508
(512) 807-3140
Hospital Affiliation: Heart Hospital Of
Austin, North Austin Medical Center, Round
Rock Medical Center, Seton Highland Lakes,
Seton Medical Center, Seton Northwest
Hospital, St Davids Hospital, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: St Davids Cardiology
PLLC
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Gigliotti, Osvaldo S, MD
Austin
Gender: Male
NPI: 1639123789
1301 W 38th St
Ste 400
J(512) 791-1224
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Interventional
Cardiology
Austin
Austin
" Demaio Jr, Samuel J, MD
Austin
Picone, Mark F, DO
Gender: Male
NPI: 1538169644
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
" Stahlman, Matthew B, MD
Austin
Gender: Male
NPI: 1548230212
1301 W 38th St
Ste 400
(512) 791-1224
NPI: 1538169644
900 W 38th St
Ste 420
J(512) 407-8346
Hospital Affiliation: Cedar Park Regional
Medical Ctr, North Austin Medical Center,
Round Rock Medical Center, Seton Medical
Center, Seton Medical Ctr Williamson, Seton
Northwest Hospital, Seton Southwest, St
Davids Georgetown Hospital, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Austin
Aus tin
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Austin
NPI: 1366435810
900 W 38th St
Ste 420
J(512) 407-8346
Hospital Affiliation: Heart Hospital Of
Austin, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, Seton Southwest,
St Davids Georgetown Hospital, St Davids
Medical Center, St Davids S Austin Medical
Center, West Houston Medical Center
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
Aus tin
Gender: Male
NPI: 1649239872
200 Medical Pkwy
Ste 270
J(512) 263-0123
Hospital Affiliation: East El Paso Phys Med
Ctr Llc, Lakeway Regional Medical Ctr Llc,
Seton Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Star State Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease, Interventional
Cardiology
Gammon, Roger S, MD
Gender: Male
NPI: 1366435810
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
Pirwitz, Mark J, MD
Gender: Male
NPI: 1063436152
1301 W 38th St
Ste 400
(512) 791-1224
NPI: 1548230212
6811 Austin Center
Blvd Ste 410
(512) 324-2705
Hospital Affiliation: Cornerstone Hosp Of
Austin, North Austin Medical Center, Seton
Highland Lakes, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties:
Cardiovascular Disease, Interventional
Cardiology
Austin
NPI: 1063436152
6811 Austin Center
Blvd Ste 410
(512) 324-2705
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Edgar B Davis, Seton Highland Lakes, Seton
Medical Center, Seton Northwest Hospital,
St Davids S Austin Medical Center
Clinic Affiliation: Seton Family of Doctors
Board Certified Specialties:
Cardiovascular Disease
Karha, Juhana K, MD
Gender: Male
NPI: 1871669564
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Center, Seton Medical
Ctr Williamson, Seton Northwest Hospital, St
Davids S Austin Medical Center
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
Austin
Lewitton, Steven, MD
Gender: Male
NPI: 1487828521
1015 E 32nd St
Ste 508
(512) 480-3147
Hospital Affiliation: St Davids Hospital, St
Davids Medical Center
Clinic Affiliation: St Davids Cardiology
PLLC
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties:
Cardiovascular Disease, Internal Medicine
Austin
Polkampally, Pritam R, MD
Gender: Male
NPI: 1487753877
200 Medical Pkwy
Ste 270
(512) 263-0123
Hospital Affiliation: Lakeway Regional
Medical Ctr Llc
Clinic Affiliation: Star State Heart PLLC
Board Certified Specialties: None
McMinn, Thomas R, MD
Gender: Male
NPI: 1316947344
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Center, Seton
Northwest Hospital, Seton Smithville Reg
Hospital, Seton Southwest, St Davids
Medical Center, St Davids S Austin Medical
Center, St Marks Medical Center, University
Med Ctr Brackenridge, West Houston
Medical Center
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
Austin
" Tucker II, Paul A, MD
Austin
Gender: Male
NPI: 1134104847
4316 James Casey St
Ste A
(512) 623-5300
Hospital Affiliation: North Austin Medical
Center, River Oaks Endoscopy Center Llp,
Seton Highland Lakes, Seton Medical
Center, Seton Northwest Hospital, Seton
Smithville Reg Hospital, Seton Southwest, St
Davids Medical Center, St Davids S Austin
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: St Davids Cardiology
PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Interventional
Cardiology
Selmon, Matthew R, MD
Gender: Male
NPI: 1316990922
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
NPI: 1316990922
900 W 38th St
Ste 420
J(512) 407-8346
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids
Hospital, St Davids Medical Center
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
Smith, Arthur M, MD
Gender: Male
NPI: 1043211444
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Georgetown Hospital, St Davids
Medical Center, St Davids S Austin Medical
Center, St Marks Medical Center, University
Med Ctr Brackenridge, West Houston
Medical Center
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
Terreson, David W, MD
Gender: Male
NPI: 1417932120
1015 E 32nd St
Ste 508
(512) 807-3140
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
Seton Smithville Reg Hospital, Seton
Southwest, St Davids Medical Center, St
Davids S Austin Medical Center, University
Med Ctr Brackenridge, West Houston
Medical Center
Clinic Affiliation: St Davids Cardiology
PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
Wozniak, Robert J, MD
Gender: Male
NPI: 1063408128
# 2200 Park Bend Dr
Ste 401
(512) 807-3180
Hospital Affiliation: North Austin Medical
Center, Seton Southwest, St Davids
Georgetown Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge, West
Houston Medical Center
Clinic Affiliation: Cardiovascular Specialists
of Tex
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
Austin
J - Wheelchair Access
90
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Aus tin
AUSTIN Cont
INTERVENTIONAL CARDIOLOGY Cont
Austin
Zidar, Francis J, MD
Gender: Male
NPI: 1972580652
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
Hospital Affiliation: Seton Medical Center,
Seton Medical Ctr Williamson, Seton
Northwest Hospital, St Davids Georgetown
Hospital, St Davids Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
Gender: Female
NPI: 1568487825
12200 Renfert Way Ste G3
(512) 821-2540
Hospital Affiliation: North Austin Medical
Center
Clinic Affiliation: North Austin Maternal
Fetal Medic
Board Certified Specialties: Maternal &
Fetal Medicine
Aus tin
Austin
Austin
Berry, David L, MD
Gender: Male
NPI: 1609052950
6500 N Mo Pac Expwy
Ste 1205 Bldg 1
J(512) 206-0101
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Berry David L MD
Practice Information: Practice Limited to
Obstetrics
Board Certified Specialties: None
Brown, Charles E, MD
Gender: Male
NPI: 1508928557
601 E 15th St
J(512) 324-7000
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Elliott, Byron D, MD
Gender: Male
NPI: 1689608101
4100 Duval Blvd
Ste 201 Bldg 2
J(512) 614-2209
NPI: 1417981994
601 E 15th St
(512) 459-1131
Harstad, Timothy W, MD
Gender: Male
NPI: 1558391847
1313 Red River
Ste 320
(512) 978-8870
NPI: 1417981994
801 W 34th St
Ste 100
J(512) 459-1131
NPI: 1417981994
911 W 38th St
Ste 205
J(512) 459-0361
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Communitycare, Magella
Medical Assoc PA, University Physicians
Group
Board Certified Specialties: None
NPI: 1558391847
801 W 34th St
Ste 100
J(512) 459-1131
" Fonseca, Linda, MD
Aus tin
Gender: Female
NPI: 1609801646
1301 Barbara Jordan Blvd
Ste 304
(512) 454-1110
NPI: 1609801646
4100 Duval Rd Ste 201
Bldg 2
(512) 339-1010
NPI: 1609801646
4314 Medical Pkwy
Ste 200
(512) 454-1110
NPI: 1558391847
911 W 38th St
Ste 205
J(512) 459-0361
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center
Clinic Affiliation: Communitycare, Magella
Medical Assoc PA
Practice Information: No Patients Under 10
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
" Sheppard, Joy C, MD
Austin
Gender: Female
NPI: 1982692984
4100 Duval Rd
Bldg 2 Ste 201
J(512) 339-1010
NPI: 1982692984
4100 Duval Rd Bldg 2
Ste 201
J(512) 339-1010
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Magella Medical Assoc PA
Practice Information: No Patients Under 10
yrs old
Board Certified Specialties: Maternal &
Fetal Medicine
" Horton, Amanda L, MD
Austin
Gender: Female
NPI: 1730131509
12200 Renfert Way
Ste G-3
J(512) 821-2540
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, St
Davids Medical Center
Clinic Affiliation: North Austin Maternal
Fetal Medic
Board Certified Specialties: Maternal &
Fetal Medicine
Austin
Austin
NPI: 1609801646
911 W 38th St
Ste 205
(512) 459-0361
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Medical Center Hays,
Seton Medical Ctr Williamson, Seton
Southwest, St Davids Medical Center, St
Davids S Austin Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Magella Medical Assoc PA
Board Certified Specialties: Maternal &
Fetal Medicine
Ridgeway, Jeffrey J, MD
Gender: Male
NPI: 1417981994
1313 Red River
Ste 320
(512) 978-8870
NPI: 1417981994
4100 Duval Rd Ste 201
Bldg 2
J(512) 339-1010
NPI: 1558391847
4100 Duval Rd Ste 201
Bldg 2
J(512) 339-1010
NPI: 1689608101
911 W 38th St
Ste 201
J(512) 459-1131
Hospital Affiliation: Baptist Health System,
Christus Santa Rosa Hosp City Ctr,
Methodist Hospital, Seton Medical Center,
Seton Northwest Hospital, St Davids
Georgetown Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Magella Medical Assoc PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
" Adusumalli, Jasvant, MD
Austin
Gender: Male
NPI: 1720138829
12200 Renfert Way
Ste G3
(512) 821-2540
Hospital Affiliation: North Austin Medical
Center
Clinic Affiliation: North Austin Maternal
Fetal Medic
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: Maternal &
Fetal Medicine
Austin
NPI: 1689608101
801 W 34th St
Ste 100
J(512) 459-1131
MATERNAL & FETAL MEDICINE
Austin
Gender: Male
NPI: 1730357039
12200 Renfert Way
Ste G3
J(512) 821-2540
Hospital Affiliation: Chi St Lukes Hlth
Baylor Coll Med, North Austin Medical
Center
Clinic Affiliation: North Austin Maternal
Fetal Medic
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: Maternal &
Fetal Medicine
" Destefano, Kimberly A, MD
" Zientek, David M, MD
!
" Haeri, Sina, MD
Austin
Aus tin
Austin
Gender: Male
NPI: 1629053061
6811 Austin Center
Blvd Ste 410
(512) 324-2705
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, St Davids
Georgetown Hospital
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Over 16
yrs old, No Patients Under 16 yrs old
Board Certified Specialties: Interventional
Cardiology
Cantu, Jessica A, MD
Gender: Female
NPI: 1619274677
911 W 38th St
Ste 201
(512) 459-1131
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, St Davids Medical Center, St
Davids S Austin Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Magella Medical Assoc PA
Board Certified Specialties: None
Singh, Jasbir, MD
Gender: Male
NPI: 1811001209
12200 Renfert Way
Ste G3
J(512) 821-2540
Hospital Affiliation: Baylor Medical Center
Waxahachie
Clinic Affiliation: North Austin Maternal
Fetal Medic
Practice Information: No Patients Under 10
yrs old
Board Certified Specialties: None
Singh, Krishna R, MD
Gender: Female
NPI: 1538368899
601 E 15th St
(512) 324-8670
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: None
MAXILLOFACIAL SURGERY
Austin
Casmedes III, Harry P, DDS
Gender: Female
NPI: 1013084169
901 W 38th St Ste 410
J(512) 324-3310
Clinic Affiliation: Pediatric Surgical
Subspecialists
Board Certified Specialties: Oral Surgery
J - Wheelchair Access
91
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Austin
AUSTIN Cont
MAXILLOFACIAL SURGERY Cont
Aus tin
Karakourtis, Mark H, DDS
Gender: Male
NPI: 1932320967
12201 Renfert Way Ste 345
(512) 836-3074
Hospital Affiliation: Seton Medical Center,
The Hosp At Westlake Med Ctr
Clinic Affiliation: Carus Dental
Board Certified Specialties: Oral Surgery
#
MEDICAL GENETICS
Aus tin
George Abraham, Jaya K, MD
Gender: Female
NPI: 1063616621
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1840
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Specially For Children
Board Certified Specialties: None
Austin
" Gibson, James B, MD
Aus tin
Gender: Male
NPI: 1023121159
1301 Barbara Jordan
Blvd Ste 200
J(512) 628-1840
Hospital Affiliation: Christus Santa Rosa
Hosp City Ctr, Dell Childrens Med Ctr Cent
Tx, Seton Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Medical
Genetics
Aus tin
Immken, Ladonna L, MD
Gender: Female
NPI: 1053363531
6811 Austin Center Blvd
Ste 400
J(512) 628-1918
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Northwest Hospital, University Med Ctr
Brackenridge
Clinic Affiliation: Esoterix Genetic
Counseling LLC
Board Certified Specialties: None
Austin
Austin
MEDICAL ONCOLOGY
Aus tin
NPI: 1902849805
901 W 38th St
Ste 300
(512) 421-4100
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Center, St Davids
Georgetown Hospital, St Marks Medical
Center
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
" Cipleu, Cristian D, MD
Austin
Gender: Male
NPI: 1689617383
3000 N IH 35 Ste 635
(512) 320-1500
NPI: 1689617383
3000 N Interstate 35
Ste 635
J(512) 320-1500
NPI: 1689617383
4100 Duval Rd
Bldg 4 Ste 102
J(512) 832-0999
Hospital Affiliation: Cornerstone Hosp Of
Austin, Healthsouth Rehabilitation Hospital
Of Austin, Seton Medical Center, St Davids
Medical Center
Clinic Affiliation: Austin Kidney Assoc PA,
Capital Nephrology Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Nephrology
Tokaz, Laurence K, MD
Gender: Male
NPI: 1124060256
# 1600 W 38th St
Ste 120
J(512) 302-1771
Netaji, Balijepalli, MD
Gender: Male
NPI: 1982642914
12221 Renfert Way Ste 300
J(512) 873-8900
Hospital Affiliation: Cedar Park Regional
Medical Ctr, North Austin Medical Center,
Round Rock Medical Center, Seton Medical
Center, Seton Medical Ctr Williamson, Seton
Northwest Hospital, Seton Smithville Reg
Hospital, St Davids Georgetown Hospital, St
Davids Medical Center, St Davids S Austin
Medical Center
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Oncology
NPI: 1124060256
4101 James Casey St
Ste 100
J(512) 447-2202
Austin
NPI: 1124060256
6101 Balcones Dr
Ste 101
J(512) 406-5150
Hospital Affiliation: Cornerstone Hosp Of
Austin, North Austin Medical Center, Seton
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
Pandey, Om N, MD
Gender: Male
NPI: 1316927353
1313 Red River St
Ste 217
J(512) 324-7300
Hospital Affiliation: Seton Medical Center,
Seton Medical Center Hays, University Med
Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: None
NPI: 1386703064
3000 N Interstate 35
Ste 635
J(512) 320-1500
Hospital Affiliation: Cornerstone Hosp Of
Austin, North Austin Medical Center, The
Hosp At Westlake Med Ctr
Clinic Affiliation: Austin Kidney Assoc PA,
Capital Nephrology Assoc PA, University
Physicians Group
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
" Alpar, Andrew, MD
Austin
Gender: Male
NPI: 1750368510
800 W 34th St
Ste 101
(512) 485-7870
Hospital Affiliation: Central Texas Medical
Center, Healthsouth Rehabilitation Hospital
Of Austin, North Austin Medical Center,
Seton Medical Center, Seton Northwest
Hospital, St Davids Medical Center, St
Davids S Austin Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Jack Moncrief Group PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Nephrology
Rubin De Celis, Carlos, MD
Gender: Male
NPI: 1275571879
12201 Renfert Way
Ste 325
J(512) 302-1771
" Gheewala, Raeeda M, MD
Austin
Gender: Female
NPI: 1851507115
4007 James Casey St
Ste A230
J(512) 451-5800
NPI: 1851507115
408 W 45th St
J(512) 451-5800
(512) 459-1399
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Cornerstone Hosp Of Austin,
Seton Highland Lakes, Seton Medical
Center, Seton Medical Center Hays, Seton
Medical Ctr Williamson, Seton Northwest
Hospital, St Davids Medical Center
Clinic Affiliation: Austin Kidney Assoc PA,
Central Texas Kidney Assoc PA
Board Certified Specialties: Nephrology
" Betts, Judith A, MD
Austin
!
Shaughnessy, Paul J, MD
Gender: Male
NPI: 1316904550
901 W Ben White Blvd
(512) 447-2211
Hospital Affiliation: Methodist Hospital,
Methodist Specialty And Transplant Hospital
Clinic Affiliation: Methodist Physician
Practices PLL
Practice Information: No Patients Under 14
yrs old
Board Certified Specialties: None
Gender: Female
NPI: 1992735120
408 W 45th St
(512) 451-5800
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Cornerstone Hosp Of Austin,
Round Rock Medical Center, Seton Medical
Center, Seton Medical Center Hays, Seton
Medical Ctr Williamson, Seton Northwest
Hospital, St Davids Medical Center, St
Davids S Austin Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Austin Kidney Assoc PA,
Central Texas Kidney Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Nephrology
Erko, Amsalu, MD
Gender: Male
NPI: 1386703064
1313 Red River St
Ste 220
(512) 324-7300
NPI: 1386703064
3000 N IH 35
Ste 635
(512) 451-5800
NEPHROLOGY
NPI: 1275571879
901 W 38th St Ste 200
J(512) 421-4100
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Oncology
Austin
Shrikhande, Shubhada S, MD
Gender: Female
NPI: 1982661674
12221 Renfert Way
Ste 300
(512) 873-8900
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Texas Oncology PA
Board Certified Specialties: Oncology
Austin
NPI: 1275571879
6204 Balcones Dr
J(512) 302-1771
Aus tin
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Austin
NPI: 1275571879
4101 James Casey St
J(512) 447-2202
Cruz, Jose C, MD
Gender: Male
NPI: 1720043524
901 W Ben White Blvd
J(512) 447-2211
Hospital Affiliation: Covenant Medical
Center, Covenant Medical Center Lakeside,
University Medical Center
Clinic Affiliation: Methodist Physician
Practices PLL
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Fain, Jerry D, MD
Gender: Male
NPI: 1447293840
# 901 W 38th St
Ste 200
(512) 421-4100
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, St Davids S
Austin Medical Center
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
Melear, Jason M, MD
Gender: Male
NPI: 1902849805
11111 Research Blvd
Ste 400
(512) 349-0081
" Hashim, Shahzad, MD
Austin
Gender: Male
NPI: 1205053147
408 W 45th St
(512) 451-5800
Hospital Affiliation: Houston Northwest
Medical Center, Mem Hermann The
Woodlands Hosp
Clinic Affiliation: Austin Kidney Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Nephrology
J - Wheelchair Access
92
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Maidment, Helen J, MD
" Moncrief, Jack W, MD
Aus tin
AUSTIN Cont
NEPHROLOGY Cont
" Hines, Peter B, MD
Austin
Gender: Male
NPI: 1932244506
408 W 45th St
(512) 451-5800
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Cornerstone Hosp Of Austin,
Heart Hospital Of Austin, Seton Medical
Center, Seton Medical Center Hays, Seton
Medical Ctr Williamson, Seton Northwest
Hospital, St Davids Medical Center
Clinic Affiliation: Austin Kidney Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Nephrology
Gender: Female
NPI: 1649378787
4007 James Casey St
Ste A230
(512) 451-5800
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Cornerstone Hosp Of Austin,
Heart Hospital Of Austin, Seton Medical
Center, Seton Medical Center Hays, Seton
Medical Ctr Williamson, Seton Northwest
Hospital, St Davids Medical Center, St
Davids S Austin Medical Center
Clinic Affiliation: Austin Kidney Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Nephrology
" Lyson, Krzysztof J, MD
Austin
Gender: Male
NPI: 1376586073
3000 N Interstate 35
Ste 635
J(512) 320-1500
NPI: 1376586073
408 W 45th St
(512) 451-5800
NPI: 1376586073
4100 Duval Rd
Bldg 2 Ste 10
J(512) 832-0999
NPI: 1376586073
8620 Burnet Rd Ste 400
J(512) 334-1810
Hospital Affiliation: Cornerstone Hosp Of
Austin, Healthsouth Rehabilitation Hospital
Of Austin, North Austin Medical Center,
Seton Medical Center, St Davids Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: Austin Kidney Assoc PA,
Capital Nephrology Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Nephrology
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Male
NPI: 1720021777
3000 N IH 35
Ste 635
J(512) 320-1500
Gender: Male
NPI: 1235176710
3000 N Interstate 35
Ste 635
J(512) 320-1500
Gender: Male
NPI: 1063446359
408 W 45th St
(512) 451-5800
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Cornerstone Hosp Of Austin,
Heart Hospital Of Austin, Round Rock
Medical Center, Seton Medical Center, Seton
Medical Center Hays, Seton Medical Ctr
Williamson, Seton Northwest Hospital, St
Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Kidney Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Nephrology
" Lu, Ting Chi, MD
" Moore, Walter S, MD
Austin
" Mididoddi, Ravi, MD
" Hines, Timothy R, MD
Austin
Gender: Male
NPI: 1164439295
800 W 34th St
Ste 101
(512) 485-7870
Hospital Affiliation: Heart Hospital Of
Austin, North Austin Medical Center, St
Davids Medical Center
Clinic Affiliation: Jack Moncrief Group PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Nephrology
Aus tin
Austin
Austin
Austin
Gender: Female
NPI: 1467495168
408 W 45th St
(512) 451-5800
Hospital Affiliation: Central Texas Medical
Center, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Kidney Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Nephrology
" Rosen, Mark S, MD
Austin
Gender: Male
NPI: 1578561411
3000 N IH 35
Ste 635
J(512) 451-5800
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Austin Kidney Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Nephrology
NPI: 1720021777
3000 N Interstate 35
Ste 635
J(512) 320-1500
NPI: 1235176710
408 W 45th St
(512) 451-5800
NPI: 1720021777
4100 Duval Rd Ste 102
J(512) 832-0999
NPI: 1235176710
4100 Duval Rd
Ste 102 Bldg 4
J(512) 832-0999
Hospital Affiliation: University Health
System
Clinic Affiliation: Austin Kidney Assoc PA,
Capital Nephrology Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Nephrology
" Miller, Peter L, MD
Gender: Male
NPI: 1619911880
3000 N Interstate 35
Ste 635
J(512) 320-1500
" Rowder, Nicholas J, MD
Austin
Gender: Male
NPI: 1942230164
408 W 45th St
(512) 451-5800
NPI: 1720021777
8620 Burnet Rd
Ste 400
J(512) 334-1810
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Kidney Assoc PA,
Capital Nephrology Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Nephrology
Aus tin
NPI: 1942230164
8620 Burnet Rd Ste 400
J(512) 334-1810
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Cornerstone Hosp Of Austin,
Heart Hospital Of Austin, Seton Medical
Center, Seton Medical Center Hays, Seton
Medical Ctr Williamson, Seton Northwest
Hospital, St Davids Medical Center, St
Davids S Austin Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Austin Kidney Assoc PA,
Central Texas Kidney Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Nephrology
" Nader, Paul C, MD
Austin
Gender: Male
NPI: 1164407102
3000 N IH 35
Ste 635
(512) 451-5800
NPI: 1619911880
4007 James Casey St
Ste A210
J(512) 320-1500
Rodriguez, William A, MD
Gender: Male
NPI: 1821028093
408 W 45th St
(512) 451-5800
Hospital Affiliation: Healthsouth
Rehabilitation Hospital Of Austin, Seton
Medical Center, Seton Northwest Hospital,
St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Kidney Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
" Simmons, Edith M, MD
Austin
NPI: 1164407102
601 E 15 St
(512) 324-7000
Hospital Affiliation: Seton Edgar B Davis,
Seton Medical Center, Seton Medical Center
Hays, Seton Northwest Hospital, Seton
Smithville Reg Hospital, Seton Southwest, St
Davids Georgetown Hospital, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Kidney Assoc PA,
University Physicians Group
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Nephrology
NPI: 1619911880
408 W 45th St
(512) 451-5800
NPI: 1619911880
4207 James Casey St
Ste 306
J(512) 320-1500
NPI: 1619911880
601 E 15 St
(512) 324-7000
NPI: 1619911880
8620 Burnet Rd Ste 400
J(512) 334-1810
Hospital Affiliation: Healthsouth
Rehabilitation Hospital Of Austin, Round
Rock Medical Center, Seton Medical Center,
Seton Medical Center Hays, Seton
Northwest Hospital, Seton Smithville Reg
Hospital, Seton Southwest, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Kidney Assoc PA,
Capital Nephrology Assoc PA, University
Physicians Group
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Nephrology
Austin
Nasser, Yasser A, MD
Gender: Male
NPI: 1760413629
408 W 45th St
J(512) 451-5800
Clinic Affiliation: Austin Kidney Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
" Perez, Annalisa B, MD
Austin
Gender: Female
NPI: 1518084862
3000 N IH 35
Ste 635
(512) 451-5800
Gender: Female
NPI: 1639112683
3000 N IH 35
Ste 635
(512) 320-1500
NPI: 1639112683
3000 N Interstate 35
Ste 635
J(512) 320-1500
NPI: 1639112683
4207 James Casey St
Ste 306
J(512) 320-1500
Hospital Affiliation: Central Texas Medical
Center, Central Texas Rehab Hospital Llc,
Cornerstone Hosp Of Austin, Healthsouth
Rehabilitation Hospital Of Austin, Heart
Hospital Of Austin, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center
Clinic Affiliation: Austin Kidney Assoc PA,
Capital Nephrology Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Nephrology
NPI: 1518084862
601 E 15th St
(512) 324-7000
Hospital Affiliation: Scott And White
Memorial Hospital
Clinic Affiliation: Austin Kidney Assoc PA,
University Physicians Group
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Nephrology
J - Wheelchair Access
93
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
AUSTIN Cont
NEUROLOGICAL SURGERY
" Kemper, Craig M, MD
Austin
" Aronin, Patricia A, MD
Austin
NEPHROLOGY Cont
Gender: Female
NPI: 1336236850
1301 Barbara Jordan
Blvd Ste 307
(512) 324-0907
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Pediatric Surgical
Subspecialists
Board Certified Specialties: Neurological
Surgery
" Simpson, Karon S, MD
Aus tin
Gender: Female
NPI: 1164465274
3000 N IH 35
Ste 635
(512) 451-5800
NPI: 1164465274
3000 N Interstate 35
Ste 635
J(512) 320-1500
NPI: 1164465274
4100 Duval Rd
Ste 102 Bldg 4
J(512) 832-0999
NPI: 1164465274
8620 Burnet Rd
Ste 400
J(512) 334-1810
Hospital Affiliation: Central Texas Medical
Center, Healthsouth Rehabilitation Hospital
Of Austin, North Austin Medical Center,
Round Rock Medical Center, Seton Medical
Center, St Davids Medical Center, St Davids
Rehabilitation Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Kidney Assoc PA,
Capital Nephrology Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Nephrology
" Burnett, Mark G, MD
Gender: Male
NPI: 1932195427
1015 E 32nd St
Ste 411
J(512) 474-1114
Gender: Female
NPI: 1518903525
408 W 45th St
(512) 451-5800
Hospital Affiliation: Cornerstone Hosp Of
Austin, Heart Hospital Of Austin, Round
Rock Medical Center, Seton Medical Center,
Seton Medical Center Hays, Seton Medical
Ctr Williamson, Seton Northwest Hospital, St
Davids Medical Center, St Davids S Austin
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Kidney Assoc PA,
Central Texas Kidney Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Nephrology
Aus tin
Gender: Male
NPI: 1871578252
12180 N Mopac Expwy
Ste A
J(512) 494-6024
Hospital Affiliation: Arise Austin Medical
Center, North Austin Medical Center, Round
Rock Medical Center, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Stanley H Kim MD
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Neurological
Surgery
" Fox Jr, Douglas J, MD
Gender: Male
NPI: 1427044924
1015 E 32nd St
Ste 411
(512) 474-1114
Aus tin
Gender: Male
NPI: 1518027366
801 W 38th St
Ste 400
(512) 306-1323
NPI: 1518027366
801 W 38th St Ste 400
J(512) 306-1323
Hospital Affiliation: Central Park Surgery
Center, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Neurosurgical Specialists,
Seton Brain and Spine Institute
Board Certified Specialties: Neurological
Surgery
" Rose, James E, MD
Austin
Gender: Male
NPI: 1003834680
1400 N IH 35
Ste 300
(512) 324-8300
Hospital Affiliation: Chi St Lukes Hlth
Baylor Coll Med, Houston Methodist
Hospital, Texas Orthopedic Hospital
Clinic Affiliation: Seton Brain and Spine
Institute
Board Certified Specialties: Neurological
Surgery
" Lee, Mark R, MD
Austin
NPI: 1427044924
1015 E 32nd St Ste 411
J(512) 474-1114
Gender: Male
NPI: 1861413536
1301 Barbara Jordan
Blvd Ste 307
J(512) 321-0910
NPI: 1427044924
4101 James Casey Ste 33A
J(512) 474-1114
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Center, St Davids
Medical Center, St Davids S Austin Medical
Center
Clinic Affiliation: Neuro Texas PLLC,
Neurotexas PLLC
Board Certified Specialties: Neurological
Surgery
NPI: 1861413536
1400 N IH 35
Ste 300
(512) 324-8300
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center
Clinic Affiliation: Pediatric Surgical
Subspecialists, Seton Brain and Spine
Institute
Board Certified Specialties: Neurological
Surgery
" Spinks, Theodore J, MD
Austin
Gender: Male
NPI: 1114065646
2500 W Wm Cannon Dr
Ste 401
(512) 451-1969
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Southwest Orthopaedic
Group
Board Certified Specialties: Neurological
Surgery
" Loftus, Thomas S, MD
" Hummell, Matthew K, MD
Austin
Austin
Gender: Male
NPI: 1548253503
2200 Park Bend Dr Bldg
2-202
J(512) 836-0900
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, St Davids S Austin Medical
Center, The Hosp At Westlake Med Ctr
Clinic Affiliation: Austin Neurosurgical
Institute
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Neurological
Surgery
Gender: Male
NPI: 1134289994
801 W 38th St
Ste 400
(512) 306-1323
NPI: 1134289994
801 W 38th St Ste 400
J(512) 306-1323
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Neurosurgical Specialists,
Seton Brain and Spine Institute
Board Certified Specialties: Neurological
Surgery
Austin
Welch, Byron R, MD
Gender: Male
NPI: 1013950062
3000 N IH 35
Ste 635
(512) 451-5800
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center
Clinic Affiliation: Austin Kidney Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
" Peterson, Daniel L, MD
Austin
" Kim, Stanley H, MD
Austin
Gender: Female
NPI: 1821028077
4007 James Casey St
Ste A230
(512) 451-5800
Hospital Affiliation: Cornerstone Hosp Of
Austin, Heart Hospital Of Austin, Northwest
Hills Surgical Hospital, Seton Medical
Center, Seton Medical Center Hays, Seton
Medical Ctr Williamson, Seton Northwest
Hospital, St Davids Medical Center, St
Davids S Austin Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Austin Kidney Assoc PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Nephrology
Gender: Male
NPI: 1295710655
12319 N Mopac Expwy
Ste C150
J(512) 837-7999
Hospital Affiliation: Arise Austin Medical
Center, North Austin Medical Center, Round
Rock Medical Center, St Davids Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: Anant I Patel MD
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Neurological
Surgery
Austin
NPI: 1932195427
4101 James Casey Ste 330A
J(512) 474-1114
Hospital Affiliation: St Davids Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: Neuro Texas PLLC,
Neurotexas PLLC
Board Certified Specialties: Neurological
Surgery
" Venkatesh, Sujatha, MD
" Vinta, Malavika, MD
NPI: 1164582912
801 W 38th St Ste 400
J(512) 306-1323
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center,
Northwest Hills Surgical Hospital, Seton
Medical Center, Seton Medical Ctr
Williamson, Seton Northwest Hospital, St
Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Neurosurgical Specialists,
Seton Brain and Spine Institute
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Neurological
Surgery
Austin
Aus tin
" Patel, Anant I, MD
Austin
Gender: Male
NPI: 1164582912
801 W 38th St
Ste 400
J(512) 306-1323
Madera, Marcella A, MD
Gender: Female
NPI: 1528287851
801 W 38th St
Ste 400
(512) 306-1323
NPI: 1528287851
801 W 38th St Ste 400
(512) 306-1323
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Neurosurgical Specialists,
Seton Brain and Spine Institute
Board Certified Specialties: None
" Stokes, John K, MD
Austin
Gender: Male
NPI: 1245390095
1600 W 38th St
Ste 200
(512) 324-3580
Hospital Affiliation: Healthsouth
Rehabilitation Hospital Of Austin, North
Austin Medical Center, Round Rock Medical
Center, Seton Medical Center, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Seton Brain and Spine
Institute
Board Certified Specialties: Neurological
Surgery
" Stovall, Richard B, MD
Austin
Gender: Male
NPI: 1134115595
1015 E 32nd St
Ste 411
(512) 454-1234
Hospital Affiliation: Medical Center Of
Plano, St Davids Medical Center, Tx Hlth
Presbyterian Hosp Plano
Clinic Affiliation: Neuro Texas PLLC
Board Certified Specialties: Neurological
Surgery
J - Wheelchair Access
94
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Wilson, Ronald J, MD
" Aung, Soe M, MD
Aus tin
AUSTIN Cont
NEUROLOGICAL SURGERY Cont
" Tumu, Hari, MD
Austin
Gender: Male
NPI: 1457427130
801 W 38th St
Ste 400
(512) 306-1323
Hospital Affiliation: Central Park Surgery
Center, Healthsouth Rehabilitation Hospital
Of Austin, North Austin Medical Center,
Round Rock Medical Center, Seton Medical
Center, St Davids Medical Center, St Davids
S Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Neurosurgical Specialists,
Seton Brain and Spine Institute
Board Certified Specialties: Neurological
Surgery
Aus tin
" Valadka, Alex B, MD
Austin
Gender: Male
NPI: 1881633709
1400 N IH 35
Ste 300
(512) 324-8300
Hospital Affiliation: Mem Hermann Mem
City Hosp, University Med Ctr Brackenridge
Clinic Affiliation: Seton Brain and Spine
Institute
Board Certified Specialties: Neurological
Surgery
" Waldron, James S, MD
Austin
Gender: Male
NPI: 1225104995
801 W 38th St
Ste 400
J(512) 306-1323
Gender: Male
NPI: 1669570255
711 W 38th St
Ste D4
(800) 638-7564
NPI: 1225104995
801 W 38th St Ste 400
J(512) 306-1323
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Healthsouth Rehabilitation Hospital
Of Austin, Seton Medical Center, Seton
Medical Ctr Williamson, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Neurosurgical Specialists,
Seton Brain and Spine Institute
Board Certified Specialties: Neurological
Surgery
NPI: 1669570255
711 W 38th St
Ste E 1
(800) 638-7564
Ziu, Mateo, MD
Gender: Male
NPI: 1417137290
1400 N IH 35 Ste 300
J(512) 324-8300
Hospital Affiliation: Md Anderson Cancer
Center, Seton Medical Center, Seton Medical
