DR. EDMUND SAMI SABANEGH JR. (NPI# 1669451506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669451506 |
| Entity Type | Individual |
| Full Name | DR. EDMUND SAMI SABANEGH JR. |
| Credential | M.D. |
| Practice Address |
2200 Berquist Dr Ste 1, Credentials/cmc Lackland Afb TX 78236-5300 |
| Mailing Address |
8602 Boutry Hts San Antonio TX 78254-2300 |
| Practice Telephone | 2102926002 |
| Mailing Telephone | 2106805856 |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 0101040527 | VA | Allopathic & Osteopathic Physicians |
| Street Address |
2200 BERQUIST DR STE 1, CREDENTIALS/CMC |
| City | LACKLAND AFB |
| State | TX |
| Zip Code | 78236-5300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659362218 | Matthew Gerard Retzloff | Obstetrics & Gynecology | 2200 Berquist Dr, 859 Mdos/mmno, Suite 1, Lackland Afb, TX 78236-5300 | 2005-11-02 |
| 1245540566 | Emmalyn V. Tague | Physician Assistant | 2200 Berquist Dr, Lackland Afb, TX 78236-6040 | 2010-10-20 |
| 1659592459 | Steven Franklin Robertson Jr. | Dentist | 2200 Berquist Dr, Ste 1, Lackland Afb, TX 78236-9908 | 2007-05-01 |
| 1497731848 | Ronald Everett Wyatt | Nurse Anesthetist, Certified Registered | 2200 Berquist Dr, 59 Medical Wing/credentials, Lackland Afb, TX 76236-5300 | 2005-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063047363 | Arnoldo Arturo Gonzalez Jr. | Specialist/Technologist | 1033 Truemper St, Lackland Afb, TX 78236 | 2020-03-06 |
| 1023643343 | Meredith Grace Cockerell | Specialist/Technologist | W Military Drive, San Antonio, TX 78236 | 2020-03-06 |
| 1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
| 1952967077 | Paul Fianza Boseman | Nurse Practitioner | 1106 Wilford Hall Loop, San Antonio, TX 78236 | 2019-05-14 |
| 1689161978 | Kelly Jones Buckshire | Dentist | Dunn Dental Clinic, 1615 Truemper Rd, San Antonio, TX 78236 | 2018-04-23 |
| 1902308570 | Roger Louis Farney | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-28 |
| 1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
| 1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
| 1376906958 | David Kephart Jr. | General Practice | 1100 Wilford Hall Loop Bldg 4454, Jbsa Lackland, TX 78236 | 2016-04-01 |
| 1184084089 | Olivia Arballo | Dermatology | Wilford Hall Asc, Attn: Dept of Dermatology, 1100 Wilford Hall Loop Bldg 4554, Jbsa-lackland, TX 78236 | 2016-03-04 |
| Find all providers in zip 78236 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518573765 | William Cooper Buschemeyer IIi, M.d. P.a. | Urology | 26620 Interstate 45-north, The Woodlands, TX 77386 | 2020-09-22 |
| 1619587169 | Jasgurpreet Singh | Urology | 4310 Dunlavy St Apt 350, Houston, TX 77006-5312 | 2020-08-08 |
| 1215443064 | Greater Austin Urology, Pllc | Urology | 11673 Jollyville Rd Ste B101, Austin, TX 78759 | 2017-12-15 |
| 1649780453 | Paul Bradley Md Pllc | Urology | 703 E Marshall Ave Ste 4009, Longview, TX 75601-5500 | 2017-10-06 |
| 1154857977 | Darren M. Chapman M.d., Pllc | Urology | 10970 Shadow Creek Pkwy # 255, Pearland, TX 77584-0100 | 2017-05-11 |
| 1114308467 | Kashyap Shatagopam | Urology | 1900 Scenic Dr Ste 2222, Georgetown, TX 78626-7703 | 2015-06-12 |
| 1114311933 | Marshall Stein | Urology | 7777 Southwest Fwy Ste 540, Houston, TX 77074-1809 | 2015-03-19 |
| 1023401510 | Robert A Bloom Md Pllc | Urology | 416 S. Henderson St., Fort Worth, TX 76104 | 2015-03-09 |
| 1366853152 | Lawrence Tsai | Urology | 12319 N Mopac Expy Ste 200, Austin, TX 78758-2497 | 2014-05-14 |
| 1558780031 | Rachel Sosland | Urology | 4207 James Casey St Ste 107, Austin, TX 78745-1192 | 2014-04-10 |
| Find all providers with the same taxonomy | ||||
| City | LACKLAND AFB |
| Zip Code | 78236 |
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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.