KELLI TWEDELL (NPI# 1477059228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477059228 |
| Entity Type | Individual |
| Full Name | KELLI TWEDELL |
| Other Name | KELLI KAUFMAN |
| Credential | PA-C |
| Practice Address |
5744 Lbj Fwy Ste 100 Dallas TX 75240-6322 |
| Mailing Address |
Po Box 3409 Pflugerville TX 78691-3409 |
| Practice Telephone | 2144662828 |
| Practice Fax Number | 2143829798 |
| Mailing Telephone | 5132527792 |
| Mailing Fax Number | 5139045908 |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2020-09-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA11922 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | TEXAS MEDICAL BOARD | PA11922 | 01 |
| TX | 382709902 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7300 Eldorado Pkwy Ste 260, Mckinney, TX 750703826 | 9727470440 | 9727470441 |
| Street Address |
5744 LBJ FWY STE 100 |
| City | DALLAS |
| State | TX |
| Zip Code | 75240-6322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770593436 | Han Pham Hulen | Internal Medicine | 5744 Lbj Fwy Ste 100, Dallas, TX 75240-6322 | 2006-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104469824 | Amber Christine Wrye | Counselor | 5433 Alpha Rd, Dallas, TX 75240 | 2019-10-25 |
| 1134610934 | Kristen Cairns | Counselor | 13140 Coit Rd # 328, Dallas, TX 75240 | 2018-05-29 |
| 1255821435 | Axiom Health Services, LLC | Specialist/Technologist, Other | 5422 Alpha Rd, Dallas, TX 75240 | 2018-05-14 |
| 1114438991 | Donald R Missel | Nurse Anesthetist, Certified Registered | 6606 Lbj Freeway, Suite 200, Dallas, TX 75240 | 2017-10-19 |
| 1689119307 | Ginger Lee Hagood | Counselor | 5580 Lbj Freeway, Suite 300, Dallas, TX 75240 | 2017-01-04 |
| 1831565712 | Stella I Clark | Nurse's Aide | 7373 Valley View Ln #2065, Dallas, TX 75240 | 2015-08-14 |
| 1790163608 | Shana Lynn Gangi | Social Worker | 13601 Preston Rd Ste W970, Dallas, TX 75240 | 2015-05-12 |
| 1134527096 | Jahvel Thompson | Physician Assistant | 8112 W. Spring Valley Rd., Dallas, TX 75240 | 2014-12-09 |
| 1295137396 | Rineil Francis Perez | Pharmacist | 13131 Monfort Dr, Dallas, TX 75240 | 2014-09-19 |
| 1255731311 | Arturo Ojeda | Counselor | 13140 Coit Rd Ste 326, Dallas, TX 75240 | 2014-08-26 |
| Find all providers in zip 75240 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326691957 | Kourtney Marie Willett | Physician Assistant | 1411 N Beckley Ave Pav 3 Suite 363, Dallas, TX 75203-1259 | 2019-07-23 |
| 1003302944 | Amk Provider Solutions Pllc | Physician Assistant | 8197 Midtown Blvd Apt 15101, Dallas, TX 75231-4566 | 2018-07-03 |
| 1184136632 | Pa Solutions, Pllc | Physician Assistant | 1408 N Riverfront Blvd # 166, Dallas, TX 75207-3912 | 2017-10-24 |
| 1528589918 | Operator Assistants, LLC | Physician Assistant | 8440 Walnut Hill Ln Ste 250, Dallas, TX 75231-3815 | 2017-07-06 |
| 1447603683 | Exos Surgical Assist, Pllc | Physician Assistant | 7324 Gaston Ave Ste 124-90, Dallas, TX 75214-6126 | 2016-07-22 |
| 1871941419 | Premier Physician Surgical Associates, Pllc | Physician Assistant | 9540 Garland Rd # 381-416, Dallas, TX 75218-5004 | 2016-05-24 |
| 1144686452 | Clara Joplin | Physician Assistant | 10830 N. Central Expy. Suite 120, Dallas, TX 75231-1050 | 2016-01-04 |
| 1689057820 | Horizon Pa Services, Pllc | Physician Assistant | 381 Casa Linda Plz # 417, Dallas, TX 75218-3471 | 2015-07-07 |
| 1942681572 | Ridgeback Assist, Pllc | Physician Assistant | 381 Casa Linda Plz # 418, Dallas, TX 75218-3471 | 2015-06-09 |
| 1164802385 | Kris Holmes Pa Pllc | Physician Assistant | 740 Peavy Rd, Dallas, TX 75218-2149 | 2015-06-03 |
| Find all providers in DALLAS | ||||
Please comment or provide details below to improve the information on KELLI TWEDELL.
| 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.