Ctr Williamson, University Med Ctr
Brackenridge
Clinic Affiliation: Seton Brain and Spine
Institute
Practice Information: Practice Limited to
Oncology
Board Certified Specialties: None
NPI: 1669570255
711 W 38th St
Ste E1
J(512) 477-5337
(734) 213-3931
(800) 638-7564
Hospital Affiliation: Healthsouth
Rehabilitation Hospital Of Austin, Heart
Hospital Of Austin, St Davids Medical
Center, Texas Neurorehab Center, University
Med Ctr Brackenridge
Clinic Affiliation: Neural Watch LLC,
Neuralview Medical Group PC, Neuralwatch
Michigan PLLC, Neuralwatch New Jersey
LLC, Neuralwatch Texas PLLC, Soe Aung
MD
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties: Neurology
Gender: Female
NPI: 1770695397
711 W 38th St
Ste F1
(512) 458-6121
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Sara Austin MD
Practice Information: No Patients Under 14
yrs old
Board Certified Specialties: Neurology
" Webb, Kristopher M, MD
" Aboumatar, Sami M, MD
Aus tin
Austin
Gender: Male
NPI: 1114913605
1015 E 32nd St
Ste 411
J(512) 474-1114
NPI: 1114913605
4316 James Casey St
Ste B101
J(512) 474-1114
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, South
Austin Surgery Center, St Davids Medical
Center
Clinic Affiliation: Neuro Texas PLLC,
Neurotexas PLLC
Board Certified Specialties: Neurological
Surgery
Austin
" Aquino, Karen M, MD
Aus tin
Aubrechtova, Hana, MD
Gender: Female
NPI: 1831307289
711 F W 38th St
J(512) 458-6121
Hospital Affiliation: St Davids Medical
Center
Clinic Affiliation: Austin Neurological Clinic
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties: None
Austin
Gender: Male
NPI: 1215959697
1600 W 38th St
Ste 308
(512) 324-3540
Hospital Affiliation: Seton Medical Center,
Seton Medical Ctr Williamson, Seton
Northwest Hospital, University Med Ctr
Brackenridge
Clinic Affiliation: Seton Brain and Spine
Institute
Board Certified Specialties: Neurology
" Bhandari, Hanul S, MD
" Fraim, C Jack, MD
Gender: Male
NPI: 1942314406
1600 W 38th St
Ste 308
(512) 324-3540
Hospital Affiliation: Baptist Beaumont
Hospital, Baylor Regional Med Ctr At Plano,
Christus Hospital, Medical City Dallas
Hospital
Clinic Affiliation: Seton Brain and Spine
Institute
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Neurology
" Grogan, Wendell A, MD
Austin
Gender: Male
NPI: 1063502912
3724 Executive Ctr Dr
Ste 163
(512) 873-3344
Hospital Affiliation: Kingwood Medical
Center, Mem Hermann Northeast Hosp
Clinic Affiliation: Hill Country Monitoring
LLC
Practice Information: No Patients Under 14
yrs old
Board Certified Specialties: Neurology
Austin
Gender: Male
NPI: 1053572164
3724 Executive Ctr Dr
Ste 163
J(512) 687-3119
Clinic Affiliation: Hill Country Monitoring
LLC
Board Certified Specialties: Neurology
" Briggs, Deborah E, MD
Austin
Gender: Female
NPI: 1497748370
1600 W 38th St
Ste 308
(512) 324-3540
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Seton Brain and Spine
Institute
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties: Neurology
Elizondo, Eduardo R, MD
Gender: Male
NPI: 1295783728
7307 Creekbluff Dr
(512) 614-3300
Hospital Affiliation: Arise Austin Medical
Center, Seton Medical Center, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Neural Watch LLC
Board Certified Specialties: None
Austin
Barson Jr, Dennis B, DO
Gender: Male
NPI: 1588628770
12701 Research Blvd
Ste 309
J(512) 464-1222
Clinic Affiliation: Neuro Wellness PLLC
Board Certified Specialties: None
" Bertelson, John A, MD
" Atkinson, Bryan R, MD
Gender: Male
NPI: 1750493243
4201 Marathon Blvd
Ste 304
J(512) 371-1200
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, St Davids S
Austin Medical Center
Clinic Affiliation: The Neurology and
Electromyography Clinic PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Neurology
Gender: Male
NPI: 1649257452
6835 Austin Ctr Blvd
(512) 346-6611
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Neurology
Austin
Aus tin
White, Gordon L, MD
Gender: Male
NPI: 1013983121
1600 W 38th St Ste 418
J(512) 467-8596
Hospital Affiliation: St Davids Medical
Center
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Austin
Aus tin
Gender: Female
NPI: 1316147150
2200 Park Bend Dr
Ste 203
J(512) 339-8831
Hospital Affiliation: North Austin Medical
Center
Clinic Affiliation: Austin Epilepsy Care
Center
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties: Neurology
" Edmond, Michael T, MD
Austin
" Austin, Sara G, MD
NEUROLOGY
Gender: Male
NPI: 1760445407
2200 Park Bend Dr
Ste 203
J(512) 339-8831
Hospital Affiliation: Cornerstone Regional
Hospital Llc, North Austin Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Epilepsy Care
Center
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Neurology
Gender: Male
NPI: 1366464745
3724 Executive Ctr Dr
Ste 163
(512) 551-0846
Hospital Affiliation: Northwest Hills Surgical
Hospital, Seton Medical Center, Seton
Medical Center Hays, Seton Medical Ctr
Williamson, Seton Northwest Hospital, Seton
Southwest, University Med Ctr Brackenridge
Clinic Affiliation: Hill Country Monitoring
LLC
Board Certified Specialties: Neurology
Austin
Austin
Gender: Male
NPI: 1902926850
3000 N IH 35
Ste 600
(512) 474-1114
(512) 474-4111
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Center, St Davids
Medical Center, Surgicare Of South Austin
Clinic Affiliation: Neuro Texas PLLC,
Neurotexas PLLC
Board Certified Specialties: Neurological
Surgery
" Camp, Darryl S, MD
Austin
" Hastings, John D, MD
Austin
Gender: Male
NPI: 1043253842
3724 Executive Center Dr
Ste 163
(512) 687-3119
Hospital Affiliation: Northwest Hills Surgical
Hospital, St Davids S Austin Medical Center
Clinic Affiliation: Hill Country Monitoring
LLC
Board Certified Specialties: Neurology
J - Wheelchair Access
95
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Hussain, Yessar M, MD
" Modur, Pradeep N, MD
Austin
AUSTIN Cont
NEUROLOGY Cont
" Heytens, Jill E, MD
Aus tin
Gender: Female
NPI: 1972625994
1015 W 39 1/2 St
(512) 371-7478
NPI: 1982852166
3724 Executive Ctr Dr
Ste 163
(512) 687-3119
NPI: 1972625994
601 E 15th St
(512) 324-7000
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Pro Care Medical Center,
University Physicians Group
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Neurology
NPI: 1982852166
6811 Austin Center
Blvd Ste 420
J(512) 324-2715
Hospital Affiliation: Central Texas Rehab
Hospital Llc, Seton Medical Center, Seton
Medical Ctr Williamson, University Med Ctr
Brackenridge
Clinic Affiliation: Hill Country Monitoring
LLC, Neural Watch LLC, Seton Brain and
Spine Institute
Board Certified Specialties: Neurology
" Hill, Thomas A, MD
Aus tin
Gender: Male
NPI: 1457321077
1015 E 32nd St Ste 406
J(512) 495-1850
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Thomas A Hill MD
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Neurology
" Horn III, Albert B, MD
Aus tin
Gender: Male
NPI: 1497750392
711 W 38th St Ste F1
J(512) 458-6121
Hospital Affiliation: Healthsouth
Rehabilitation Hospital Of Austin, Seton
Medical Center, St Davids Medical Center,
Texas Neurorehab Center, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Neurological Clinic
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties: Neurology
" Hudson, John D, MD
Aus tin
Gender: Male
NPI: 1487626008
5508 Parkcrest Dr
Ste 310
(512) 420-9900
Hospital Affiliation: Cornerstone Hosp Of
Austin, Heart Hospital Of Austin, Scott &
White Hospital Llano, Seton Medical Center,
St Davids Medical Center, St Davids S
Austin Medical Center, Texas Neurorehab
Center
Clinic Affiliation: Sleep Medicine
Consultants, Sleep Medicine Consultants of
Cen
Practice Information: Limited to Sleep
Disorders, No Patients Under 14 yrs old
Board Certified Specialties: Neurology,
Sleep Medicine
#
" Morledge, David W, MD
Gender: Male
NPI: 1225129703
711 F1 W 38th St
J(512) 458-6121
Hospital Affiliation: Healthsouth
Rehabilitation Hospital Of Austin, Seton
Medical Center, St Davids Medical Center,
Texas Neurorehab Center, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Neurological Clinic
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties: Neurology
Gender: Male
NPI: 1295726453
3724 Executive Ctr Dr
Ste 163
(512) 687-3119
Clinic Affiliation: Hill Country Monitoring
LLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Neurology
" Roy, Marci, MD
#
" Izor, Robert M, MD
Gender: Male
NPI: 1164409108
12201 Renfert Way
Ste 360
J(512) 977-7000
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center
Clinic Affiliation: Neurology Solutions
Consultants PA
Board Certified Specialties: Neurology
" Shen, Jason Y, MD
Austin
Gender: Male
NPI: 1689696072
1600 W 38th St
Ste 308
J(512) 324-3540
" Packard, Russell C, MD
Austin
Gender: Male
NPI: 1881686392
3301 Northland Dr
Ste 320
(512) 228-2543
Hospital Affiliation: John Peter Smith
Hospital, Palestine Regional Medical Center
Clinic Affiliation: Texas Diagnostic
Laboratories Inc
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Neurology
" Karnik, Dilip J, MD
Austin
NPI: 1689696072
601 E 15th St
(512) 324-7000
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Highland Lakes, Seton
Medical Center, Seton Medical Center Hays,
Seton Medical Ctr Williamson, Seton
Northwest Hospital, Seton Southwest, St
Davids Medical Center, St Davids S Austin
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Hill Country Monitoring
LLC, Seton Brain and Spine Institute
Board Certified Specialties: Neurology
" Perkins Jr, Freedom F, MD
Austin
Gender: Male
NPI: 1407808900
6811 Austin Center
Blvd Ste 400
(512) 628-1850
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Northwest Hospital, University Med Ctr
Brackenridge
Clinic Affiliation: Pediatric Surgical
Subspecialists
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Neurology
Gender: Male
NPI: 1679530554
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1850
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Neurology
" Tempest, Gregory R, MD
Austin
Gender: Male
NPI: 1366478737
5508 Parkcrest Dr
Ste 310
(512) 420-9900
Hospital Affiliation: Central Texas Medical
Center, Reliant Rehab Hosp Central Tx Lp,
Seton Medical Center, Seton Medical Ctr
Williamson, Seton Northwest Hospital, Seton
Southwest, St Davids Medical Center, Texas
Neurorehab Center, Warm Springs Spec
Hosp Luling Llc
Clinic Affiliation: Sleep Medicine
Consultants, Sleep Medicine Consultants of
Cen
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties: Neurology,
Sleep Medicine
" Perurena, Osvaldo H, MD
Austin
Gender: Male
NPI: 1629176961
1600 W 38th St
Ste 308
(512) 324-3540
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Seton Brain and Spine
Institute
Board Certified Specialties: Neurology
" Keough, Karen C, MD
Austin
Gender: Female
NPI: 1538147707
3724 Executive Ctr Dr
Ste 163
(512) 687-3119
Clinic Affiliation: Hill Country Monitoring
LLC
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Neurology
" Raymond, Andrea S, MD
Austin
Gender: Female
NPI: 1538181920
4544 S Lamar Blvd
Ste 750
(512) 433-6333
Hospital Affiliation: Seton Medical Center,
Seton Medical Ctr Williamson, Seton
Northwest Hospital, Seton Southwest,
University Med Ctr Brackenridge
Clinic Affiliation: Neuroaustin Neurology
Assoc
Board Certified Specialties: Neurology
" Mandalapu, Bhuvanaprasad L, MD
Austin
Gender: Male
NPI: 1881639581
8700 Manchaca Rd Unit 205
J(512) 617-1841
Hospital Affiliation: Seton Medical Center,
St Davids S Austin Medical Center,
Woodland Heights Medical Center
Clinic Affiliation: Divija Neurology Center
PA
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties: Neurology,
Sleep Medicine
Gender: Female
NPI: 1457356073
6611 River Place Blvd
Ste 201
J(512) 467-7770
NPI: 1457356073
6611 Riverplace Blvd
Ste 201
(512) 467-7770
Hospital Affiliation: Seton Medical Center,
The Hosp At Westlake Med Ctr
Clinic Affiliation: Arise Physician Group,
Marci A Roy MD PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Neurology
" Ong, Jinfon, MD
Gender: Male
NPI: 1326239518
1301 Barbara Jordan Blvd
J(512) 628-1850
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Neurology
Gender: Male
NPI: 1053363366
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1850
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Driscoll ChildrensHospital', North
Austin Medical Center, Round Rock Medical
Center, Seton Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Neurology
Austin
Austin
Austin
#
" Reardon, Michael S, MD
Austin
Austin
" Ibrahim, Badreldin A, MD
" Hummer, Michael G, MD
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Male
NPI: 1346248515
1400 N IH 35 Ste 300
(512) 324-8300
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: Seton Brain and Spine
Institute
Board Certified Specialties: Neurology
Austin
Aus tin
Gender: Male
NPI: 1972553964
711 W 38th St
Ste E1
(512) 477-5337
Hospital Affiliation: Healthsouth
Rehabilitation Hospital Of Austin, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Soe Aung MD
Practice Information: No Patients Under 17
yrs old
Board Certified Specialties: Neurology
Austin
Gender: Male
NPI: 1982852166
3301 River Rd
(734) 213-3931
" Vaillant, Brian D, MD
Austin
Gender: Male
NPI: 1922119890
1301 W 38th St
Ste 113
(512) 324-3395
NPI: 1922119890
1400 N IH 35
Ste 300
(512) 324-8300
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Seton Brain and Spine
Institute
Board Certified Specialties: Neurology
J - Wheelchair Access
96
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
AUSTIN Cont
NEUROMUSCULAR MEDICINE
Aus tin
NEUROLOGY Cont
" Varga, Mariana G, MD
Austin
Gender: Female
NPI: 1962542225
3001 Bee Caves Rd
Ste 210
(512) 900-2477
Clinic Affiliation: Georgeta Varga MD
Parkinson Disea
Board Certified Specialties: Neurology
" Verona, Montgomery A, MD
Austin
Gender: Male
NPI: 1326048729
711 F W 38th St
J(512) 458-6121
Hospital Affiliation: Heart Hospital Of
Austin, St Davids Medical Center, Texas
Neurorehab Center
Clinic Affiliation: Austin Neurological Clinic
Board Certified Specialties: Neurology
Aus tin
" Warach, Steven J, MD
Austin
Westgate, Sara A, MD
Gender: Female
NPI: 1336147941
3724 Executive Ctr Dr
Ste 163
(512) 687-3119
Bhatt, Kunjan A, MD
Gender: Male
NPI: 1770668758
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
Hospital Affiliation: Central Texas Rehab
Hospital Llc, Seton Medical Center, Seton
Northwest Hospital, St Davids Georgetown
Hospital, St Davids Medical Center
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
Chalkias, Fotini M, MD
Gender: Female
NPI: 1518065317
# 11111 Research Blvd
Ste 360
(512) 617-1916
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
Aus tin
Nguyen, Tuan D, MD
Gender: Male
NPI: 1952341034
1301 W 38th St
Ste 400
(512) 791-1224
Austin
Gender: Female
NPI: 1710008792
711 W 38th St
Ste E1
(512) 477-5337
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Soe Aung MD
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Neurology
" York, Jennifer A, MD
Austin
Gender: Female
NPI: 1326133885
6500 N Mo Pac Expwy
Ste 220 Bldg 3
J(512) 338-4500
Clinic Affiliation: Shelley Madsen and
Assoc Inc
Board Certified Specialties: Nutrition &
Dietetics
" Gumto, Margaret B, RD
Austin
#
Austin
Bunker, Stephen R, MD
Gender: Male
NPI: 1427014117
2712 Bee Caves Rd
Ste 122
(512) 726-0599
Hospital Affiliation: Arise Austin Medical
Center
Clinic Affiliation: Austin Imaging and Vein
Center
Board Certified Specialties: None
Nguyen, Vinh D, DO
Gender: Male
NPI: 1306886387
# 4316 James Casey St
Ste A
(512) 623-5300
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, St
Davids Medical Center, St Davids S Austin
Medical Center
Clinic Affiliation: St Davids Cardiology
PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Austin
" Hanawalt, Elizabeth, RD
Gender: Female
NPI: 1508185562
6500 N Mo Pac Expwy
Ste 220 Bldg 3
J(512) 338-4500
Clinic Affiliation: Shelley Madsen and
Assoc Inc
Board Certified Specialties: Nutrition &
Dietetics
Austin
Austin
Austin
Austin
Aus tin
Amerault, Julie, RD
Gender: Female
NPI: 1669421988
7112 Ed Bluestein
Blvd Ste 155
(512) 978-9300
Clinic Affiliation: Communitycare
Board Certified Specialties: None
Brent, Nicole M, RD
Gender: Female
NPI: 1548445950
6500 N Mo Pac Expwy
Ste 220 Bldg 3
J(512) 338-4500
Clinic Affiliation: Shelley Madsen and
Assoc Inc
Board Certified Specialties: None
Coble, Katie M, RD
Gender: Female
NPI: 1467718817
6500 N Mo Pac Expwy
Ste 220 Bldg 3
J(512) 338-4500
Clinic Affiliation: Shelley Madsen and
Assoc Inc
Board Certified Specialties: None
Conroy, Maria A, RD
Gender: Female
NPI: 1427489830
# 3724 Jefferson St
Ste 104
(512) 693-7045
Clinic Affiliation: I Live Well Nutrition
Therapy LLC
Board Certified Specialties: None
Austin
Gender: Female
NPI: 1174640254
901 S Mo Pac Expwy
Ste 300
(512) 573-5665
Clinic Affiliation: Richmark Nutrition
Consultants
Board Certified Specialties: Nutrition &
Dietetics
Austin
NUCLEAR MEDICINE
Austin
NPI: 1952341034
6811 Far West Blvd
Ste 410
(512) 324-2705
Hospital Affiliation: Little River Healthcare,
Seton Edgar B Davis, Seton Highland Lakes,
Seton Medical Center, Seton Medical Center
Hays, Seton Northwest Hospital, Seton
Smithville Reg Hospital, Seton Southwest, St
Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Wingrove, Iris S, MD
Zidar, Francis J, MD
Gender: Male
NPI: 1972580652
3801 N Lamar Blvd
Ste 300
J(512) 206-3600
Hospital Affiliation: Seton Medical Center,
Seton Medical Ctr Williamson, Seton
Northwest Hospital, St Davids Georgetown
Hospital, St Davids Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Heart PLLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties:
Cardiovascular Disease
" Fillman, Cassie L, RD
Austin
NUTRITION & DIETETICS
NPI: 1952341034
6811 Austin Center
Blvd Ste 410
(512) 324-2705
Austin
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
NPI: 1093755357
6811 Austin Center
Blvd Ste 410
(512) 324-2705
Hospital Affiliation: Cornerstone Hosp Of
Austin, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
Seton Southwest, St Davids Medical Center,
St Davids S Austin Medical Center
Clinic Affiliation: Seton Family of Doctors
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties:
Cardiovascular Disease
Aus tin
NPI: 1336147941
5900 Southwest Pkwy
Ste 4 401 Bldg 4
J(512) 458-6656
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Hill Country Monitoring
LLC, Sara Westgate MD
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Gender: Female
NPI: 1194728535
5750 Balcones Dr
Ste 110
J(512) 744-0015
Hospital Affiliation: Seton Medical Center,
St Davids S Austin Medical Center
Clinic Affiliation: Texas Neurology Center
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Neurology,
Sleep Medicine
Hussain, Yessar M, MD
Gender: Male
NPI: 1982852166
6811 Austin Center
Blvd Ste 420
J(512) 324-2715
Hospital Affiliation: Central Texas Rehab
Hospital Llc, Seton Medical Center, Seton
Medical Ctr Williamson, University Med Ctr
Brackenridge
Clinic Affiliation: Seton Brain and Spine
Institute
Board Certified Specialties: Neurology
NUCLEAR CARDIOLOGY
Austin
Gender: Male
NPI: 1407925886
1400 N IH 35 Ste 300
J(512) 324-8300
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Edgar B Davis, Seton
Highland Lakes, Seton Medical Center,
Seton Medical Center Hays, Seton Medical
Ctr Williamson, Seton Northwest Hospital,
Seton Smithville Reg Hospital, Seton
Southwest, University Med Ctr Brackenridge
Clinic Affiliation: Seton Brain and Spine
Institute
Board Certified Specialties: Neurology
Nguyen, Vu D, MD
Gender: Male
NPI: 1093755357
# 1301 W 38th St
Ste 400
(512) 791-1224
Austin
Madsen, Michelle M, RD
Gender: Female
NPI: 1649210246
6500 N Mo Pac Expwy
Ste 220 Bldg 3
J(512) 338-4500
Clinic Affiliation: Shelley Madsen and
Assoc Inc
Board Certified Specialties: None
Mangum, Laura L, RD
Gender: Female
NPI: 1255543989
11673 Jollyville Rd
Ste 205B
(512) 731-8679
Board Certified Specialties: None
Morris, Kimberly, RD
Gender: Female
NPI: 1790952323
5555 N Lamar Blvd
Ste D-125
(512) 324-1891
NPI: 1790952323
5555 N Lamar Blvd
Ste D125
J(512) 791-1224
Clinic Affiliation: Seton Family of Doctors,
Seton Medical Group
Board Certified Specialties: None
Austin
Paczosa, Adrien, RD
Gender: Female
NPI: 1700077062
3724 Jefferson St Ste 104
(512) 547-9274
#
NPI: 1700077062
3724 Jefferson Ste 316
J(512) 547-9274
Clinic Affiliation: I Live Well Nutrition
Therapy LLC
Board Certified Specialties: None
" Paff, Julie A, RD
Austin
Gender: Female
NPI: 1700982469
5555 N Lamar Blvd
Ste D125
J(512) 791-1224
Clinic Affiliation: Seton Family of Doctors
Board Certified Specialties: Nutrition &
Dietetics
J - Wheelchair Access
97
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Wilfong, Anne L, RD
Austin
AUSTIN Cont
NUTRITION & DIETETICS Cont
Aus tin
Plyler, Catherine P, RD
Gender: Female
NPI: 1942489927
1611 Headway Cir
Bldg 2
(512) 478-2581
Clinic Affiliation: Capital Area Easter Seals
Society
Practice Information: No Patients Over 3
yrs old
Board Certified Specialties: None
#
OBSTETRIC/GYNECOLOGIC SURGERY
Austin
" Press, Rachael, RD
Aus tin
Gender: Female
NPI: 1760828040
3724 Jefferson Ste 104
(440) 263-2713
Clinic Affiliation: I Live Well Nutrition
Therapy LLC
Board Certified Specialties: Nutrition &
Dietetics
Aus tin
Robison, Roxanne D, RD
Gender: Female
NPI: 1154456176
# 1611 Headway Cir
Bldg B
J(512) 478-2581
Clinic Affiliation: Capital Area Easter Seals
Society
Board Certified Specialties: None
" Seay, Mandy, RD
Payne, Thomas N, MD
Gender: Male
NPI: 1710904388
12221 Renfert Way
Ste 220
J(512) 719-5224
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center
Clinic Affiliation: North Austin Maternal
Fetal Medic
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties: None
Austin
" Asfouri, Souhail, MD
Gender: Male
NPI: 1699722199
4316 James Casey St
Ste F-200
J(512) 444-1811
Hospital Affiliation: Arise Austin Medical
Center, Seton Southwest, St Davids S Austin
Medical Center
Clinic Affiliation: Austin Southwest OB/
GYN PC
Board Certified Specialties:
Obstetrics-Gynecology
Aus tin
Aus tin
Spicer Moore, Sandra M, RD
Gender: Female
NPI: 1982647863
6500 N Mopac
J(512) 338-4500
Clinic Affiliation: Shelley Madsen and
Assoc Inc
Board Certified Specialties: None
Stuckwisch, Marjorie L, RD
Gender: Female
NPI: 1205014610
6500 N Mo Pac Expwy
Ste 220 Bldg 3
J(512) 338-4500
Clinic Affiliation: Shelley Madsen and
Assoc Inc
Board Certified Specialties: None
Tanaka, Jill, RD
Gender: Female
NPI: 1598959801
# 4607 Manchaca Rd
J(512) 916-1511
Aus tin
#
NPI: 1598959801
7336 Tanaqua Ln
(512) 301-8705
Clinic Affiliation: Kidtherapy PLLC
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Female
NPI: 1508891169
3705 Medical Pkwy Ste 540
J(512) 452-8888
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Balcones Obstetrics and
Gynecolog
Board Certified Specialties:
Obstetrics-Gynecology
" Blumhagen, Guy V, MD
Austin
Gender: Male
NPI: 1730195009
11111 Research Blvd
Ste 475
J(512) 338-8181
Hospital Affiliation: Bailey Square Surgery
Center, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: Practice Limited to
Gynecology
Board Certified Specialties:
Obstetrics-Gynecology
" Askari, Sasan, MD
Gender: Male
NPI: 1013986843
4007 James Casey St
Ste A250
(512) 444-2111
Hospital Affiliation: Seton Medical Center,
Seton Southwest, St Davids Medical Center,
St Davids S Austin Medical Center,
Surgicare Of South Austin, University Med
Ctr Brackenridge
Clinic Affiliation: Sasan Askari MD
Board Certified Specialties:
Obstetrics-Gynecology
NPI: 1699762427
6836 Bee Caves Rd
Ste 111
(512) 327-4243
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 14
yrs old
Board Certified Specialties: None
" Brasher Giles, Sharyl R, MD
Austin
Gender: Female
NPI: 1649286915
11111 Research Blvd Ste 475
J(512) 338-8181
Hospital Affiliation: Bailey Square Surgery
Center, Central Park Surgery Center,
Northwest Hills Surgical Hospital, Seton
Medical Center, Seton Northwest Hospital,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: Practice Limited to
Gynecology
Board Certified Specialties:
Obstetrics-Gynecology
" Bachus, Lois A, MD
Austin
Gender: Female
NPI: 1396819173
1221 W Ben White Blvd
Ste B250
J(512) 462-1717
Hospital Affiliation: St Davids S Austin
Medical Center
Clinic Affiliation: A Womans Place
Practice Information: No Patients Under 13
yrs old, Practice Limited to Gynecology
Board Certified Specialties:
Obstetrics-Gynecology
Aus tin
Gender: Female
NPI: 1326353616
6500 N Mo Pac Expwy
Ste 220 Bldg 3
(512) 338-4500
Clinic Affiliation: Shelley Madsen and
Assoc Inc
Board Certified Specialties: Nutrition &
Dietetics
" Binford, Nancy E, MD
Austin
Austin
Abikhaled, Shannon M, MD
Gender: Female
NPI: 1699762427
1301 W 38th St
Ste 300
(512) 454-5721
#
Arredondo, Francisco, MD
Gender: Male
NPI: 1265465827
911 W 38th St Ste 402
(512) 479-7979
Hospital Affiliation: Baptist Health System,
ChildrensHospitalSanAntonio', Methodist
Ambulatory Surg Hosp Nw, Methodist
Hospital, North Central Baptist Hospital
Clinic Affiliation: Rmatx Com PLLC
Board Certified Specialties: None
Austin
OBSTETRICS-GYNECOLOGY
Randall, Leann, RD
Gender: Female
NPI: 1245472620
4614 N IH 35
J(512) 978-9100
Clinic Affiliation: Communitycare
Board Certified Specialties: None
Aus tin
Austin
Gender: Female
NPI: 1528377249
4131 Spicewood Spgs L4
(512) 257-0898
Board Certified Specialties: Nutrition &
Dietetics
" Akin, Mark D, MD
Austin
Gender: Male
NPI: 1871512475
12200 Renfert Way
Ste 100
(512) 451-8211
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Aa OB/GYN PLLC
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
" Breedlove, Rachel L, MD
Austin
!
Austin
" Belt, Melanie M, MD
Austin
Gender: Female
NPI: 1639396849
4101 James Casey St
Ste 300
(512) 383-9752
Hospital Affiliation: Bailey Square Surgery
Center, Central Park Surgery Center, Seton
Medical Center, St Davids Medical Center, St
Davids S Austin Medical Center
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties:
Obstetrics-Gynecology
" Anderson, Allison L, MD
Austin
Gender: Female
NPI: 1619170677
12200 Renfert Way
Ste 100
(512) 451-8211
Hospital Affiliation: North Austin Medical
Center, St Davids Medical Center
Clinic Affiliation: Aa OB/GYN PLLC
Practice Information: No Patients Over 12
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
Austin
" Antonini, Tomas G, MD
Austin
Gender: Male
NPI: 1265494827
1305 W 34th St Ste 407
J(512) 716-0861
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Medical Ctr
Williamson, Seton Northwest Hospital, Seton
Southwest, University Med Ctr Brackenridge
Clinic Affiliation: Lone Star Urogynecology
and Conti
Board Certified Specialties:
Obstetrics-Gynecology
Bhagat, Sapna R, MD
Gender: Female
NPI: 1265698872
1301 W 38th St
Ste 205
(512) 451-0161
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
" Billue, David C, MD
Austin
Gender: Male
NPI: 1982795407
11111 Research Blvd
Ste 230
J(877) 800-5722
Hospital Affiliation: Seton Northwest
Hospital
Clinic Affiliation: Lone Star Circle of Care
Practice Information: Female Patients only,
No Patients Under 2 yrs old
Board Certified Specialties:
Obstetrics-Gynecology
Gender: Female
NPI: 1083821243
4101 James Casey St
Ste 300
(512) 383-9752
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties:
Obstetrics-Gynecology
Breen, Michael T, MD
Gender: Male
NPI: 1225190259
911 W 38th St
Ste 202
J(512) 324-9650
Hospital Affiliation: Bailey Square Surgery
Center, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: None
" Brinkman, Diane L, MD
Austin
Gender: Female
NPI: 1558377820
1301 W 38th St Ste 205
J(512) 451-0161
Hospital Affiliation: Bailey Square Surgery
Center, Central Park Surgery Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: Practice Limited to
Gynecology
Board Certified Specialties:
Obstetrics-Gynecology
J - Wheelchair Access
98
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Aus tin
AUSTIN Cont
OBSTETRICS-GYNECOLOGY Cont
Austin
Brown, Charles E, MD
Gender: Male
NPI: 1508928557
601 E 15th St
J(512) 324-7000
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: None
" Browne, Catherine P, DO
Gender: Male
NPI: 1174538227
11111 Research Blvd Ste 475
J(512) 338-8181
Hospital Affiliation: Bailey Square Surgery
Center, Central Park Surgery Center, North
Austin Medical Center, Northwest Hills
Surgical Hospital, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: Practice Limited to
Gynecology
Board Certified Specialties:
Obstetrics-Gynecology
" Capet, Christy L, MD
Austin
Gender: Female
NPI: 1346443611
12200 Renfert Way
Ste 100
(512) 451-8211
Clinic Affiliation: Aa OB/GYN PLLC
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
Gender: Female
NPI: 1700891850
4101 James Casey St
Ste 300
(512) 383-9752
Hospital Affiliation: Bailey Square Surgery
Center, Central Park Surgery Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: Practice Limited to
Gynecology
Board Certified Specialties:
Obstetrics-Gynecology
" Carrera Leal, Benito, MD
Gender: Male
NPI: 1467595405
911 W 38th St Ste 402
(512) 479-7979
Hospital Affiliation: Methodist Ambulatory
Surg Hosp Nw, Metropolitan Methodist
Hospital, Valley Baptist Medical Center
Brownsville, Valley Regional Medical Center
Clinic Affiliation: Rmatx Com PLLC
Board Certified Specialties:
Obstetrics-Gynecology
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Aus tin
" Darby, Byron G, MD
Austin
Gender: Male
NPI: 1417959669
12201 Renfert Way Ste 215
(512) 425-3885
Hospital Affiliation: North Austin Medical
Center, North Austin Surgery Center, Seton
Medical Center, Seton Northwest Hospital
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 11
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
Gender: Male
NPI: 1366450652
12200 Renfert Way
Ste 100
(512) 451-8211
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Aa OB/GYN PLLC
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
" Davis, Lendol L, MD
Austin
#
" Cox, Alinda, MD
Austin
Gender: Female
NPI: 1346256625
4315 James Casey St
Ste 200
J(512) 383-9752
Hospital Affiliation: Bailey Square Surgery
Center, Central Park Surgery Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: Practice Limited to
Gynecology
Board Certified Specialties:
Obstetrics-Gynecology
Chipman, Zachary A, MD
Gender: Male
NPI: 1083776041
! 313 E 12th St
Ste 104
J(512) 324-9650
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: None
Austin
NPI: 1447232467
911 W 38th St
Ste 202
J(512) 324-8670
Hospital Affiliation: Mem Hermann
Hospital, Mem Hermann Southeast Hosp,
Mem Hermann Southwest Hospital, Seton
Medical Center, St Joseph Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties:
Obstetrics-Gynecology
" Cowan, Robert K, MD
Aus tin
Aus tin
Gender: Male
NPI: 1447232467
1313 Red River
Ste 305
J(512) 324-7789
Austin
" Cherry, Tara A, MD
" Campaigne, Andrea L, MD
Gender: Female
NPI: 1013197748
12174 N Mopac Expwy Ste A
(512) 994-2662
Hospital Affiliation: North Austin Medical
Center
Clinic Affiliation: Andrea L Campaigne MD
PLLC
Board Certified Specialties:
Obstetrics-Gynecology
Gender: Male
NPI: 1528074804
1301 W 38th St Ste 205
J(512) 451-0161
Hospital Affiliation: Bailey Square Surgery
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: Practice Limited to
Gynecology
Board Certified Specialties:
Obstetrics-Gynecology
Aus tin
Austin
" Dalrymple, John L, MD
Austin
" Cosentino, Robert, MD
" Chalasani, Renu, MD
" Bushart, Paul S, MD
Collins, Melanie A, MD
Gender: Female
NPI: 1407858707
12201 Renfert Way
Ste 205
(512) 339-6626
Hospital Affiliation: North Austin Medical
Center, Seton Northwest Hospital
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties: None
Austin
Aus tin
Austin
Gender: Male
NPI: 1710992862
1301 W 38th St Ste 205
J(512) 451-0161
Hospital Affiliation: Bailey Square Surgery
Center, Central Park Surgery Center, Seton
Medical Center, St Davids Medical Center, St
Davids S Austin Medical Center
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: Practice Limited to
Gynecology
Board Certified Specialties:
Obstetrics-Gynecology
Austin
NPI: 1538193495
911 W 38th St
Ste 202
J(512) 324-8670
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Communitycare,
University Physicians Group
Board Certified Specialties: None
Austin
Gender: Female
NPI: 1740251610
12201 Renfert Way
Ste 325
(512) 836-2536
Hospital Affiliation: Conroe Regional
Medical Center, North Austin Medical Center
Clinic Affiliation: Capital OB/GYN Assoc of
TX PA
Board Certified Specialties:
Obstetrics-Gynecology
Carter, Kimberly, MD
Gender: Female
NPI: 1538193495
1313 Red River
Ste 320
(512) 978-8870
" Doss Jr, Noble W, MD
Austin
Gender: Male
NPI: 1467554832
4201 Marathon Blvd
Ste 301
J(512) 451-7991
Hospital Affiliation: Bailey Square Surgery
Center, Seton Medical Center, St Davids
Medical Center
Board Certified Specialties:
Obstetrics-Gynecology
" Crozier, Mark A, MD
Austin
Chouteau, Ruth M, MD
Gender: Female
NPI: 1851309553
2911 Medical Arts St
Ste 19A
J(512) 477-1954
Hospital Affiliation: St Davids Medical
Center, St Davids S Austin Medical Center
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Coates, Kimberly W, MD
Gender: Female
NPI: 1699838755
2502 Oestrick Ln
(512) 454-5911
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, St
Davids Medical Center
Clinic Affiliation: Urogyn Diagnostic LLC
Board Certified Specialties: None
Gender: Male
NPI: 1376586271
1313 Red River
Ste 320
(512) 978-8870
Hospital Affiliation: Bailey Square Surgery
Center, Seton Medical Center, Seton
Northwest Hospital, Seton Southwest, St
Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Communitycare
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
" Crumb, Robert S, MD
Austin
Gender: Male
NPI: 1376516732
1007 E 41st St
J(512) 451-3131
Gender: Male
NPI: 1255336855
1902 S IH 35
J(512) 443-9595
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
Seton Southwest, St Davids Medical Center,
St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Brookside Womens
Medical Services
Practice Information: No Patients Under 15
yrs old, Practice Limited to Gynecology
Board Certified Specialties:
Obstetrics-Gynecology
Austin
Edgerton, Screven T, MD
Gender: Male
NPI: 1033114376
1010 W Ninth St
(512) 459-4405
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, St Davids
