JENTRY DANIELLE RIDDLE (NPI# 1003849837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003849837 |
| Entity Type | Individual |
| Full Name | JENTRY DANIELLE RIDDLE |
| Other Name | JENTRY DANIELLE ANDREWS |
| Credential | PA |
| Practice Address |
4204 East Stan Schleuter Loop Killeen TX 76542-8352 |
| Mailing Address |
1201 Sam Bass Road Round Rock TX 78681-4137 |
| Practice Telephone | 2546902800 |
| Practice Fax Number | 2546905401 |
| Mailing Telephone | 5123881861 |
| Mailing Fax Number | 5123880373 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2009-06-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | PA05748 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | MP00154600 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA05748 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 1991747-02 | 05 | |
| TX | 1991747-01 | 05 |
| Street Address |
4204 EAST STAN SCHLEUTER LOOP |
| City | KILLEEN |
| State | TX |
| Zip Code | 76542-8352 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841839446 | Phuong Lan Carter | Counselor | 9312 Bowlfield Drive, Killeen, TX 76542 | 2019-12-30 |
| 1083252209 | Killeen Dental and Orthodontics Pllc | Dentist | 2620 Trimmier Rd, Killeen, TX 76542 | 2019-12-18 |
| 1750935391 | Leo Mora Therapy Services Pllc | Marriage & Family Therapist | 400 W. Jasper Dr. Ste. 100b, Killeen, TX 76542 | 2019-08-01 |
| 1730742305 | Angela Eads | Behavioral Analyst | 3106 S Ws Young Dr, Building A, Suite 104/105, Killen, TX 76542 | 2019-04-18 |
| 1801370572 | Keri Keller | Dentist | 507 W Stan Schlueter Loop Ste 400, Killeen, TX 76542 | 2018-09-19 |
| 1740787209 | Cynthia Waller | Speech-Language Pathologist | 4205 Old Florence Road, Killeen, TX 76542 | 2018-04-11 |
| 1275034597 | Killeen Modern Dentistry, PC | Dentist | 507 W Stan Schlueter Loop, Suite 104, Killeen, TX 76542 | 2018-02-22 |
| 1780182691 | Jennifer Monique Coleman | Counselor | 9706 Shimla Drive, Killeen, TX 76542 | 2018-01-25 |
| 1255870440 | Glori Sommerer | Counselor | 100 S Central Texas Expressway, # 208, Harker Heights, TX 76542 | 2017-02-21 |
| 1306382775 | Dana Michelle Kerekes | Massage Therapist | 5001 Teal Drive, Killeen, TX 76542 | 2017-01-10 |
| Find all providers in zip 76542 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093063380 | Jennifer Ellen Young | Physician Assistant | 2301 S Clear Creek Rd Ste 206, Killeen, TX 76549-4119 | 2012-08-17 |
| 1033259155 | Dorothy Mae Thompson | Physician Assistant | 4310 Boots Dr, Killeen, TX 76549-2794 | 2007-02-07 |
| 1861556631 | Jeffrey A Brooks | Physician Assistant | 4400-3 E Central Texas Expy, Suite A, Killeen, TX 76543-7372 | 2006-12-19 |
| 1760042071 | Samantha Duran Mcgrade | Physician Assistant | 4501 S Clear Creek Rd, Killeen, TX 76549-4218 | 2019-06-18 |
| 1023044898 | Matt P. Prewitt | Physician Assistant | 2201 S Clear Creek Rd, Killeen, TX 76549-4110 | 2006-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831704576 | Leila Olive Adell | Physician Assistant | 1221 S Congress Ave Apt 331, Austin, TX 78704-2461 | 2020-09-10 |
| 1619591864 | Today Telemedicine Pllc | Physician Assistant | 404 Oxford St Apt 2219, Houston, TX 77007-2679 | 2020-06-03 |
| 1497384168 | Gregory C Etienne | Physician Assistant | 7400 N 4th St, Mcallen, TX 78504-1859 | 2020-04-05 |
| 1689202475 | Theodore Inthaphom | Physician Assistant | 25222 Northwest Fwy Apt 349, Cypress, TX 77429-1065 | 2020-03-29 |
| 1740816982 | Alyssa Conrad | Physician Assistant | 4818 Star Jasmine Dr, Austin, TX 78723-6059 | 2020-03-19 |
| 1114558335 | Erin Lynn Brown | Physician Assistant | 1504 Taub Loop Houston, Houston, TX 77030 | 2020-01-27 |
| 1245870930 | Jessica Grimaldo | Physician Assistant | 1200 Brooklyn Ave Ste 230, San Antonio, TX 78212-0010 | 2020-01-09 |
| 1730728528 | Holli Marie Beard | Physician Assistant | 2625 Scripture St Ste 101, Denton, TX 76201-2304 | 2019-12-27 |
| 1477191237 | Ronald Edwin Brown | Physician Assistant | 1427 Cypress Point Dr, Gunter, TX 75058-3201 | 2019-12-11 |
| 1053957910 | Rossalya Aracely Granda Gutierrez | Physician Assistant | 4150 N Collins St, Arlington, TX 76005-4547 | 2019-11-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.