BLACK ACRE EMERGENCY PHYSICIANS MEDICAL GROUP PLLC (NPI# 1013559707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013559707 |
| Entity Type | Organization |
| Organization Name | BLACK ACRE EMERGENCY PHYSICIANS MEDICAL GROUP PLLC |
| Practice Address |
100 Medical Pkwy Lakeway TX 78738-5621 |
| Mailing Address |
Po Box 8292 Fort Worth TX 76124-0292 |
| Practice Telephone | 8174514208 |
| Practice Fax Number | 8175633699 |
| Mailing Telephone | 8174514208 |
| Mailing Fax Number | 8175633699 |
| Enumeration Date | 2019-10-14 |
| Last Update Date | 2019-10-14 |
| Authorized Official Name | BRIAN C DAWSON (OWNER) |
| Authorized Official Telephone | 8174514208 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
100 MEDICAL PKWY |
| City | LAKEWAY |
| State | TX |
| Zip Code | 78738-5621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417472879 | Lowell M Scott | Specialist/Technologist, Other | 100 Medical Pkwy, Lakeway, TX 78738-5621 | 2017-08-07 |
| 1740729052 | Community Radiology Associates, Pa | Clinic/Center | 100 Medical Pkwy, Radiology Department, Lakeway, TX 78738-5621 | 2017-02-20 |
| 1790238574 | Minda Zhu | Physician Assistant | 100 Medical Pkwy, Lakeway, TX 78738-5621 | 2016-07-28 |
| 1619358934 | Mary Theoktisto | Internal Medicine | 100 Medical Pkwy, Lakeway, TX 78738-5621 | 2015-06-11 |
| 1508244799 | Mohammad Luqman | Internal Medicine | 100 Medical Pkwy, Lakeway, TX 78738-5621 | 2015-05-08 |
| 1346645900 | Tania Ramirez Fonseca | Internal Medicine | 100 Medical Pkwy, Lakeway, TX 78738 | 2014-10-24 |
| 1417367202 | Andrea Ahern | Dietitian, Registered | 100 Medical Pkwy, Lakeway, TX 78738-5621 | 2014-05-01 |
| 1881004034 | Austin Lemaster | Internal Medicine | 100 Medical Pkwy, Lakeway, TX 78738 | 2014-04-28 |
| 1164865788 | Tara Kulkarni | Family Medicine | 100 Medical Pkwy, Lakeway, TX 78738-5621 | 2013-04-12 |
| 1942541552 | Kurt Von Rueden, Md, Pa | Orthopaedic Surgery | 100 Medical Pkwy, Lakeway, TX 78738-5621 | 2013-03-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841808987 | Innovative Sports Therapy LLC | Clinic/Center | 3932-a Rr 620 S., Bee Cave, TX 78738 | 2020-07-15 |
| 1447807839 | Texas Physical Therapy Specialists | Durable Medical Equipment & Medical Supplies | 101 Medical Parkway, Suite 110, Lakeway, TX 78738 | 2019-08-21 |
| 1831744101 | Laurel Brynne Boyd | Physical Therapist | 2501 Rr 620, Suite 140, Lakeway, TX 78738 | 2019-08-05 |
| 1033777404 | Maria Wesley-pinion Lcsw Csat Pllc | Social Worker | 2802 Flintorock Trace, Suite B101, Lakeway, TX 78738 | 2019-05-31 |
| 1801362637 | Iq Dental Pllc | Dentist | 15511 State Highway 71 West, Suite # 120, Bee Cave, TX 78738 | 2018-10-19 |
| 1790264687 | Doctx3 Pllc | Orthopaedic Surgery | 11514 Bee Caves Rd., Suite 130, Bee Cave, TX 78738 | 2018-08-10 |
| 1710479530 | Herbert A Fritsche Jr. | Pathology | 12117 Bee Caves Road, Building 3 Suite 100, Austin, TX 78738 | 2018-06-06 |
| 1518456417 | Chemist Laboratory LLC | Pharmacy | 3944 Ranch Road 620s, Bldg 6, Bee Cave, TX 78738 | 2018-05-07 |
| 1700397809 | Katrina Balangue | Speech-Language Pathologist | 3595 Ranch Road 620 S Unit 220, Austin, TX 78738 | 2017-10-16 |
| 1013468586 | Muve - Lakeway Ambulatory Surgical Center, LLC | Clinic/Center | 5329 Serene Hills Drive, Suite 100, Lakeway, TX 78738 | 2016-10-20 |
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| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245469832 | Fatima Suleman Hatia | Emergency Medicine | 1518 Ranch Road 620 S Ste 100, Lakeway, TX 78734 | 2009-07-06 |
| 1659645356 | Eplrmc, Pa | Emergency Medicine | 100 Medical Parkway, Lakeway, TX 78738-1782 | 2012-02-28 |
| 1679872204 | Steven T. Elsbecker | Emergency Medicine | 100 Medical Pkwy, Lakeway, TX 78738-5621 | 2011-03-22 |
| 1346401999 | Dan Gozhansky | Emergency Medicine | 100 Medical Parkway, Lakeway, TX 78734 | 2008-06-17 |
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|---|---|---|---|---|
| 1568062297 | Davies Recovery,llc | Emergency Medicine | 9503 Middlex Dr, San Antonio, TX 78217-5915 | 2020-10-30 |
| 1841807526 | Talo Medical Management, LLC | Emergency Medicine | 4190 Fm 2933, Mckinney, TX 75071-0352 | 2020-09-28 |
| 1770199101 | Mavon Oversight Pllc | Emergency Medicine | 340 Van Bibber, Salado, TX 76571 | 2020-09-21 |
| 1568077675 | Eir Pllc | Emergency Medicine | 5150 Lemmon Ave Ste 108, Dallas, TX 75209-6428 | 2020-09-15 |
| 1942819479 | Atascocita Emergency Center, LLC | Emergency Medicine | 5324 Atascocita Rd Ste T, Humble, TX 77346-2971 | 2020-07-30 |
| 1467070698 | Emer Rowlett Physicians, Pllc | Emergency Medicine | 3301 Lakeview Pkwy, Rowlett, TX 75088-3321 | 2020-07-14 |
| 1225656176 | Summit Emergency Medicine Pllc | Emergency Medicine | 2501 W 7th St Ste 101, Fort Worth, TX 76107-8014 | 2020-07-08 |
| 1720604937 | Summit Emergency Medicine Pllc | Emergency Medicine | 606 Grapevine Hwy Ste Abc, Hurst, TX 76054-2758 | 2020-06-23 |
| 1669097382 | Star Ed Pllc | Emergency Medicine | 4617 Saint Clair Ct, Flower Mound, TX 75022-1041 | 2020-06-09 |
| 1992326078 | Sarah N Ibanez Shaw | Emergency Medicine | Ut Austin Dell Medical School Em Residency Program, 1400 N. I-35, Suite 2.230, Austin, TX 78701 | 2020-04-30 |
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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.