Medical Center
Clinic Affiliation: Premier Gynecology
Board Certified Specialties: None
NPI: 1376516732
2911 Medical Arts St
Ste 19A
J(512) 477-1954
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Gynics Assoc, Robert
Crumb MD
Board Certified Specialties:
Obstetrics-Gynecology
J - Wheelchair Access
99
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Austin
AUSTIN Cont
OBSTETRICS-GYNECOLOGY Cont
" Eduardo, Ana M, MD
Aus tin
Gender: Female
NPI: 1205809654
200 Medical Pkwy Ste 110
J(512) 462-1936
NPI: 1205809654
7900 FM 1826
Ste 200
J(512) 462-1936
NPI: 1205809654
9805 Brodie Ln
J(512) 462-1936
Hospital Affiliation: Corpus Christi Medical
Center Bay Area, Seton Southwest, St
Davids Medical Center, St Davids S Austin
Medical Center
Clinic Affiliation: Hill Country OB/GYN
Assoc
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
Aus tin
Austin
Gender: Male
NPI: 1285609735
1301 W 38th St
Ste 300
(512) 454-5721
Hospital Affiliation: Baptist St Anthonys
Health System, Seton Medical Center, Seton
Medical Ctr Williamson, St Davids Medical
Center
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 11
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
Evans, Jayme B, DO
Gender: Female
NPI: 1508186495
1301 W 38th St
(512) 451-8354
Hospital Affiliation: Bailey Square Surgery
Center, Cedar Park Regional Medical Ctr,
Seton Medical Center
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
" Fung-Yip, Katie L, MD
Aus tin
Gender: Female
NPI: 1003074881
2909 N IH 35
(512) 478-4939
Hospital Affiliation: The Womans Hospital
Of Texas
Clinic Affiliation: Peoples Community Clinic
Inc
Board Certified Specialties:
Obstetrics-Gynecology
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
" Guzman Winn, Melissa A, MD
Austin
Hagen, Jeff E, MD
Gender: Male
NPI: 1710965488
2410 E Riverside Dr
Ste G2
J(512) 445-4800
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
NPI: 1558391847
601 E 15th St
(512) 324-7000
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center
Clinic Affiliation: Communitycare,
University Physicians Group
Practice Information: No Patients Under 10
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
" Hart, Chris C, MD
Austin
Gender: Female
NPI: 1003034091
200 Medical Pkwy
Ste 110
J(512) 462-1936
NPI: 1003034091
7900 FM 1826
Ste 200
J(512) 610-8432
NPI: 1003034091
9805 Brodie Ln
J(512) 462-1936
Hospital Affiliation: Seton Southwest, St
Davids S Austin Medical Center
Clinic Affiliation: Hill Country OB/GYN
Assoc
Board Certified Specialties:
Obstetrics-Gynecology
" Hansen Peterm, Kristen, MD
Austin
Gender: Female
NPI: 1134135486
1301 W 38th St Ste 201
J(512) 451-0161
Hospital Affiliation: Bailey Square Surgery
Center, Central Park Surgery Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: Practice Limited to
Gynecology
Board Certified Specialties:
Obstetrics-Gynecology
" Hanson Jr, Robert E, MD
Austin
#
Grogono, Sally M, MD
Gender: Female
NPI: 1437146263
1301 W 38th St
Ste 300
J(512) 454-5721
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 11
yrs old
Board Certified Specialties: None
Gender: Male
NPI: 1558391847
1313 Red River
Ste 320
(512) 978-8870
Gender: Female
NPI: 1255318713
2911 Medical Atrs St
Ste 19A
J(512) 477-1954
Hospital Affiliation: St Davids Medical
Center, St Davids S Austin Medical Center
Practice Information: Practice Limited to
Gynecology
Board Certified Specialties:
Obstetrics-Gynecology
" Grimes, Julie A, MD
Austin
" Harstad, Timothy W, MD
Austin
" Hammer, Jo B, MD
Austin
Gender: Female
NPI: 1942318282
4101 James Casey St
Ste 300
(512) 383-9752
Hospital Affiliation: Seton Southwest, St
Davids S Austin Medical Center, Surgicare
Of South Austin
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties:
Obstetrics-Gynecology
Gender: Female
NPI: 1659383594
1007 E 41st St
(512) 451-3131
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Gynics Assoc
Board Certified Specialties:
Obstetrics-Gynecology
Austin
" Gooch, Michelle C, MD
Gender: Female
NPI: 1861408130
5625 Eiger Rd Ste 205
(512) 454-5721
Hospital Affiliation: Bailey Square Surgery
Center, Central Park Surgery Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 11
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
" Harris, April S, MD
Austin
Gender: Female
NPI: 1053341495
2911 Medical Arts St
Ste 3
J(512) 391-0175
Hospital Affiliation: St Davids Medical
Center, University Medical Center
Board Certified Specialties:
Obstetrics-Gynecology
Austin
" Eng Cohen, Caroline D, MD
Aus tin
Gutierrez, Clarissa, MD
Gender: Female
NPI: 1326278631
12201 Renfert Way
Ste 225
(512) 339-6626
Hospital Affiliation: North Austin Medical
Center
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Board Certified Specialties: None
Austin
" Gooch, Jason L, MD
Aus tin
Gender: Female
NPI: 1528222544
2911 Medical Arts St
Ste 3
J(512) 391-0175
Hospital Affiliation: St Davids Medical
Center
Clinic Affiliation: Austin OB GYN Assoc PA,
Caroline Cohen PA
Board Certified Specialties:
Obstetrics-Gynecology
Gonzalez Deleon, Delia, MD
Gender: Female
NPI: 1205062726
1007 E 41st St
J(512) 451-3131
Hospital Affiliation: St Davids Medical
Center
Clinic Affiliation: Gynics Assoc
Practice Information: Female Patients only
Board Certified Specialties: None
Austin
Austin
Elliott, Byron D, MD
Gender: Male
NPI: 1689608101
1313 Red River
Ste 320
(512) 978-8870
NPI: 1689608101
601 E 15th St
(512) 324-7000
Hospital Affiliation: Baptist Health System,
Christus Santa Rosa Hosp City Ctr,
Methodist Hospital, Seton Medical Center,
Seton Northwest Hospital, St Davids
Georgetown Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Communitycare,
University Physicians Group
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
Garza, Devin M, MD
Gender: Male
NPI: 1780691147
12201 Renfert Way
Ste 215
(512) 425-3835
Hospital Affiliation: North Austin Medical
Center, Seton Northwest Hospital
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 14
yrs old
Board Certified Specialties: None
Austin
Austin
Austin
Gender: Male
NPI: 1760484620
8401 N Interstate 35
Ste 200
J(512) 250-1005
Hospital Affiliation: Baptist Beaumont
Hospital
Clinic Affiliation: Whole Womans Health of
Austin
Board Certified Specialties:
Obstetrics-Gynecology
Harkins, John G, MD
Gender: Male
NPI: 1629130513
911 W 38th St
Ste 202
J(512) 324-9650
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: None
Hemkumar, Sasikala, MD
Gender: Female
NPI: 1336145564
4310 James Casey St
Ste 1E
J(512) 416-9800
Hospital Affiliation: Seton Southwest
Clinic Affiliation: Hemkumar Sasikala MD
Board Certified Specialties: None
Hoenicke, Nicole A, MD
Gender: Female
NPI: 1306860598
12200 Renfert Way
Ste 100
J(512) 451-8211
Hospital Affiliation: North Austin Medical
Center
Clinic Affiliation: Aa OB/GYN PLLC
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
" Hooi, Emily E, MD
Austin
Gender: Female
NPI: 1770599045
4101 James Casey Ste 300
(512) 383-9752
Hospital Affiliation: Bailey Square Surgery
Center, Central Park Surgery Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties:
Obstetrics-Gynecology
J - Wheelchair Access
100
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Kavoussi, Keikhosron M, MD
Aus tin
AUSTIN Cont
OBSTETRICS-GYNECOLOGY Cont
" Hughes, Robert S, MD
Austin
Gender: Male
NPI: 1417963786
11111 Research Ste 475
J(512) 338-8181
NPI: 1417963786
1301 W 38th Ste 205
J(512) 451-0161
Hospital Affiliation: Bailey Square Surgery
Center, Central Park Surgery Center, North
Austin Medical Center, Seton Medical
Center, Seton Northwest Hospital, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: Practice Limited to
Gynecology
Board Certified Specialties:
Obstetrics-Gynecology
Austin
Hull Jr, Felix, MD
Gender: Male
NPI: 1871602557
2911 Medical Arts St
Ste 16
J(512) 473-2037
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Practice Information: No Patients Under 8
yrs old
Board Certified Specialties: None
" Kish, Karen M, MD
Gender: Female
NPI: 1124015953
1301 W 38th St
Ste 300
(512) 454-5721
#
Gender: Male
NPI: 1972576445
1007 E 41st St
J(512) 451-3131
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Gynics Assoc
Board Certified Specialties:
Obstetrics-Gynecology
Aus tin
" Ingram, Wayne W, MD
Austin
Jehangir, Saima K, MD
Gender: Female
NPI: 1740256452
1305 W 34th St Ste 407
J(512) 716-0971
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Center, Seton
Northwest Hospital
Clinic Affiliation: Saima Jehangir MD PLLC
Board Certified Specialties: None
Kalamarides, Jeremy A, DO
Gender: Male
NPI: 1588987432
1600 W 38th St Ste 115
(512) 458-6060
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Vitae Clinic Inc
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Aus tin
Kung, Amy, MD
Gender: Female
NPI: 1205129848
1305 W 34th St
Ste 308
J(512) 459-8082
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Landherr, Kathryn M, MD
Gender: Female
NPI: 1144203431
12200 Renfert Way
Ste 100
(512) 451-8211
Hospital Affiliation: North Austin Medical
Center
Clinic Affiliation: Aa OB/GYN PLLC
Board Certified Specialties: None
Loar, Kimberly B, MD
Gender: Female
NPI: 1528002847
12201 Renfert Way
Ste 215
(512) 339-6626
Hospital Affiliation: North Austin Medical
Center, Seton Northwest Hospital
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties: None
Lockey, Renee G, MD
Gender: Female
NPI: 1447265509
4101 James Casey Ste 300
J(512) 383-9752
Hospital Affiliation: Bailey Square Surgery
Center, Central Park Surgery Center, North
Austin Medical Center, North Austin Surgery
Center, Seton Medical Center, Seton
Northwest Hospital, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Austin
Austin
Gender: Female
NPI: 1316949605
12201 Renfert Way
Ste 205
J(512) 425-3855
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
Gender: Male
NPI: 1891788428
900 E 30th St Ste 107
(512) 476-9699
Hospital Affiliation: St Davids Medical
Center
Clinic Affiliation: Mikeal R Love MD
Board Certified Specialties:
Obstetrics-Gynecology
Austin
#
Gender: Male
NPI: 1740227065
8401 N Interstate 35
Ste 200
J(512) 250-1005
Hospital Affiliation: Doctors Hospital At
Renaissance
Clinic Affiliation: Whole Womans Health of
Austin
Board Certified Specialties:
Obstetrics-Gynecology
Austin
" Mankovsky, Jerald A, MD
Austin
Gender: Male
NPI: 1225258551
3705 Medical Parkway Ste 220
J(512) 451-9055
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Board Certified Specialties:
Obstetrics-Gynecology
Austin
" Maradani, Sarita, MD
Austin
#
" Landwermeyer, Margaret R, MD
Aus tin
Gender: Female
NPI: 1790758134
200 Medical Pkwy
Ste 110
J(512) 462-1936
Gender: Female
NPI: 1871582338
4007 James Casey St
Ste D250
J(512) 443-6100
Hospital Affiliation: Seton Southwest, St
Davids S Austin Medical Center
Clinic Affiliation: Maradani PA
Practice Information: No Patients Under 11
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
#
NPI: 1790758134
9805 Brodie Ln
J(512) 445-0815
Hospital Affiliation: Seton Southwest, St
Davids S Austin Medical Center
Clinic Affiliation: Hill Country OB/GYN
Assoc
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
Mills, Tara A, MD
Gender: Female
NPI: 1891797197
12201 Renfert Way
Ste 225
J(512) 425-3895
Hospital Affiliation: North Austin Medical
Center, Seton Northwest Hospital
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: None
" Mingea, Cynthia J, MD
Gender: Female
NPI: 1497731871
2911 Medical Arts St
Ste B3
J(512) 479-6655
Hospital Affiliation: St Davids Medical
Center
Clinic Affiliation: Cindy J Mingea MD
Board Certified Specialties:
Obstetrics-Gynecology
" Massman, Andrew E, MD
Gender: Male
NPI: 1104896729
1902 S IH 35
J(512) 443-9595
Hospital Affiliation: Bailey Square Surgery
Center, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, Seton Southwest,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Brookside Womens
Medical Services
Board Certified Specialties:
Obstetrics-Gynecology
Mileur, Christie S, MD
Gender: Female
NPI: 1811257801
2911 Medical Arts St
Ste 3
J(512) 391-0175
Hospital Affiliation: St Davids Medical
Center
Clinic Affiliation: Austin OB/GYN Assoc
PLLC
Practice Information: No Patients Under 10
yrs old
Board Certified Specialties: None
Austin
Austin
NPI: 1790758134
7900 FM 1826
Ste 200
J(512) 445-0815
McKenzie, Kristi H, MD
Gender: Female
NPI: 1811946346
900 E 30th St
Ste 107
J(512) 476-9699
Clinic Affiliation: Kristi McKenzie MD
Practice Information: Female Patients only,
No Patients Under 14 yrs old
Board Certified Specialties: None
" Meritt, Laura A, MD
" Love, Mikeal R, MD
" Lynn Jr, Sherwood C, MD
McCoin, Megan L, MD
Gender: Female
NPI: 1043471824
1301 W 38th St
Ste 300
J(512) 454-5721
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Austin
Austin
" Kuhlmann, Terrence A, MD
Austin
Austin
NPI: 1124015953
6836 Bee Caves Rd
Ste 111
(512) 327-4243
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 14
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
Aus tin
" Ikbal, Natasya A, MD
Gender: Male
NPI: 1134120702
711 W 38th St Ste G-4
Medical Science Ctr
J(512) 458-1208
Hospital Affiliation: North Austin Medical
Center, Seton Northwest Hospital
Practice Information: No Obstetrics
Board Certified Specialties:
Obstetrics-Gynecology
Austin
Aus tin
Austin
Gender: Female
NPI: 1962610659
1305 W 34th St
Ste 308
J(512) 459-8082
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 11
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
Austin
Gender: Male
NPI: 1013102904
4303 James Casey St
Ste A
J(512) 444-1414
Hospital Affiliation: Seton Southwest, St
Davids S Austin Medical Center
Clinic Affiliation: Austin Endometriosis &
Female Infertility Ctr P
Practice Information: Gynecology and
Infertility
Board Certified Specialties:
Obstetrics-Gynecology
Austin
Mirto, Mary V, DO
Gender: Female
NPI: 1861403917
900 E 30th St
Ste 211
J(512) 476-5090
Hospital Affiliation: St Davids Medical
Center
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: None
J - Wheelchair Access
101
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Austin
AUSTIN Cont
OBSTETRICS-GYNECOLOGY Cont
" Moghadam, Kenneth K, MD
Aus tin
Gender: Male
NPI: 1033120282
2200 Park Bend Dr
Ste 402 Bldg 1
(512) 339-4234
Hospital Affiliation: Arise Austin Medical
Center, Cedar Park Regional Medical Ctr,
North Austin Medical Center, Round Rock
Medical Center, Seton Medical Center, Seton
Northwest Hospital, Seton Southwest, St
Davids Medical Center, St Davids S Austin
Medical Center
Clinic Affiliation: Austin Fertility Institute PA
Practice Information: BH 13-17 Abuse
(Physical and/or Sexual), BH 13-17 Affective
Mood Disorders, BH 13-17 Anxiety
Disorders, BH 13-17 Attention Deficit
Disorders, BH 13-17 Schizophrenia & other
Psych Disorders, BH 18-64 Abuse (Physical
and/or Sexual), BH 18-64 Affective Mood
Disorders, BH 18-64 Anxiety Disorders, BH
18-64 Attention Deficit Disorders, BH 18-64
Schizophrenia & other Psych Disorders, BH
6-12 Abuse (Physical and/or Sexual), BH
6-12 Affective Mood Disorders, BH 6-12
Anxiety Disorders, BH 6-12 Attention Deficit
Disorders, BH 6-12 Schizophrenia & other
Psych Disorders, BH 65+ Abuse (Physical
and/or Sexual), BH 65+ Affective Mood
Disorders, BH 65+ Anxiety Disorders, BH
65+ Attention Deficit Disorders, BH 65+
Schizophrenia and other Psychotic
Disorders, No Patients Under 18 yrs old
Board Certified Specialties:
Obstetrics-Gynecology
Austin
Austin
" Mumfrey II, Paul D, MD
Gender: Male
NPI: 1447237763
4101 James Casey St
Ste 300
(512) 383-9752
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, St
Davids Medical Center, St Davids S Austin
Medical Center, Surgicare Of South Austin
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties:
Obstetrics-Gynecology
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Male
NPI: 1285621011
1301 W 38th St
Ste 300
(512) 454-5721
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 14
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
Austin
" Phillips, Michael F, MD
Nash, Felicia B, MD
Gender: Female
NPI: 1427093095
1305 W 34th St
Ste 308
(512) 459-8082
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
" Nunnelly, Patrick D, MD
Austin
Gender: Male
NPI: 1295743482
12200 Renfert Way
Ste 100
(512) 451-8211
Hospital Affiliation: Bailey Square Surgery
Center, Seton Medical Center, St Davids
Medical Center
Clinic Affiliation: Aa OB/GYN PLLC
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
Austin
Polon, Clive, MD
Gender: Male
NPI: 1962476762
900 E 30th Ste 107
J(512) 476-9699
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Board Certified Specialties: None
Saarikoski, Heikki H, MD
Gender: Male
NPI: 1013055409
# 8401 N Interstate 35
Ste 200
J(512) 250-1005
Hospital Affiliation: St Davids Medical
Center
Clinic Affiliation: Whole Womans Health of
Austin
Board Certified Specialties: None
" Schiemenz, April A, MD
Austin
Gender: Female
NPI: 1881890697
12221 Renfert Way
Ste 330
J(512) 425-3825
Hospital Affiliation: North Austin Medical
Center
Clinic Affiliation: Christina Sebestyen PA
Board Certified Specialties:
Obstetrics-Gynecology
" Price, Bradley B, MD
Austin
Gender: Male
NPI: 1649214842
2911 Medical Arts St
Ste 6
J(512) 476-6691
Hospital Affiliation: Bailey Square Surgery
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Board Certified Specialties:
Obstetrics-Gynecology
Austin
" Prisacaru, Genoveva N, MD
Gender: Female
NPI: 1740325133
4007 James Casey St
Ste A-100
(512) 442-2300
Clinic Affiliation: Seven Hills Womens
Health PLLC
Board Certified Specialties:
Obstetrics-Gynecology
Austin
" Ofobike, Blake A, MD
Austin
Gender: Female
NPI: 1467471607
12174 N Mopac Expwy Ste A
(512) 994-2662
Hospital Affiliation: North Austin Medical
Center
Clinic Affiliation: Andrea L Campaigne MD
PLLC
Board Certified Specialties:
Obstetrics-Gynecology
Reich, Stephanie J, MD
Gender: Female
NPI: 1346234143
1305 W 34th St
Ste 308
(512) 459-8082
Hospital Affiliation: Bailey Square Surgery
Center, Seton Medical Center, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Ridgeway, Jeffrey J, MD
Gender: Male
NPI: 1417981994
1313 Red River
Ste 320
(512) 978-8870
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Communitycare
Board Certified Specialties: None
Austin
Austin
Gender: Male
NPI: 1386631117
1301 W 38th St
Ste 300
(512) 454-5721
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
" Moreno, Rosa, MD
" Reue, David W, MD
Austin
Austin
Gender: Female
NPI: 1770585069
12201 Renfert Way
Ste 200
(512) 425-3875
Hospital Affiliation: Arise Austin Medical
Center, North Austin Medical Center, Round
Rock Medical Center, Seton Northwest
Hospital, St Davids S Austin Medical Center
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
Aus tin
Aus tin
Gender: Female
NPI: 1285679787
1305 W 34th St
Ste 308
(512) 459-8082
Hospital Affiliation: Central Park Surgery
Center, Seton Medical Center, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
" Neyman, Sherry L, MD
" Montalvo, Jessica M, MD
Gender: Female
NPI: 1790791044
1301 W 38th St
Ste 201
J(512) 451-0161
Hospital Affiliation: Bailey Square Surgery
Center, Central Park Surgery Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties:
Obstetrics-Gynecology
NIX, Michael L, MD
Gender: Male
NPI: 1891857884
1313 Red River
Ste 320
(512) 978-8870
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: Communitycare
Board Certified Specialties: None
" Oliver, Donell B, MD
Austin
Austin
Aus tin
Gender: Female
NPI: 1740498492
12201 Renfert Way
Ste 225
(512) 425-3895
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
Mushtaler, Jennifer L, MD
Gender: Female
NPI: 1649260332
12201 Renfert Way 325
Ste 325
(512) 836-2536
Hospital Affiliation: Arise Austin Medical
Center, North Austin Medical Center
Clinic Affiliation: Capital OB/GYN Assoc of
TX PA
Board Certified Specialties: None
Austin
Schmitz, Martha E, MD
Gender: Female
NPI: 1881601136
4007 James Casey St
Ste A240
J(512) 394-0054
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Southwest, St Davids Medical Center, St
Davids S Austin Medical Center
Clinic Affiliation: Martha E Schmitz MD
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Schneider, Lisa B, MD
Gender: Female
NPI: 1194798124
200 Medical Pkwy
Ste 110
J(512) 462-1936
NPI: 1194798124
4207 James Casey St
Ste 201
J(512) 462-1936
NPI: 1194798124
7900 FM 1826
Ste 200
J(512) 610-8432
NPI: 1194798124
9805 Brodie Ln
J(512) 462-1936
Hospital Affiliation: Seton Southwest, St
Davids S Austin Medical Center
Clinic Affiliation: Hill Country OB/GYN
Assoc
Board Certified Specialties: None
J - Wheelchair Access
102
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Sorin, Robert, MD
Aus tin
AUSTIN Cont
OBSTETRICS-GYNECOLOGY Cont
Austin
Sebestyen, Christina E, MD
Gender: Female
NPI: 1104859073
12201 Renfert Way
Ste 220
J(512) 425-3825
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center
Clinic Affiliation: Christina Sebestyen PA
Board Certified Specialties: None
Aus tin
" Seeker, Christopher G, MD
Austin
Gender: Male
NPI: 1255349528
12200 Renfert Way
Ste 100
(512) 451-8211
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Aa OB/GYN PLLC
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
Gender: Female
NPI: 1780678565
1305 W 34th St
Ste 308
(512) 459-8082
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
Aus tin
" Solomon, Steve, MD
Austin
Gender: Male
NPI: 1932115292
11111 Research Blvd
Ste 475
J(512) 338-8181
NPI: 1932115292
1301 W 38th Ste 205
J(512) 451-0161
Hospital Affiliation: Bailey Square Surgery
Center, Central Park Surgery Center, North
Austin Medical Center, Seton Medical
Center, Seton Northwest Hospital, St Davids
S Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: Practice Limited to
Gynecology
Board Certified Specialties:
Obstetrics-Gynecology
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Aus tin
Thoppil, John J, MD
Gender: Male
NPI: 1336138064
6611 River Place Blvd
Ste 202
(512) 473-8300
Clinic Affiliation: River Place OB GYN PA
Board Certified Specialties: None
Uribe, Marco A, MD
Gender: Male
NPI: 1750399036
12200 Renfert Way
Ste 100
(512) 451-8211
Hospital Affiliation: North Austin Medical
Center, St Davids Medical Center
Clinic Affiliation: Aa OB/GYN PLLC
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Urrutia, Allison A, MD
Gender: Female
NPI: 1194916387
1007 E 41st St
(512) 451-3131
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Gynics Assoc
Board Certified Specialties: None
" Weihs, Diana G, MD
Austin
Gender: Female
NPI: 1699769489
1305 W 34th St
Ste 308
(512) 459-8082
Hospital Affiliation: Bailey Square Surgery
Center, Central Park Surgery Center, Seton
Medical Center, St Davids Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
Austin
" White, Amanda B, MD
Gender: Female
NPI: 1164642237
911 W 38th St
Ste 202
(512) 324-8670
Hospital Affiliation: Northwest Surgery
Center Llp, Seton Medical Center, Seton
Medical Center Hays, Seton Southwest, St
Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties:
Obstetrics-Gynecology
Gender: Female
NPI: 1215137328
200 Medical Pkwy
Ste 110
J(512) 462-1936
NPI: 1215137328
7900 FM 1826
J(512) 610-8421
" Yamamoto, Krissy M, MD
Austin
NPI: 1215137328
9805 Brodie Ln
J(512) 610-8421
Hospital Affiliation: Seton Southwest, St
Davids S Austin Medical Center
Clinic Affiliation: Hill Country OB/GYN
Assoc
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
Gender: Female
NPI: 1194916395
11111 Research Blvd
Ste 230
J(877) 800-5722
Hospital Affiliation: Seton Medical Ctr
Williamson
Clinic Affiliation: Lone Star Circle of Care
Practice Information: No Patients Under 14
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
" Wang, Diana Y, MD
Austin
Gender: Female
NPI: 1144425786
12200 Renfert Way
Ste 100
(512) 451-8211
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, North
Austin Surgery Center, Seton Medical
Center, Seton Northwest Hospital, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Aa OB/GYN PLLC
Practice Information: Female Patients only
Board Certified Specialties:
Obstetrics-Gynecology
Truitt, Ginger E, MD
Gender: Female
NPI: 1376876136
12201 Renfert Way
Ste 225
(512) 339-6626
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 11
yrs old
Board Certified Specialties: None
Tsai, Rita, MD
Gender: Female
NPI: 1609085042
1313 Red River
Ste 320
(512) 978-8870
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Communitycare
Board Certified Specialties: None
Westbrook Jr, Robert A, MD
Gender: Male
NPI: 1184991838
8401 N Interstate 35
Ste 200
(512) 250-1005
Hospital Affiliation: Baptist Health System,
Christus Santa Rosa Hosp City Ctr,
Metropolitan Methodist Hospital
Clinic Affiliation: Whole Womans Health of
Austin
Board Certified Specialties: None
Austin
" Walker, Candice E, MD
Gender: Male
NPI: 1518940808
12200 Renfert Way
Ste 100
(512) 451-8211
Hospital Affiliation: Bailey Square Surgery
Center, North Austin Medical Center, North
Austin Surgery Center
Clinic Affiliation: Aa OB/GYN PLLC
Board Certified Specialties:
Obstetrics-Gynecology
Aus tin
Turner, Nancy A, MD
Gender: Female
NPI: 1083788855
1221 W Ben White Blvd
Ste 250
J(512) 462-1717
Hospital Affiliation: St Davids S Austin
Medical Center
Clinic Affiliation: A Womans Place
Practice Information: No Patients Under 13
yrs old, Practice Limited to Gynecology
Board Certified Specialties: None
Austin
" Tassone, Shawn A, MD
" Siarezi, Sherry, MD
Smith, Laurette N, MD
Gender: Female
NPI: 1669474912
12201 Renfert Way Ste 200
(512) 425-3875
Hospital Affiliation: North Austin Medical
Center, Seton Northwest Hospital
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties: None
Austin
Aus tin
Austin
Austin
Austin
" Swenson, Karen G, MD
" Shashoua, George L, MD
Gender: Female
NPI: 1942267208
11111 Research Blvd
Ste 230
(877) 800-5722
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Lone Star Circle of Care
Board Certified Specialties:
Obstetrics-Gynecology
Summers, Jennifer S, MD
Gender: Female
NPI: 1588894323
1305 W 34th St
Ste 308
(512) 459-8082
Hospital Affiliation: Medical City Dallas
Hospital, Tx Hlth Presbyterian Hosp Plano
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: Practice Limited to
Gynecology
Board Certified Specialties: None
Aus tin
Austin
Gender: Male
NPI: 1245379551
12319 N Mopac Expwy
Ste 200 Bldg C
(512) 973-8276
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Urogynecology
PLLC
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties:
Obstetrics-Gynecology
Austin
Gender: Male
NPI: 1154307833
900 E 30th St
Ste 107
J(512) 452-1521
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Board Certified Specialties:
Obstetrics-Gynecology
" Ward, Donald P, MD
Austin
Gender: Male
NPI: 1093790222
4007 James Casey Ste B220
J(000) 440-1113
Hospital Affiliation: Seton Medical Center,
Seton Southwest, St Davids Medical Center,
St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Practice Information: Practice Limited to
Gynecology
Board Certified Specialties:
Obstetrics-Gynecology
Austin
Austin
Yium, Vanessa J, MD
Gender: Female
NPI: 1598759300
1305 W 34th St
Ste 308
J(512) 459-8082
Hospital Affiliation: Bailey Square Surgery
Center, Central Park Surgery Center, Seton
Medical Center, St Davids Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Central Texas OB/GYN
Assoc Pl
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Yoo, Sonja L, DO
Gender: Female
NPI: 1124222724
11111 Research Blvd
(512) 338-8181
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
" Youngkin, Jeffrey T, MD
Austin
Gender: Male
NPI: 1912982000
805 E 32nd St
J(512) 478-3188
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Jeffrey T Youngkin MD
Assoc
Board Certified Specialties:
Obstetrics-Gynecology
J - Wheelchair Access
103
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Austin
AUSTIN Cont
OCCUPATIONAL THERAPY
Anderson, Lisa, OT
Gender: Female
NPI: 1376882779
# 4607 Manchaca Rd
(512) 916-1511
Clinic Affiliation: Kidtherapy PLLC
Board Certified Specialties: None
Aus tin
Anderson, Tina M, OT
Gender: Female
NPI: 1063684983
# 12524 Capella Trl
J(512) 587-5671
Clinic Affiliation: Growing Places Therapy
Services
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
Austin
Aus tin
Aus tin
Annis, Courtney B, OT
Gender: Female
NPI: 1508276502
9433 Bee Cave Rd
Ste 101 Bldg 3
(512) 306-8007
Clinic Affiliation: Big Sky Pediatric Therapy
Board Certified Specialties: None
Arnold, Caren E, OT
Gender: Female
NPI: 1376789164
# 9433 Bee Cave Rd
Ste 101 Bldg 3
J(512) 529-7239
Clinic Affiliation: Big Sky Pediatric Therapy
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Cecil, Tara R, OT
Gender: Female
NPI: 1053648840
# 1611 Headway Cir
Bldg 2
J(512) 478-2581
Clinic Affiliation: Capital Area Easter Seals
Society
Board Certified Specialties: None
Cercone, Gemma C, OT
Gender: Female
NPI: 1346439577
!# 4422 Pack Saddle Pass
Ste 104
(512) 444-3345
Clinic Affiliation: Total Communication
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Aus tin
Chmiel, Anna, OT
Gender: Female
NPI: 1407113244
# 9433 Bee Caves Rd
Ste 101 Bldg 3
J(512) 306-8007
Clinic Affiliation: Big Sky Pediatric Therapy
Board Certified Specialties: None
Austin
Austin
Chmiel, Dana M, OT
Gender: Female
NPI: 1578895843
# 12524 Capella Trl
J(512) 587-5671
Clinic Affiliation: Growing Places Therapy
Services
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Curtis, Terri E, OT
Gender: Female
NPI: 1477765519
706A W Ben White Blvd
Ste 150A
(512) 441-5100
Clinic Affiliation: Cole Consolidated Rehab
LLC
Board Certified Specialties: None
Austin
Dandignac, Melissa L, OT
Gender: Female
NPI: 1932468139
9101 Burnet Rd
Ste 103
(512) 248-2422
Clinic Affiliation: Ltts LLP
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
#
Austin
Dea, Willow, OT
Gender: Female
NPI: 1245316983
12524 Capella Trl
(512) 587-5671
Clinic Affiliation: Growing Places Therapy
Services
Board Certified Specialties: None
NPI: 1013060433
8868 Research Blvd
Ste 601
J(512) 467-7232
Clinic Affiliation: Concentra Medical
Centers
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Fields, Lisa M, OT
Gender: Female
NPI: 1578583860
4602 Balcomes Woods Dr
J(512) 418-1052
Clinic Affiliation: Independence With
Therapy
Practice Information: No Patients Over 12
yrs old
Board Certified Specialties: None
Finley, Melissa A, OT
Gender: Female
NPI: 1972652188
# 12524 Capella Trl
(512) 587-5671
Clinic Affiliation: Growing Places Therapy
Services
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
Austin
Donohue, Juliet R, OT
Gender: Female
NPI: 1164430724
# 9101 Burnet Rd
J(512) 248-2422
Clinic Affiliation: Ltts LLP
Board Certified Specialties: None
Austin
Austin
NPI: 1013060433
4301 W William Cannon Dr
Bldg E Ste 320
J(512) 467-6608
Austin
Ditucci, Mary P, OT
Gender: Female
NPI: 1053625871
# 4607 Manchaca Rd
(512) 916-1511
Clinic Affiliation: Kidtherapy PLLC
Board Certified Specialties: None
Austin
NPI: 1457368557
9101 Burnet Rd Ste 103
J(512) 248-2422
Clinic Affiliation: Ltts LLP
Board Certified Specialties: None
Erben, David M, OT
Gender: Male
NPI: 1013060433
2171 Woodward St
Ste B
J(888) 997-2669
#
Austin
Aus tin
Aus tin
#
Dacy, Sarah E, OT
Gender: Female
NPI: 1164850871
# 4607 Manchaca Rd
J(512) 916-1511
Clinic Affiliation: Kidtherapy PLLC
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
Aus tin
Aus tin
Engber, Deanna S, OT
Gender: Female
NPI: 1457368557
# 4407 Monterey Oaks Blvd
Ste 140
J(512) 248-2422
Austin
Austin
Aus tin
Bryan, Alison T, OT
Gender: Female
NPI: 1841572138
# 9101 Burnet Rd
Ste 103
J(512) 248-2422
Clinic Affiliation: Ltts LLP
Board Certified Specialties: None
Cook, Stacy E, OT
Gender: Female
NPI: 1851415269
7800 Shoal Creek
Blvd Ste 110W
J(512) 610-1190
Clinic Affiliation: Austin Communication
Station Inc
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
Edwards, Sara H, OT
Gender: Female
NPI: 1679706626
1400 N IH 35
Ste 320
J(512) 324-8240
Clinic Affiliation: Institute of Reconstructive
Plast
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
Austin
#
Fontana, Emily E, OT
Gender: Female
NPI: 1255399390
1033 La Posada Dr
Ste 308
(512) 284-7192
Friedrich, Josephine L, OT
Gender: Female
NPI: 1386986636
3607 Manchaca
(512) 444-7219
NPI: 1386986636
4607 Manchaca Rd
(512) 916-1511
Clinic Affiliation: Kidtherapy PLLC, Pokluda
Rebecca L OT
Board Certified Specialties: None
Gebhardt, Ana M, OT
Gender: Female
NPI: 1124328091
# 7800 Shoal Creek Blvd
Ste 110W
J(512) 610-1190
Clinic Affiliation: Austin Communication
Station Inc
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
Austin
Gebhart, Katherine E, OT
Gender: Female
NPI: 1417254103
# 111 W Anderson Ln
Ste C-100
J(512) 451-0961
Clinic Affiliation: Language Inc
Practice Information: No Patients Over 16
yrs old
Board Certified Specialties: None
Austin
Austin
Gieringer, Abbye C, OT
Gender: Female
NPI: 1790026805
706A W Ben White Blvd
Ste 150A
J(512) 441-5100
Clinic Affiliation: Cole Consolidated Rehab
LLC
Board Certified Specialties: None
Gist, Rachel, OT
Gender: Female
NPI: 1205101284
# 4607 Manchaca Rd
J(512) 916-1511
Clinic Affiliation: Kidtherapy PLLC
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
Austin
Austin
Fisher, Deborah M, OT
Gender: Female
NPI: 1902846009
9333 Research Blvd
Ste 400
(888) 997-2669
Clinic Affiliation: Concentra Medical
Centers
Board Certified Specialties: None
Guebert, Sharon D, OT
Gender: Female
NPI: 1770698847
3705 Medical Pkwy
Ste 515
(512) 452-6475
NPI: 1770698847
711 W 38th St
Ste B3 and B4
(512) 450-0909
Clinic Affiliation: Select Physical Therapy
Holdings
Board Certified Specialties: None
Austin
NPI: 1255399390
1825 Fortview Rd
Ste 103
(512) 444-4263
NPI: 1255399390
6911 RR 620 N Ste B201
(512) 467-4546
Clinic Affiliation: Endeavor Rehab Center,
The Hand Clinic of Austin PC
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
Elrod, Erin E, OT
Gender: Female
NPI: 1376890921
9101 Burnet Rd
Ste 103
(512) 248-2422
Clinic Affiliation: Ltts LLP
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
Austin
Haass, Jean C, OT
Gender: Female
NPI: 1205191921
13642 N Hwy 183
Ste 200
(512) 331-4115
Clinic Affiliation: Therapy One Ste 203
Board Certified Specialties: None
Hamrick, Mary E, OT
Gender: Female
NPI: 1023367067
! 176 E Ben White Blvd
Ste 150A
(512) 441-5100
Austin
!
