PHYSICIANS OF KING'S DAUGHTERS, PA (NPI# 1518268812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1518268812 |
Entity Type | Organization |
Organization Name | PHYSICIANS OF KING'S DAUGHTERS, PA |
Other Organization Name | KING'S DAUGHTERS CLINIC |
Practice Address |
1909 Sw H K Dodgen Loop Temple TX 76502-1814 |
Mailing Address |
1905 Sw H K Dodgen Loop Temple TX 76502-1814 |
Practice Telephone | 2542951210 |
Practice Fax Number | 2542951205 |
Mailing Telephone | 2542982400 |
Mailing Fax Number | 2547787197 |
Enumeration Date | 2010-11-03 |
Last Update Date | 2010-11-03 |
Authorized Official Name | DR. JEFFERY D. KROLL (PRESIDENT) |
Authorized Official Telephone | 2542982400 |
Authorized Official Credential | MD |
Is Organization Subpart | Y |
Parent Organization Name | PHYSICIANS OF KING'S DAUGHTERS, PA |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
R04610 | TX | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | 110836702 | 05 |
Other Name | Type Code |
---|---|
King's Daughters Clinic | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619213873 | Physicians of King's Daughters, Pa | Internal Medicine | 800 W Central Texas Expy, Harker Heights, TX 76548-1899 | 2012-12-17 |
1134465396 | Physicians of King's Daughters, Pa | Obstetrics & Gynecology | 2025 Memory Ln, Suite 500, Harker Heights, TX 76548-7487 | 2012-12-17 |
1033375076 | Physicians of King's Daughters, Pa | Allergy & Immunology | 1905 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2008-07-30 |
1609066620 | Physicians of King's Daughters, Pa | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1905 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2007-07-26 |
1710103163 | Physicians of King's Daughters, Pa | Durable Medical Equipment & Medical Supplies | 1713 Sw H K Dodgen Loop, Temple, TX 76502-1836 | 2007-04-17 |
1184840530 | Physicians of King's Daughters, Pa | Durable Medical Equipment & Medical Supplies | 401 W Jasper Dr, Killeen, TX 76542-1323 | 2007-04-17 |
1992921340 | Physicians of King's Daughters, Pa | Durable Medical Equipment & Medical Supplies | 1817 Sw H K Dodgen Loop, Temple, TX 76502-1815 | 2007-04-17 |
1801012257 | Physicians of King's Daughters, Pa | Durable Medical Equipment & Medical Supplies | 1717 Sw H K Dodgen Loop, Temple, TX 76502-1838 | 2007-04-17 |
1740406198 | Physicians of King's Daughters, Pa | Durable Medical Equipment & Medical Supplies | 1300 E 6th Ave, Belton, TX 76513-2810 | 2007-04-17 |
1275756264 | Physicians of King's Daughters, Pa | Clinic/Center | 1905 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2007-04-10 |
Street Address |
1909 SW H K DODGEN LOOP |
City | TEMPLE |
State | TX |
Zip Code | 76502-1814 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508489782 | Seton Family of Doctors | Clinic/Center | 1909 Sw H K Dodgen Loop, Suite A, Temple, TX 76502 | 2020-05-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033710850 | Bih Mobanoe Chi | Pharmacist | 6801 West Adams Avenue, Temple, TX 76502 | 2020-11-06 |
1639705403 | Robert David Pompella | Chiropractor | 4805 Stone Ridge Dr, Temple, TX 76502 | 2020-03-12 |
1275167488 | Luong Dental, LLC | Dentist | 5297 S. 31st Street, Ste 111, Temple, TX 76502 | 2020-02-26 |
1093357931 | Ryan T Stephens Dmd Pllc | Dentist | 5408 W. Adams Suite 102, Temple, TX 76502 | 2019-10-11 |
1164071817 | Danyelle Denise Pividori | Licensed Vocational Nurse | 992 Marlandwood Rd, Temple, TX 76502 | 2019-09-05 |
1831670652 | Jane Lida Jarosz | Registered Nurse | 99 Marlandwood, Temple, TX 76502 | 2018-08-29 |
1043791809 | Elsa Gamban Baker | Licensed Practical Nurse | 5711 Hopkins Dr, Temple, TX 76502 | 2018-08-28 |
1659859288 | Laura Bright | Licensed Vocational Nurse | 990 Marlanwood, Temple, TX 76502 | 2018-08-06 |
1811489974 | Rockdale Blackhawk, LLC | Clinic/Center | 1909 Sw Hk Dodgen Loop, Temple, TX 76502 | 2018-06-05 |
1871094573 | Moc Temple, LLC | Skilled Nursing Facility | 725 Marlandwood Rd., Temple, TX 76502 | 2018-02-27 |
Find all providers in zip 76502 |
Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134574882 | Kurt Fraivillig | Radiology | 2401 S 31st St # Ms 01w256, Temple, TX 76508-0001 | 2016-05-02 |
1699069260 | Grace M Thomas | Radiology | 1213 Waters Dairy Rd, Apt 1015, Temple, TX 76502-3425 | 2011-06-01 |
1851453534 | Matthew Brandon Crisp | Radiology | Scott & White Healthcare Radiology, 2401 S 31st St, Temple, TX 76508-0001 | 2006-12-15 |
1285743369 | Johnnie Gene Hutka | Radiology | 7312 Boutwell Dr., Temple, TX 76502-4208 | 2006-08-30 |
1750497566 | Harry Heungho Ko | Radiology | 1901 S 1st Street, Temple, TX 76504-9976 | 2006-08-22 |
1205849445 | Yashodeep P Jadhav | Radiology | 1901 S First Street, Temple, TX 76504-9976 | 2006-08-15 |
1538157771 | Gordon Vincent | Radiology | 1901 South 1st Street, Imaging Service (114t), Temple, TX 76504-7451 | 2005-10-12 |
1720436900 | Jared Corn | Radiology | 2401 S 31st St, Temple, TX 76508-0001 | 2016-05-29 |
1053768788 | Robert Edward Smith | Radiology | 2401 S 31st St, Temple, TX 76508-0001 | 2016-05-23 |
1598142226 | Gregory Ryan Stenoien | Radiology | 2401 S 31st St, Ms-01-w256, Temple, TX 76508-0001 | 2015-05-01 |
Find all providers in TEMPLE |
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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.