DENNIS AGRICOLA (NPI# 1518367622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1518367622 |
Entity Type | Individual |
Full Name | DENNIS AGRICOLA |
Credential | NP |
Practice Address |
6200 Knauth Road Beaumont TX 77705 |
Mailing Address |
Po Box 1050 China TX 77613-1050 |
Practice Telephone | 4096585395 |
Mailing Telephone | 4096585395 |
Enumeration Date | 2014-08-26 |
Last Update Date | 2014-08-26 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
249768 | TX | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
6200 KNAUTH ROAD |
City | BEAUMONT |
State | TX |
Zip Code | 77705 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801431390 | Iris Fiaui | Specialist/Technologist | 4400 Mlk Jr Pkwy, Beaumont, TX 77705 | 2019-11-08 |
1437644937 | Kolten Elizabeth Adams | Specialist/Technologist | 4400 S Mlk Jr Parkway, Beaumont, TX 77705 | 2018-06-27 |
1326443391 | Scott Forbes | Psychologist | 6200 Knauth Rd, Beaumont, TX 77705 | 2014-11-03 |
1639591480 | Chs Texas Medical, P.a. | General Practice | 11357 Highway 10 Sw, Smith Rd, Beaumont, TX 77705 | 2014-01-14 |
1649523309 | Tri-medical Emergency Medical Services Lp | Ambulance | 4610 St. Louis St, Beaumont, TX 77705 | 2012-10-18 |
1437462785 | Cynthia Ksiazek | Social Worker | 857 E Virginia, Beaumont, TX 77705 | 2010-07-15 |
1457509424 | Gaurav Puri | Dentist | 4400 Highland Ave, Beaumont, TX 77705 | 2008-09-03 |
1588811731 | Prasad L Surapaneni | Family Medicine | 5430 Knauth Rd, Beaumont, TX 77705 | 2008-08-19 |
1891994612 | Jennifer Lien Truong | Occupational Therapist | 4205 Grandberry, Beaumont, TX 77705 | 2007-07-12 |
1578624219 | Kensley Enterprises, Inc. | Clinic/Center | 1945 Sarah, Beaumont, TX 77705 | 2006-12-13 |
Find all providers in zip 77705 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033725718 | Wendi Ellen Ames | Nurse Practitioner | 350 Pine St Ste 755, Beaumont, TX 77701-2437 | 2020-09-18 |
1093340697 | Amber Tenille Goldsmith | Nurse Practitioner | 4347 Phelan Blvd, Beaumont, TX 77707-2159 | 2020-03-04 |
1851925267 | Trey Perkins | Nurse Practitioner | 3650 N Major Dr Ste A, Beaumont, TX 77713-9573 | 2020-02-25 |
1972141158 | Lisa Marie Davila | Nurse Practitioner | 14870 Michelle Ln, Beaumont, TX 77713-2308 | 2019-12-18 |
1467095224 | Fines Pafira Pruett | Nurse Practitioner | 35232 Hogan Dr, Beaumont, CA 92223-7407 | 2019-10-24 |
1952944399 | Kevin Ray Jones | Nurse Practitioner | 6040 Carrie Ln, Beaumont, TX 77713-4192 | 2019-10-17 |
1447891320 | Summer Mcclain | Nurse Practitioner | 740 Hospital Dr Ste 250, Beaumont, TX 77701-4666 | 2019-10-02 |
1114579059 | Amy Rae Hederman | Nurse Practitioner | 3070 College St Ste 100b, Beaumont, TX 77701-4652 | 2019-07-11 |
1245898808 | Primary Care Anywhere, Pllc | Nurse Practitioner | 4347 Phelan, Suite 101, Beaumont, TX 77707 | 2019-05-30 |
1548824253 | Lisa Marie Leger | Nurse Practitioner | 3129 College St Ste 200, Beaumont, TX 77701-4682 | 2019-04-29 |
Find all providers in BEAUMONT |
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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.