NPI: 1023367067
706 W Ben White Blvd
Ste 150A
(512) 441-5100
Clinic Affiliation: Cole Consolidated Rehab
LLC
Board Certified Specialties: None
J - Wheelchair Access
104
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Aus tin
AUSTIN Cont
OCCUPATIONAL THERAPY Cont
Haydon, Natalie R, OT
Gender: Female
NPI: 1275721011
# 9101 Burnet Rd
Ste 103
(512) 248-2422
Clinic Affiliation: Ltts LLP
Board Certified Specialties: None
Austin
Austin
Hazel, Enrique R, OT
Gender: Male
NPI: 1730282807
1033 La Posada Dr
Ste 308
J(512) 284-7192
Clinic Affiliation: Endeavor Rehab Center
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
Hefft, Emily S, OT
Gender: Female
NPI: 1538392121
# 3607 Manchaca
J(512) 444-7219
Clinic Affiliation: Pokluda Rebecca L OT
Practice Information: No Patients Over 20
yrs old
Board Certified Specialties: None
Austin
Hersom, Lynne L, OT
Gender: Female
NPI: 1972705234
# 12524 Capella Trl
(512) 587-5671
Clinic Affiliation: Growing Places Therapy
Services
Practice Information: No Patients Over 20
yrs old
Board Certified Specialties: None
Austin
#
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Austin
Knife, Kelsi B, OT
Gender: Female
NPI: 1366866915
# 12710 Research Blvd
Ste 395
(512) 250-8706
Clinic Affiliation: Capital Area Speech
Therapy PLLC
Board Certified Specialties: None
Aus tin
Aus tin
Knight, Christina L, OT
Gender: Female
NPI: 1588779490
12201 Renfert Way
Ste 115
(512) 551-0375
Austin
Austin
NPI: 1588779490
711 W 38th St
Bldg B3
(512) 450-0909
Clinic Affiliation: Harris S Rose MD PLLC,
Select Physical Therapy Holdings
Board Certified Specialties: None
Aus tin
Lafitte, Erin M, OT
Gender: Female
NPI: 1902166432
12201 Renfert Way
Ste 115
J(512) 551-0375
Clinic Affiliation: Harris S Rose MD PLLC
Board Certified Specialties: None
Austin
Lied, Carolyn P, OT
Gender: Female
NPI: 1669747556
# 9433 Bee Cave Rd
Ste 101 Bldg 3
J(512) 306-8007
Clinic Affiliation: Big Sky Pediatric Therapy
Board Certified Specialties: None
Aus tin
Aus tin
Lopez, Guillermo, OT
Gender: Male
NPI: 1427188648
1121 E Seventh St
J(512) 454-3743
Clinic Affiliation: Any Baby Can
Practice Information: No Patients Over 3
yrs old
Board Certified Specialties: None
McCaffery, Kari J, OT
Gender: Female
NPI: 1083941074
3705 Medical Pkwy
Ste 515
(512) 452-6475
NPI: 1083941074
3901 S Lamar Blvd
Ste 140
(512) 462-3275
Clinic Affiliation: Select Physical Therapy
Holdings
Board Certified Specialties: None
NPI: 1588779490
3705 Medical Pkwy
Ste 515
(512) 452-6475
Austin
Jansky, Erin C, OT
Gender: Female
NPI: 1881832467
# 4407 Monterey Oaks Blvd
Ste 140
J(512) 248-3422
Clinic Affiliation: Ltts LLP
Board Certified Specialties: None
Marshall, Deborah L, OT
Gender: Female
NPI: 1306095369
# 13642 N Hwy 183
Bldg 2 Ate 200
(512) 331-4115
Clinic Affiliation: Therapy One Ste 203
Board Certified Specialties: None
Kemper, Mary K, OT
Gender: Female
NPI: 1518974658
# 9101 Burnet Rd Ste 103
J(512) 248-2422
Clinic Affiliation: Ltts LLP
Board Certified Specialties: None
Hoke, Valerie I, OT
Gender: Female
NPI: 1346554789
# 12701 FM 620
(512) 401-0700
Austin
Maas, Christene B, OT
Gender: Female
NPI: 1245506542
# 4607 Manchaca Rd
(512) 916-1511
Clinic Affiliation: Kidtherapy PLLC
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
Austin
Austin
Aus tin
Austin
Howell, Luann H, OT
Gender: Female
NPI: 1619262706
# 1611 Headway Cir
Bldg 2
J(512) 478-2581
Clinic Affiliation: Capital Area Easter Seals
Society
Board Certified Specialties: None
NPI: 1669807467
8863 Anderson Mill Rd
Ste 117
(512) 250-5299
Clinic Affiliation: Austin Communication
Station Inc, Turning Point Integrated Therapy
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
Jones, Molly A, OT
Gender: Female
NPI: 1356760086
# 4607 Manchaca Rd
(512) 916-1511
Clinic Affiliation: Kidtherapy PLLC
Board Certified Specialties: None
Hiebeler, Diana L, OT
Gender: Female
NPI: 1962578492
# 13642 N Hwy 183
Bldg 2 Ste 200
(512) 331-4115
Clinic Affiliation: Therapy One Ste 203
Board Certified Specialties: None
NPI: 1346554789
4310 James Casey St
Ste 3C
(512) 441-6008
Clinic Affiliation: Greater Austin
Orthopaedics
Board Certified Specialties: None
Lundborg, Samantha M, OT
Gender: Female
NPI: 1558569152
# 1701 W Ben White Blvd
Ste 100B
J(512) 440-1441
Clinic Affiliation: South Austin
Rehabilitation and Wound Clinic
Board Certified Specialties: None
Austin
Aus tin
Austin
#
Jones, Ashley M, OT
Gender: Female
NPI: 1669807467
7800 Shoal Creek Blvd
Ste 110W
(512) 610-1190
McSpadden, Jenna K, OT
Gender: Female
NPI: 1821330994
9333 Research Blvd
Ste 400
(888) 997-2669
Clinic Affiliation: Concentra Medical
Centers
Board Certified Specialties: None
Menzes, Melissa B, OT
Gender: Female
NPI: 1891941860
8820 Business Park Dr
Ste 300
(512) 689-0236
Clinic Affiliation: Extra Credit LLC
Practice Information: No Patients Over 16
yrs old
Board Certified Specialties: None
Miro, Terri L, OT
Gender: Female
NPI: 1831157544
1300 Barbara Jordan Blvd
Ste 300
(512) 478-8116
Clinic Affiliation: Central Texas Pediatric
Orthopedic and Scoliosi
Board Certified Specialties: None
Moore, Farah M, OT
Gender: Female
NPI: 1447563564
# 12710 Research Blvd
Ste 395
(512) 250-8706
Clinic Affiliation: Capital Area Speech
Therapy PLLC
Board Certified Specialties: None
Austin
Austin
Mutschink, Jaime D, OT
Gender: Female
NPI: 1811321326
9433 Bee Cave Rd
Ste 101 Bldg 3
(512) 306-8007
Clinic Affiliation: Big Sky Pediatric Therapy
Board Certified Specialties: None
Myers, Kristin, OT
Gender: Female
NPI: 1902053325
# 12524 Capella Trl
(512) 587-5671
Clinic Affiliation: Growing Places Therapy
Services
Board Certified Specialties: None
Austin
Ongay, Paulina, OT
Gender: Female
NPI: 1174949788
# 12524 Capella Trl
(512) 587-5671
Clinic Affiliation: Growing Places Therapy
Services
Board Certified Specialties: None
Austin
Otoole, Dale D, OT
Gender: Male
NPI: 1487714135
# 11101 Burnet Rd
Ste A170
J(512) 835-5000
Austin
NPI: 1487714135
7401 W Hwy 71
Ste 130
J(512) 288-2700
Clinic Affiliation: Star Physical Therapy
Practice Information: No Patients Under 5
yrs old
Board Certified Specialties: None
Pokluda, Rebecca L, OT
Gender: Female
NPI: 1962584847
# 3607 Manchaca
J(512) 444-7219
Clinic Affiliation: Pokluda Rebecca L OT
Practice Information: No Patients Over 21
yrs old, No Patients Under 1 yrs old
Board Certified Specialties: None
Austin
Polston, Brittany L, OT
Gender: Female
NPI: 1831459510
# 3211 Hancock Dr
J(512) 533-9313
Clinic Affiliation: Childrens Therapeutics of
Austin
Practice Information: No Patients Over 16
yrs old
Board Certified Specialties: None
Austin
Pryne, Rama C, OT
Gender: Female
NPI: 1164530192
# 2312 Western Trails Blvd
Ste 401
(512) 293-5388
Clinic Affiliation: Acupuncture and Rehab
Clinic of A
Board Certified Specialties: None
Austin
Austin
Richards, Andrea M, OT
Gender: Female
NPI: 1588819270
4700 Seton Center
Pkwy Ste 200
(512) 439-1953
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: None
Ricketts, Lisa A, OT
Gender: Female
NPI: 1144656745
# 3607 Manchaca
(512) 444-7219
Clinic Affiliation: Pokluda Rebecca L OT
Board Certified Specialties: None
Austin
Ritter, Jody, OT
Gender: Female
NPI: 1548500564
# 9433 Bee Cave Rd
Ste 101 Bldg 3
J(512) 306-8007
Clinic Affiliation: Big Sky Pediatric Therapy
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Austin
J - Wheelchair Access
105
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Austin
AUSTIN Cont
OCCUPATIONAL THERAPY Cont
Aus tin
Aus tin
Robin, Susan F, OT
Gender: Female
NPI: 1922015759
6507 Jester Blvd
Ste 309
(512) 343-1200
Clinic Affiliation: Red Wagon Childrens
Therapy
Board Certified Specialties: None
Roseland, Kimberly A, OT
Gender: Female
NPI: 1851619530
4607 Manchaca Rd
(512) 916-1511
Clinic Affiliation: Kidtherapy PLLC
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
Ruiz, Raiza C, OT
Gender: Female
NPI: 1467678995
# 1611 Headway Cir
Bldg 2
J(512) 478-2581
Clinic Affiliation: Capital Area Easter Seals
Society
Board Certified Specialties: None
Austin
Aus tin
Rusnak, Katie N, OT
Gender: Female
NPI: 1013106145
9333 Research Blvd
Ste 400
(888) 997-2669
Clinic Affiliation: Concentra Medical
Centers
Board Certified Specialties: None
Sanders, Jennifer M, OT
Gender: Female
NPI: 1497860357
1400 N IH 35
Ste 320
J(512) 324-8240
Clinic Affiliation: Institute of Reconstructive
Plast
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
Santoro, Signe M, OT
Gender: Female
NPI: 1154617363
# 3724 Jefferson St
Ste 316
(512) 453-6778
Clinic Affiliation: Danina L Culver PT
Practice Information: No Patients Over 22
yrs old
Board Certified Specialties: None
Aus tin
Schiff, Rachel G, OT
Gender: Female
NPI: 1467794719
# 4607 Manchaca Rd
(512) 916-1511
Clinic Affiliation: Kidtherapy PLLC
Board Certified Specialties: None
NPI: 1518139864
706B W Ben White Blvd
Ste 160B
J(512) 293-9849
Clinic Affiliation: Pain Rehab and Wellness
Yoga Cent, South Austin Rehabilitation and
Wound Clinic
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Tannreuther, Dianne H, OT
Gender: Female
NPI: 1770660466
# 12501 Hymeadow Dr
Ste F
J(512) 331-5488
Austin
Simpson, Michelle L, OT
Gender: Female
NPI: 1700973393
# 4607 Manchaca Rd
J(512) 916-1511
Clinic Affiliation: Kidtherapy PLLC
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
Tisdell, Keith, OT
Gender: Male
NPI: 1477550630
# 4422 Pack Saddle Pass
Ste 104
J(512) 444-3345
Clinic Affiliation: Total Communication
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Austin
Smart, Jessica L, OT
Gender: Female
NPI: 1689948028
# 706A W Ben White Blvd
Ste 150A
(512) 441-5100
Clinic Affiliation: Cole Consolidated Rehab
LLC
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: None
Austin
Smart, Sonja M, OT
Gender: Female
NPI: 1598041717
5555 N Lamar Blvd
Ste L103
J(512) 200-2332
Clinic Affiliation: Progressive Neuro
Therapy
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Snyder, Allison T, OT
Gender: Female
NPI: 1528207057
3901 S Lamar Blvd
Ste 140
(512) 462-3275
Clinic Affiliation: Select Physical Therapy
Holdings
Board Certified Specialties: None
Spence, Alicia L, OT
Gender: Female
NPI: 1730365578
# 12524 Capella Trl
J(512) 587-5671
Clinic Affiliation: Growing Places Therapy
Services
Board Certified Specialties: None
Winter, Jamie L, OT
Gender: Female
NPI: 1346424801
# 1825 Fortview Rd
Ste 103
J(512) 444-4263
Clinic Affiliation: The Hand Clinic of Austin
PC
Practice Information: No Patients Under 1
yrs old
Board Certified Specialties: None
Austin
Austin
Austin
Austin
Aus tin
#
NPI: 1790861433
9101 Burnet Rd
Ste 103
J(512) 248-2422
Clinic Affiliation: Ltts LLP, Progressive
Neuro Therapy
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Tobias, Lisa, OT
Gender: Female
NPI: 1487809240
# 3211 Hancock Dr
J(512) 533-9313
Austin
Austin
NPI: 1487809240
4607 Manchaca Rd
(512) 916-1511
Clinic Affiliation: Childrens Therapeutics of
Austin, Kidtherapy PLLC
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
Tomlinson, Sarah A, OT
Gender: Female
NPI: 1609141746
# 4407 Monterey Oaks Blvd
Ste 140
J(512) 248-2422
Austin
#
Austin
#
Austin
Austin
Austin
NPI: 1609141746
9101 Burnet Rd Ste 103
J(512) 248-2422
Clinic Affiliation: Ltts LLP
Board Certified Specialties: None
Villamin, Heidi D, OT
Gender: Female
NPI: 1578749693
3607 Manchaca
J(512) 444-7219
Clinic Affiliation: Pokluda Rebecca L OT
Practice Information: No Patients Under 21
yrs old
Board Certified Specialties: None
Ward, Delfin B, OT
Gender: Male
NPI: 1497009559
1700 S Lamar Blvd
Ste 330
(512) 774-0260
Clinic Affiliation: Primo Performance and
Rehab Inc
Board Certified Specialties: None
Willms, M Renee, OT
Gender: Female
NPI: 1790825230
1701 W Ben White Blvd
Ste 100B
J(512) 439-1000
(512) 440-1441
NPI: 1790825230
1825 Fortview Rd
Ste 103
(512) 444-4263
Clinic Affiliation: South Austin
Rehabilitation and Wound Clinic, Texas
Orthopedics Sports And Rehab Assoc, The
Hand Clinic of Austin PC
Practice Information: No Patients Under 10
yrs old
Board Certified Specialties: None
Stuart, Molly M, OT
Gender: Female
NPI: 1740424316
# 9433 Bee Cave Rd
Ste 101 Bldg 3
(512) 306-8007
Clinic Affiliation: Big Sky Pediatric Therapy
Board Certified Specialties: None
NPI: 1770660466
13642 N Hwy 183
Bldg 2 Ste 200
(512) 331-4115
Clinic Affiliation: Carmen Tyler & Dianne
Tannreuther, Therapy One Ste 203
Practice Information: No Patients Over 15
yrs old
Board Certified Specialties: None
Austin
Austin
Austin
Simon, Michelle G, OT
Gender: Female
NPI: 1841597481
3705 Medical Pkwy
Ste 515
(512) 452-6475
Clinic Affiliation: Select Physical Therapy
Holdings
Board Certified Specialties: None
Austin
Aus tin
Shroff, Nimisha M, OT
Gender: Female
NPI: 1518139864
# 1701 W Ben White Blvd
Ste 100B
(512) 440-1441
Springfield, Stephanie, OT
Gender: Female
NPI: 1871753129
# 12524 Capella Trl
(512) 587-5671
Clinic Affiliation: Growing Places Therapy
Services
Practice Information: No Patients Under 21
yrs old
Board Certified Specialties: None
Austin
Simmons, Christa R, OT
Gender: Female
NPI: 1790861433
5555 N Lamar Blvd
Ste L103
(512) 200-2332
#
Aus tin
Aus tin
Silva, Isabel J, OT
Gender: Female
NPI: 1255462438
1121 E Seventh St
J(512) 454-3743
Clinic Affiliation: Any Baby Can
Practice Information: No Patients Over 3
yrs old
Board Certified Specialties: None
Wisnieski, Sharon A, OT
Gender: Female
NPI: 1750539417
3303 Northland Dr Ste 312
J(512) 291-2669
Clinic Affiliation: Line Leader Pediatric
Therapy PLL
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Young, Rosalinda, OT
Gender: Female
NPI: 1376962886
13642 N Hwy 183
Bldg 2 Ste 200
J(512) 331-4115
Clinic Affiliation: Therapy One Ste 203
Board Certified Specialties: None
Zeeck, Becky R, OT
Gender: Female
NPI: 1427191444
4407 Monterey Oaks Blvd
Ste 140
J(512) 248-2422
NPI: 1427191444
9101 Burnet Rd Ste 103
J(512) 248-2422
Clinic Affiliation: Ltts LLP
Board Certified Specialties: None
Zumberge, Robin M, OT
Gender: Female
NPI: 1942399662
# 1825 Fortview Rd
Ste 103
J(512) 444-4263
Clinic Affiliation: The Hand Clinic of Austin
PC
Practice Information: No Patients Under 1
yrs old
Board Certified Specialties: None
Austin
ONCOLOGY
" Aung, Thomas L, MD
Austin
Gender: Male
NPI: 1679515530
12221 Renfert Way
Ste 300
J(512) 873-8900
Hospital Affiliation: Cornerstone Hosp Of
Austin, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
St Davids S Austin Medical Center
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Oncology
J - Wheelchair Access
106
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Gorrebeeck, Allison E, MD
" Kampe, Carsten E, MD
Aus tin
AUSTIN Cont
ONCOLOGY Cont
" Bachier, Carlos R, MD
Austin
Gender: Male
NPI: 1588621031
901 W Ben White Blvd
(512) 447-2211
Hospital Affiliation: Methodist Hospital
Clinic Affiliation: Methodist Physician
Practices PLL
Practice Information: No Patients Under 14
yrs old
Board Certified Specialties: Oncology
Austin
Castillo, Rene A, MD
Gender: Male
NPI: 1134186166
4101 James Casey St
Ste 100
J(512) 447-2202
Aus tin
Aus tin
NPI: 1134186166
901 W 38th St Ste 200
J(512) 421-4100
Hospital Affiliation: Central Texas Medical
Center, North Austin Medical Center,
Northwest Surgery Center Llp, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
" Chadha, Punit, MD
" George, David W, MD
Gender: Male
NPI: 1164465563
901 W 38th St Ste 200
J(512) 421-4100
Hospital Affiliation: Cornerstone Hosp Of
Austin, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Georgetown Hospital, St Davids
Medical Center
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Oncology
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Male
NPI: 1982642914
12221 Renfert Way Ste 300
J(512) 873-8900
Hospital Affiliation: Cedar Park Regional
Medical Ctr, North Austin Medical Center,
Round Rock Medical Center, Seton Medical
Center, Seton Medical Ctr Williamson, Seton
Northwest Hospital, Seton Smithville Reg
Hospital, St Davids Georgetown Hospital, St
Davids Medical Center, St Davids S Austin
Medical Center
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Oncology
" Patt, Debra A, MD
Austin
Gender: Female
NPI: 1003839820
12201 Renfert Way
Ste 370
J(512) 302-1771
" Kasper, Michael L, MD
Austin
Hellerstedt, Beth A, MD
Gender: Female
NPI: 1215975487
6101 Balcones Dr
Ste 101
J(512) 406-5150
Gender: Male
NPI: 1669414652
6101 Balcones Dr
Ste 101
J(512) 302-1771
Hoverman, John R, MD
Gender: Male
NPI: 1508808494
4101 James Casey St
Ste 100
J(512) 447-2202
NPI: 1508808494
6204 Balcones Dr
J(512) 302-1771
Hospital Affiliation: Cornerstone Hosp Of
Austin, North Austin Medical Center, Seton
Medical Center, St Davids Medical Center
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
NPI: 1003839820
2911 Medical Arts St
Ste 13
J(512) 478-9990
NPI: 1669414652
6204 Balcones Dr
J(512) 302-1771
Hospital Affiliation: Cornerstone Hosp Of
Austin, Heart Hospital Of Austin, North
Austin Medical Center, Round Rock Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Oncology
NPI: 1508808494
6101 Balcones Dr
Ste 101
J(512) 406-5150
" Doner, Kevin T, MD
Austin
NPI: 1912944521
6204 Balcones Dr
J(512) 302-1771
Hospital Affiliation: Cornerstone Hosp Of
Austin, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Oncology
Austin
Aus tin
Austin
Gender: Male
NPI: 1336115880
12221 Renfert Way
Ste 300
(512) 873-8900
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, St Davids
Medical Center
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Oncology
Hagin, Gerald D, MD
Gender: Male
NPI: 1285606483
11111 Research Blvd
Ste 450
(512) 505-5500
Clinic Affiliation: Austin Cancer Centers
Georgetown
Board Certified Specialties: None
" Netaji, Balijepalli, MD
Austin
Gender: Male
NPI: 1912944521
4101 James Casey St
Ste 100
J(512) 447-2202
NPI: 1215975487
6204 Balcones Dr
J(512) 427-9400
Hospital Affiliation: Cornerstone Hosp Of
Austin, Heart Hospital Of Austin, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, St Davids
Georgetown Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
Austin
Gender: Male
NPI: 1497778229
4101 James Casey St
Ste 100
J(512) 447-2202
Hospital Affiliation: Cornerstone Hosp Of
Austin, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Oncology
Austin
Gender: Female
NPI: 1467548628
12221 N Mopac Expwy
(512) 505-5500
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center
Clinic Affiliation: Austin Cancer Centers
Georgetown
Board Certified Specialties: Oncology
Kocs, Darren M, MD
Gender: Male
NPI: 1972541357
6204 Balcones Dr
J(512) 302-1771
Hospital Affiliation: Cornerstone Hosp Of
Austin, Round Rock Medical Center, Scott &
White Hospital Taylor, Seton Medical Center,
St Davids Georgetown Hospital, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
NPI: 1003839820
4101 James Casey St
Ste 100
J(512) 447-2202
NPI: 1003839820
6204 Balcones Dr
J(512) 302-1771
Hospital Affiliation: Md Anderson Cancer
Center, Seton Medical Center, St Davids
Georgetown Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old, Practice Limited to Oncology
Board Certified Specialties: Oncology
" Rubin De Celis, Carlos, MD
Austin
Gender: Male
NPI: 1275571879
12201 Renfert Way
Ste 325
J(512) 302-1771
NPI: 1275571879
4101 James Casey St
J(512) 447-2202
" Loukas, Demetrius F, MD
Austin
NPI: 1154369775
901 W 38th St Ste 200
J(512) 421-4100
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old, Practice Limited to Hematology,
Practice Limited to Oncology
Board Certified Specialties: Oncology
" Jeter, Ashley A, MD
Aus tin
Gender: Female
NPI: 1053518555
901 W 38th St
Ste 200
(512) 421-4100
Hospital Affiliation: St Davids Medical
Center
Clinic Affiliation: Texas Oncology PA
Board Certified Specialties: Oncology
NPI: 1275571879
6204 Balcones Dr
J(512) 302-1771
Gender: Male
NPI: 1154369775
11111 Research Blvd
Ste 400
J(512) 349-0081
NPI: 1275571879
901 W 38th St Ste 200
J(512) 421-4100
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Oncology
" Ruud, Christopher O, MD
Austin
Gender: Male
NPI: 1124089412
901 W 38th St
Ste 200
(512) 421-4100
Hospital Affiliation: Abilene Regional
Medical Center, Scott And White Memorial
Hospital
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: Oncology
J - Wheelchair Access
107
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Austin
AUSTIN Cont
ONCOLOGY Cont
" Sandbach, John F, MD
Aus tin
Gender: Male
NPI: 1376585505
6101 Balcones Dr
Ste 101
(512) 406-5150
NPI: 1376585505
6204 Balcones Dr
(512) 427-9400
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
St Marks Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old, Practice Limited to Oncology
Board Certified Specialties: Oncology
Aus tin
Shimkus, Brian J, MD
Gender: Male
NPI: 1730164591
11111 Research Blvd
Ste 450
(512) 505-5500
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Georgetown Hospital, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Cancer Centers
Georgetown
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
" Shrikhande, Shubhada S, MD
" Smith, Jason L, MD
Aus tin
Gender: Male
NPI: 1114137064
4101 James Casey St
Ste 100
J(512) 447-2202
Hospital Affiliation: Central Texas Medical
Center, Seton Medical Center
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Oncology
Yorio, Jeffrey T, MD
Gender: Male
NPI: 1215197314
6204 Balcones Dr
(512) 427-9400
Hospital Affiliation: Md Anderson Cancer
Center, North Austin Medical Center, Seton
Medical Center, St Davids Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: Practice Limited to
Oncology
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Male
NPI: 1477717759
2600 Via Fortuna
Ste 400
(512) 327-4123
Hospital Affiliation: Hillcrest Baptist
Medical Center, Tx Hlth Harris Methodist
Hosp Sw
Clinic Affiliation: Mann Eye Center
Practice Information: No Patients Under 5
yrs old
Board Certified Specialties:
Ophthalmology
" Briggs, Richard B, MD
Gender: Male
NPI: 1699740712
6801 Manchaca
J(512) 444-2015
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Richard Briggs
Board Certified Specialties:
Ophthalmology
" Broberg, Peter H, MD
Austin
Gender: Male
NPI: 1326040635
4207 James Casey Ste 305
J(512) 447-6096
Hospital Affiliation: Seton Medical Center,
St Davids S Austin Medical Center
Clinic Affiliation: Broberg Peter MD
Board Certified Specialties:
Ophthalmology
" Berger, Brian B, MD
#
Youman III, Joseph D, MD
Gender: Male
NPI: 1679511125
# 901 W 38th St Ste 300
J(512) 421-4100
Hospital Affiliation: Cornerstone Hosp Of
Austin, Heart Hospital Of Austin, North
Austin Medical Center, Northwest Surgery
Center Llp, Round Rock Medical Center,
Seton Medical Center, Seton Northwest
Hospital, St Davids Medical Center
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: None
" Buckingham, Dawn C, MD
Austin
Gender: Female
NPI: 1346241122
5011 Burnet Rd
J(512) 583-2020
Hospital Affiliation: Bailey Square Surgery
Center, Scott & White Hospital Llano, Seton
Highland Lakes, Seton Medical Center
Clinic Affiliation: Eye Physicians of Austin
PA
Board Certified Specialties:
Ophthalmology
" Berkowitz, Richard A, MD
Austin
Gender: Male
NPI: 1093743056
2610 S IH 35
J(512) 443-9715
NPI: 1093743056
5625 Eiger Rd
Ste 100
(512) 872-6061
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Round Rock Medical Center, Seton
Medical Center Hays, South Texas Health
System, St Davids Medical Center, Valley
Baptist Medical Center, Valley Regional
Medical Center
Clinic Affiliation: Howerton Eye Center PA,
Howerton Eye Clinic PLLC
Board Certified Specialties:
Ophthalmology
" Zoghi, Behyar, MD
Austin
Gender: Male
NPI: 1497955447
901 W Ben White Blvd
J(512) 447-2211
Hospital Affiliation: Methodist Hospital,
Methodist Specialty And Transplant Hospital
Clinic Affiliation: Methodist Physician
Practices PLL
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Oncology
Gender: Male
NPI: 1649257312
3705 Medical Pkwy Ste 410
J(512) 454-5851
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Brian B Berger MD
Practice Information: Public Transportation
Access, Wheelchair Accessibility
Board Certified Specialties:
Ophthalmology
" Blaydon, Sean M, MD
Austin
OPHTHALMOLOGY
" Alexander, Maureen M, MD
Austin
Gender: Female
NPI: 1275619496
4207 James Casey St
Ste 303
J(512) 443-2046
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, St Davids S
Austin Medical Center
Practice Information: Public Transportation
Access, TDD Capacity, Wheelchair
Accessibility
Board Certified Specialties:
Ophthalmology
Bui, Marie T, MD
Gender: Female
NPI: 1174757751
11901 Jollyville Rd
(512) 250-2020
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center
Clinic Affiliation: Austin Eye Clinic Assoc
Practice Information: Public Transportation
Access, Wheelchair Accessibility
Board Certified Specialties: None
" Busse Jr, Franklin K, MD
Austin
#
Austin
Gender: Male
NPI: 1730170622
3705 Medical Pkwy
Ste 120
J(512) 458-2141
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Texas Oculoplastic
Consultants
Practice Information: Public Transportation
Access, Wheelchair Accessibility
Board Certified Specialties:
Ophthalmology
Gender: Male
NPI: 1942395165
11111 Research Blvd
Ste 170
J(512) 338-5222
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Premier Eye Care PA
Practice Information: No Patients Under 3
yrs old
Board Certified Specialties:
Ophthalmology
Austin
Austin
Austin
#
#
" Barker, Luke A, MD
Gender: Male
NPI: 1609010800
900 E 30th St
Ste 100
(512) 505-5500
Clinic Affiliation: Austin Cancer Centers
Georgetown
Board Certified Specialties: Oncology
Austin
" Brent, Byron D, MD
Austin
Austin
" Vinjamaram, Sanjay, MD
" Tebcherany, Dina J, MD
NPI: 1578501664
6204 Balcones Dr
J(512) 302-1771
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Oncology
Gender: Female
NPI: 1275611352
3705 Medical Pkwy
Ste 120
J(512) 458-2141
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, St Davids S
Austin Medical Center
Clinic Affiliation: Texas Oculoplastic
Consultants
Practice Information: Public Transportation
Access, Wheelchair Accessibility
Board Certified Specialties:
Ophthalmology
Austin
Aus tin
Gender: Female
NPI: 1578501664
4101 James Casey St
Ste 100
J(512) 447-2202
" Amato, Malena M, MD
Austin
NPI: 1801834809
6204 Balcones Dr
J(512) 427-9400
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Texas Oncology PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
Aus tin
Gender: Female
NPI: 1982661674
12221 Renfert Way
Ste 300
(512) 873-8900
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Texas Oncology PA
Board Certified Specialties: Oncology
Teneriello, Michael G, MD
Gender: Male
NPI: 1801834809
4101 James Casey St
Ste 100
J(512) 447-2202
Gender: Male
NPI: 1770677908
4700 Seton Center Pkwy
Ste 150
J(512) 345-3595
Hospital Affiliation: Bailey Square Surgery
Center, Dell Childrens Med Ctr Cent Tx,
North Austin Medical Center, Round Rock
Medical Center, Seton Northwest Hospital,
St Davids Medical Center
Clinic Affiliation: Austin Pediatric
Ophthalmology & Strabismus PA
Practice Information: Public Transportation
Access, TDD Capacity, Wheelchair
Accessibility
Board Certified Specialties:
Ophthalmology
" Chou, Eva, MD
Austin
Gender: Female
NPI: 1376717041
3705 Medical Pkwy
Ste 120
(512) 458-2141
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Texas Oculoplastic
Consultants
Board Certified Specialties:
Ophthalmology
J - Wheelchair Access
108
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Djafari, Valla, MD
" Falknor, Clayton L, MD
Aus tin
AUSTIN Cont
OPHTHALMOLOGY Cont
" Cottle, Gina R, MD
Austin
Gender: Female
NPI: 1407963432
11614 Bee Caves Rd
Ste 110
J(512) 263-1113
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Hill Country Surgery Ctr,
Oakwood Surgery Center, Round Rock
Medical Center, Surgicare Of South Austin
Clinic Affiliation: Lake Austin Eye PLLC
Board Certified Specialties:
Ophthalmology
NPI: 1881648038
5625 Eiger Rd
Ste 100
J(512) 651-2201
Hospital Affiliation: Scott And White
Memorial Hospital, Seton Medical Center,
Seton Medical Ctr Williamson, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Texas Retina Institute PA
Practice Information: No Patients Under 10
yrs old
Board Certified Specialties:
Ophthalmology
" Dai, Eric, MD
Gender: Female
NPI: 1588788830
4207 James Casey St
Ste 301
J(512) 451-0103
" Dell, Steven J, MD
Austin
NPI: 1366428856
7000 N Mo Pac Expwy
Ste 110
J(512) 327-7000
Hospital Affiliation: Bailey Square Surgery
Center, Dell Childrens Med Ctr Cent Tx,
Seton Medical Center, Seton Northwest
Hospital, Texan Surgery Center, Texas
Childrens Hospital, University Med Ctr
Brackenridge
Clinic Affiliation: Texan Eye
Board Certified Specialties:
Ophthalmology
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Male
NPI: 1013989706
3300 W Anderson Ln
Ste 308
J(512) 451-0103
NPI: 1013989706
801 W 38th St Ste 200
J(512) 451-0103
Hospital Affiliation: North Austin Medical
Center, Northwest Hills Surgical Hospital,
San Angelo Community Medical Center,
Seton Medical Center, St Davids Medical
Center, University Health System
Clinic Affiliation: Austin Retina Assoc
Practice Information: Public Transportation
Access, TDD Capacity, Wheelchair
Accessibility
Board Certified Specialties:
Ophthalmology
" Dudek, Lara T, MD
Gender: Female
NPI: 1740461136
1700 S Mo Pac Expwy
(512) 327-7000
Gender: Female
NPI: 1720223449
11111 Research Blvd
Ste 220
J(512) 324-6755
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Medical Ctr Williamson, Seton Northwest
Hospital
Clinic Affiliation: Pediatric Surgical
Subspecialists
Board Certified Specialties:
Ophthalmology
" Hollsten, Donald A, MD
Austin
Gender: Male
NPI: 1508829227
7000 N Mo Pac Expwy
Ste 110
J(512) 327-7000
Hospital Affiliation: Bailey Square Surgery
Center, Methodist Hospital, Nix Health Care
System, St Lukes Baptist Hospital, Texan
Surgery Center
Clinic Affiliation: Texan Eye
Practice Information: Public Transportation
Access, Wheelchair Accessibility
Board Certified Specialties:
Ophthalmology
" Hawthorne, Kristen M, MD
Austin
NPI: 1740461136
5717 Balcones Dr
(512) 327-7000
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, Seton Southwest,
Texan Surgery Center
Clinic Affiliation: Texan Eye
Practice Information: No Patients Under 6
yrs old
Board Certified Specialties:
Ophthalmology
Aus tin
" Hoang, Lan T, MD
Austin
NPI: 1013989706
4207 James Casey St
Ste 301
J(512) 451-0103
Aus tin
NPI: 1366428856
5717 Balcones Dr
J(512) 327-7000
Gender: Male
NPI: 1407045339
3410 Far West Blvd
Ste 140
J(512) 427-1100
Hospital Affiliation: Bailey Square Surgery
Center, North Austin Medical Center,
Northwest Hills Surgical Hospital, Seton
Medical Center, St Davids Medical Center, St
Davids S Austin Medical Center, Texan
Surgery Center, University Med Ctr
Brackenridge
Clinic Affiliation: Eye Clinic of Austin
Board Certified Specialties:
Ophthalmology
" Harper III, Clio A, MD
NPI: 1962474643
801 W 38th St
Ste 200
J(512) 451-0103
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center,
Northwest Hills Surgical Hospital, Round
Rock Medical Center, San Angelo
Community Medical Center, Seton Medical
Center, Seton Northwest Hospital, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Retina Assoc
Board Certified Specialties:
Ophthalmology
NPI: 1588788830
801 W 38th St Ste 200
J(512) 451-0103
Clinic Affiliation: Austin Retina Assoc
Practice Information: Public Transportation
Access, TDD Capacity, Wheelchair
Accessibility
Board Certified Specialties:
Ophthalmology
" Henderson, Thomas T, MD
Austin
Austin
NPI: 1962474643
4207 James Casey St
Ste 301
J(512) 451-0103
" Day, Shelley, MD
Gender: Male
NPI: 1609861897
901 W 38th St
Ste 303
J(512) 452-8467
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center,
Northwest Hills Surgical Hospital, Seton
Medical Center, Seton Northwest Hospital,
St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Glaucoma Institute of
Austin PA
Practice Information: Public Transportation
Access, TDD Capacity, Wheelchair
Accessibility
Board Certified Specialties:
Ophthalmology
Gender: Female
NPI: 1457512451
6801 Manchaca
(512) 444-2015
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, University Med Ctr Brackenridge
Clinic Affiliation: Richard Briggs
Board Certified Specialties:
Ophthalmology
" Dooner, James W, MD
Austin
Gender: Male
NPI: 1366428856
1700 S Mo Pac Expwy
J(512) 327-7000
" Golde, Kimberly T, MD
Austin
Aus tin
Gender: Male
NPI: 1962474643
3300 W Anderson Ln
Ste 308
J(512) 451-0103
" Hayhurst, Russell A, MD
Austin
Gender: Male
NPI: 1164625018
3410 Far West Blvd
Ste 140
(512) 427-1100
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Dell Childrens Med Ctr Cent Tx,
North Austin Medical Center, Northwest Hills
Surgical Hospital, Round Rock Medical
Center, Seton Medical Center, Seton Medical
Ctr Williamson, Seton Northwest Hospital, St
Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Eye Clinic of Austin
Practice Information: No Patients Under 5
yrs old
Board Certified Specialties:
Ophthalmology
NPI: 1881648038
3807 Spicewood Springs Rd
Ste 101
J(512) 651-2201
Austin
Gender: Male
NPI: 1679778245
5011 Burnet Rd
J(512) 583-2020
Hospital Affiliation: Bailey Square Surgery
Center, Hill Country Memorial Surgery Ctr,
Northwest Hills Surgical Hospital, Seton
Highland Lakes, Seton Medical Center,
Seton Northwest Hospital, Seton Southwest
Clinic Affiliation: Eye Physicians of Austin
PA
Board Certified Specialties:
Ophthalmology
Austin
Gender: Male
NPI: 1881648038
2610 S Interstate 35
J(512) 651-2201
Durairaj, Vikram D, MD
Gender: Male
NPI: 1871683540
3705 Medical Pkwy
Ste 120
(512) 458-2141
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Texas Oculoplastic
Consultants
Practice Information: Public Transportation
Access, Wheelchair Accessibility
Board Certified Specialties: None
Gender: Female
NPI: 1003019092
2610 S IH 35
(512) 443-9715
NPI: 1003019092
5625 Eiger Rd
Ste 100
(512) 443-9715
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center Hays, St
Davids Medical Center
Clinic Affiliation: Howerton Eye Clinic PLLC
Practice Information: Public Transportation
Access, Wheelchair Accessibility
Board Certified Specialties:
Ophthalmology
" Jackson Jr, Oscar B, MD
Austin
Gender: Male
NPI: 1215019278
3509 Lawton Ave
J(512) 451-0234
Hospital Affiliation: Bailey Square Surgery
Center, Seton Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Jackson Jr Oscar B MD
Practice Information: No Patients Over 16
yrs old
Board Certified Specialties:
Ophthalmology
J - Wheelchair Access
109
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Levitan, Mark, MD
" Mann II, Paul M, MD
Austin
AUSTIN Cont
OPHTHALMOLOGY Cont
" Jhaveri, Chirag D, MD
Aus tin
#
Aus tin
Gender: Male
NPI: 1114117769
3705 Medical Pkwy
Ste 410
J(512) 454-5851
Hospital Affiliation: Seton Medical Center,
Seton Medical Ctr Williamson, Seton
Northwest Hospital, University Med Ctr
Brackenridge
Clinic Affiliation: Brian B Berger MD
Practice Information: Public Transportation
Access, Wheelchair Accessibility
Board Certified Specialties:
Ophthalmology
Kalpaxis, James G, MD
Gender: Male
NPI: 1063594281
4005 Spicewood Spgs
Ste C600
J(512) 346-6421
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Board Certified Specialties: None
NPI: 1609848399
801 W 38th St
Ste 200
J(512) 451-0103
Hospital Affiliation: Northwest Hills Surgical
Hospital, San Angelo Community Medical
Center, Seton Medical Center, Shannon
Medical Center, St Davids Medical Center
Clinic Affiliation: Austin Retina Assoc
Practice Information: Public Transportation
Access, TDD Capacity, Wheelchair
Accessibility
Board Certified Specialties:
Ophthalmology
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
NPI: 1679545370
4207 James Casey St
Ste 301
J(512) 451-0103
" Loose, Isaac A, MD
" Monheit, Blythe E, MD
Austin
