WELLSPRING PHYSICIAN, P.A. (NPI# 1437558210) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437558210 |
| Entity Type | Organization |
| Organization Name | WELLSPRING PHYSICIAN, P.A. |
| Other Organization Name | 1STMD |
| Practice Address |
309 N. Washington Ave Suite 13 Bryan TX 76248 |
| Practice Telephone | 9794315664 |
| Mailing Telephone | 9794315664 |
| Enumeration Date | 2014-08-18 |
| Last Update Date | 2018-05-17 |
| Authorized Official Name | STEVEN GAFFNEY (ASSISTANT SECRETARY) |
| Authorized Official Telephone | 9794313451 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| 1stMD | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | WELLSPRING PHYSICIAN, P.A. | 309 N Washington Avenue, Suite 13, Bryan, TX 77803 |
| Vermont Business Registrations | WELLSPRING PHYSICIAN, P.A. | 219 North Main Street, Varisco Bldg., 5th Floor, Bryan, TX 77803 |
| Washington State Corporations | WELLSPRING PHYSICIAN, P.A. | 309 N Washington Ave, Suite 13, Bryan, TX 77803-5369 |
| Iowa Business Entities | WELLSPRING PHYSICIAN, P.A. P.C. | 309 N. Washington Avenue Suite 13, Bryan, TX 77803 |
| Street Address |
309 N. WASHINGTON AVE SUITE 13 |
| City | BRYAN |
| State | TX |
| Zip Code | 76248 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316556145 | Tyler Woodall | Counselor | 1668 Keller Parkway, Suite 200, Keller, TX 76248 | 2020-07-28 |
| 1396366456 | Kelcie Dao | Speech-Language Pathologist | 630 B Stoneglen Drive, Keller, TX 76248 | 2020-04-29 |
| 1003447384 | Alliance Orthotics and Prosthetics, L.L.C. | Prosthetic/Orthotic Supplier | 101 Bourland Rd Suite A, Keller, TX 76248 | 2020-01-27 |
| 1033759832 | Everest Rehabilitation Hospital Keller, LLC | Rehabilitation Hospital | 955 S. Main St., Keller, TX 76248 | 2020-01-09 |
| 1750934253 | Pediatric Dentistry of Keller Pllc | Dentist | 1627 Keller Parkway, Suite 100, Keller, TX 76248 | 2019-07-23 |
| 1306345293 | Jaqui Otto | Psychologist | 1664 Keller Parkway Ste 102, Keller, TX 76248 | 2018-02-06 |
| 1194223404 | Hartman Samuel Ian Watson | Chiropractor | 1211 S Main St Ste 300h, Keller, TX 76248 | 2018-02-01 |
| 1760900997 | Md First Watch Healthcare Pllc | Clinic/Center | 310 Keller Parkway, Keller, TX 76248 | 2017-09-08 |
| 1588104541 | Elias Alharari | Nurse Practitioner | 651 S Main St Ste 102, Keller, TX 76248 | 2017-02-24 |
| 1730631698 | Alliance Counseling and Education Center | Social Worker | 1540 Keller Parkway, Ste. 108-205, Keller, TX 76248 | 2016-10-26 |
| Find all providers in zip 76248 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609333095 | Holly Ann Kleypas | Family Medicine | 1121 Briarcrest Dr Ste 303, Bryan, TX 77802-2500 | 2019-02-21 |
| 1073047437 | Abbi Messer | Family Medicine | 2900 29th Street, Suite 100, Bryan, TX 77802 | 2017-04-12 |
| 1457898660 | Wellspring Physician, P.C. | Family Medicine | 309 N Washington Ave, Suite 13, Bryan, TX 77803-5368 | 2017-01-25 |
| 1700286986 | Michael D. Mckinney, Md. | Family Medicine | 3313 Emory Oak Dr, Bryan, TX 77807-4001 | 2014-08-25 |
| 1639490089 | Kuy Houser | Family Medicine | 2800 S Texas Ave, Suite 202, Bryan, TX 77802-5361 | 2010-06-21 |
| 1275705089 | Michael F. Ruggiero, Do, Pa | Family Medicine | 2901 E 29th St, Suite 123, Bryan, TX 77802-2692 | 2008-04-01 |
| 1750572681 | Benjamin W. Dudycha | Family Medicine | 3351 University Dr E Ste 111, Bryan, TX 77802-3470 | 2007-08-06 |
| 1164634606 | Sybil Jane Taquet | Family Medicine | 2410 Boonville Rd, Bryan, TX 77808-2226 | 2007-05-04 |
| 1831259399 | Davelyn Eaves Hood | Family Medicine | 3370 South Texas Avenue, Suite B, Bryan, TX 77802 | 2006-12-12 |
| 1275604878 | Warren Paul Roquet | Family Medicine | 3201 University Drive East, Suite 135, Bryan, TX 77802-3481 | 2006-11-13 |
| Find all providers in BRYAN | ||||
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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.