LAKESHIA TAMARA CARTER-LOGAN (NPI# 1699057414) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699057414 |
| Entity Type | Individual |
| Full Name | LAKESHIA TAMARA CARTER-LOGAN |
| Credential | PA-C |
| Practice Address |
271 Fort Richardson Ave 17th Medical Group Goodfellow Afb TX 76908 |
| Practice Telephone | 3256543677 |
| Mailing Telephone | 3256543677 |
| Enumeration Date | 2011-09-19 |
| Last Update Date | 2012-08-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
1091556 | ZZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
271 FORT RICHARDSON AVE 17TH MEDICAL GROUP |
| City | GOODFELLOW AFB |
| State | TX |
| Zip Code | 76908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780662197 | Clifton Wallace Bailey | Dentist | 271 Fort Richardson Ave, Goodfellow Afb, TX 76908-4901 | 2006-01-05 |
| 1487290912 | Stacy Poindexter | Pharmacist | 271 Fort Richardson Ave, Goodfellow Afb, TX 76908-4901 | 2019-11-19 |
| 1386106409 | Olivia Rosemary Tighe | Student in an Organized Health Care Education/Training Program | 271 Fort Richardson Ave, Goodfellow Afb, TX 76908 | 2019-04-06 |
| 1326545450 | Matthew Thomas Bean | Dentist | 271 Fort Richardson Ave, Goodfellow Afb, TX 76908-4901 | 2018-04-05 |
| 1548779234 | Stravens Moseti Omwenga | Nurse Practitioner | 271 Fort Richardson Ave, Goodfellow Afb, TX 76908-4901 | 2017-09-25 |
| 1326576521 | Aleksandr Golden Mcpike | Military Health Care Provider | 271 Fort Richardson Ave, Goodfellow Afb, TX 76908-4901 | 2017-06-01 |
| 1295263663 | Peter Dang | Dentist | 271 Fort Richardson Ave, Goodfellow Afb, TX 76908 | 2017-05-30 |
| 1306385083 | Latoya Danielle Johnson | Physician Assistant | 271 Fort Richardson Ave, Goodfellow Afb, TX 76908-4901 | 2017-02-15 |
| 1235687799 | Thomas Montgomery | Dentist | 271 Fort Richardson Ave, Goodfellow Afb, TX 76908-4901 | 2016-09-13 |
| 1497201925 | Samantha Slikkers | Dentist | 271 Fort Richardson Ave, Goodfellow Afb, TX 76908-4901 | 2016-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164590048 | George E Jones Jr. | Pharmacist | 271 Fort Richardson Avenue, San Angelo, TX 76908 | 2006-12-01 |
| 1679649750 | Denise Robin Lyons | Dentist | Dept of The Air Force, 17th Dental Flight (aetc), Goodfellow Afb, TX 76908 | 2006-11-28 |
| 1326132010 | David Franklin-fernandez | Physician Assistant | 271 Fort Richardson, Goodfellow Afb, TX 76908 | 2006-10-03 |
| 1609961077 | Iris Belmar Ortiz Gonzalez | Dentist | 271 Ft Richardson Ave, Goodfellow Afb, TX 76908 | 2006-10-03 |
| 1740785906 | Krishna Kidambi | Internal Medicine | 271 Fort Richardson Avenue, San Angelo, TX 76908 | 2018-03-28 |
| 1861705865 | Justin T Gathercoal | Family Medicine | 17th Medical Operations Squadron, Goodfellow Afb, San Angelo, TX 76908 | 2010-07-19 |
| 1609936848 | Robert Wesley Rainey | Pharmacist | 271 Ft Richardson Ave, Goodfellow Afb, TX 76908 | 2006-12-11 |
| 1760034698 | Lisbet Ivicic | Nurse Practitioner | 351 Kearney Blvd, San Angelo, TX 76908-3215 | 2019-07-11 |
| 1164088266 | Paul B Brown | Optometrist | 271 Fort Richardson Ave Ste 356, San Angelo, TX 76908-4901 | 2019-05-14 |
| 1821572561 | Andrew Amadeus De Los Reyes | Military Health Care Provider | 271 Fort Richardson Ave Bldg 1001, Goodfellow Afb, TX 76908-4901 | 2018-09-19 |
| Find all providers in zip 76908 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306385083 | Latoya Danielle Johnson | Physician Assistant | 271 Fort Richardson Ave, Goodfellow Afb, TX 76908-4901 | 2017-02-15 |
| 1952574824 | Teresa Marie Stanley | Physician Assistant | 271 Fort Richardson Ave, Bldg 1001, Goodfellow Afb, TX 76908-4901 | 2008-04-10 |
| 1851486419 | Warren Dial | Physician Assistant | 271 Fort Richardson Ave, Goodfellow Afb, TX 76908 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831704576 | Leila Olive Adell | Physician Assistant | 1221 S Congress Ave Apt 331, Austin, TX 78704-2461 | 2020-09-10 |
| 1619591864 | Today Telemedicine Pllc | Physician Assistant | 404 Oxford St Apt 2219, Houston, TX 77007-2679 | 2020-06-03 |
| 1497384168 | Gregory C Etienne | Physician Assistant | 7400 N 4th St, Mcallen, TX 78504-1859 | 2020-04-05 |
| 1689202475 | Theodore Inthaphom | Physician Assistant | 25222 Northwest Fwy Apt 349, Cypress, TX 77429-1065 | 2020-03-29 |
| 1740816982 | Alyssa Conrad | Physician Assistant | 4818 Star Jasmine Dr, Austin, TX 78723-6059 | 2020-03-19 |
| 1114558335 | Erin Lynn Brown | Physician Assistant | 1504 Taub Loop Houston, Houston, TX 77030 | 2020-01-27 |
| 1245870930 | Jessica Grimaldo | Physician Assistant | 1200 Brooklyn Ave Ste 230, San Antonio, TX 78212-0010 | 2020-01-09 |
| 1730728528 | Holli Marie Beard | Physician Assistant | 2625 Scripture St Ste 101, Denton, TX 76201-2304 | 2019-12-27 |
| 1477191237 | Ronald Edwin Brown | Physician Assistant | 1427 Cypress Point Dr, Gunter, TX 75058-3201 | 2019-12-11 |
| 1053957910 | Rossalya Aracely Granda Gutierrez | Physician Assistant | 4150 N Collins St, Arlington, TX 76005-4547 | 2019-11-25 |
| Find all providers with the same taxonomy | ||||
| City | GOODFELLOW AFB |
| Zip Code | 76908 |
Please comment or provide details below to improve the information on LAKESHIA TAMARA CARTER-LOGAN.
| 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.