Gender: Female
NPI: 1336196542
1700 S Mopac Expwy
(512) 327-7000
NPI: 1679545370
801 W 38th St Ste 200
J(512) 451-0103
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Northwest Hills Surgical Hospital,
San Angelo Community Medical Center,
Seton Medical Center, Seton Northwest
Hospital, St Davids Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Retina Assoc
Practice Information: Public Transportation
Access, TDD Capacity, Wheelchair
Accessibility
Board Certified Specialties:
Ophthalmology
" McCluskey, Marilyn M, MD
NPI: 1336196542
5717 Balcones Dr
(512) 327-7000
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, St Davids
Georgetown Hospital
Clinic Affiliation: Texan Eye
Practice Information: Specializing in
Glaucoma
Board Certified Specialties:
Ophthalmology
Austin
Gender: Male
NPI: 1821075664
5717 Balcones Dr
J(512) 327-7000
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Healthsouth Rehabilitation Hospital
Of Austin, Medical Park Tower Surg Ctr Llc,
Northwest Hills Surgical Hospital, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, Texan Surgery
Center, University Med Ctr Brackenridge
Clinic Affiliation: Texan Eye
Board Certified Specialties:
Ophthalmology
Gender: Male
NPI: 1811126105
2610 S IH 35
(512) 443-9715
NPI: 1811126105
5625 Eiger Rd
Ste 100
(512) 872-6061
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Medical Center Hays, St Davids Medical
Center
Clinic Affiliation: Howerton Eye Clinic PLLC
Board Certified Specialties:
Ophthalmology
Gender: Male
NPI: 1679545370
3300 W Anderson Ln
Ste 308
J(512) 451-0103
Austin
" Kelly, Scott D, MD
Gender: Male
NPI: 1780786491
3300 W Anderson Ln
Ste 308
(512) 454-8744
Hospital Affiliation: Medical Park Tower
Surg Ctr Llc, Seton Medical Center
Clinic Affiliation: Eye Institute of Austin
Practice Information: No Patients Under 13
yrs old, Public Transportation Access,
Wheelchair Accessibility
Board Certified Specialties:
Ophthalmology
" Martinez, Jose A, MD
Gender: Female
NPI: 1790781029
3300 W Anderson Ln
Ste 308
J(512) 454-8744
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Eye Institute of Austin
Practice Information: Public Transportation
Access, Wheelchair Accessibility
Board Certified Specialties:
Ophthalmology
Aus tin
" McKinley, Steven H, MD
Austin
Austin
" Lindsey, Janet A, MD
" Kelinske, Marilyn A, MD
Gender: Female
NPI: 1740274034
11623 Angus Rd
Ste 12
J(512) 346-2903
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Practice Information: Public Transportation
Access, Wheelchair Accessibility
Board Certified Specialties:
Ophthalmology
NPI: 1902881048
5717 Balcones Dr
J(512) 327-7000
Hospital Affiliation: John Peter Smith
Hospital, Parkland Health And Hospital Sys,
Seton Medical Center, Seton Northwest
Hospital, Texan Surgery Center
Clinic Affiliation: Texan Eye
Board Certified Specialties:
Ophthalmology
Austin
Aus tin
NPI: 1376729673
4314 W Braker Ln
Ste 215
(512) 327-4123
Hospital Affiliation: Hill Country Surgery
Ctr, Medical Park Tower Surg Ctr Llc, St
Davids S Austin Medical Center, The Hosp
At Westlake Med Ctr
Clinic Affiliation: Mann Eye Center
Practice Information: Public Transportation
Access, TDD Capacity, Wheelchair
Accessibility
Board Certified Specialties:
Ophthalmology
Gender: Male
NPI: 1902881048
1700 S Mopac
J(512) 327-7000
NPI: 1225013980
7000 N Mopac Ste 110
J(512) 327-7000
Hospital Affiliation: Bailey Square Surgery
Center, Dell Childrens Med Ctr Cent Tx,
Seton Medical Center, Seton Northwest
Hospital, Texan Surgery Center, University
Med Ctr Brackenridge
Clinic Affiliation: Texan Eye
Board Certified Specialties:
Ophthalmology
Gender: Female
NPI: 1265417315
1700 S Mopac
J(512) 327-7000
NPI: 1376729673
2610 S IH 35
(512) 443-9715
" Marquis, Robert E, MD
" Lewis, Douglas E, MD
" Keeland, Ruth Kimberly, MD
Gender: Female
NPI: 1376729673
2600 Via Fortuna
Ste 400
(512) 327-4123
Austin
Austin
Gender: Male
NPI: 1225013980
1700 S Mopac
J(512) 327-7000
" McIntire, Lisa U, MD
Austin
Gender: Male
NPI: 1467440909
2600 Via Fortuna
J(888) 809-1133
Hospital Affiliation: Kingwood Medical
Center, Mem Hermann Katy Hospital
Clinic Affiliation: Mann Eye Center
Practice Information: Public Transportation
Access, TDD Capacity
Board Certified Specialties:
Ophthalmology
NPI: 1609848399
4207 James Casey St
Ste 301
J(512) 451-0103
Aus tin
NPI: 1265417315
5717 Balcones Dr
J(512) 327-7000
Hospital Affiliation: Bailey Square Surgery
Center, Dell Childrens Med Ctr Cent Tx,
Seton Medical Center, Seton Northwest
Hospital, Texan Surgery Center, University
Med Ctr Brackenridge
Clinic Affiliation: Texan Eye
Board Certified Specialties:
Ophthalmology
Austin
Gender: Male
NPI: 1609848399
3300 W Anderson Ln
Ste 308
J(512) 451-0103
#
Gender: Female
NPI: 1104907492
11111 Research Blvd
Ste 170
(512) 338-5222
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Premier Eye Care PA
Board Certified Specialties:
Ophthalmology
Austin
" McGlathery IV, William T, MD
Austin
#
" Mann, Paul M, MD
Austin
Gender: Male
NPI: 1366447559
2600 Via Fortuna
Ste 400
J(512) 327-3524
NPI: 1366447559
4314 W Braker Ln
Ste 215
J(281) 353-8300
Hospital Affiliation: Kingwood Medical
Center, Mem Hermann Katy Hospital, Mem
Hermann Northeast Hosp
Clinic Affiliation: Mann Eye Center
Practice Information: Public Transportation
Access, TDD Capacity
Board Certified Specialties:
Ophthalmology
Gender: Male
NPI: 1659329555
4207 James Casey Ste 305
J(512) 447-6096
Hospital Affiliation: St Davids S Austin
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Broberg Peter MD
Board Certified Specialties:
Ophthalmology
Murphy, Lori M, MD
Gender: Female
NPI: 1821223850
3300 W Anderson Ln
Ste 308
J(512) 454-8744
Hospital Affiliation: Medical Park Tower
Surg Ctr Llc, Seton Medical Center
Clinic Affiliation: Eye Institute of Austin
Practice Information: No Patients Under 12
yrs old, Public Transportation Access,
Wheelchair Accessibility
Board Certified Specialties: None
" Neuhaus, Russell W, MD
Austin
Gender: Male
NPI: 1326039264
3705 Medical Pkwy Ste 120
J(512) 458-2141
Hospital Affiliation: Central Texas Medical
Center, Seton Medical Center, St Davids
Medical Center
Clinic Affiliation: Texas Oculoplastic
Consultants
Board Certified Specialties:
Ophthalmology
J - Wheelchair Access
110
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Pierce, Karl R, MD
Aus tin
AUSTIN Cont
OPHTHALMOLOGY Cont
#
" Nieman, Yen Dang, MD
Austin
Gender: Female
NPI: 1295825784
1700 S Mopac
J(512) 327-7000
NPI: 1720089592
5011 Burnet Rd
J(512) 583-2020
Hospital Affiliation: Bailey Square Surgery
Center, Northwest Hills Surgical Hospital,
Round Rock Medical Center, Seton Medical
Center, Seton Northwest Hospital
Clinic Affiliation: Eye Physicians of Austin
PA, Premier Eye Care PA
Practice Information: Wheelchair
Accessibility
Board Certified Specialties:
Ophthalmology
NPI: 1295825784
5717 Balcones Dr
J(512) 327-7000
NPI: 1295825784
7000 N Mo Pac Ste 110
J(512) 327-7000
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, Texan Surgery
Center
Clinic Affiliation: Texan Eye
Board Certified Specialties:
Ophthalmology
" Nixon, Peter A, MD
Gender: Male
NPI: 1467438531
3300 W Anderson Ln
Ste 308
J(512) 451-0103
NPI: 1467438531
801 W 38th St
Ste 200
J(512) 451-0103
Hospital Affiliation: Medical Park Tower
Surg Ctr Llc, Northwest Hills Surgical
Hospital, San Angelo Community Medical
Center, Seton Medical Center, Seton
Northwest Hospital, Shannon Medical
Center, St Davids Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Austin Retina Assoc
Practice Information: Public Transportation
Access, TDD Capacity, Wheelchair
Accessibility
Board Certified Specialties:
Ophthalmology
Austin
Odette, John D, MD
Gender: Male
NPI: 1124224464
11901 Jollyville Rd
(512) 250-2020
Hospital Affiliation: Austin Eye Laser And
Surgicenter, Bailey Square Surgery Center,
Heart Hospital Of Austin, St Davids Medical
Center
Clinic Affiliation: Austin Eye Clinic Assoc
Practice Information: Public Transportation
Access, Wheelchair Accessibility
Board Certified Specialties: None
" Onan, Marsha H, MD
Austin
Gender: Female
NPI: 1376545186
11111 Research Blvd
Ste 220
(512) 324-6755
Hospital Affiliation: Bailey Square Surgery
Center, Dell Childrens Med Ctr Cent Tx,
North Austin Medical Center, Northwest Hills
Surgical Hospital, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Pediatric Surgical
Subspecialists
Practice Information: No Patients Over 19
yrs old
Board Certified Specialties:
Ophthalmology
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Male
NPI: 1205831344
3300 W Anderson Ln
Ste 308
J(512) 454-8744
Hospital Affiliation: Bailey Square Surgery
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center
Clinic Affiliation: Eye Institute of Austin
Practice Information: No Patients Under 13
yrs old, Public Transportation Access,
Wheelchair Accessibility
Board Certified Specialties:
Ophthalmology
Gender: Male
NPI: 1245233618
3300 W Anderson Ln
Ste 308
J(512) 454-8744
Hospital Affiliation: Round Rock Medical
Center, Scott & White Hospital Llano, Seton
Medical Center
Clinic Affiliation: Eye Institute of Austin
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties:
Ophthalmology
" Roller, Aaron B, MD
Gender: Male
NPI: 1700085248
2610 S Interstate 35
J(512) 651-2201
NPI: 1700085248
3807 Spicewood Springs
Rd Ste 101
J(512) 651-2201
NPI: 1700085248
5625 Eiger Rd
Ste 100
J(512) 651-2201
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Texas Retina Institute PA
Practice Information: No Patients Under 10
yrs old
Board Certified Specialties:
Ophthalmology
" Settle III, Halsey M, MD
Austin
Gender: Male
NPI: 1962404269
4207 James Casey Ste 305
J(512) 447-6096
Hospital Affiliation: St Davids S Austin
Medical Center
Clinic Affiliation: Broberg Peter MD
Board Certified Specialties:
Ophthalmology
" Shore, John W, MD
Austin
Gender: Male
NPI: 1194716035
3705 Medical Pkwy
Ste 120
J(512) 458-2141
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Texas Oculoplastic
Consultants
Practice Information: Public Transportation
Access, Wheelchair Accessibility
Board Certified Specialties:
Ophthalmology
" Sanchez, Cecilia R, MD
Gender: Female
NPI: 1376616011
5717 Balcones Dr
(512) 327-7000
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Texan
Surgery Center
Clinic Affiliation: Texan Eye
Board Certified Specialties:
Ophthalmology
" Smith, Randolph T, MD
Austin
Gender: Male
NPI: 1710970132
3300 W Anderson Ln
Ste 308
(512) 454-8744
Hospital Affiliation: Bailey Square Surgery
Center, Medical Park Tower Surg Ctr Llc,
Seton Medical Center, St Davids Medical
Center
Clinic Affiliation: Eye Institute of Austin
Practice Information: No Patients Under 13
yrs old, Public Transportation Access,
Wheelchair Accessibility
Board Certified Specialties:
Ophthalmology
" Sargent, Julia B, MD
Austin
Gender: Female
NPI: 1699752576
5717 Balcones Dr
J(512) 327-7000
NPI: 1699752576
7000 N Mopac
Ste 110
J(512) 327-7000
Hospital Affiliation: Bailey Square Surgery
Center, Seton Medical Center, Seton
Northwest Hospital, Texan Surgery Center,
University Med Ctr Brackenridge
Clinic Affiliation: Texan Eye
Board Certified Specialties:
Ophthalmology
Aus tin
NPI: 1508841644
7000 N Mo Pac Expwy
Ste 110
J(512) 327-7000
Hospital Affiliation: Bailey Square Surgery
Center, Medical City Dallas Hospital, Park
Central Surgical Center, Parkland Health
And Hospital Sys, Seton Medical Center,
Seton Northwest Hospital, Texan Surgery
Center
Clinic Affiliation: Texan Eye
Board Certified Specialties:
Ophthalmology
Austin
Aus tin
Gender: Male
NPI: 1821272378
3410 Far West Blvd
Ste 140
(512) 427-1100
Hospital Affiliation: North Austin Medical
Center, Parkland Health And Hospital Sys,
Round Rock Medical Center, Seton Medical
Center, Seton Northwest Hospital, St Davids
Medical Center
Clinic Affiliation: Eye Clinic of Austin
Practice Information: Wheelchair
Accessibility
Board Certified Specialties:
Ophthalmology
NPI: 1508841644
5717 Balcones Dr
J(512) 327-7000
" Rylander, Henry G, MD
" Rainey, Annis M, MD
" Rhodes, Kyle M, MD
Gender: Female
NPI: 1508841644
1700 S Mo Pac Expwy
J(512) 327-7000
Austin
Aus tin
Gender: Female
NPI: 1538111968
11111 Research Blvd
Ste 220
(512) 324-3313
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Pediatric Surgical
Subspecialists
Practice Information: No Patients Over 19
yrs old
Board Certified Specialties:
Ophthalmology
" Sargent, Kristin A, MD
Austin
" Rylander, Gary R, MD
" Plunkett, Mark A, MD
Gender: Male
NPI: 1821099698
5011 Burnet Rd
J(512) 583-2020
Hospital Affiliation: Bailey Square Surgery
Center, Round Rock Medical Center, Seton
Medical Center, St Davids Medical Center
Clinic Affiliation: Eye Physicians of Austin
PA
Board Certified Specialties:
Ophthalmology
Ross, Andrew W, MD
Gender: Male
NPI: 1992708242
3300 W Anderson Ln
Ste 308
(512) 454-8744
Hospital Affiliation: Bailey Square Surgery
Center, Seton Medical Center, St Davids
Medical Center
Clinic Affiliation: Eye Institute of Austin
Practice Information: No Patients Under 13
yrs old, Public Transportation Access,
Wheelchair Accessibility
Board Certified Specialties: None
Austin
Aus tin
Austin
NPI: 1467438531
4207 James Casey St
Ste 301
J(512) 451-0103
Austin
Gender: Male
NPI: 1720089592
11111 Research Blvd
Ste 170
J(512) 338-5222
" Smith, Stephen R, MD
Austin
Gender: Male
NPI: 1063402295
7200 N Mopac Expwy
Ste 200
(512) 241-1806
Hospital Affiliation: Northwest Hills Surgical
Hospital, Seton Medical Center
Clinic Affiliation: Central Texas Retina and
Vitreous
Practice Information: Public Transportation
Access, Wheelchair Accessibility
Board Certified Specialties:
Ophthalmology
J - Wheelchair Access
111
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
ORTHOPAEDIC SPORTS MEDICINE
" Wong, Lawrence S, MD
Austin
AUSTIN Cont
Gender: Male
NPI: 1720066731
4019 Spicewood Springs
Rd Ste 100
J(512) 345-5030
Hospital Affiliation: Northwest Hills Surgical
Hospital, St Davids Medical Center, St
Davids S Austin Medical Center
Clinic Affiliation: Eyes of Texas Laser
Center
Board Certified Specialties:
Ophthalmology
OPHTHALMOLOGY Cont
" Tasker, David I, MD
Aus tin
#
Gender: Male
NPI: 1659363810
100 Congress Ave Ste 2000
J(210) 496-0496
Hospital Affiliation: Baptist Health System,
ChildrensHospitalSanAntonio', Christus
Santa Rosa Hosp City Ctr, North Central
Baptist Hospital
Practice Information: No Patients Under 5
yrs old, Public Transportation Access,
Wheelchair Accessibility
Board Certified Specialties:
Ophthalmology
Gender: Male
NPI: 1275699274
3300 W Anderson Ln
Ste 308
(512) 451-0103
Gender: Male
NPI: 1073514170
5011 Burnet Rd
J(512) 583-2020
Hospital Affiliation: Bailey Square Surgery
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center
Clinic Affiliation: Eye Physicians of Austin
PA
Board Certified Specialties:
Ophthalmology
NPI: 1275699274
4207 James Casey St
Ste 301
(512) 451-0103
" Wagner, Theresa E, MD
NPI: 1609852664
5717 Balcones Dr
J(512) 327-7000
NPI: 1609852664
7000 N Mo Pac Expwy
Ste 110
J(512) 327-7000
Hospital Affiliation: Bailey Square Surgery
Center, Dell Childrens Med Ctr Cent Tx,
Seton Medical Center, Seton Northwest
Hospital, Texan Surgery Center, University
Med Ctr Brackenridge
Clinic Affiliation: Texan Eye
Board Certified Specialties:
Ophthalmology
NPI: 1497753040
11901 Jollyville Rd
J(512) 250-2020
Hospital Affiliation: Austin Eye Laser And
Surgicenter, Bailey Square Surgery Center,
Seton Northwest Hospital
Clinic Affiliation: Austin Eye Clinic Assoc
Practice Information: Public Transportation
Access, Wheelchair Accessibility
Board Certified Specialties:
Ophthalmology
" Woodward, Lee M, MD
Gender: Male
NPI: 1619157419
1301 Barbara Jordan
Blvd Ste 307
J(512) 324-6755
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Pediatric Surgical
Subspecialists
Board Certified Specialties:
Ophthalmology
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Male
NPI: 1740493188
12701 FM 620
(512) 401-8400
NPI: 1740493188
4310 James Casey St
Ste 3C
(512) 326-2800
NPI: 1740493188
7900 FM 1826
Ste 120 Bldg 2
(512) 326-2800
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Dell Childrens Med Ctr Cent Tx,
Seton Medical Center, Seton Northwest
Hospital, St Davids Medical Center
Clinic Affiliation: Greater Austin
Orthopaedics
Practice Information: Clinic charge will
apply; may increase your costs
Board Certified Specialties: Orthopedic
Surgery
" Albrecht, Michael M, MD
Austin
" Casmedes III, Harry P, DDS
Austin
Gender: Female
NPI: 1013084169
901 W 38th St Ste 410
J(512) 324-3310
Clinic Affiliation: Pediatric Surgical
Subspecialists
Board Certified Specialties: Oral Surgery
" Billante, Mark J, MD
Gender: Male
NPI: 1417150202
12201 Renfert Way
Ste 370
(512) 617-1989
Hospital Affiliation: North Austin Medical
Center
Clinic Affiliation: Capital City Orthopaedics
PA
Board Certified Specialties: Orthopedic
Surgery
Gender: Male
NPI: 1366423246
2500 W Wm Cannon Dr
Ste 401
J(512) 451-1969
Hospital Affiliation: Arise Austin Medical
Center, Cedar Park Regional Medical Ctr,
Central Park Surgery Center, North Austin
Medical Center, Round Rock Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, Surgicare Of South Austin, The Hosp
At Westlake Med Ctr, University Med Ctr
Brackenridge
Clinic Affiliation: Southwest Orthopaedic
Group
Board Certified Specialties: Orthopedic
Surgery
Austin
" Karakourtis, Mark H, DDS
Austin
Gender: Male
NPI: 1932320967
12201 Renfert Way Ste 345
(512) 836-3074
Hospital Affiliation: Seton Medical Center,
The Hosp At Westlake Med Ctr
Clinic Affiliation: Carus Dental
Board Certified Specialties: Oral Surgery
Amis, Benjamin P, MD
Gender: Male
NPI: 1528266863
7200 N Mopac Ste 370
(512) 346-4933
Hospital Affiliation: Northwest Hills Surgical
Hospital
Clinic Affiliation: All Star Orthopedics of
Austin
Board Certified Specialties: None
Gender: Female
NPI: 1891797072
4700 Seton Center Pkwy
Ste 200
J(512) 439-1000
Hospital Affiliation: Arise Austin Medical
Center, Cedar Park Regional Medical Ctr,
Dell Childrens Med Ctr Cent Tx, Healthsouth
Rehabilitation Hospital Of Austin, North
Austin Medical Center, Round Rock Medical
Center, St Davids Medical Center, St Davids
S Austin Medical Center, Texas Orthopedic
Hospital, University Med Ctr Brackenridge
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: Orthopedic
Surgery
Austin
" Akhtar, Omar H, MD
ORAL SURGERY
" Wollan, Peter T, MD
Gender: Male
NPI: 1457353518
4700 Seton Center Pkwy
Ste 200
J(512) 439-1000
Hospital Affiliation: Arise Austin Medical
Center, Dell Childrens Med Ctr Cent Tx,
North Austin Medical Center, Northwest Hills
Surgical Hospital, Round Rock Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: Orthopedic
Surgery
Austin
Austin
Aus tin
Gender: Male
NPI: 1205837432
5011 Burnet Rd
J(512) 583-2020
Hospital Affiliation: Bailey Square Surgery
Center, Seton Highland Lakes, Seton
Medical Center, Seton Northwest Hospital
Clinic Affiliation: Eye Physicians of Austin
PA
Board Certified Specialties:
Ophthalmology
#
Gender: Male
NPI: 1497753040
1009 E 40th St Ste 200
J(512) 454-2020
Gender: Male
NPI: 1609852664
1700 S Mo Pac Expwy
J(512) 327-7000
#
" Adams, Bradley R, DO
" Wong, Shannon M, MD
" Walters, Thomas R, MD
" Bergin, Barbara L, MD
Austin
Austin
Austin
Aus tin
Gender: Male
NPI: 1124020185
4700 Seton Center Pkwy
Ste 200
J(512) 439-1000
Hospital Affiliation: Christus Santa Rosa
Hsp Med Ctr, Healthsouth Riosa, Methodist
Hospital, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge, Warm Springs Rehab Hosp
San Anton
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: Orthopaedic
Sports Medicine, Orthopedic Surgery
ORTHOPEDIC SURGERY
NPI: 1275699274
801 W 38th St Ste 200
(512) 451-0103
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center
Clinic Affiliation: Austin Retina Assoc
Practice Information: Public Transportation
Access, TDD Capacity, Wheelchair
Accessibility
Board Certified Specialties:
Ophthalmology
Aus tin
Gender: Female
NPI: 1912984857
7000 N Mopac Expwy
Ste 110
J(512) 327-7000
Hospital Affiliation: Bailey Square Surgery
Center, Dell Childrens Med Ctr Cent Tx,
Scott & White Hospital Llano, Seton Medical
Center, Seton Northwest Hospital, Texan
Surgery Center, University Med Ctr
Brackenridge
Clinic Affiliation: Texan Eye
Board Certified Specialties:
Ophthalmology
#
" Wong, Robert W, MD
" Thorne Jr, George C, MD
Gender: Male
NPI: 1952331423
1301 W 38th St
Ste 102
(512) 454-4561
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Neck or Back
surgery
Board Certified Specialties: Orthopedic
Surgery
" Dehart, Marc M, MD
Austin
Austin
Aus tin
" Andreo, Michael A, MD
Austin
" Blais, Robert E, MD
Austin
Gender: Male
NPI: 1982614020
3755 S Capital of Texas
Hwy Ste 160
(512) 439-1005
NPI: 1982614020
911 W 38th St
Ste 300
(512) 439-1002
Hospital Affiliation: St Davids S Austin
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: Orthopedic
Surgery
" Borer, Drake S, MD
Austin
Gender: Male
NPI: 1295890531
1313 Red River
Ste 200
J(512) 391-1751
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Seton Medical Center, Seton
Medical Ctr Williamson, Seton Northwest
Hospital, University Med Ctr Brackenridge
Clinic Affiliation: Austin Skeletal Trauma
Specialists
Board Certified Specialties: Orthopedic
Surgery
J - Wheelchair Access
112
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Aus tin
AUSTIN Cont
ORTHOPEDIC SURGERY Cont
" Breazeale, Nathan M, MD
Austin
NPI: 1952313181
6611 Riverplace Blvd
Ste 100
(512) 326-2800
Hospital Affiliation: Cedar Park Regional
Medical Ctr, North Austin Medical Center,
Round Rock Medical Center, Seton Medical
Center, Seton Northwest Hospital, Seton
Southwest, St Davids Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Greater Austin
Orthopaedics
Board Certified Specialties: None
" Brotzman, Steven B, MD
Austin
NPI: 1023015773
12309 N Mopac Expwy
Ste 150
(512) 977-0000
Hospital Affiliation: Arise Austin Medical
Center, Central Park Surgery Center, North
Austin Medical Center, Seton Northwest
Hospital
Clinic Affiliation: North Austin Sports
Medicine, Orthopaedic Assoc of Central
Texas PA
Practice Information: No Patients Under 6
yrs old
Board Certified Specialties: Orthopedic
Surgery
" Cunningham, F K, MD
Aus tin
Gender: Male
NPI: 1003029828
12201 Renfert Way
Ste 370
J(512) 617-1989
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, St
Davids Medical Center
Clinic Affiliation: Capital City Orthopaedics
PA
Board Certified Specialties: Orthopedic
Surgery
Austin
" Elenz, Douglas R, MD
Austin
Gender: Male
NPI: 1205806171
900 W 38th St Ste 300
J(512) 450-1300
Hospital Affiliation: Arise Austin Medical
Center, Central Park Surgery Center, North
Austin Medical Center, Seton Medical
Center, Seton Northwest Hospital, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Sports Medicine
Board Certified Specialties: Orthopedic
Surgery
#
Gender: Male
NPI: 1124020185
4700 Seton Center Pkwy
Ste 200
J(512) 439-1000
Hospital Affiliation: Christus Santa Rosa
Hsp Med Ctr, Healthsouth Riosa, Methodist
Hospital, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge, Warm Springs Rehab Hosp
San Anton
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: Orthopaedic
Sports Medicine, Orthopedic Surgery
Dodgin, David A, MD
Gender: Male
NPI: 1821047200
# 4611 Guadalupe St
Ste 200
J(512) 476-2830
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Hyde Park Surgery Center Lp,
Seton Medical Center, St Davids Medical
Center, The Hosp At Westlake Med Ctr
Clinic Affiliation: Heinrich-Josey
Orthpaedics PA
Board Certified Specialties: None
" Foster, Robert A, MD
Austin
#
Austin
Austin
" Danney, Christopher M, MD
Aus tin
Gender: Male
NPI: 1578720876
4700 Seton Center Pkwy
Ste 200
J(512) 439-1000
Hospital Affiliation: Arise Austin Medical
Center, Dell Childrens Med Ctr Cent Tx,
North Austin Medical Center, Round Rock
Medical Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
The Hosp At Westlake Med Ctr, University
Med Ctr Brackenridge
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: Orthopedic
Surgery
" Davis, David G, MD
Aus tin
Gender: Male
NPI: 1871591354
11623 Angus Rd Ste 15
J(512) 346-7170
Hospital Affiliation: North Austin Medical
Center, Northwest Hills Surgical Hospital,
Northwest Surgery Center Llp, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, University Med Ctr
Brackenridge
Practice Information: No Patients Under 4
yrs old
Board Certified Specialties: Orthopedic
Surgery
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Male
NPI: 1952344657
4611 Guadalupe St
Ste 200
J(512) 476-2830
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Hyde Park Surgery Center Lp,
Seton Medical Center, St Davids Medical
Center, The Hosp At Westlake Med Ctr
Clinic Affiliation: Heinrich-Josey
Orthpaedics PA
Board Certified Specialties: Orthopedic
Surgery
" Dehart, Marc M, MD
" Dalton, Mark R, MD
Gender: Male
NPI: 1457324816
901 W 38th St
Ste 301
J(512) 225-6335
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Mark Ray Dalton MD
Practice Information: Foot and Ankle
surgery only, No Patients Under 14 yrs old
Board Certified Specialties: Orthopedic
Surgery
" Ebert, Andrew M, MD
Austin
Austin
Aus tin
" Burris, Michael W, MD
Gender: Male
NPI: 1417987983
1301 W 38th St
Ste 102
(512) 454-4561
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Orthopedic
Surgery
Gender: Male
NPI: 1073516472
911 W 38th St
Ste 300
J(512) 439-1002
Hospital Affiliation: Bailey Square Surgery
Center, Cedar Park Regional Medical Ctr,
Dell Childrens Med Ctr Cent Tx, Healthsouth
Rehabilitation Hospital Of Austin, North
Austin Medical Center, Seton Medical
Center, Seton Northwest Hospital, St Davids
Medical Center, Texas Orthopedics Surgery
Center, University Med Ctr Brackenridge
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Practice Information: No Neck or Back
surgery
Board Certified Specialties: Orthopedic
Surgery
Gender: Male
NPI: 1528038312
900 W 38th St
Ste 300
J(512) 450-1300
Hospital Affiliation: Arise Austin Medical
Center, North Austin Medical Center,
Northwest Hills Surgical Hospital, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center
Clinic Affiliation: Austin Sports Medicine
Board Certified Specialties: Orthopedic
Surgery
Austin
" Carter III, Shelby H, MD
" Davis, Donald R, MD
Austin
NPI: 1952313181
4310 James Casey St
Ste 3C
(512) 326-2800
Gender: Male
NPI: 1194795062
900 W 38th St Ste 300
J(512) 450-1300
Hospital Affiliation: Arise Austin Medical
Center, Central Park Surgery Center, North
Austin Medical Center, Seton Medical
Center, Seton Northwest Hospital, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Sports Medicine
Board Certified Specialties: Orthopedic
Surgery
Gender: Male
NPI: 1023015773
12176 N Mo Pac Expwy
Ste D
J(512) 977-0000
Chen, Dean, MD
Gender: Male
NPI: 1952313181
12701 FM 620
(512) 401-8400
Driscoll, Matthew, MD
Gender: Male
NPI: 1437307592
1301 W 38th St
Ste 102
(512) 454-4561
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
" Dryer, Randall F, MD
Austin
Gender: Male
NPI: 1912904053
6818 Austin Center
Blvd Ste 200
J(512) 795-2225
Hospital Affiliation: North Austin Medical
Center, Northwest Hills Surgical Hospital,
Seton Medical Center, St Davids Medical
Center, The Hosp At Westlake Med Ctr,
University Med Ctr Brackenridge
Clinic Affiliation: Central Texas Spine
Institute LLP
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Orthopedic
Surgery
Austin
Austin
Gender: Male
NPI: 1437153210
4700 Seton Center Pkwy
Ste 200
J(512) 439-1000
Hospital Affiliation: Arise Austin Medical
Center, Healthsouth Rehabilitation Hospital
Of Austin, North Austin Medical Center,
Round Rock Medical Center, Seton Medical
Center, Seton Northwest Hospital, St Davids
Medical Center, St Davids S Austin Medical
Center, The Hosp At Westlake Med Ctr,
University Med Ctr Brackenridge
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: Orthopedic
Surgery
Fox, Joshua C, MD
Gender: Male
NPI: 1760685366
1015 E 32nd St Ste 101
J(512) 477-6341
Hospital Affiliation: Bailey Square Surgery
Center, Parkland Health And Hospital Sys
Clinic Affiliation: Austin Bone & Joint Clinic
Board Certified Specialties: None
Gallagher, Sean M, MD
Gender: Male
NPI: 1477744654
7200 N Mopac Expwy
Ste 370
J(512) 346-4933
Hospital Affiliation: Arise Austin Medical
Center, Seton Medical Center, St Davids
Medical Center, St Davids S Austin Medical
Center, The Hosp At Westlake Med Ctr
Clinic Affiliation: All Star Orthopedics of
Austin
Board Certified Specialties: None
J - Wheelchair Access
113
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Greenway, Larry D, MD
" Hurt, Joel H, MD
Austin
AUSTIN Cont
ORTHOPEDIC SURGERY Cont
" Garcia Jr, Peter M, MD
Aus tin
Gender: Male
NPI: 1881698876
3755 S Capital of Texas
Hwy Ste 160
J(512) 439-1005
#
NPI: 1881698876
4700 Seton Center Pkwy
Ste 200
J(512) 439-1000
Hospital Affiliation: Arise Austin Medical
Center, Dell Childrens Med Ctr Cent Tx,
North Austin Medical Center, Seton Medical
Center, St Davids Medical Center, St Davids
Rehabilitation Center, St Davids S Austin
Medical Center, Texas Orthopedic Hospital,
The Hosp At Westlake Med Ctr, University
Med Ctr Brackenridge
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: Orthopedic
Surgery
" Gueramy, Timothy C, MD
Gender: Male
NPI: 1720019060
1301 W 38th St Ste 102
(512) 454-4561
Hospital Affiliation: Seton Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Orthopedic
Surgery
Gender: Male
NPI: 1730382193
911 W 38th St
Ste 300
J(512) 439-1002
Hospital Affiliation: Texas Orthopedics
Surgery Center
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: Orthopedic
Surgery
NPI: 1881802601
6911 N FM 620 Ste C200
J(512) 478-8116
Clinic Affiliation: Central Texas Pediatric
Orthopedic and Scoliosi
Board Certified Specialties: None
NPI: 1659381358
4316 James Casey St
Ste F-100
J(512) 707-8544
Hospital Affiliation: Arise Austin Medical
Center, Baptist Health System, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Greater Austin
Orthopaedics, Hc Orthopaedics PA
Board Certified Specialties: Orthopedic
Surgery
" Graham II, Robert D, MD
Aus tin
Gender: Male
NPI: 1215935820
12309 N Mopac Expwy
Ste 150
(512) 977-0000
Hospital Affiliation: North Austin Medical
Center, North Austin Surgery Center, Seton
Edgar B Davis, Seton Medical Center, Seton
Northwest Hospital, Seton Southwest
Clinic Affiliation: Orthopaedic Assoc of
Central Texas PA
Practice Information: No Neck or Back
surgery, No Patients Under 6 yrs old
Board Certified Specialties: Orthopedic
Surgery
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Male
NPI: 1609974955
3705 Medical Pkwy
Ste 530
J(512) 443-3933
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Board Certified Specialties: Orthopedic
Surgery
" Laverty, David C, MD
Austin
Gender: Male
NPI: 1912062753
1313 Red River Ste 200
J(512) 391-1751
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Seton Medical Center, Seton
Medical Ctr Williamson, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Skeletal Trauma
Specialists
Board Certified Specialties: Orthopedic
Surgery
" Loeb, Michael D, MD
Austin
Gender: Male
NPI: 1477665727
4700 Seton Center Pkwy
Ste 200
J(512) 439-1000
NPI: 1477665727
911 W 38th St
Ste 300
J(512) 439-1002
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: Orthopedic
Surgery
" Josey III, Robert A, MD
Austin
Gender: Male
NPI: 1912977794
4611 Guadalupe St
Ste 200
J(512) 476-2830
Hospital Affiliation: Hyde Park Surgery
Center Lp, North Austin Medical Center,
Seton Medical Center, St Davids Medical
Center, St Davids Rehabilitation Center, The
Hosp At Westlake Med Ctr, University Med
Ctr Brackenridge
Clinic Affiliation: Heinrich-Josey
Orthpaedics PA
Board Certified Specialties: Orthopedic
Surgery
" Heinrich, Eric M, MD
Austin
Gender: Male
NPI: 1518937952
4611 Guadalupe St
Ste 200
J(512) 476-2830
Hospital Affiliation: Arise Austin Medical
Center, Hyde Park Surgery Center Lp, Seton
Medical Center, St Davids Medical Center,
The Hosp At Westlake Med Ctr
Clinic Affiliation: Heinrich-Josey
Orthpaedics PA
Board Certified Specialties: Orthopedic
Surgery
Austin
Gender: Male
NPI: 1922038108
100 Medical Pkwy
(512) 347-7463
Clinic Affiliation: Kurt Von Rueden MD
Board Certified Specialties: Orthopedic
Surgery
" Johnson, Don E, MD
Gender: Male
NPI: 1659381358
4310 James Casey St
Ste 3C
(512) 326-2800
NPI: 1881802601
6836 Bee Cave Rd Ste 112
J(512) 478-8116
" Kuhns, Craig A, MD
Austin
Austin
" Hasson, Newton E, MD
Gender: Male
NPI: 1528034451
4700 Seton Center Pkwy
Ste 200
J(512) 439-1001
Hospital Affiliation: Arise Austin Medical
Center, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: Orthopedic
Surgery
Gottschalk, Hilton P, MD
Gender: Male
NPI: 1881802601
1301 Barbara Jordan
Blvd Ste 3
J(512) 478-8116
Gender: Female
NPI: 1922003227
7200 N Mo Pac Ste 370
(512) 346-4933
Hospital Affiliation: Arise Austin Medical
Center, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: All Star Orthopedics of
Austin
Board Certified Specialties: Orthopedic
Surgery
Austin
" Goldberg, Tyler D, MD
Gender: Male
NPI: 1649262536
1313 Red River Ste 200
J(512) 391-1751
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Seton Medical Center, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Skeletal Trauma
Specialists
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: Orthopedic
Surgery
" Hyde, Carolyn M, MD
" Hardy, Brian T, MD
Aus tin
" Kilbride Jr, Earl J, MD
Austin
Austin
Austin
" Geck, Matthew J, MD
Aus tin
Gender: Male
NPI: 1811998651
4700 Seton Center Pkwy
Ste 200
(512) 201-2668
Hospital Affiliation: Round Rock Medical
Center, Seton Edgar B Davis, Seton
Highland Lakes, Seton Medical Center,
Seton Northwest Hospital, Seton Southwest,
St Davids Medical Center, St Davids S
Austin Medical Center, Texas Orthopedic
Hospital, University Med Ctr Brackenridge
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: Orthopedic
Surgery
Austin
Aus tin
Gender: Male
NPI: 1073561833
1600 W 38th St
Ste 200
(512) 324-3580
Hospital Affiliation: Arise Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Seton Brain and Spine
Institute
Board Certified Specialties: Orthopedic
Surgery
Austin
Gender: Male
NPI: 1730181314
3001 Bee Caves Rd
Ste 220
J(512) 795-8812
Hospital Affiliation: Arise Austin Medical
Center, Bailey Square Surgery Center,
Healthsouth Rehabilitation Hospital Of
Austin, Northwest Hills Surgical Hospital,
Seton Medical Center, St Davids Medical
Center, The Hosp At Westlake Med Ctr
Clinic Affiliation: Austin Bone & Joint Clinic
Board Certified Specialties: Orthopedic
Surgery
" Kelso, Kalin D, MD
Austin
Hill, Austin D, MD
Gender: Male
NPI: 1225233489
1313 Red River
Ste 200
(512) 391-1751
Hospital Affiliation: Seton Medical Center,
Seton Medical Ctr Williamson, University
Med Ctr Brackenridge
Clinic Affiliation: Austin Skeletal Trauma
Specialists
Practice Information: No Patients Under 15
yrs old
Board Certified Specialties: None
Gender: Male
NPI: 1932178001
2200 Park Bend Dr Ste 301
Bldg 1
J(512) 339-0440
Hospital Affiliation: North Austin Medical
Center, Northwest Hills Surgical Hospital,
Seton Medical Center, Seton Northwest
Hospital, St Davids Medical Center, St
Davids S Austin Medical Center
Clinic Affiliation: Austin Orthopedics and
Sports Med
Board Certified Specialties: Orthopedic
Surgery
" Lutz, Richard A, DO
Austin
#
Gender: Male
NPI: 1841294113
4700 Seton Center Pkwy
Ste 200
J(512) 439-1000
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Dell Childrens Med Ctr Cent Tx,
North Austin Medical Center, Seton Medical
Center, Seton Northwest Hospital, St Davids
Medical Center, St Davids S Austin Medical
Center, Texas Orthopedic Hospital, Texas
