HORATIO SPRAGUE TAVEAU IV (NPI# 1366632580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1366632580 |
Entity Type | Individual |
Full Name | HORATIO SPRAGUE TAVEAU IV |
Credential | DO |
Practice Address |
2300 S Clear Creek Rd Suite 101 Killeen TX 76549-4984 |
Practice Telephone | 2546344325 |
Practice Fax Number | 2542004099 |
Mailing Telephone | 8559634325 |
Mailing Fax Number | 8559634325 |
Enumeration Date | 2007-07-25 |
Last Update Date | 2014-05-16 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208D00000X | General Practice | J0696 | TX | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | MEDICARE PTAN | 00632M | 01 |
TX | 140005324 | 05 |
Street Address |
2300 S CLEAR CREEK RD SUITE 101 |
City | KILLEEN |
State | TX |
Zip Code | 76549-4984 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376541219 | Monty Lee Gohl | Surgery | 2300 S Clear Creek Rd, Killeen, TX 76549-4984 | 2005-07-13 |
1790026946 | Mandy Elaine Ethridge | Counselor | 2300 S Clear Creek Rd, Suite 205, Killeen, TX 76549-4984 | 2013-03-13 |
1649559188 | Shivani Patel | Pediatrics | 2300 S Clear Creek Rd, Suite 105, Killeen, TX 76549-4984 | 2011-08-15 |
1376840140 | Lone Star Circle of Care | Clinic/Center | 2300 S Clear Creek Rd, Suite 105, Killeen, TX 76549-4985 | 2011-02-14 |
1851590087 | Petra Welch | Nurse Practitioner | 2300 S Clear Creek Rd, Suite 103, Killeen, TX 76549-4984 | 2007-07-17 |
1134286024 | William Robert Rediske | Podiatrist | 2300 S Clear Creek Rd, Suite 203, Killeen, TX 76549-4984 | 2007-01-02 |
1215097761 | Karen Lynn Seitz | Nurse Practitioner | 2300 S Clear Creek Rd, Killeen, TX 76549-4984 | 2006-12-12 |
1306930250 | H. Sprague Taveau Iv Do Pa | General Practice | 2300 S Clear Creek Rd, Suite 101, Killeen, TX 76549-4984 | 2006-10-03 |
1760594329 | Shree Om Shrestha | Psychiatry & Neurology | 2300 S Clear Creek Rd, Killeen, TX 76549-4984 | 2006-08-31 |
1346275971 | Robert L. Allred Md Pa | Orthopaedic Surgery | 2300 S Clear Creek Rd, Suite 203, Killeen, TX 76549-4984 | 2006-07-12 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023630191 | Joy Angolo | Registered Nurse | 1403 Chips Drive, Unit A, Killeen, TX 76549 | 2020-05-12 |
1215587308 | Jacqueline Nicole Estrella | Nurse Practitioner | Med Options Killeen Nursing Homes, Kileen, TX 76549 | 2019-09-19 |
1366924052 | Barbara Ann Vaughn | Licensed Vocational Nurse | 413 Apt A Study Hall Loop, Killeen, TX 76549 | 2018-08-30 |
1124505359 | Carl R Darnall Army Medical Center | Clinic/Center | 5200 Bunny Trail, Killeen, TX 76549 | 2018-07-20 |
1518456961 | Robert Brott | Counselor | 1103west Stan Schuleter Loop, Building A, Suite 100, Killeen, TX 76549 | 2018-05-01 |
1922507417 | Family Endeavors, Inc. | Community/Behavioral Health | 1103 West Stan Schlueter Loop, Building A Suite 100, Killeen, TX 76549 | 2018-02-09 |
1285143859 | Jennifer Dawn Rothman | Behavioral Analyst | 4506 The Searchers Dr, Killeen, TX 76549 | 2017-09-26 |
1700307964 | City of Ennis | Skilled Nursing Facility | 5000 Thayer Dr, Killeen, TX 76549 | 2017-06-28 |
1790216190 | Neysa Stegmeyer | Nurse Practitioner | 4102 S. Clear Creek Road, Ste 107, Killeen, TX 76549 | 2017-03-27 |
1740721471 | Lspd At Killeen, Pllc | Dentist | 1103 West Stan Schlueter Loop Suite B-800, Killeen, TX 76549 | 2017-03-14 |
Find all providers in zip 76549 |
Taxonomy Code | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
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1578614996 | Omega Elmore | General Practice | 2900 Trimmier Rd, Killeen, TX 76542-6005 | 2007-01-13 |
1306930250 | H. Sprague Taveau Iv Do Pa | General Practice | 2300 S Clear Creek Rd, Suite 101, Killeen, TX 76549-4984 | 2006-10-03 |
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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.