Orthopedics Surgery Center, University Med
Ctr Brackenridge
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: Orthopedic
Surgery
J - Wheelchair Access
114
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Mundanthanam, George J, MD
" Pearce, John C, MD
Aus tin
AUSTIN Cont
ORTHOPEDIC SURGERY Cont
" Malone, Charles B, MD
Austin
Gender: Male
NPI: 1538164306
1015 E 32nd St
Ste 101
J(512) 477-6341
NPI: 1538164306
3001 Bee Caves Rd
Ste 220
J(512) 795-8812
Hospital Affiliation: Arise Austin Medical
Center, North Austin Medical Center, Seton
Medical Center, St Davids Medical Center,
The Hosp At Westlake Med Ctr, University
Med Ctr Brackenridge
Clinic Affiliation: Austin Bone & Joint Clinic
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Orthopedic
Surgery
Austin
" Murdock, Ryan C, MD
Aus tin
Gender: Male
NPI: 1790909281
1301 Barbara Jordan
Blvd Ste 300
J(512) 478-8116
" Marshall, Gordon P, MD
" Onan, Okay A, MD
Aus tin
NPI: 1194737320
6611 Riverplace Blvd
Ste 100
(512) 326-2800
Hospital Affiliation: St Davids S Austin
Medical Center
Clinic Affiliation: Greater Austin
Orthopaedics
Board Certified Specialties: Orthopedic
Surgery
Gender: Male
NPI: 1447229166
4316 James Casey St
Bldg F Ste 100
(512) 707-8544
Hospital Affiliation: Arise Austin Medical
Center, Doctors Hospital Of Laredo,
Lakeway Regional Medical Ctr Llc, St Davids
S Austin Medical Center
Clinic Affiliation: Hc Orthopaedics PA
Practice Information: No Patients Over 17
yrs old
Board Certified Specialties: Orthopedic
Surgery
Gender: Male
NPI: 1780896241
3755 S Capital of Texas
Hwy Ste 160
(512) 439-1005
NPI: 1780896241
4700 Seton Center Pkwy
Ste 200
(512) 439-1000
NPI: 1780896241
911 W 38th St
Ste 300
(512) 439-1002
Hospital Affiliation: Cedar Park Regional
Medical Ctr, North Austin Medical Center,
Seton Medical Center, Seton Northwest
Hospital, St Davids Medical Center, St
Davids S Austin Medical Center, Texas
Orthopedics Surgery Center, University Med
Ctr Brackenridge
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: Orthopedic
Surgery
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Aus tin
NPI: 1639160476
6611 Riverplace Blvd
Ste 100
(512) 401-8400
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Dell Childrens Med Ctr Cent Tx,
Seton Medical Center, Seton Northwest
Hospital, Seton Southwest, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Greater Austin
Orthopaedics
Board Certified Specialties: Orthopedic
Surgery
Padalecki, Jeffrey R, MD
Gender: Male
NPI: 1821290446
1301 W 38th St Ste 102
(512) 282-8967
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
" Parker, William B, MD
Aus tin
Gender: Male
NPI: 1255361655
1301 W 38th St
Ste 102
(512) 454-4561
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Austin Regional Clinic PA
Practice Information: No Neck or Back
surgery
Board Certified Specialties: Orthopedic
Surgery
" Savage, David C, MD
Austin
Gender: Male
NPI: 1346259199
3755 S Capital of Texas
Hwy
(512) 439-1105
Hospital Affiliation: Seton Medical Center,
St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: Orthopedic
Surgery
" Race, Clark, MD
Austin
Gender: Male
NPI: 1366451130
3755 S Capital of Texas
Hwy Ste 160
J(512) 439-1002
NPI: 1366451130
911 W 38th St
Ste 300
J(512) 439-1002
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Healthsouth Rehabilitation Hospital
Of Austin, Seton Medical Center, Seton
Northwest Hospital, South Austin Surgery
Center, St Davids S Austin Medical Center,
Texas Orthopedic Hospital, University Med
Ctr Brackenridge
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: Orthopedic
Surgery
" Oronoz Jr, Joaquin F, MD
" McDonald Jr, John E, MD
NPI: 1639160476
5625 Eiger Rd Ste 175
(512) 401-8400
NPI: 1922000504
3001 Bee Caves Rd
Ste 220
J(512) 795-8812
Hospital Affiliation: Arise Austin Medical
Center, Seton Medical Center, St Davids
Medical Center, The Hosp At Westlake Med
Ctr, University Med Ctr Brackenridge
Clinic Affiliation: Austin Bone & Joint Clinic
Board Certified Specialties: Orthopedic
Surgery
Aus tin
Austin
NPI: 1710979547
3001 Bee Caves Rd Ste 220
J(512) 795-8812
Hospital Affiliation: Arise Austin Medical
Center, North Austin Medical Center, Seton
Medical Center, St Davids Medical Center,
The Hosp At Westlake Med Ctr, University
Med Ctr Brackenridge
Clinic Affiliation: Austin Bone & Joint Clinic
Board Certified Specialties: Orthopedic
Surgery
Gender: Male
NPI: 1922000504
1015 E 32nd St
Ste 101
J(512) 477-6341
Gender: Male
NPI: 1841297843
6818 Austin Center Blvd
Ste 200
J(512) 795-2225
Hospital Affiliation: Northwest Hills Surgical
Hospital, Seton Medical Center, Seton
Northwest Hospital, Seton Southwest, St
Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Central Texas Spine
Institute LLP
Board Certified Specialties: Orthopedic
Surgery
NPI: 1194737320
5625 Eiger Rd Ste 175
(512) 401-8400
Gender: Male
NPI: 1639160476
4310 James Casey St
Ste 3C
(512) 326-2800
" Pearce, Stephen M, MD
NPI: 1790909281
6911 N FM 620 Ste C200
J(512) 478-8116
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
Strictly Pediatrics Surg Ctr, University Med
Ctr Brackenridge
Clinic Affiliation: Central Texas Pediatric
Orthopedic and Scoliosi
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Orthopedic
Surgery
Austin
" Rose, Stephen D, MD
Austin
Gender: Male
NPI: 1710979547
1015 E 32nd St
Ste 101
J(512) 477-6341
Austin
NPI: 1790909281
6836 Bee Cave Rd
Ste 112
J(512) 478-8116
Manuel, Jacob B, MD
Gender: Male
NPI: 1063628964
900 W 38th St Ste 300
(512) 450-1300
Hospital Affiliation: St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Sports Medicine
Board Certified Specialties: None
Gender: Male
NPI: 1194737320
4310 James Casey St
Ste 3C
(512) 326-2800
Austin
Gender: Male
NPI: 1821268798
7900 FM 1826 Bldg II
Ste 100
J(512) 301-9922
Hospital Affiliation: Seton Medical Center,
Seton Southwest, South Austin Surgery
Center, Stonegate Surgery Center Lp
Board Certified Specialties: Orthopedic
Surgery
" Schoch III, Eugene P, MD
Austin
Gender: Male
NPI: 1023011889
3001 Bee Caves Rd
Ste 220
(512) 795-8812
Hospital Affiliation: Arise Austin Medical
Center, Bailey Square Surgery Center, Hill
Country Memorial Surgery Ctr, Seton
Medical Center, St Davids Medical Center, St
Davids S Austin Medical Center, St Marks
Medical Center, Surgicare Of South Austin
Clinic Affiliation: Austin Bone & Joint Clinic
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Orthopedic
Surgery
" Schoen Jr, Robert W, MD
Austin
Gender: Male
NPI: 1447253935
911 W 38th St
Ste 300
(512) 439-1002
Hospital Affiliation: Arise Austin Medical
Center, Cedar Park Regional Medical Ctr,
Cornerstone Hosp Of Austin, Healthsouth
Rehabilitation Hospital Of Austin, Seton
Highland Lakes, Seton Medical Center,
Seton Medical Ctr Williamson, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: Orthopedic
Surgery
" Roden, William C, MD
Austin
Gender: Male
NPI: 1851301972
4316 James Casey St
Bldg F Ste 100
J(512) 707-8544
Hospital Affiliation: Arise Austin Medical
Center, St Davids Medical Center, St Davids
S Austin Medical Center
Clinic Affiliation: Hc Orthopaedics PA
Board Certified Specialties: Orthopedic
Surgery
" Rose, Harris S, MD
Austin
Gender: Male
NPI: 1558304196
12201 Renfert Way
Ste 115
(512) 551-0375
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
University Med Ctr Brackenridge
Clinic Affiliation: Harris S Rose MD PLLC
Board Certified Specialties: Orthopedic
Surgery
" Schram, Richard A, MD
Austin
Gender: Male
NPI: 1548274913
7900 FM 1826
Ste 100 Bldg 2
J(512) 301-9922
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Northwest Hills Surgical
Hospital, Seton Medical Center, Seton
Southwest, Stonegate Surgery Center Lp,
The Hosp At Westlake Med Ctr
Clinic Affiliation: Cypress Creek
Orthopedics
Board Certified Specialties: Orthopedic
Surgery
J - Wheelchair Access
115
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Smith, Todd B, MD
" Taylor, William P, MD
Austin
AUSTIN Cont
ORTHOPEDIC SURGERY Cont
" Schultz, William R, MD
Aus tin
Gender: Male
NPI: 1598768079
3755 S Capital of Texas
Hwy Ste 160
(512) 439-1005
NPI: 1174599732
5625 Eiger Rd Ste 175
J(512) 401-8400
NPI: 1174599732
6611 Riverplace Blvd
Ste 100
J(512) 326-2800
Hospital Affiliation: Arise Austin Medical
Center, Cedar Park Regional Medical Ctr,
Seton Medical Center, Seton Southwest, St
Davids Medical Center, St Davids S Austin
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Greater Austin
Orthopaedics
Board Certified Specialties: Orthopedic
Surgery
NPI: 1598768079
4700 Seton Center Pkwy
Ste 200
(512) 439-1000
NPI: 1598768079
911 W 38th St
Ste 300
(512) 439-1002
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: Orthopedic
Surgery
" Seaquist, Jack L, MD
Aus tin
Gender: Male
NPI: 1699705145
1301 W 38th St
Ste 102
(512) 454-4561
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: Orthopedic
Surgery
" Smith, James L, MD
" Smith, Scott A, MD
Aus tin
Gender: Male
NPI: 1972507853
4700 Seton Center Pkwy
Ste 200
J(512) 439-1000
Hospital Affiliation: Arise Austin Medical
Center, Cedar Park Regional Medical Ctr,
Dell Childrens Med Ctr Cent Tx, North Austin
Medical Center, Round Rock Medical Center,
Seton Medical Center, St Davids Medical
Center, Texas Orthopedic Hospital, The
Hosp At Westlake Med Ctr, University Med
Ctr Brackenridge
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: Orthopedic
Surgery
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
NPI: 1477555423
4700 Seton Center Pkwy
Ste 200
J(512) 439-1000
Hospital Affiliation: Arise Austin Medical
Center, Cornerstone Hosp Of Austin, Dell
Childrens Med Ctr Cent Tx, North Austin
Medical Center, Seton Medical Center, Seton
Northwest Hospital, Seton Southwest, St
Davids Medical Center, The Hosp At
Westlake Med Ctr, University Med Ctr
Brackenridge
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: Orthopedic
Surgery
Austin
NPI: 1316050990
4029 S Capital of
Texas Hwy Ste 111
(512) 345-5925
Hospital Affiliation: Central Park Surgery
Center, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Medical Ctr Williamson, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Seton Brain and Spine
Institute
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Orthopedic
Surgery
Gender: Male
NPI: 1356455604
3301 Steck Ave
Ste 103
J(512) 708-8834
Hospital Affiliation: Northwest Hills Surgical
Hospital, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Teddie D Spears MD
Board Certified Specialties: Orthopedic
Surgery
Austin
NPI: 1326029497
7200 N Mopac Expwy
Ste 370
J(512) 346-4933
Hospital Affiliation: Arise Austin Medical
Center, Scott And White Memorial Hospital,
Seton Medical Center
Clinic Affiliation: All Star Orthopedics of
Austin, Wellness Med Clinics LLC
Board Certified Specialties: Orthopedic
Surgery
" Tibbetts, Ryan M, MD
Austin
Gender: Male
NPI: 1013953900
7900 FM 1826
Health Plaza E Ste 201
J(512) 504-0076
Hospital Affiliation: Methodist Ambulatory
Surg Hosp Nw, Seton Medical Center, St
Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Seton Family of Doctors
Board Certified Specialties: Orthopedic
Surgery
" Spears, Teddie D, MD
Aus tin
Gender: Male
NPI: 1245232172
6818 Austin Center Blvd
Ste 200
J(512) 795-2225
Hospital Affiliation: North Austin Medical
Center, Northwest Hills Surgical Hospital,
Seton Medical Center, St Davids Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: Central Texas Spine
Institute LLP
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Orthopedic
Surgery
#
Austin
#
NPI: 1366440828
911 W 38th St
Ste 300
(512) 439-1002
Hospital Affiliation: North Austin Medical
Center, Northwest Hills Surgical Hospital,
Seton Medical Center, St Davids Medical
Center
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: Orthopedic
Surgery
Gender: Male
NPI: 1326029497
5510 S IH 35
Ste 250A
(512) 301-1166
Gender: Male
NPI: 1477555423
3755 S Capital of Texas
Hwy Ste 160
J(512) 439-1005
#
Gender: Male
NPI: 1316050990
3724 Executive Center
Dr Ste G10
(512) 345-5925
" Thomas, Darryl B, MD
" Smoot, John B, MD
" Seade, Louis E, MD
" Tran, Viet N, MD
Austin
Gender: Male
NPI: 1366440828
4700 Seton Center Pkwy
Ste 200
(512) 439-1000
Austin
Austin
Aus tin
Gender: Male
NPI: 1871596361
4611 Guadalupe St
Ste 200
J(512) 476-2830
Hospital Affiliation: Central Park Surgery
Center, Hyde Park Surgery Center Lp,
Northwest Hills Surgical Hospital, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, The Hosp At
Westlake Med Ctr, University Med Ctr
Brackenridge
Clinic Affiliation: Heinrich-Josey
Orthpaedics PA
Board Certified Specialties: Orthopedic
Surgery
Austin
Gender: Male
NPI: 1174599732
4310 James Casey Ste 3C
J(512) 326-2800
" Tsourmas, Nicholas F, MD
Austin
Gender: Male
NPI: 1336130665
2500 W Wm Cannon Dr
Ste 401
J(512) 451-1969
Hospital Affiliation: Arise Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, Seton Smithville Reg
Hospital, St Davids Medical Center, The
Hosp At Westlake Med Ctr, University Med
Ctr Brackenridge
Clinic Affiliation: Southwest Orthopaedic
Group
Board Certified Specialties: Orthopedic
Surgery
" Tipton Jr, George W, MD
Austin
Stockton, Kristopher G, MD
Gender: Male
NPI: 1245430289
901 W 38th St Ste 301
J(512) 225-6335
Hospital Affiliation: Medical City Dallas
Hospital
Clinic Affiliation: Mark Ray Dalton MD
Board Certified Specialties: None
" Sullivan, Brian L, MD
Austin
Gender: Male
NPI: 1053395079
2500 W Wm Cannon Dr
Ste 401
J(512) 451-1969
Hospital Affiliation: Arise Austin Medical
Center, Dell Childrens Med Ctr Cent Tx,
Seton Medical Center, Seton Medical Center
Hays, Seton Northwest Hospital, Seton
Smithville Reg Hospital, Seton Southwest, St
Davids Medical Center, The Hosp At
Westlake Med Ctr, University Med Ctr
Brackenridge
Clinic Affiliation: Southwest Orthopaedic
Group
Board Certified Specialties: Orthopedic
Surgery
Gender: Male
NPI: 1508970096
3724 Executive Center
Dr Ste G10
(512) 345-5925
NPI: 1508970096
4029 S Capital of Texas
Hwy Ste 111
(512) 345-5925
Hospital Affiliation: Central Park Surgery
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital
Clinic Affiliation: Seton Brain and Spine
Institute
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: Orthopedic
Surgery
Truumees, Eeric, MD
Gender: Male
NPI: 1356322630
1600 W 38th St
Ste 200
(512) 324-3560
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Medical Center Hays, Seton Medical Ctr
Williamson, Seton Northwest Hospital, St
Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Seton Brain and Spine
Institute
Board Certified Specialties: None
" Vagner, Gregg A, MD
Austin
Gender: Male
NPI: 1295705986
4611 Guadalupe St
Ste 200
J(512) 476-2830
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Central Park Surgery Center,
Hyde Park Surgery Center Lp, St Davids
Medical Center, St Davids S Austin Medical
Center, The Hosp At Westlake Med Ctr
Clinic Affiliation: Heinrich-Josey
Orthpaedics PA
Board Certified Specialties: Orthopedic
Surgery
" Von Rueden, Kurt W, MD
Austin
Gender: Male
NPI: 1114975893
100 Medical Pkwy
(512) 347-7463
NPI: 1114975893
1015 E 32nd St
(512) 474-1114
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Kurt Von Rueden MD,
Neuro Texas PLLC
Board Certified Specialties: Orthopedic
Surgery
J - Wheelchair Access
116
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Bittar, Anthony R, MD
" Fulmer, Robert P, MD
Aus tin
AUSTIN Cont
ORTHOPEDIC SURGERY Cont
" Welsh, Scott A, MD
Austin
Gender: Male
NPI: 1043217276
7900 FM 1826
Ste 120
J(512) 322-9163
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Southwest
Clinic Affiliation: Scott Andrew Welsh MD
Board Certified Specialties: Orthopedic
Surgery
Gender: Male
NPI: 1942245196
2765 Bee Caves Rd
Ste 205
J(512) 328-7722
Hospital Affiliation: St Davids Medical
Center
Clinic Affiliation: Ear Nose and Throat
Center of Aus
Board Certified Specialties:
Otolaryngology
Gender: Male
NPI: 1023024395
11762 Jolleyville Rd
J(512) 258-2300
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Northwest Hills Surgical Hospital,
Northwest Surgery Center Llp, Seton
Medical Center, Seton Northwest Hospital,
Strictly Pediatrics Surg Ctr, University Med
Ctr Brackenridge
Clinic Affiliation: Great Hills ENT
Board Certified Specialties:
Otolaryngology, Sleep Medicine
!
Gender: Female
NPI: 1235355637
12309 N Mopac Expwy
Ste 100
(512) 339-4040
OTOLARYNGOLOGY
" Austin, John R, MD
Austin
Gender: Male
NPI: 1740251057
3705 Medical Pkwy Ste 310
J(512) 458-6391
Hospital Affiliation: Bailey Square Surgery
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin ENT Assoc
Board Certified Specialties:
Otolaryngology
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Kriesel, Kevin J, MD
Gender: Male
NPI: 1720093883
6811 Austin Center Blvd
Ste 300
J(512) 346-8888
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
" Sawyer, Drew S, MD
Austin
Gender: Male
NPI: 1679629349
1305 W 34th St
Ste 408
(512) 593-5200
Hospital Affiliation: Bailey Square Surgery
Center, Dell Childrens Med Ctr Cent Tx,
Mem Hermann Northwest Hosp, Northwest
Hills Surgical Hospital, Seton Medical
Center, Seton Northwest Hospital, St Davids
Medical Center, St Joseph Medical Center,
Strictly Pediatrics Surg Ctr, University Med
Ctr Brackenridge
Clinic Affiliation: Drew S Sawyer MD PLLC
Board Certified Specialties:
Otolaryngology
" Leary, Joseph M, MD
Austin
Gender: Male
NPI: 1730195082
6811 Austin Center Blvd
Ste 300
J(512) 346-8888
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties:
Otolaryngology
NPI: 1235355637
200 Medical Pkwy
Ste 380
(512) 682-4798
Clinic Affiliation: Capital Otolaryngology
Head & Neck Surgeons PA
Board Certified Specialties:
Otolaryngology
Gender: Male
NPI: 1760539647
100 Medical Pkwy
(512) 347-7463
NPI: 1760539647
6818 Austin Center
Blvd Ste 200
J(512) 745-2225
Hospital Affiliation: Northwest Hills Surgical
Hospital, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, The Hosp At Westlake Med Ctr
Clinic Affiliation: Central Texas Spine
Institute LLP, Kurt Von Rueden MD
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Orthopedic
Surgery, Surgery Of The Spine
Austin
" Cheung-Phillips, Esther J, MD
" Wupperman, Richard M, MD
Gender: Male
NPI: 1861585499
3705 Medical Pkwy
Ste 200
(512) 324-2720
Hospital Affiliation: Bailey Square Surgery
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Seton ENT
Practice Information: No Patients Over 14
yrs old
Board Certified Specialties:
Otolaryngology
Gender: Male
NPI: 1124034491
6811 Austin Center Blvd
Ste 300
J(512) 346-8888
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties:
Otolaryngology
Aus tin
Austin
" Sawyer, Drew G, MD
Austin
" Jones, Kent P, MD
" Brown, Mark T, MD
" Windler, Edwin C, MD
Gender: Male
NPI: 1477640357
3705 Medical Pkwy
Ste 310
J(512) 380-4050
Hospital Affiliation: Bailey Square Surgery
Center, Central Park Surgery Center, Dell
Childrens Med Ctr Cent Tx, Oakwood
Surgery Center, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin ENT Assoc
Board Certified Specialties:
Otolaryngology
Austin
Aus tin
Austin
Gender: Male
NPI: 1619947587
900 W 38th St
Ste 300
J(512) 450-1300
Hospital Affiliation: Central Park Surgery
Center, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Sports Medicine
Board Certified Specialties: Orthopedic
Surgery
NPI: 1447223003
5929 Balcones Dr
Ste 102
(512) 550-1800
Hospital Affiliation: East Texas Medical
Center, Mother Frances Hospital, The Hosp
At Westlake Med Ctr
Clinic Affiliation: R Paul Fulmer MD, Sinus
& Allergy Specialists of TX
Board Certified Specialties:
Otolaryngology
" Briggs, Russell D, MD
" Westmoreland, Greg L, MD
" Ratcliff, Daniel J, MD
Austin
Gender: Male
NPI: 1447223003
3500 Jefferson St
Ste 200
(512) 656-1196
Aus tin
Austin
Gender: Male
NPI: 1790794592
3755 S Capital of Texas
Hwy Ste 160
(512) 439-1005
Hospital Affiliation: Arise Austin Medical
Center, Dell Childrens Med Ctr Cent Tx,
Seton Medical Center, Seton Southwest,
South Austin Surgery Center, St Davids S
Austin Medical Center, Surgicare Of South
Austin, University Med Ctr Brackenridge
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: Orthopedic
Surgery
Austin
Gender: Male
NPI: 1760411292
4101 James Casey St
Ste 310
J(512) 448-4422
Hospital Affiliation: Seton Southwest, St
Davids Medical Center, St Davids S Austin
Medical Center, Surgicare Of South Austin,
University Med Ctr Brackenridge
Clinic Affiliation: Anthony R Bittar MD
Board Certified Specialties:
Otolaryngology
" Scholl, Peter D, MD
Austin
Gender: Male
NPI: 1720059504
3705 Medical Pkwy
Ste 310
J(512) 458-6391
Hospital Affiliation: Round Rock Medical
Center, Seton Medical Center, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin ENT Assoc
Board Certified Specialties:
Otolaryngology
" Leeman, Daniel J, MD
Austin
" Chu, Laurence, MD
Gender: Male
NPI: 1508849696
1015 E 32nd St Ste 205
J(512) 478-2273
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Comprehensive ENT
Center of Texas PA
Board Certified Specialties:
Otolaryngology
Aus tin
Gender: Male
NPI: 1902854680
1015 E 32nd St Ste 316
(512) 320-9915
Hospital Affiliation: North Austin Medical
Center, St Davids Medical Center
Clinic Affiliation: Laurence Chu MD
Board Certified Specialties:
Otolaryngology
" Dhruva, Achal R, MD
Aus tin
Gender: Male
NPI: 1154336212
6811 Austin Center Blvd
Ste 300
(512) 346-8888
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties:
Otolaryngology
" Sebastian, Jeremy S, MD
Austin
Gender: Male
NPI: 1235309246
3816 S First St
(512) 443-1311
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties:
Otolaryngology
" Nason, Robert, MD
Austin
Gender: Male
NPI: 1538370309
720 W 34th St
Ste 110
(512) 346-7600
Clinic Affiliation: Steven T Fyfe MD
Board Certified Specialties:
Otolaryngology
" Slater II, Patrick W, MD
Austin
Gender: Male
NPI: 1467440180
12319 N Mopac Expwy
Bldg C Ste 300
J(512) 454-0341
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Joseph Regional Health Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Ear Clinic
Board Certified Specialties:
Otolaryngology
J - Wheelchair Access
117
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Young, Lindsay E, MD
Austin
AUSTIN Cont
OTOLARYNGOLOGY Cont
" Slaughter, Daniel P, MD
Aus tin
Gender: Male
NPI: 1477527778
12309 N Mopac Expwy
Ste 100
J(512) 339-4040
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, St
Davids Medical Center, The Hosp At
Westlake Med Ctr
Clinic Affiliation: Capital Otolaryngology
Head & Neck Surgeons PA
Board Certified Specialties:
Otolaryngology
" Zapalac, Jeffrey S, MD
Austin
Gender: Male
NPI: 1013988336
3705 Medical Pkwy
Ste 310
J(512) 458-6391
Hospital Affiliation: Central Park Surgery
Center, Dell Childrens Med Ctr Cent Tx,
North Austin Medical Center, Round Rock
Medical Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Austin ENT Assoc
Board Certified Specialties:
Otolaryngology
" Stewart, Kendal L, MD
Aus tin
Gender: Male
NPI: 1225115876
300 Beardsley Ln
Ste D101
J(512) 338-9840
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: United Otolaryngology
Assoc
Board Certified Specialties:
Otolaryngology
Austin
" Taylor Jr, Wallace E, MD
Gender: Male
NPI: 1831173707
300 Beardsley Ln
Ste D 101
J(512) 338-9840
Clinic Affiliation: United Otolaryngology
Assoc
Board Certified Specialties:
Otolaryngology
" Thompson, Christopher P, MD
Aus tin
" Wassmuth, Zachary D, MD
Aus tin
Gender: Male
NPI: 1972577534
12309 N Mopac Expwy
Ste 100
J(512) 339-4040
Hospital Affiliation: North Austin Medical
Center, Texan Surgery Center
Clinic Affiliation: Capital Otolaryngology
Head & Neck Surgeons PA
Board Certified Specialties:
Otolaryngology
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Austin
Slater II, Patrick W, MD
Gender: Male
NPI: 1467440180
12319 N Mopac Expwy
Bldg C Ste 300
J(512) 454-0341
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Joseph Regional Health Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Ear Clinic
Board Certified Specialties:
Otolaryngology
Austin
Austin
Austin
Blauzvern, Neal H, DO
Gender: Male
NPI: 1609873603
6818 Austin Center Blvd
Ste 200
J(512) 795-2225
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Hill Country Surgery Ctr, North
Austin Medical Center, Northwest Hills
Surgical Hospital, Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: Central Texas Spine
Institute LLP
Practice Information: Limited to Pain
Management
Board Certified Specialties: None
Carpentier, Bradley W, MD
Gender: Male
NPI: 1568577211
6818 Austin Center Blvd
Ste 205
J(512) 244-4272
Clinic Affiliation: Mark T Malone MD
Board Certified Specialties: None
Carter, Russell H, MD
Gender: Male
NPI: 1609842012
4534 Westgate Blvd
Ste 112
J(512) 334-2144
Hospital Affiliation: Texas Neurorehab
Center
Board Certified Specialties: Physical
Medicine & Rehabilitation
Austin
Austin
Austin
" Desai, Anjuli, MD
Austin
Gender: Female
NPI: 1760648372
3508 Far West Blvd
Ste 150
(512) 467-7246
Hospital Affiliation: Northwest Hills Surgical
Hospital
Clinic Affiliation: Capitol Pain Institute PA
Board Certified Specialties: Pain
Management
PAIN MANAGEMENT
NPI: 1548234842
2500 W William Cannon
Dr Ste 803
(512) 550-1800
NPI: 1548234842
7900 FM 1826
Ste 260 Bldg 1
(512) 550-1800
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Scott &
White Hospital Taylor, Seton Medical Center,
Seton Medical Center Hays, St Davids
Medical Center, Texan Surgery Center, The
Hosp At Westlake Med Ctr
Clinic Affiliation: Capital Otolaryngology
Head & Neck Surgeons PA, Sinus & Allergy
Specialists of TX
Board Certified Specialties:
Otolaryngology
Austin
OTOLOGY/NEUROTOLOGY
Aus tin
Gender: Male
NPI: 1548234842
12309 N Mopac Expwy
Ste 100
J(512) 339-4040
Austin
Gender: Female
NPI: 1538368618
11762 Jollyville Rd
J(512) 258-2300
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Northwest Hospital, University Med Ctr
Brackenridge
Clinic Affiliation: Great Hills ENT
Board Certified Specialties:
Otolaryngology
Aijaz, Asim S, MD
Gender: Male
NPI: 1164641494
2200 Park Bend Dr
Ste 201 Bldg 1
(512) 416-7246
Hospital Affiliation: North Austin Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: Austin Pain Assoc
Board Certified Specialties: None
Austin
Amasha, Raimy, MD
Gender: Male
NPI: 1760643498
3508 Far West Blvd
Ste 150
J(512) 467-7246
Hospital Affiliation: Northwest Hills Surgical
Hospital
Clinic Affiliation: Capitol Pain Institute PA
Board Certified Specialties: None
Anderson, Christine M, MD
Gender: Female
NPI: 1265575260
2200 Park Bend Dr
Bldg 1 Ste 201
J(512) 416-7246
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Medical Ctr Williamson, Seton
Northwest Hospital, Seton Southwest, St
Davids S Austin Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Austin Pain Assoc
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Austin
Austin
Dubois, Craig R, MD
Gender: Male
NPI: 1972662732
7307 Creekbluff Dr
(512) 614-3300
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital
Clinic Affiliation: David Keith Harris MD
PLLC
Board Certified Specialties: None
Ezekiel, Bennett J, MD
Gender: Male
NPI: 1477734721
2200 Park Bend Dr
Ste 201 Bldg 1
(512) 416-7246
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Ctr
Williamson, Seton Northwest Hospital, Seton
Southwest, St Davids Georgetown Hospital,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Pain Assoc
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Feferman, Kery L, MD
Gender: Female
NPI: 1811172620
2200 Park Bend Dr
Ste 201 Bldg 1
(512) 416-7246
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, St
Davids S Austin Medical Center
Clinic Affiliation: Austin Pain Assoc
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Frank, Brannon R, MD
Gender: Male
NPI: 1568465763
2501 W William
Cannon Dr Ste 401
J(512) 416-7246
Hospital Affiliation: Arise Austin Medical
Center, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Medical Center Hays, Seton
Northwest Hospital, Seton Southwest, St
Davids Medical Center, St Davids S Austin
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Pain Assoc
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Frederick, Daniel A, MD
Gender: Male
NPI: 1801973581
4316 James Casey St
Bldg F Ste 100
(830) 498-1029
Hospital Affiliation: Christus Santa Rosa
New Braunfels, North Austin Medical Center,
Round Rock Medical Center, Seton Medical
Center, Seton Northwest Hospital, Seton
Southwest, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Eric J Miller MD
Board Certified Specialties: None
Haro, J Lowell, MD
Gender: Male
NPI: 1992708820
101 W Koenig Ln Ste 100
J(512) 454-9426
NPI: 1992708820
15808 FM 620 N
J(512) 454-9426
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Pain Management
Consultants PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
Austin
#
Austin
Higginbotham, Jeffrey N, MD
Gender: Male
NPI: 1316169170
101 W Koenig Ln
Ste 100
J(512) 454-9426
NPI: 1316169170
15808 FM 620 N
Ste 215
J(512) 454-9426
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center
Clinic Affiliation: Pain Management
Consultants PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Joshi, Anand, MD
Gender: Male
NPI: 1992716237
2315 W Ben White Blvd
J(512) 326-5440
Hospital Affiliation: Central Texas Medical
Center, Mother Frances Hospital, Seton
Medical Center, Seton Southwest, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Spine Diagnostic and
Treatment Center
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Physical
Medicine & Rehabilitation
J - Wheelchair Access
118
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Malone, Mark T, MD
Gender: Male
NPI: 1659399871
# 6000 S Mo Pac Expwy
J(512) 244-4272
Aus tin
AUSTIN Cont
PAIN MANAGEMENT Cont
Austin
Austin
Austin
Austin
Austin
Kaplan, Matthew A, DO
Gender: Male
NPI: 1558423038
12319 N Mopac Expwy
Ste 350
(512) 255-7246
Hospital Affiliation: Round Rock Medical
Center
Clinic Affiliation: Preferred Spine and Pain
PLLC
Board Certified Specialties: None
Khan, Adnan A, MD
Gender: Male
NPI: 1083861249
6611 River Place Blvd
Ste 300
J(512) 416-7246
Hospital Affiliation: Conroe Regional
Medical Center, Mem Hermann The
Woodlands Hosp, St Lukes The Woodlands
Hospital
Clinic Affiliation: Austin Pain Assoc
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Le, Paul H, MD
Gender: Male
NPI: 1770766313
711 W 38th St
Ste F3
J(512) 416-7246
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Austin Pain Assoc
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Lowry, Angus M, MD
Gender: Male
NPI: 1073773727
4544 S Lamar Blvd
Ste 700
J(512) 834-4141
Hospital Affiliation: Arise Austin Medical
Center, Seton Medical Center, St Davids
Medical Center, St Davids S Austin Medical
Center, The Hosp At Westlake Med Ctr
Clinic Affiliation: Balcones Pain
Consultants
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
NPI: 1659399871
6818 Austin Center Blvd
Ste 205
J(512) 244-4272
Hospital Affiliation: Arise Austin Medical
Center, Northwest Hills Surgical Hospital,
Seton Medical Center, St Davids Medical
Center
Clinic Affiliation: Mark T Malone MD
Board Certified Specialties: None
Aus tin
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Austin
Manees, Christopher R, MD
Gender: Male
NPI: 1528276771
2500 W William Cannon Dr
Ste 201
J(512) 485-7200
NPI: 1528276771
4100 Duval Rd Bldg 3
Ste 200
J(512) 485-7200
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Medical Center Hays, Seton Medical Ctr
Williamson, Seton Northwest Hospital, Seton
Southwest, St Davids Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Central Texas Pain
Institute PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Aus tin
Aus tin
Mahendru, Vivek, MD
Gender: Male
NPI: 1316989023
2500 W William Cannon Dr
Ste 206
J(512) 485-7200
NPI: 1316989023
4100 Duval Rd Bldg 3
Ste 200
J(512) 485-7200
Hospital Affiliation: Arise Austin Medical
Center, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, St Davids
Georgetown Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Central Texas Pain
Institute PA
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Austin
Aus tin
Marks, Robert S, MD
Gender: Male
NPI: 1447450796
11615 Angus Rd
Ste 107
(512) 981-7246
Clinic Affiliation: Robert Marks MD PLLC
Board Certified Specialties: None
Austin
Ostadian, Mahan, DO
Gender: Male
NPI: 1821263005
9707 Anderson Mill Rd
Ste 230
(512) 219-8787
Hospital Affiliation: Cedar Park Regional
Medical Ctr, North Austin Medical Center,
Scott And White Memorial Hospital, Seton
Medical Center, St Davids Medical Center
Clinic Affiliation: Republic Spine and Pain
PA
Board Certified Specialties: None
Ozuna, Eduardo, MD
Gender: Male
NPI: 1003007469
4544 S Lamar Blvd
Ste 700
(512) 834-4141
Hospital Affiliation: Lakeway Regional
Medical Ctr Llc, North Austin Medical Center,
Round Rock Medical Center, St Davids S
Austin Medical Center, The Hosp At
Westlake Med Ctr
Clinic Affiliation: Balcones Pain
Consultants
Board Certified Specialties: None
Parthasarathy, Srinivason R, MD
Gender: Female
NPI: 1639122963
1215 Red River St
Ste 427
J(512) 324-7000
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center Hays, Seton
Medical Ctr Williamson, Seton Northwest
Hospital, Seton Southwest, University Med
Ctr Brackenridge
Clinic Affiliation: Seton Brain and Spine
Institute
Board Certified Specialties: None
Austin
NPI: 1902075922
4413 Spicewood Springs
Rd Ste 200
(512) 692-4915
Hospital Affiliation: North Austin Medical
Center, Seton Medical Center Hays, Seton
Northwest Hospital, Seton Southwest, St
Davids S Austin Medical Center
Clinic Affiliation: Austin Pain Assoc
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Austin
" Wages, John W, MD
Austin
Gender: Male
NPI: 1013139286
2501 W William
Cannon Dr Ste 401
(512) 416-7246
Hospital Affiliation: North Austin Medical
Center, Seton Medical Ctr Williamson, Seton
Northwest Hospital, St Davids Georgetown
Hospital, St Davids S Austin Medical Center
Clinic Affiliation: Austin Pain Assoc
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Pain
Management
" Queralt, Mark V, MD
McCarty, Matthew F, MD
Gender: Male
NPI: 1235132432
4544 S Lamar Blvd
Ste 700
J(512) 834-4141
Hospital Affiliation: East Texas Medical
Center, Mother Frances Hospital, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, Seton Southwest,
St Davids Medical Center, St Davids
Rehabilitation Center, St Davids S Austin
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Balcones Pain
Consultants
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Austin
Mehta, Pankaj, MD
Gender: Male
NPI: 1073787909
2500 W William Cannon Dr
Ste 206
J(512) 485-7200
NPI: 1073787909
4100 Duval Rd
Bldg 3 Ste 200
J(512) 485-7200
Clinic Affiliation: Central Texas Pain
Institute PA
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Austin
Ramchandani, Avinash N, MD
Gender: Male
NPI: 1730358532
2315 W Ben White Blvd
(512) 326-5440
Hospital Affiliation: Central Texas Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: Spine Diagnostic and
Treatment Center
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Physical
Medicine & Rehabilitation
Schocket, Sandford M, MD
Gender: Male
NPI: 1851381818
3508 Far West Blvd
Ste 150
J(512) 467-7246
Hospital Affiliation: North Austin Medical
Center, Northwest Hills Surgical Hospital,
Seton Medical Center, St Davids Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: Capitol Pain Institute PA
Board Certified Specialties: None
Vije, Christopher D, MD
Gender: Male
NPI: 1316009525
2500 W William Cannon Dr
Ste 206
(512) 485-7200
NPI: 1316009525
4100 Duval Rd Bldg 3
(512) 485-7200
Hospital Affiliation: Arise Austin Medical
Center, Seton Medical Center, St Davids
Medical Center
Clinic Affiliation: Central Texas Pain
Institute PA
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Austin
Gender: Male
NPI: 1437160934
4029 S Capital of Texas
Hwy Ste 111
(512) 345-5925
Hospital Affiliation: Central Park Surgery
Center, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Southwest, St Davids Medical Center,
St Davids S Austin Medical Center
Clinic Affiliation: Seton Brain and Spine
Institute
Practice Information: No Patients Under 13
yrs old
Board Certified Specialties: Pain
Management
Silberberg, Alan D, MD
Gender: Male
NPI: 1902075922
2501 W William Cannon
Dr Ste 401
J(512) 416-7246
White, Mark S, DO
Gender: Male
NPI: 1477557239
# 4807 Spicewood Springs
Rd Ste 1235
J(512) 795-9977
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: Integrative Pain Services
PA
Board Certified Specialties: None
Austin
Austin
Wills, Robert P, MD
Gender: Male
NPI: 1043213259
2501 W William
Cannon Dr Ste 401
J(512) 416-7246
Hospital Affiliation: Arise Austin Medical
Center, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
Seton Southwest, St Davids Medical Center,
St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Pain Assoc
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
J - Wheelchair Access
119
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Varshney, Pooja, MD
Austin
AUSTIN Cont
PAIN MANAGEMENT Cont
Aus tin
Aus tin
Yanosik, Justin E, MD
Gender: Male
NPI: 1326289406
4100 Duval Rd Bldg 3
Ste 200
(512) 485-7200
Hospital Affiliation: North Austin Medical
Center
Clinic Affiliation: Central Texas Pain
Institute PA
Board Certified Specialties: None
Yeh, Clement C, MD
Gender: Male
NPI: 1275744435
9707 Anderson Mill Rd
Ste 230
(512) 219-8787
Hospital Affiliation: Cedar Park Regional
Medical Ctr, Seton Northwest Hospital
Clinic Affiliation: Republic Spine and Pain
PA
Board Certified Specialties: None
PEDIATRIC CARDIOLOGY
Austin
NPI: 1588693717
6811 Austin Center Blvd
Ste 400
(512) 628-1850
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Mother Frances Hospital, Seton
Medical Center
Clinic Affiliation: Pediatric Surgical
Subspecialists, Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
PEDIATRIC ALLERGY & IMMUNOLOGY
Aus tin
Kayser, Jackee D, MD
Gender: Female
NPI: 1285686683
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1870
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Northwest Hospital, Seton Southwest,
University Med Ctr Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Navarro, Maritza, MD
Gender: Female
NPI: 1346212180
# 12414 Alderbrook Dr
Ste 201
J(512) 873-7468
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, St Davids Medical Center
Clinic Affiliation: Maritza Navarro MD
Board Certified Specialties:
Allergy-Immunology
Aus tin
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
" Johnson, Gregory L, MD
Austin
Gender: Male
NPI: 1437107331
1301 Barbara Jordan
Blvd Ste 304
J(512) 454-1110
NPI: 1154386753
3305 Northland Dr
Ste 512
J(512) 380-9200
NPI: 1437107331
4100 Duval Rd
Bldg 2 Ste 201
J(512) 339-1010
NPI: 1154386753
3801 N Lamar Blvd
J(512) 206-3600
NPI: 1437107331
4314 Medical Pkwy
Ste 200
J(512) 454-1110
NPI: 1437107331
6500 N Mopac Expwy
I/1205 Epxy
J(512) 206-0101
NPI: 1154386753
4314 Medical Pkwy
Ste 200
J(512) 454-1110
NPI: 1437107331
911 W 38th St
Ste 201
J(512) 459-1131
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, Seton Southwest,
St Davids S Austin Medical Center
Clinic Affiliation: Magella Medical Assoc PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Cardiology
NPI: 1154386753
6500 N Mopac Expwy
I-1205 Expwy
J(512) 206-0101
NPI: 1134474380
4314 Medical Pkwy
Ste 200
(512) 454-1110
Fasci, Siv L, MD
Gender: Female
NPI: 1588693717
6811 Austin Center
Blvd Ste 400
(512) 628-1850
Finnigan, James P, MD
Gender: Male
NPI: 1154386753
1301 Barbara Jordan
Blvd Ste 304
J(512) 454-1110
NPI: 1154386753
4100 Duval Rd
Bldg 2 Ste 201
J(512) 339-1010
Burkholder IV, Henry L, MD
Gender: Male
NPI: 1134474380
1301 Barbara Jordan Blvd
Ste 304
(512) 454-1110
NPI: 1134474380
4100 Duval Rd
Bldg 2 Ste 201
(512) 339-1010
PEDIATRIC - DEVELOPMENTAL
BEHAVIOR
Aus tin
Austin
Gender: Female
NPI: 1255507943
1301 Barbara Jordan Blvd
Ste 200
(512) 628-1870
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Allergy & Immunology
NPI: 1154386753
801 W 34th St
Ste 100
J(512) 454-1110
NPI: 1134474380
6500 N Mopac Expwy
I-1205 Expwy
(512) 206-0101
NPI: 1154386753
911 W 38th St
Ste 201
J(512) 459-1131
Hospital Affiliation: College Station Medical
Center, Round Rock Medical Center, Scott
And White Memorial Hospital, Seton Medical
Center, Seton Medical Center Hays, Seton
Northwest Hospital, Seton Southwest, St
Davids Georgetown Hospital, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Magella Medical Assoc PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
NPI: 1134474380
911 W 38th St
Ste 201
(512) 459-1131
Clinic Affiliation: Magella Medical Assoc PA
Board Certified Specialties: None
" Fenrich Jr, Arnold L, MD
Austin
Gender: Male
NPI: 1790736494
1301 Barbara Jordan
Blvd Ste 304
J(512) 454-1110
" Goldstein, Brian S, MD
Austin
NPI: 1790736494
3305 S Northland Dr
J(512) 380-9200
Gender: Male
NPI: 1588845705
1110 E 32nd St
(210) 614-3264
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Magella Medical Assoc PA
Board Certified Specialties: Pediatric
Cardiology
NPI: 1790736494
4100 Duval Rd
Bldg 2 Stee 201
J(512) 454-1110
NPI: 1790736494
6500 N Mopac Expwy
I-1205 Expwy
J(512) 454-1110
" Holt, Dudley B, MD
Austin
NPI: 1790736494
911 W 38th St
Ste 201
J(512) 459-1131
Hospital Affiliation: College Station Medical
Center, Medical City Dallas Hospital,
Methodist Hospital, Seton Medical Center,
Seton Medical Center Hays, Seton
Northwest Hospital, Seton Southwest, St
Davids Georgetown Hospital, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Magella Medical Assoc PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Cardiology
Gender: Male
NPI: 1043438450
1110 E 32nd St
(512) 320-8388
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Lakeway Regional Medical Ctr Llc,
North Austin Medical Center, Round Rock
Medical Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Georgetown
Hospital, St Davids Medical Center, St
Davids S Austin Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Magella Medical Assoc PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Cardiology
Austin
Lorch, Steven M, MD
Gender: Male
NPI: 1366649048
1301 Barbara Jordan Blvd
Ste 304
J(512) 454-1110
NPI: 1366649048
4100 Duval Rd
Bldg 2 Ste 201
J(512) 339-1010
NPI: 1366649048
4314 Medical Pkwy
Ste 200
J(512) 454-1110
NPI: 1366649048
6500 N Mopac Expwy
I 1205 Expwy
J(512) 206-0101
NPI: 1366649048
911 W 38th St
Ste 201
J(512) 459-1131
Hospital Affiliation: College Station Medical
Center, Medical City Dallas Hospital, Mem
Hermann Hospital, Mem Hermann
Southwest Hospital, Metroplex Hospital,
Seton Northwest Hospital, Seton Southwest,
St Davids Georgetown Hospital, St Davids
Medical Center, St Joseph Regional Health
Center
Clinic Affiliation: Magella Medical Assoc PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
J - Wheelchair Access
120
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Aus tin
AUSTIN Cont
PEDIATRIC CARDIOLOGY Cont
Austin
Patt, Hanoch A, MD
Gender: Male
NPI: 1730113754
1301 Barbara Jordan Blvd
Ste 304
J(512) 454-1110
NPI: 1730113754
4100 Duval Rd
Bldg 2 Ste 201
J(512) 339-1010
Gender: Male
NPI: 1922062652
1301 Barbara Jordan
Blvd Ste 304
J(512) 454-1110
NPI: 1922062652
4314 Medical Pkwy
Ste 200
J(512) 454-1110
NPI: 1922062652
6500 N Mopac Expwy
I-1205 Expwy
J(512) 203-0101
Rowe, Stuart A, MD
Gender: Male
NPI: 1811954787
# 1301 Barbara Jordan
Blvd Ste 304
J(512) 454-1110
NPI: 1811954787
4100 Duval Rd
Bldg 2 Ste 201
J(512) 339-1010
NPI: 1811954787
801 W 34th St
Ste 100
J(512) 454-1110
Aus tin
Austin
Austin
Shapiro, Ronald B, MD
Gender: Male
NPI: 1861533259
1110 E 32nd St
(512) 320-8388
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Magella Medical Assoc PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Gender: Male
NPI: 1306857784
1301 Barbara Jordan
Blvd Ste 304
(512) 454-1110
NPI: 1306857784
4100 Duval Rd
Bldg 2 Ste 201
(512) 339-1010
NPI: 1306857784
4314 Medical Pkwy
Ste 200
(512) 454-1110
Levy, Moise L, MD
Gender: Male
NPI: 1013097419
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1920
Hospital Affiliation: Chi St Lukes Hlth
Baylor Coll Med, Dell Childrens Med Ctr Cent
Tx, Houston Methodist Hospital, Texas
Childrens Hospital, The Womans Hospital Of
Texas
Clinic Affiliation: Specially For Children
Board Certified Specialties: Dermatology
PEDIATRIC ENDOCRINOLOGY
" Goldsmith, Bonnie G, MD
Austin
Gender: Female
NPI: 1952560062
1301 Barbara Jordan Blvd
Ste 200
(512) 628-1830
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Texas Childrens Hospital
Clinic Affiliation: Specially For Children
Board Certified Specialties: Pediatric
Endocrinology
NPI: 1306857784
6500 N Mopac Expwy
I-1205 Expwy
(512) 206-0101
NPI: 1306857784
911 W 38th St
Ste 201
(512) 459-1131
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Detar Hospital Navarro, Driscoll
ChildrensHospital', Seton Medical Center,
Seton Medical Center Hays, Seton Medical
Ctr Williamson, Seton Northwest Hospital,
Seton Southwest
Clinic Affiliation: Magella Medical Assoc PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Cardiology
Wong, Frank, MD
Gender: Male
NPI: 1831230127
1110 E 32nd St
(512) 320-8388
Hospital Affiliation: Seton Medical Center,
Seton Northwest Hospital, Seton Southwest,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Magella Medical Assoc PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
PEDIATRIC DERMATOLOGY
" Stern, Herbert J, MD
NPI: 1811954787
911 W 38th St
Ste 201
J(512) 459-1131
Hospital Affiliation: North Austin Medical
Center, Scott And White Memorial Hospital,
Seton Medical Center
Clinic Affiliation: Magella Medical Assoc PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
NPI: 1326234345
4314 Medical Pkwy
Ste 200
J(512) 454-1110
Hospital Affiliation: College Station Medical
Center, Seton Medical Center, St Joseph
Regional Health Center
Clinic Affiliation: Magella Medical Assoc PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Cardiology, Pediatrics
Austin
NPI: 1922062652
911 W 38th St
Ste 201
J(512) 459-1131
Hospital Affiliation: College Station Medical
Center, Metroplex Hospital, Providence
Memorial Hospital, Scott And White
Memorial Hospital, Seton Medical Center,
Seton Medical Center Hays, Seton
Northwest Hospital, Seton Southwest, St
Davids Medical Center, St Joseph Regional
Health Center
Clinic Affiliation: Magella Medical Assoc PA
Board Certified Specialties: Pediatric
Cardiology
NPI: 1811954787
3305 Northland Dr
Ste 512
J(512) 380-9200
NPI: 1841251246
4100 Duval Rd
Bldg 2 Ste 201
J(512) 339-1010
NPI: 1841251246
911 W 38th St
Ste 201
J(512) 459-1131
Hospital Affiliation: College Station Medical
Center, Medical City Dallas Hospital,
Metroplex Hospital, Seton Medical Center,
Seton Northwest Hospital, Seton Southwest,
St Davids Georgetown Hospital, St Davids
Medical Center, St Davids S Austin Medical
Center, St Joseph Regional Health Center
Clinic Affiliation: Magella Medical Assoc PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Cardiology
NPI: 1922062652
4100 Duval Rd
Bldg 2 Ste 201
J(512) 339-1010
Austin
Gender: Female
NPI: 1326234345
1301 Barbara Jordan
Blvd Ste 304
J(512) 454-1110
NPI: 1841251246
6500 N Mopac Expwy
I-1205 Expwy
J(512) 206-0101
NPI: 1922062652
3305 Northland Dr
Ste 512
J(512) 380-9200
NPI: 1730113754
911 W 38th St
Ste 201
J(512) 459-1131
Hospital Affiliation: Scott And White
Memorial Hospital, Seton Medical Center,
Seton Northwest Hospital, Seton Southwest,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Magella Medical Assoc PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
" Weinstein, Ellen M, MD
Austin
Gender: Male
NPI: 1841251246
1301 Barbara Jordan
Blvd Ste 304
J(512) 454-1110
NPI: 1841251246
4314 Medical Pkwy
Ste 200
J(512) 454-1110
" Shaffer, Kenneth M, MD
NPI: 1730113754
6500 N Mopac Expwy
I-1250 Expwy
J(512) 206-0101
NPI: 1811954787
6500 N Mopac Expwy
I-1205 Expwy
J(512) 206-0101
" Shmorhun, Daniel P, MD
Austin
Aus tin
NPI: 1730113754
4314 Medical Pkwy
Ste 200
J(512) 454-1110
NPI: 1811954787
4314 Medical Pkwy
Ste 200
J(512) 454-1110
Schuman-Mccoy, Jeannine M, MD
Gender: Female
NPI: 1558577676
1110 E 32nd St
(512) 320-8388
Hospital Affiliation: Central Texas Medical
Center, Dell Childrens Med Ctr Cent Tx,
Lakeway Regional Medical Ctr Llc, Seton
Northwest Hospital, St Davids S Austin
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Magella Medical Assoc PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
" Nunez, Susan B, MD
Austin
Gender: Female
NPI: 1295816817
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1830
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Northwest Hospital, University Med Ctr
Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Endocrinology
" Prabhakaran, Rajani, MD
Austin
Gender: Female
NPI: 1316073067
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1830
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Endocrinology
J - Wheelchair Access
121
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Austin
AUSTIN Cont
PEDIATRIC ENDOCRINOLOGY Cont
" Rabon, Shona, MD
Aus tin
Gender: Female
NPI: 1679739502
1301 Barbara Jordan Blvd
Ste 200
(512) 628-1830
NPI: 1679739502
6811 Austin Center Blvd
Ste 400
(512) 628-1830
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Endocrinology
Aus tin
Tacquard, Stephanie L, MD
Gender: Female
NPI: 1669721916
1301 Barbara Jordan Blvd
Ste 200
(512) 628-1830
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Specially For Children
Board Certified Specialties: None
Gender: Male
NPI: 1447462940
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1810
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Gastroenterology
Austin
" Easley, David J, MD
Aus tin
Heintz, D Dyer, MD
Gender: Male
NPI: 1568673705
1301 Barbara Jordan Blvd
Ste 200
(512) 628-1810
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Specially For Children
Board Certified Specialties: None
" Fowler, Amy C, MD
Austin
Gender: Female
NPI: 1568673887
1301 Barbara Jordan Blvd
Ste 401
J(512) 628-1900
Hospital Affiliation: Baylor University
Medical Center, Dell Childrens Med Ctr Cent
Tx, Seton Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: Pediatric
Hematology-Oncology
Austin
Austin
Gender: Female
NPI: 1619180601
1301 Barbara Jordan Blvd
Ste 401
J(512) 628-1900
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Hematology-Oncology
" Rangwalla, Sujal C, DO
Aus tin
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Austin
PEDIATRIC HEMATOLOGY-ONCOLOGY
Pandrangi, Bharani, MD
Gender: Female
NPI: 1063617868
1301 Barbara Jordan
Blvd Ste 200
(512) 628-1810
Clinic Affiliation: Specially For Children
Board Certified Specialties: None
Gender: Male
NPI: 1144354440
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1810
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Driscoll ChildrensHospital'
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Gastroenterology
Austin
Zwiener, Robert J, MD
Gender: Male
NPI: 1598717936
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1810
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, St Davids Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
" Harrod, Virginia L, MD
Austin
Hurwitz, Craig A, MD
Gender: Male
NPI: 1669567178
4900 Mueller Blvd
J(512) 324-0197
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center
Clinic Affiliation: Specially For Children
Board Certified Specialties: Hospice &
Palliative Medicine, Pediatrics
" Ching, Natascha, MD
Austin
Gender: Female
NPI: 1164474474
1301 Barbara Jordan Blvd
Ste 401
J(512) 628-1900
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, St Davids Medical Center, St
Davids S Austin Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Hematology-Oncology
" Siddiqui, Anees A, MD
Aus tin
Aus tin
" Lockhart, Sharon K, MD
Austin
Austin
PEDIATRIC GASTROENTEROLOGY
Gender: Male
NPI: 1639139488
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1810
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, San Angelo Community Medical
Center, Scott And White Memorial Hospital
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Gastroenterology
Sanders, Kathleen D, MD
Gender: Female
NPI: 1679525158
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1810
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, St Davids
Medical Center, St Davids Rehabilitation
Center, University Med Ctr Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Mignacca, Robert, MD
Gender: Male
NPI: 1891707733
1301 Barbara Jordan Blvd
Ste 401
J(512) 628-1900
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Neff, Philip E, MD
Gender: Male
NPI: 1295729093
1301 Barbara Jordan Blvd
Ste 401
J(512) 628-1900
Hospital Affiliation: Baylor All Saints
Medical Center At Fort Worth, Dell Childrens
Med Ctr Cent Tx, North Austin Medical
Center, Round Rock Medical Center, Seton
Medical Center, St Davids Medical Center, St
Davids S Austin Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Shaffer, Linda G, MD
Gender: Female
NPI: 1285686790
1301 Barbara Jordan Blvd
Ste 401
J(512) 628-1900
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Medical Ctr Williamson, University Med Ctr
Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old, Specialized in Pediatrics
Board Certified Specialties: None
Gender: Female
NPI: 1215957113
1301 Barbara Jordan Blvd
Ste 200
(512) 628-1820
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
Seton Southwest, St Davids Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Infectious Disease
Austin
" Hauger, Sarmistha B, MD
Austin
Gender: Female
NPI: 1871559880
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1820
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Round Rock Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids
Rehabilitation Center, St Davids S Austin
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old, Specialized in Pediatrics
Board Certified Specialties: Pediatric
Infectious Disease
PEDIATRIC NEPHROLOGY
" Berry, Phillip L, MD
Austin
Gender: Male
NPI: 1568428571
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1860
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Scott And White Memorial Hospital,
Seton Medical Center, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Nephrology
" Wells, Donald T, MD
Austin
Gender: Male
NPI: 1629020029
1301 Barbara Jordan Blvd
Ste 401
J(512) 628-1900
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
Seton Southwest, St Davids Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Hematology-Oncology
PEDIATRIC INFECTIOUS DISEASE
" Allen, Coburn H, MD
Austin
Gender: Male
NPI: 1114923984
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1820
Hospital Affiliation: Texas Childrens
Hospital
Clinic Affiliation: Specially For Children
Board Certified Specialties: Pediatric
Infectious Disease
Fernandez, Marisol, MD
Gender: Female
NPI: 1881651867
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1820
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, St Davids
Hospital, University Med Ctr Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
" Simon, David H, MD
Austin
Gender: Male
NPI: 1386678993
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1860
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Nephrology
J - Wheelchair Access
122
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
AUSTIN Cont
PEDIATRIC OPHTHALMOLOGY
Aus tin
PEDIATRIC NEUROLOGY
Austin
Clarke, Dave F, MD
Gender: Male
NPI: 1871550772
1301 Barbara Jordan
Blvd Ste 200
(512) 628-1850
NPI: 1871550772
1301 Barbara Jordan Blvd
Ste 200
(512) 628-1850
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Northwest Hospital
Clinic Affiliation: Pediatric Surgical
Subspecialists, Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Austin
Aus tin
Elton, Lindsey E, MD
Gender: Female
NPI: 1013119130
1301 Barbara Jordan
Blvd Ste 200
(512) 628-1850
Austin
Ghodsi, Ezam, MD
Gender: Male
NPI: 1275599284
6811 Austin Center Blvd
Ste 400
J(512) 628-1850
Hospital Affiliation: University Med Ctr
Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Pillutla, Kartik, MD
Gender: Male
NPI: 1770775728
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1860
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, University Med Ctr Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
PEDIATRIC NEUROSURGERY
Austin
Austin
George, Timothy M, MD
Gender: Male
NPI: 1326060161
1301 Barbara Jordan
Blvd Ste 307
J(512) 324-0907
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Pediatric Surgical
Subspecialists
Board Certified Specialties: None
Jackson Jr, Oscar B, MD
Gender: Male
NPI: 1215019278
3509 Lawton Ave
J(512) 451-0234
Hospital Affiliation: Bailey Square Surgery
Center, Seton Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Jackson Jr Oscar B MD
Practice Information: No Patients Over 16
yrs old
Board Certified Specialties:
Ophthalmology
PEDIATRIC ORTHOPEDICS
Dehne, Robert, MD
Gender: Male
NPI: 1982678256
1301 Barbara Jordan Blvd
Ste 3
J(512) 478-8116
NPI: 1982678256
6836 Bee Cave Rd
Ste 112
J(512) 478-8116
Austin
NPI: 1982678256
6911 N FM 620 Ste C200
J(512) 478-8116
Hospital Affiliation: Central Park Surgery
Center, Dell Childrens Med Ctr Cent Tx,
North Austin Medical Center, Seton Medical
Center, Seton Northwest Hospital, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Central Texas Pediatric
Orthopedic and Scoliosi
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
NPI: 1013119130
1301 Barbara Jordan Blvd
Ste 200
(512) 628-1850
Clinic Affiliation: Pediatric Surgical
Subspecialists, Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Austin
Austin
Aus tin
Kahn, Anthony, MD
Gender: Male
NPI: 1174596779
1301 Barbara Jordan Blvd
Ste 3
J(512) 478-8116
Murdock, Ryan C, MD
Gender: Male
NPI: 1790909281
1301 Barbara Jordan
Blvd Ste 300
J(512) 478-8116
Austin
NPI: 1790909281
6836 Bee Cave Rd
Ste 112
J(512) 478-8116
NPI: 1720052079
6836 Bee Cave Rd
Ste 112
J(512) 478-8116
NPI: 1790909281
6911 N FM 620 Ste C200
J(512) 478-8116
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
Strictly Pediatrics Surg Ctr, University Med
Ctr Brackenridge
Clinic Affiliation: Central Texas Pediatric
Orthopedic and Scoliosi
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Orthopedic
Surgery
NPI: 1720052079
6911 N FM 620 Ste C200
J(512) 478-8116
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Same
Day Surgicare, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, Strictly Pediatrics Surg Ctr,
University Med Ctr Brackenridge
Clinic Affiliation: Central Texas Pediatric
Orthopedic and Scoliosi
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Sargent, Mary C, MD
Gender: Female
NPI: 1578595690
1301 Barbara Jordan Blvd
Ste 3
J(512) 478-8116
PEDIATRIC OTOLARYNGOLOGY
Austin
NPI: 1578595690
6836 Bee Cave Rd
Ste 112
J(512) 478-8116
NPI: 1578595690
6911 N FM 620 Ste C200
J(512) 478-8116
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Central Texas Pediatric
Orthopedic and Scoliosi
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Austin
NPI: 1174596779
6836 Bee Cave Rd
Ste 112
J(512) 478-8116
NPI: 1174596779
6911 N FM 620 Ste C200
J(512) 478-8116
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, Strictly Pediatrics
Surg Ctr, University Med Ctr Brackenridge
Clinic Affiliation: Central Texas Pediatric
Orthopedic and Scoliosi
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Williams, John J, MD
Gender: Male
NPI: 1720052079
1301 Barbara Jordan Blvd
Ste 300
J(512) 478-8116
NPI: 1184808511
3705 Medical Pkwy Ste 200
J(512) 324-2720
Hospital Affiliation: Bailey Square Surgery
Center, Dell Childrens Med Ctr Cent Tx,
Seton Medical Center, Seton Northwest
Hospital, St Davids Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Seton ENT
Board Certified Specialties: None
Austin
Shapiro, Jay, MD
Gender: Male
NPI: 1184698706
1301 Barbara Jordan Blvd
Ste 3
J(512) 478-8116
NPI: 1184698706
6836 Bee Cave Rd
Ste 112
J(512) 478-8116
NPI: 1184698706
6911 N FM 620 Ste C200
J(512) 478-8116
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Same
Day Surgicare, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Davids Rehabilitation Center,
Strictly Pediatrics Surg Ctr, University Med
Ctr Brackenridge
Clinic Affiliation: Central Texas Pediatric
Orthopedic and Scoliosi
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
Clark, Stacey L, MD
Gender: Female
NPI: 1184808511
1301 Barbara Jordan Blvd
Ste 303
J(512) 324-2720
Austin
Connolly, Patrick K, MD
Gender: Male
NPI: 1497841084
3705 Medical Pkwy
Ste 200
(512) 324-2720
Hospital Affiliation: Bailey Square Surgery
Center, Dell Childrens Med Ctr Cent Tx,
North Austin Medical Center, Seton Medical
Center, Seton Northwest Hospital, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Seton ENT
Practice Information: No Patients Over 14
yrs old
Board Certified Specialties: None
Nowlin, John H, MD
Gender: Male
NPI: 1952497497
3705 Medical Pkwy
Ste 200
(512) 324-2720
Hospital Affiliation: Bailey Square Surgery
Center, Dell Childrens Med Ctr Cent Tx,
Northwest Hills Surgical Hospital, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Seton ENT
Practice Information: No Patients Over 14
yrs old
Board Certified Specialties: None
Lee, Mark R, MD
Gender: Male
NPI: 1861413536
1301 Barbara Jordan
Blvd Ste 307
J(512) 321-0910
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center
Clinic Affiliation: Pediatric Surgical
Subspecialists
Board Certified Specialties: Neurological
Surgery
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
J - Wheelchair Access
123
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Austin
AUSTIN Cont
PEDIATRIC OTOLARYNGOLOGY Cont
Aus tin
Aus tin
Roehm, Corrie E, MD
Gender: Female
NPI: 1770736084
3705 Medical Pkwy
Ste 200
(512) 324-2720
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, Seton
Northwest Hospital, Seton Southwest, St
Davids Medical Center, Strictly Pediatrics
Surg Ctr, University Med Ctr Brackenridge
Clinic Affiliation: Seton ENT
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
" McWilliams, Bennie C, MD
Austin
Gender: Male
NPI: 1689746935
11111 Research Blvd
Ste 300
J(512) 380-9200
" Zapata, Syboney, MD
Aus tin
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
" Sanchez, Julie I, MD
Austin
Gender: Female
NPI: 1649262841
1301 Barbara Jordan Blvd
Ste 400
J(512) 708-1234
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, St Davids Medical Center,
Strictly Pediatrics Surg Ctr, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Pediatric Surgery
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Surgery
" Schlechter, Robert D, MD
Austin
Gender: Male
NPI: 1396737599
1301 Barbara Jordan Blvd
Ste 400
J(512) 708-1234
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, St Davids Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Pediatric Surgery
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Surgery
" Horwitz, Jeffrey R, MD
Gender: Male
NPI: 1083617369
1301 Barbara Jordan Blvd
Ste 400
J(512) 708-1234
Hospital Affiliation: North Austin Medical
Center, Round Rock Medical Center, Seton
Edgar B Davis, Seton Highland Lakes, Seton
Medical Center, Seton Northwest Hospital,
Seton Southwest, St Davids Medical Center,
St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Pediatric Surgery
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Surgery
" Tuggle, David W, MD
Austin
Gender: Male
NPI: 1346218526
1301 Barbara Jordan Blvd
Ste 400
(512) 708-1234
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Austin Pediatric Surgery
Board Certified Specialties: Pediatric
Surgery
" Josephs, Michael D, MD
Austin
Gender: Male
NPI: 1083606289
1301 Barbara Jordan Blvd
Ste 400
J(512) 708-1234
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Round
Rock Medical Center, Seton Medical Center,
Seton Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
Strictly Pediatrics Surg Ctr, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Pediatric Surgery
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Surgery
Carrasco, Ruy, MD
Gender: Male
NPI: 1063478154
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1880
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, University
Med Ctr Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
" Moser, David W, DO
Austin
Gender: Male
NPI: 1124158928
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1880
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Rheumatology
Gender: Male
NPI: 1184840886
1301 Barbara Jordan
Blvd Ste 400
J(512) 708-1234
Clinic Affiliation: Austin Pediatric Surgery
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Surgery
Austin
Gender: Male
NPI: 1013089218
11111 Research Blvd
Ste 300
J(512) 380-9200
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Austin Childrens Chest
Assoc
Practice Information: No Patients Over 22
yrs old
Board Certified Specialties: Pediatric
Pulmonology
Fullmer, Jason J, MD
Gender: Male
NPI: 1184796401
11111 Research Blvd
Ste 300
J(512) 380-9200
NPI: 1184796401
1301 Barbara Jordan Blvd
Ste 303
J(512) 380-9200
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, Seton Medical Ctr
Williamson, Seton Northwest Hospital, Seton
Southwest, St Davids Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Austin Childrens Chest
Assoc
Practice Information: No Patients Over 22
yrs old
Board Certified Specialties: None
Gender: Male
NPI: 1003945411
1301 Barbara Jordan
Blvd Ste 400
(512) 708-1234
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center
Clinic Affiliation: Austin Pediatric Surgery
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Surgery
" Scalo, Jordan V, MD
Austin
" Rana, Ankur R, MD
" Grethel, Erich J, MD
Austin
PEDIATRIC RHEUMATOLOGY
Garcia, Nilda M, MD
Gender: Female
NPI: 1407815533
1301 Barbara Jordan Blvd
Ste 400
(512) 708-1234
Hospital Affiliation: Childrens Medical
Center Of Dallas, Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center,
Parkland Health And Hospital Sys, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, St Davids S
Austin Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Pediatric Surgery
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: General
Surgery
Austin
Austin
NPI: 1689746935
1301 Barbara Jordan Blvd
Ste 303
J(512) 904-2954
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Childrens Chest
Assoc
Practice Information: No Patients Over 22
yrs old
Board Certified Specialties: Pediatric
Pulmonology
Aus tin
PEDIATRIC PULMONOLOGY
Austin
NPI: 1235285909
1301 Barbara Jordan Blvd
Ste 303
(512) 380-9200
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Austin Childrens Chest
Assoc
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
Sawyer, Drew G, MD
Gender: Male
NPI: 1861585499
3705 Medical Pkwy
Ste 200
(512) 324-2720
Hospital Affiliation: Bailey Square Surgery
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center, St Davids S Austin Medical Center,
University Med Ctr Brackenridge
Clinic Affiliation: Seton ENT
Practice Information: No Patients Over 14
yrs old
Board Certified Specialties:
Otolaryngology
Gender: Female
NPI: 1295822757
3705 Medical Pkwy
Ste 200
(512) 324-2720
Hospital Affiliation: Arise Austin Medical
Center, Bailey Square Surgery Center, Dell
Childrens Med Ctr Cent Tx, Seton Medical
Center, Seton Northwest Hospital, St Davids
Medical Center, Surgicare Of South Austin,
University Med Ctr Brackenridge
Clinic Affiliation: Seton ENT
Practice Information: No Patients Over 14
yrs old
Board Certified Specialties: Pediatric
Otolaryngology
PEDIATRIC SURGERY
Kang, June Ku B, MD
Gender: Female
NPI: 1235285909
11111 Research Blvd
Ste 300
(512) 380-9200
" Meyer, Tory A, MD
PEDIATRIC UROLOGY
" Cortez, Jose C, MD
Austin
Gender: Male
NPI: 1548262728
1301 Barbara Jordan Blvd
Ste 302
J(512) 472-6134
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Pediatric Urology of
Central Texas
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Urology
Austin
Gender: Male
NPI: 1205828407
1301 Barbara Jordan Blvd
Ste 400
(512) 708-1234
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, North Austin Medical Center, Seton
Medical Center, Seton Northwest Hospital,
Seton Southwest, St Davids Medical Center,
Strictly Pediatrics Surg Ctr, University Med
Ctr Brackenridge
Clinic Affiliation: Austin Pediatric Surgery
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Surgery
" McQuiston, Leslie T, MD
Austin
Gender: Female
NPI: 1699761700
1301 Barbara Jordan
Ste 302
J(512) 472-6134
Hospital Affiliation: Baylor All Saints
Medical Center At Fort Worth, Cook
Childrens Medical Center, Dell Childrens
Med Ctr Cent Tx, St Davids Medical Center,
Tx Hlth Harris Methodist Hosp Fw, Tx Hlth
Huguley Fort Worth South, Usmd Hospital At
Arlington Lp
Clinic Affiliation: Pediatric Urology of
Central Texas
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Urology
J - Wheelchair Access
124
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Aus tin
AUSTIN Cont
PEDIATRIC UROLOGY Cont
" Seremetis, George M, MD
Austin
Gender: Male
NPI: 1942202114
1301 Barbara Jordan Blvd
Ste 302
J(512) 472-6134
Hospital Affiliation: Seton Medical Center,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Pediatric Urology of
Central Texas
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Urology
Gender: Male
NPI: 1942384052
4900 Mueller Blvd
J(512) 324-0137
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Ctr Williamson,
University Med Ctr Brackenridge
Clinic Affiliation: University Physicians
Group
Board Certified Specialties: Pediatrics
NPI: 1154386753
911 W 38th St
Ste 201
J(512) 459-1131
Hospital Affiliation: College Station Medical
Center, Round Rock Medical Center, Scott
And White Memorial Hospital, Seton Medical
Center, Seton Medical Center Hays, Seton
Northwest Hospital, Seton Southwest, St
Davids Georgetown Hospital, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Magella Medical Assoc PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: None
" Case, Ann M, MD
Gender: Female
NPI: 1932102175
1301 Barbara Jordan Blvd
Ste 307
(512) 324-0907
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Scott And White Memorial Hospital,
Seton Medical Center, Seton Medical Center
Hays, Seton Medical Ctr Williamson, Seton
Northwest Hospital, Texas Childrens
Hospital, The Womans Hospital Of Texas
Clinic Affiliation: Pediatric Surgical
Subspecialists
Board Certified Specialties: Pediatrics
Gender: Female
NPI: 1326234345
1301 Barbara Jordan
Blvd Ste 304
J(512) 454-1110
" Fernandez, Jim B, MD
Austin
Gender: Male
NPI: 1831135953
900 W 38th St Ste 300
J(512) 450-1300
NPI: 1326234345
4314 Medical Pkwy
Ste 200
J(512) 454-1110
Hospital Affiliation: College Station Medical
Center, Seton Medical Center, St Joseph
Regional Health Center
Clinic Affiliation: Magella Medical Assoc PA
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatric
Cardiology, Pediatrics
NPI: 1831135953
9600 Great Hills Trl
Ste 150W
(214) 452-7722
Hospital Affiliation: Arise Austin Medical
Center, Central Park Surgery Center, Dallas
Medical Center Llc, Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Austin Sports Medicine,
TX Fidelis PA
Board Certified Specialties: Physical
Medicine & Rehabilitation
PHYSICAL MEDICINE &
REHABILITATION
" Arizmendez, Maria E, MD
Austin
Gender: Female
NPI: 1194702423
1215 Red River St
Ste 427
(512) 479-3609
Hospital Affiliation: Healthsouth
Rehabilitation Hospital Of Austin, St Davids
Medical Center
Clinic Affiliation: Central Austin
Rehabilitation PA
Board Certified Specialties: Physical
Medicine & Rehabilitation
" Hurwitz, Craig A, MD
Aus tin
Gender: Male
NPI: 1669567178
4900 Mueller Blvd
J(512) 324-0197
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center
Clinic Affiliation: Specially For Children
Board Certified Specialties: Hospice &
Palliative Medicine, Pediatrics
NPI: 1295783728
900 E 30th St
Ste 303
(512) 454-1234
Hospital Affiliation: Arise Austin Medical
Center, Seton Medical Center, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: David Keith Harris MD
PLLC, Neuralwatch Texas PLLC, Neuro
Texas PLLC
Board Certified Specialties: Physical
Medicine & Rehabilitation
" Weinstein, Ellen M, MD
" Bunch, Kenneth, MD
Austin
Leath, Thomas M, MD
Gender: Male
NPI: 1497767420
# 3410 Far West Blvd
Ste 146
J(512) 349-0777
Hospital Affiliation: Scott & White Hlthcare
Round Rock
Clinic Affiliation: Allergy & Asthma Asso
Ciatespllc
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties:
Allergy-Immunology
Aus tin
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Gender: Male
NPI: 1295783728
7307 Creekbluff Dr
(512) 614-3300
(800) 638-7564
Austin
" Havemann, Cathleen M, MD
" Fasci, Siv L, MD
" Elizondo, Eduardo R, MD
Austin
Gender: Male
NPI: 1154528727
1301 Barbara Jordan Blvd
Ste 200
(512) 628-1830
Hospital Affiliation: Cook Childrens Medical
Center, Dell Childrens Med Ctr Cent Tx,
Seton Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: Pediatrics
Aus tin
Austin
Gender: Male
NPI: 1841470275
900 E 30th St
Ste 303
(512) 454-1234
Hospital Affiliation: St Davids Medical
Center
Clinic Affiliation: Neuro Texas PLLC
Board Certified Specialties: Physical
Medicine & Rehabilitation
" Smith, Joshua M, MD
NPI: 1154386753
801 W 34th St
Ste 100
J(512) 454-1110
Austin
" Chavez, Justin C, MD
Austin
Austin
NPI: 1154386753
6500 N Mopac Expwy
I-1205 Expwy
J(512) 206-0101
Boeck, Ryan A, MD
Gender: Male
NPI: 1013182955
1301 Barbara Jordan
Blvd Ste 200
(512) 628-1850
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center, St Davids
Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 16
yrs old
Board Certified Specialties: None
Gender: Male
NPI: 1609842012
4534 Westgate Blvd
Ste 112
J(512) 334-2144
Hospital Affiliation: Texas Neurorehab
Center
Board Certified Specialties: Physical
Medicine & Rehabilitation
" Pont, Stephen J, MD
NPI: 1154386753
4314 Medical Pkwy
Ste 200
J(512) 454-1110
PEDIATRICS
" Carter, Russell H, MD
Austin
Austin
NPI: 1154386753
4100 Duval Rd
Bldg 2 Ste 201
J(512) 339-1010
Gender: Female
NPI: 1245497387
1301 Barbara Jordan Blvd
Ste 302
J(512) 538-2102
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Pediatric Urology of
Central Texas
Board Certified Specialties: Pediatric
Urology
Gender: Female
NPI: 1588693717
6811 Austin Center Blvd
Ste 400
(512) 628-1850
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Mother Frances Hospital, Seton
Medical Center
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
Gender: Male
NPI: 1770775728
1301 Barbara Jordan Blvd
Ste 200
J(512) 628-1860
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, University Med Ctr Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
NPI: 1154386753
3801 N Lamar Blvd
J(512) 206-3600
" Sweeney, Danielle, MD
Gender: Female
NPI: 1861628950
4900 Mueller Blvd
(512) 324-0197
Hospital Affiliation: Central Texas Medical
Center, Dell Childrens Med Ctr Cent Tx,
Seton Medical Center, Seton Medical Ctr
Williamson, Seton Northwest Hospital, Seton
Southwest, University Med Ctr Brackenridge
Clinic Affiliation: Specially For Children
Practice Information: No Patients Over 18
yrs old
Board Certified Specialties: Pediatrics
" Pillutla, Kartik, MD
Austin
NPI: 1154386753
3305 Northland Dr
Ste 512
J(512) 380-9200
Austin
Austin
Finnigan, James P, MD
Gender: Male
NPI: 1154386753
1301 Barbara Jordan
Blvd Ste 304
J(512) 454-1110
Gender: Male
NPI: 1871543405
4700 Seton Center Pkwy
Ste 200
J(512) 439-1000
Hospital Affiliation: Seton Northwest
Hospital, Texas Orthopedics Surgery Center
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: Physical
Medicine & Rehabilitation
Austin
Foreman, Wesley D, MD
Gender: Male
NPI: 1548316706
11111 Research Blvd
Ste 395
(512) 324-6785
Hospital Affiliation: Arise Austin Medical
Center, Central Park Surgery Center, Central
Texas Rehab Hospital Llc, Healthsouth
Rehabilitation Hospital Of Austin, Seton
Medical Center, Seton Northwest Hospital,
St Davids Medical Center, University Med Ctr
Brackenridge
Clinic Affiliation: Seton Brain and Spine
Institute
Board Certified Specialties: None
J - Wheelchair Access
125
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
" Lee, Robert K, MD
" Persyn, Lisa D, MD
Austin
AUSTIN Cont
PHYSICAL MEDICINE &
REHABILITATION Cont
" Garrison, Christopher J, MD
Aus tin
Gender: Male
NPI: 1427066117
1301 W 38th St
Ste 113
(512) 324-3395
NPI: 1427066117
601 E 15th St
Fl 4 W
(512) 324-7131
Hospital Affiliation: Baylor Regional Med
Ctr Grapevine, Dell Childrens Med Ctr Cent
Tx, Healthsouth Rehabilitation Hospital Of
Austin
Clinic Affiliation: Seton Brain and Spine
Institute
Board Certified Specialties: Physical
Medicine & Rehabilitation
Austin
Gender: Male
NPI: 1013163146
1015 E 32nd St
Ste 306
J(512) 236-1310
Clinic Affiliation: Neuro Texas PLLC
Board Certified Specialties: Physical
Medicine & Rehabilitation
" Moroz, Lee E, MD
Austin
Gender: Male
NPI: 1609824457
1600 W 38th St
Ste 200
(512) 324-3580
Hospital Affiliation: Arise Austin Medical
Center, Seton Highland Lakes, Seton
Medical Center, Seton Northwest Hospital,
Seton Southwest, St Davids Rehabilitation
Center, University Med Ctr Brackenridge
Clinic Affiliation: Seton Brain and Spine
Institute
Board Certified Specialties: Physical
Medicine & Rehabilitation
Gonzales, Mary A, MD
Gender: Female
NPI: 1609845957
1201 W 38th St
J(512) 406-6300
NPI: 1609845957
4207 Burnet Rd
(512) 706-1900
Hospital Affiliation: Central Texas Rehab
Hospital Llc, Healthsouth Rehabilitation
Hospital Of Austin, St Davids Medical
Center, St Davids Rehabilitation Center
Clinic Affiliation: Mary Gonzales MD, Post
Acute Physicans of Texas
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: None
Gender: Male
NPI: 1730358532
2315 W Ben White Blvd
(512) 326-5440
Hospital Affiliation: Central Texas Medical
Center, St Davids S Austin Medical Center
Clinic Affiliation: Spine Diagnostic and
Treatment Center
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Physical
Medicine & Rehabilitation
#
" Harris, David K, MD
Austin
" Joshi, Anand, MD
Aus tin
Gender: Male
NPI: 1992716237
2315 W Ben White Blvd
J(512) 326-5440
Hospital Affiliation: Central Texas Medical
Center, Mother Frances Hospital, Seton
Medical Center, Seton Southwest, St Davids
Medical Center, St Davids S Austin Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Spine Diagnostic and
Treatment Center
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Physical
Medicine & Rehabilitation
Aus tin
Latorre, Juan M, MD
Gender: Male
NPI: 1841269263
1015 E 32nd St
Ste 411
(512) 474-1114
Hospital Affiliation: St Davids Hospital
Clinic Affiliation: Neuro Texas PLLC
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Austin
" Nelson, Maureen R, MD
Aus tin
Gender: Male
NPI: 1710935093
7307 Creekbluff Dr
(512) 614-3300
Hospital Affiliation: Arise Austin Medical
Center, Seton Medical Center, Seton
Northwest Hospital, St Davids Medical
Center
Clinic Affiliation: David Keith Harris MD
PLLC
Board Certified Specialties: Physical
Medicine & Rehabilitation
Gender: Male
NPI: 1942457304
11851 Jollyville Rd
Ste 202
(512) 249-5583
Hospital Affiliation: Reliant Rehab Hosp
Central Tx Lp
Clinic Affiliation: Physical Medicne and
Neurotoxin
Board Certified Specialties: Physical
Medicine & Rehabilitation
Austin
Gender: Female
NPI: 1790909067
330 W Ben White Blvd
(512) 730-4800
Hospital Affiliation: Reliant Austin
Board Certified Specialties: Physical
Medicine & Rehabilitation
Parthasarathy, Srinivason R, MD
Gender: Female
NPI: 1639122963
1215 Red River St
Ste 427
J(512) 324-7000
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx, Seton Medical Center Hays, Seton
Medical Ctr Williamson, Seton Northwest
Hospital, Seton Southwest, University Med
Ctr Brackenridge
Clinic Affiliation: Seton Brain and Spine
Institute
Board Certified Specialties: None
Rawson, Benjamin L, DO
Gender: Male
NPI: 1902889397
7307 Creekbluff Dr
(512) 614-3300
Clinic Affiliation: David Keith Harris MD
PLLC
Board Certified Specialties: None
PHYSICAL THERAPY
Aggelaki Wiltens, Sofia S, LPT
Gender: Female
NPI: 1376656652
# 1221 W Ben White Blvd
Ste 211A
J(512) 707-8392
Clinic Affiliation: Versatile Physical Therapy
&Fitness Center
Board Certified Specialties: None
Austin
Austin
" Staggs, Deacon W, MD
Austin
Gender: Male
NPI: 1356551279
12501 Longhorn Blvd
(512) 382-4664
NPI: 1356551279
12501 Longhorn Pkwy
(512) 382-4664
Hospital Affiliation: Baylor Institute For
Rehabilitation At Gaston, Baylor Specialty
Hospital, Baylor University Medical Center
Clinic Affiliation: Post Acute Physicans of
Texas
Board Certified Specialties: Physical
Medicine & Rehabilitation
" Tynes, Steven S, MD
Austin
Gender: Male
NPI: 1205837994
1215 Red River St
Ste 442
J(512) 479-3632
Hospital Affiliation: Healthsouth
Rehabilitation Hospital Of Austin, Seton
Medical Center, St Davids Medical Center,
University Med Ctr Brackenridge
Practice Information: No Patients Under 10
yrs old
Board Certified Specialties: Physical
Medicine & Rehabilitation
" Pena, Enrique B, MD
Austin
Gender: Male
NPI: 1003922964
1600 W 35th St
Ste 200
(512) 324-3580
Hospital Affiliation: Arise Austin Medical
Center, Dell Childrens Med Ctr Cent Tx,
Seton Medical Center, St Davids Medical
Center, University Med Ctr Brackenridge
Clinic Affiliation: Seton Brain and Spine
Institute
Board Certified Specialties: Physical
Medicine & Rehabilitation
Gender: Female
NPI: 1245240712
3724 Executive Center
Dr Ste G 10
(512) 345-5925
Hospital Affiliation: Seton Medical Center
Clinic Affiliation: Seton Brain and Spine
Institute
Practice Information: No Patients Under 10
yrs old
Board Certified Specialties: Physical
Medicine & Rehabilitation
" Ramos, Jesus M, MD
NPI: 1871788927
911 W 38th St
Ste 300
J(512) 439-1002
Hospital Affiliation: Arise Austin Medical
Center, Texas Orthopedics Surgery Center
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: Physical
Medicine & Rehabilitation
" Gray, Laura A, MD
" Yaniv, Esther, MD
Austin
Austin
Gender: Female
NPI: 1871788927
3755 S Capital of Texas
Hwy Ste 160
J(512) 439-1005
Gender: Female
NPI: 1801820170
1301 Barbara Jordan
Blvd Ste 307
(512) 628-1893
Hospital Affiliation: Chi St Lukes Hlth
Baylor Coll Med, Houston Methodist
Hospital, Seton Medical Center, Texas
Childrens Hospital, University Med Ctr
Brackenridge
Clinic Affiliation: Pediatric Surgical
Subspecialists
Practice Information: Specialized in
Pediatrics
Board Certified Specialties: Physical
Medicine & Rehabilitation
NPI: 1124017926
9101 Burnet Rd
Ste 103
(512) 248-2422
Hospital Affiliation: Dell Childrens Med Ctr
Cent Tx
Clinic Affiliation: Pediatric Surgical
Subspecialists
Board Certified Specialties: Physical
Medicine & Rehabilitation
" Ramchandani, Avinash N, MD
" Mukai, Ai, MD
Aus tin
Gender: Male
NPI: 1124017926
1301 Barbara Jordan Blvd
Ste 301
(512) 324-0919
Austin
Austin
Aus tin
" Wright, Edward A, MD
Austin
Gender: Female
NPI: 1619935616
12180 N Mopac Expwy
Ste B
(512) 836-8800
Clinic Affiliation: San Antonio Osteo Relief
Ctr PA
Practice Information: No Patients Under 16
yrs old
Board Certified Specialties: Physical
Medicine & Rehabilitation
" Urquidez, Jose A, MD
Austin
Gender: Male
NPI: 1053357871
11851 Jollyville Rd
Ste 202
J(512) 249-5583
Hospital Affiliation: Mem Hermann
Hospital, Seton Northwest Hospital
Clinic Affiliation: Physical Medicne and
Neurotoxin
Board Certified Specialties: Physical
Medicine & Rehabilitation
Austin
Aguilar, Erika, LPT
Gender: Female
NPI: 1265518286
5555 N Lamar Blvd
Ste L103
(512) 200-2332
Clinic Affiliation: Progressive Neuro
Therapy
Board Certified Specialties: None
Alaimo, Jason E, LPT
Gender: Male
NPI: 1457461907
12 Oaks 11623 Angus Rd
Ste 18
(512) 345-4421
NPI: 1457461907
2765 Bee Caves Rd
Ste 209
(512) 327-5100
NPI: 1457461907
3200 Red River St
Ste 101
(512) 476-8857
NPI: 1457461907
3705 Medical Pkwy
Ste 515
(512) 452-6475
NPI: 1457461907
3901 S Lamar Blvd
Ste 140
(512) 462-3275
NPI: 1457461907
6818 Austin Center Blvd
Ste 111
(512) 418-8870
NPI: 1457461907
900 W 38th St Ste 110
(512) 450-0909
Clinic Affiliation: Select Physical Therapy
Holdings
Board Certified Specialties: None
J - Wheelchair Access
126
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Aus tin
AUSTIN Cont
PHYSICAL THERAPY Cont
Austin
Albright, Meridith S, LPT
Gender: Female
NPI: 1255447983
4700 Seton Center Pkwy
Ste 175
(512) 439-1000
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: None
Almodovar, Eduardo, LPT
Gender: Male
NPI: 1407039951
# 4210 W Braker Ln
J(512) 342-2200
Austin
NPI: 1407039951
7817 Rockwood Ln
Ste 322
(512) 323-0802
Clinic Affiliation: Hope Physical Therapy
and Wellnes, So Fit LLC
Practice Information: No Patients Under 18
yrs old
Board Certified Specialties: None
Amitrani, Heather A, LPT
Gender: Female
NPI: 1326374505
# 6618 Sitio Del Rio Blvd
Ste D102
J(512) 331-6200
Clinic Affiliation: Tillman Physical Therapy
Andsports Training Ctr
Practice Information: No Patients Under 5
yrs old
Board Certified Specialties: None
Aus tin
Aus tin
Aus tin
#
NPI: 1740548510
2500 W William Cannon Dr
Ste 409
J(512) 852-8434
Aus tin
Aus tin
NPI: 1740548510
9185 Research Blvd
J(512) 339-2800
Clinic Affiliation: Your Personal Best
Physical Therapy
Board Certified Specialties: None
Andrew, Kevin A, LPT
Gender: Male
NPI: 1063538411
# 9707 Anderson Mill Rd
Ste 340
J(512) 258-5300
Clinic Affiliation: Eagle Rehab Center, One
On One Physical Therapy Inc
Practice Information: No Patients Under 2
yrs old
Board Certified Specialties: None
Austin
Aus tin
Aus tin
Austin
Askarinasab, Laleh, LPT
Gender: Female
NPI: 1609909001
7801 N Lamar Blvd
(512) 371-7273
Clinic Affiliation: Austin Physical Therapy
Specialis
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Babin, Kyle R, LPT
Gender: Male
NPI: 1891127114
7401 W Hwy 71
Ste 130
(512) 835-5000
Clinic Affiliation: Star Physical Therapy
Board Certified Specialties: None
Ballinger, Jeanne B, LPT
Gender: Female
NPI: 1033357017
5555 N Lamar Blvd
Ste L103
J(512) 200-2332
Clinic Affiliation: Progressive Neuro
Therapy
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Baugh, Tommie J, LPT
Gender: Male
NPI: 1720255573
10001 S Interstate 35
Ste 300
J(512) 440-0555
Boidock, Erin T, LPT
Gender: Female
NPI: 1700141538
7600 Burnet Rd
(512) 458-1183
Clinic Affiliation: Physiotherapy Assoc In
Plano
Board Certified Specialties: None
Bose, Nisha H, LPT
Gender: Female
NPI: 1427339902
# 11614 Bee Caves Rd
Ste 100
J(512) 428-4261
Austin
NPI: 1427339902
2500 W William Cannon Dr
Ste 409
J(512) 852-8434
Clinic Affiliation: Your Personal Best
Physical Therapy
Board Certified Specialties: None
Austin
Austin
NPI: 1720255573
8868 Research Blvd
Ste 601
J(888) 997-2669
Clinic Affiliation: Concentra Medical
Centers
Board Certified Specialties: None
Austin
#
Austin
Aubert, Molly E, LPT
Gender: Female
NPI: 1841578952
# 4607 Manchaca Rd
J(512) 916-1511
Clinic Affiliation: Kidtherapy PLLC
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
Andersen, Amber K, LPT
Gender: Female
NPI: 1588896021
3755 S Capital of Texas
Hwy Ste 160
(512) 439-1005
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: None
Anderson, Hazel D, LPT
Gender: Female
NPI: 1740548510
# 11614 Bee Caves Rd
Ste 160
J(512) 428-4261
Bliss, Ryan C, LPT
Gender: Male
NPI: 1699706085
# 9101 Burnet Rd Ste 103
J(512) 248-2422
Clinic Affiliation: Ltts LLP
Board Certified Specialties: None
Austin
Aus tin
Austin
Austin
Atkins, Chere D, LPT
Gender: Female
NPI: 1164433322
12524 Copella Trl
(512) 587-5671
Clinic Affiliation: Growing Places Therapy
Services
Board Certified Specialties: None
Brady, Jeremy L, LPT
Gender: Male
NPI: 1508281460
3724 Executive Ctr Dr
Ste G-10
(512) 345-5925
Clinic Affiliation: Seton Brain and Spine
Institute
Board Certified Specialties: None
Brewster, Elva M, LPT
Gender: Female
NPI: 1659637981
6811 Austin Center
Blvdste 400
J(512) 628-1918
Clinic Affiliation: Pediatric Surgical
Subspecialists
Board Certified Specialties: None
Broadbelt, Colin J, LPT
Gender: Male
NPI: 1740462126
# 9004 Wildridge Dr
J(512) 712-5348
Clinic Affiliation: Pro-Active Physical
Therapy
Board Certified Specialties: None
Austin
Benedisuk, Michele F, LPT
Gender: Female
NPI: 1063500627
1600 W 38th St
Ste 201
(512) 206-0433
Clinic Affiliation: Sports Center
Board Certified Specialties: None
Austin
Bennett, Marjorie R, LPT
Gender: Female
NPI: 1912250994
11623 Angus Rd
Ste 18
(512) 345-4421
Clinic Affiliation: Select Physical Therapy
Holdings
Board Certified Specialties: None
Brodbeck, Linda M, LPT
Gender: Female
NPI: 1912036831
1121 E Seventh St
J(512) 334-4411
Clinic Affiliation: Any Baby Can
Practice Information: No Patients Over 3
yrs old
Board Certified Specialties: None
Brophy, Laurie T, LPT
Gender: Female
NPI: 1215174719
# 12524 Capella Trl
(512) 587-5671
Clinic Affiliation: Growing Places Therapy
Services
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
Austin
Bennett, Matthew M, LPT
Gender: Male
NPI: 1639583271
6818 Austin Center Blvd
Ste 111
(512) 418-8870
Clinic Affiliation: Select Physical Therapy
Holdings
Board Certified Specialties: None
Austin
#
NPI: 1619992831
801 E William Cannon Dr
Ste 225
J(512) 270-2060
Clinic Affiliation: Texas Physical Therapy
Specialist, Town & Country Physical Therapy
Practice Information: No Patients Under 8
yrs old
Board Certified Specialties: None
Brown, Jason, LPT
Gender: Male
NPI: 1285922476
# 1212 W Parmer Ln Ste E
J(512) 794-8863
Austin
NPI: 1285922476
801 E William Cannon Dr
Ste 225
J(512) 270-2060
Clinic Affiliation: Town & Country Physical
Therapy
Board Certified Specialties: None
Brown, Michele P, LPT
Gender: Female
NPI: 1770817900
# 12524 Capella Trl
(512) 587-5671
Austin
NPI: 1770817900
9433 Bee Cave Rd
Ste 101 Bldg 3
(512) 306-8007
Clinic Affiliation: Big Sky Pediatric Therapy,
Growing Places Therapy Services
Practice Information: No Patients Under 3
yrs old
Board Certified Specialties: None
Bryan, Natalie E, LPT
Gender: Female
NPI: 1306107693
# 11614 Bee Caves Rd
Ste 160
J(512) 428-4261
Austin
#
#
NPI: 1306107693
2500 W William Cannon Dr
Ste 409
J(512) 852-8434
NPI: 1306107693
9185 Research Blvd
J(512) 339-2800
Clinic Affiliation: Your Personal Best
Physical Therapy
Board Certified Specialties: None
Calabria, Elizabeth S, LPT
Gender: Female
NPI: 1780993550
# 5114 Balcones Woods Dr
Ste 306
(512) 794-8863
Austin
NPI: 1780993550
801 E William Cannon Dr
Ste 225
(512) 270-2060
Clinic Affiliation: Town & Country Physical
Therapy
Board Certified Specialties: None
Austin
Bledsoe, Vicky L, LPT
Gender: Female
NPI: 1336142546
7718 Wood Hollow Dr
Ste 105
J(512) 795-0053
Clinic Affiliation: Atlas Physical Therapy Inc
Board Certified Specialties: None
Browder, David A, LPT
Gender: Male
NPI: 1619992831
10526 W Parmer Ln
Ste 403
(512) 900-3302
Campbell, Cheryl A, LPT
Gender: Female
NPI: 1396180279
13001 Bloomfield Hills
Ln
(512) 466-2065
Clinic Affiliation: Home Field Advantage
Therapy PLLC
Board Certified Specialties: None
J - Wheelchair Access
127
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Austin
AUSTIN Cont
PHYSICAL THERAPY Cont
Aus tin
Carlegis, Megan K, LPT
Gender: Female
NPI: 1629366430
1301 Barbara Jordan
Blvd Ste 3
(512) 478-8116
NPI: 1629366430
6836 Bee Cave Rd
Ste 112
(512) 478-8116
Clinic Affiliation: Central Texas Pediatric
Orthopedic and Scoliosi
Board Certified Specialties: None
Aus tin
Caro-Mata, Aaron, LPT
Gender: Male
NPI: 1366775397
10526 W Parmer Ln
Ste 403
J(512) 900-3302
Clinic Affiliation: Texas Physical Therapy
Specialist
Board Certified Specialties: None
Cartwright, Scott M, LPT
Gender: Male
NPI: 1033286224
# 2013 Wells Branch Pkwy
Ste 103
J(512) 835-6077
Clinic Affiliation: Community Health and
Rehab Centre
Board Certified Specialties: None
Aus tin
Aus tin
Cecalek, Matthew J, LPT
Gender: Male
NPI: 1184777476
2171 Woodward St
Ste B
J(888) 997-2669
#
NPI: 1184777476
4301 W William Cannon
Dr Bldg E Ste 320
J(512) 467-6608
#
NPI: 1184777476
8868 Research Blvd
Ste 601
J(512) 467-7232
NPI: 1184777476
9333 Research Blvd
Ste 400
J(512) 440-0555
Clinic Affiliation: Concentra Medical
Centers
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Aus tin
Cherry, Meredith H, LPT
Gender: Female
NPI: 1720381239
9101 Burnet Rd
Ste 103
(512) 248-2422
Clinic Affiliation: Ltts LLP
Board Certified Specialties: None
Chmiel, Susan J, LPT
Gender: Female
NPI: 1881951515
# 4407 Monterey Oaks Blvd
Ste 140
J(512) 248-2422
Aus tin
#
Ciaverelli, Carrie A, LPT
Gender: Female
NPI: 1538292719
6810 Poncha Pass
(512) 814-6526
Clinic Affiliation: Healing Foundations
Physical Ther
Board Certified Specialties: None
Austin
Cohen, Eliette, LPT
Gender: Female
NPI: 1225152606
# 4607 Manchaca Rd
J(512) 916-1511
Clinic Affiliation: Kidtherapy PLLC
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
Austin
Austin
Coyne, Daniel S, LPT
Gender: Male
NPI: 1740510866
4700 Seton Ctr Pkwy
Ste 175
(512) 439-1000
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: None
Austin
#
NPI: 1669515185
500 San Marcos St
(512) 467-1100
NPI: 1669515185
911 W Anderson Ln
Ste 103
(512) 467-1100
Clinic Affiliation: Advanced Rehabilitation
PC
Board Certified Specialties: None
Culver, Danina L, LPT
Gender: Female
NPI: 1780696377
# 3724 Jefferson St
Ste 316
(512) 453-6778
Austin
NPI: 1740424191
4701 Westgate Blvd
D401
(512) 467-1100
NPI: 1326084062
3705 Medical Pkwy
Ste 515
(512) 452-6475
NPI: 1740424191
4701 Westgate Blvd
Ste D401
J(512) 467-1100
NPI: 1326084062
3901 S Lamar Blvd Ste 140
(512) 462-3275
NPI: 1326084062
6818 Austin Center Blvd
Ste 111
(512) 418-8870
Clinic Affiliation: Select Physical Therapy
Holdings
Board Certified Specialties: None
Austin
Dempski, Angela N, LPT
Gender: Female
NPI: 1598181117
# 9101 Burnet Rd
Ste 103
J(512) 248-2422
Clinic Affiliation: Ltts LLP
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
NPI: 1780696377
3724 Jefferson Ste 316
J(512) 453-6778
Clinic Affiliation: Danina L Culver PT
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
Dennis, Lisa J, LPT
Gender: Female
NPI: 1942591029
# 1611 Headway Cir
Bldg 2
J(512) 478-2581
Clinic Affiliation: Capital Area Easter Seals
Society
Practice Information: No Patients Under 3
yrs old
Board Certified Specialties: None
Austin
Austin
Austin
Austin
Davis, Phillip L, LPT
Gender: Male
NPI: 1073703203
# 210 Barton Springs Rd
Ste 215
(512) 442-3200
Clinic Affiliation: The Training Room
Board Certified Specialties: None
Austin
Dickmann, Sharon S, LPT
Gender: Female
NPI: 1396838488
2501 W William Cannon Dr
Bldg 1
(512) 651-0301
Downing, Suzanne, LPT
Gender: Female
NPI: 1457606246
6818 Austin Center
Blvd Ste 111
(512) 418-8870
NPI: 1457606246
7718 Wood Hollow Dr
Ste 105
J(512) 795-0053
Clinic Affiliation: Atlas Physical Therapy
Inc, Select Physical Therapy Holdings
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Dehne, Pamela J, LPT
Gender: Female
NPI: 1164538898
3816 S First St
(512) 443-1311
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Austin
Austin
Austin
NPI: 1396838488
3901 S Lamar Blvd
Ste 140
(512) 462-3275
Clinic Affiliation: Physiotherapy Assoc In
Plano, Select Physical Therapy Holdings
Board Certified Specialties: None
NPI: 1881951515
9101 Burnet Rd Ste 103
J(512) 248-2422
Clinic Affiliation: Ltts LLP
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
NPI: 1326084062
3200 Red River St
Ste 101
(512) 476-8857
Austin
#
Dobbs, Debra L, LPT
Gender: Female
NPI: 1326084062
12 Oaks 11623 Angus Rd
Ste 18
(512) 345-4421
NPI: 1740424191
4316 James Casey St
Ste F 201
(512) 442-2727
NPI: 1740424191
911 W Anderson Ln
Ste 103
J(512) 467-1100
Clinic Affiliation: Advanced Rehabilitation
PC, Art Medical Alliance, Austin Preferred
Chiropractic and, Select Physical Therapy
Holdings
Board Certified Specialties: None
Croll, Kelli M, LPT
Gender: Female
NPI: 1275795031
# 9101 Burnet Rd Ste 103
J(512) 248-2422
Clinic Affiliation: Ltts LLP
Board Certified Specialties: None
#
Austin
NPI: 1740424191
500 San Marcos St
Ste 104
J(512) 467-1100
Austin
Cuellar, Cristi Y, LPT
Gender: Female
NPI: 1669515185
# 4701 Westgate Blvd
Ste D401
(512) 467-1100
Deboise Brown, Ashley A, LPT
Gender: Female
NPI: 1740424191
3901 S Lamar Blvd
Ste 140
(512) 462-3275
Doyle, Jill D, LPT
Gender: Female
NPI: 1518291764
1210 W Braker Ln
(817) 251-9386
Clinic Affiliation: Southlake Sports and
Spine Rehab
Board Certified Specialties: None
Driscoll, Jennifer L, LPT
Gender: Female
NPI: 1144258294
3901 S Lamar Blvd
Ste 140
(512) 462-3275
Clinic Affiliation: Select Physical Therapy
Holdings
Board Certified Specialties: None
Drost, Janice F, LPT
Gender: Female
NPI: 1275796724
1121 E Seventh St
J(512) 454-3743
Clinic Affiliation: Any Baby Can
Board Certified Specialties: None
Duke, Kelly A, LPT
Gender: Female
NPI: 1437404191
6618 Sitio Del Rio Blvd
Ste D102
J(512) 331-6200
Clinic Affiliation: Tillman Physical Therapy
Andsports Training Ctr
Practice Information: No Patients Under 6
yrs old
Board Certified Specialties: None
Durden, Andre L, LPT
Gender: Male
NPI: 1093884017
# 7920 San Felipe Blvd
Ste 2008
J(512) 947-6418
Practice Information: No Patients Under 18
yrs old, Orthopedics Spine Only, Practice
Limited to Geriatrics
Board Certified Specialties: None
Austin
J - Wheelchair Access
128
OCTOBER 15, 2014
Independent Provider Network (IPN)
bmkpi_n_spec
AUSTIN
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Aus tin
AUSTIN Cont
PHYSICAL THERAPY Cont
Austin
Austin
Austin
Austin
Ebem, Henry C, LPT
Gender: Male
NPI: 1275714750
13279 Pond Springs Rd
Ste 2
J(512) 472-2020
Clinic Affiliation: Bluestone Physical
Therapy
Board Certified Specialties: None
Echols, Samantha R, LPT
Gender: Female
NPI: 1518281765
1611 Headway Cir
Bldg 2
J(512) 478-2581
Clinic Affiliation: Capital Area Easter Seals
Society
Board Certified Specialties: None
Elizondo, Matthew X, LPT
Gender: Male
NPI: 1245475870
3200 Red River St
Ste 101
(512) 476-8857
Clinic Affiliation: Select Physical Therapy
Holdings
Board Certified Specialties: None
Austin
Austin
Austin
Austin
NPI: 1932429511
7401 W Hwy 71
Ste 130
(512) 288-2700
Clinic Affiliation: Star Physical Therapy
Practice Information: No Patients Under 5
yrs old
Board Certified Specialties: None
Engel, Nicholas, LPT
Gender: Male
NPI: 1659601003
13805 Research Blvd
Ste 150
(512) 257-2500
Clinic Affiliation: Medicine In Motion Martha
Pyron M
Board Certified Specialties: None
English, Deborah K, LPT
Gender: Female
NPI: 1043473697
12701 FM 620
(512) 326-2800
Clinic Affiliation: Greater Austin
Orthopaedics
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Faubion, Cheryl A, LPT
Gender: Male
NPI: 1154576767
6618 Sitio Del Rio Blvd
Ste D102
J(512) 331-6200
Clinic Affiliation: Tillman Physical Therapy
Andsports Training Ctr
Practice Information: No Patients Under 5
yrs old
Board Certified Specialties: None
Feagin, Montgomery R, LPT
Gender: Male
NPI: 1750673893
2603 Jones Rd
J(512) 644-3354
Clinic Affiliation: The Weston Group Inc
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Austin
NPI: 1588896476
8868 Research Blvd
Ste 601
J(888) 997-2669
Clinic Affiliation: Concentra Medical
Centers
Board Certified Specialties: None
Aus tin
Austin
Fish, Annalisa S, LPT
Gender: Female
NPI: 1073895603
630 W 34th St
J(512) 439-1002
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: None
Austin
Flees, Josephine J, LPT
Gender: Female
NPI: 1972617470
# 300 Beardsley Ln
Bldg B
J(512) 345-5925
Aus tin
#
Elrod, Joshua D, LPT
Gender: Male
NPI: 1932429511
11101 N Burnet Rd
Ste A 170
(512) 835-5000
#
Finger, Eric J, LPT
Gender: Male
NPI: 1588896476
4301 W Wm Cannon Dr E
Ste 320
J(888) 997-2669
Aus tin
Aus tin
Aus tin
Foreman, Aaron E, LPT
Gender: Male
NPI: 1033214952
8000 Anderson Sq 301A
J(512) 377-2323
Clinic Affiliation: Orthotic and Prosthetic
Technologies
Board Certified Specialties: None
Frickey, Jill, LPT
Gender: Female
NPI: 1063781276
3901 S Lamar Blvd
Ste 140
(512) 462-3275
Clinic Affiliation: Select Physical Therapy
Holdings
Board Certified Specialties: None
Frost, Nicole F, LPT
Gender: Female
NPI: 1760417521
711 W 38th St
Ste B3 and B4
(512) 450-0909
Clinic Affiliation: Select Physical Therapy
Holdings
Board Certified Specialties: None
Gaewsky, Jennifer A, LPT
Gender: Female
NPI: 1750631354
13642 N Hwy 183
Bldg 2 Ste 200
(512) 331-4115
NPI: 1750631354
3303 Northland Dr Ste 312
(512) 291-2669
Clinic Affiliation: Line Leader Pediatric
Therapy PLL, Therapy One Ste 203
Board Certified Specialties: None
Galvan, Elias L, LPT
Gender: Male
NPI: 1730258724
1825 Fortview Rd
Ste 109
J(512) 892-5250
Clinic Affiliation: South Austin Therapy
Group Inc
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Gamm, Meredith K, LPT
Gender: Female
NPI: 1649522251
6818 Austin Center
Blvd Ste 111
(512) 418-8870
Clinic Affiliation: Select Physical Therapy
Holdings
Board Certified Specialties: None
Gray, Mary C, LPT
Gender: Female
NPI: 1528222346
# 12701 FM 620
(512) 401-0700
Austin
#
Austin
Austin
Garrett, Carole B, LPT
Gender: Female
NPI: 1730196536
# 9101 Burnet Rd Ste 103
J(512) 248-2422
Clinic Affiliation: Ltts LLP
Board Certified Specialties: None
Austin
NPI: 1972617470
4029 S Capital of Texas
Hwy Ste 111
J(512) 448-0995
NPI: 1972617470
6835 Austin Center Blvd
(512) 231-5210
Clinic Affiliation: Austin Regional Clinic PA,
The Spine Center
Practice Information: No Patients Under 12
yrs old
Board Certified Specialties: None
Aus tin
Gall, Michael, LPT
Gender: Male
NPI: 1831167550
7600 Burnet Rd
(512) 458-1183
Clinic Affiliation: Physiotherapy Assoc In
Plano
Board Certified Specialties: None
Austin
Austin
Austin
Austin
Grace Jr, James G, LPT
Gender: Male
NPI: 1679773790
# 4534 Westgate Blvd
Ste 104
(512) 892-7337
Austin
NPI: 1679773790
801 E William Cannon Dr
Ste 225
(512) 270-2060
Clinic Affiliation: Town & Country Physical
Therapy
Practice Information: No Patients Under 5
yrs old
Board Certified Specialties: None
Galewsky, Margaret I, LPT
Gender: Female
NPI: 1003162140
# 4607 Manchaca Rd
(512) 916-1511
Clinic Affiliation: Kidtherapy PLLC
Board Certified Specialties: None
Aus tin
Grijalva, Vanessa C, LPT
Gender: Female
NPI: 1710126693
11623 Angus Rd
Ste 18
(512) 345-4421
NPI: 1710126693
3705 Medical Pkwy
Ste 515
(512) 452-6475
NPI: 1710126693
3901 S Lamar Blvd
Ste 140
(512) 462-3275
NPI: 1710126693
6818 Austin Center Blvd
Ste 111
(512) 418-8870
Geibel, Laura T, LPT
Gender: Female
NPI: 1346358561
911 W 38th St
Ste 300
(512) 439-1953
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: None
Gossen, Laura M, LPT
Gender: Female
NPI: 1861828154
711 W 38th St Ste B3
and B4
(512) 450-0909
Clinic Affiliation: Select Physical Therapy
Holdings
Board Certified Specialties: None
Grebla, Kimberly, LPT
Gender: Female
NPI: 1588920839
3901 S Lamar Blvd
Ste 140
(512) 462-3275
Clinic Affiliation: Select Physical Therapy
Holdings
Board Certified Specialties: None
NPI: 1710126693
3200 Red River St
Ste 101
(512) 476-8857
Garwood, Margaret T, LPT
Gender: Female
NPI: 1902178189
6811 Austin Center
Blvd Ste 400
J(512) 628-1918
Clinic Affiliation: Pediatric Surgical
Subspecialists
Board Certified Specialties: None
Gillis, Shelley L, LPT
Gender: Female
NPI: 1124450770
1212 W Parmer Ln
Ste E
(512) 670-3238
Clinic Affiliation: Town & Country Physical
Therapy
Board Certified Specialties: None
NPI: 1528222346
4310 James Casey St
Ste 3C
(512) 441-6008
Clinic Affiliation: Greater Austin
Orthopaedics
Board Certified Specialties: None
NPI: 1710126693
711 W 38th St
Bldg B 3
(512) 450-0909
Clinic Affiliation: Select Physical Therapy
Holdings
Board Certified Specialties: None
Austin
Grimberg, Mary, LPT
Gender: Female
NPI: 1851675581
4534 Westgate Blvd
Ste 104
(512) 892-7337
Clinic Affiliation: Town & Country Physical
Therapy
Board Certified Specialties: None
Grossman, Jenna M, LPT
Gender: Female
NPI: 1710252986
# 4607 Manchaca Rd
J(512) 916-1511
Clinic Affiliation: Kidtherapy PLLC
Practice Information: No Patients Over 21
yrs old
Board Certified Specialties: None
Austin
Hadash, George, LPT
Gender: Male
NPI: 1891753612
# 3755 S Capital of Texas
Hwy Ste 150
(512) 439-1980
Clinic Affiliation: Texas Orthopedics Sports
And Rehab Assoc
Board Certified Specialties: None
Austin
J - Wheelchair Access
129
AUSTIN
Independent Provider Network (IPN)
bmk_pin_spec
OCTOBER 15, 2014
Specialists
The providers listed in this section are part of a Limited Provider Network. Please note: If your Primary Care Physician is with a Limited Provider Network, all your medical care must come
from providers who are in the same Limited Provider Network. For more information on Limited Provider Networks, please see the bottom of the Table of Contents of this directory.
Austin
AUSTIN Cont
PHYSICAL THERAPY Cont
Aus tin
Hadley, Megan D, LPT
Gender: Female
NPI: 1063811081
11623 Angus Rd
Ste 18
(512) 345-4421
Clinic Affiliation: Select Physical Therapy
Holdings
Board Certified Specialties: None
Hahn, Stephanie R, LPT
Gender: Female
NPI: 1376855239
# 7401 Hwy 71 W
Ste 130
(512) 288-2700
Clinic Affiliation: Star Physical Therapy
Board Certified Specialties: None
Austin
Aus tin
Hall, Scott L, LPT
Gender: Male
NPI: 1679517536
# 11614 Bee Caves Rd
Ste 160
J(512) 428-4261
Clinic Affiliation: Your Personal Best
Physical Therapy
Board Certified Specialties: None
Austin
Aus tin
Aus tin
Hamilton, Casey P, LPT
Gender: Male
NPI: 1356644629
3200 Red River St
Ste 101
(512) 476-8857
NPI: 1356644629
3901 S Lamar Blvd
Ste 140
(512) 462-3275
Clinic Affiliation: Select Physical Therapy
Holdings
Board Certified Specialties: None
Hammonds, Basimma F, LPT
Gender: Female
NPI: 1639225857
# 2200 Park Bend Dr
Bldg 1 Ste 202
(512) 339-1500
Aus tin
Austin
Harris, James T, LPT
Gender: Male
NPI: 1891789319
3508 Far West Blvd
Ste 240
J(512) 832-9411
Clinic Affiliation: Austin Manual Therapy
Assoc PC
Board Certified Specialties: None
! - Accepting Existing Patients Only
" - Board Certified In Listed Specialty
#- Extended Office Hours
Hasham, Laila H, LPT
Gender: Female
NPI: 1255748786
11623 Angus Rd
Ste 18
(512) 345-4421
Clinic Affiliation: Select Physical Therapy
Holdings
Board Certified Specialties: None
#
Hastings, Arthur A, LPT
Gender: Male
NPI: 1295854222
6835 Austin Ctr Blvd
(512) 346-6611
Clinic Affiliation: Austin Regional Clinic PA
Board Certified Specialties: None
Austin
Haynes, Jennifer L, LPT
Gender: Female
NPI: 1881855286
13450 Research Blvd
Ste 102
(512) 450-1300
Clinic Affiliation: Austin Sports Medicine
Board Certified Specialties: None
Austin
NPI: 1013916337
7401 W Hwy 71
Ste 130
J(512) 835-5000
Clinic Affiliation: Star Physical Therapy
Practice Information: No Patients Under 5
yrs old
Board Certified Specialties: None
Hurley, Thomas J, LPT
Gender: Male
NPI: 1508818840
3901 S Lamar Blvd
Ste 140
(512) 462-3275
Clinic Affiliation: Select Physical Therapy
Holdings
Board Certified Specialties: None
Jacobson, Kendal, LPT
Gender: Female
NPI: 1689962540
# 11614 Bee Caves Rd
Ste 100
J(512) 428-4261
#
Hilton, Lou Ann B, LPT
Gender: Female
NPI: 1841428778
4700 Seton Pkwy
(512) 439-1000
Austin
NPI: 1689962540
2500 W William Cannon Dr
Ste 409
J(512) 852-8434
Clinic Affiliation: Your Personal Best
Physical Therapy
Board Certified Specialties: None
Kertz, Laurie J, LPT
Gender: Female
NPI: 1346319811
# 1600 W 38th St
Ste 201
J(512) 206-0433
#
Austin
Austin
Austin
Austin
" Jeffery, Lisa M, LPT
Austi