DR. JOEL BRENNAN MAHAN (NPI# 1720239106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720239106 |
| Entity Type | Individual |
| Full Name | DR. JOEL BRENNAN MAHAN |
| Credential | M.D. |
| Practice Address |
609 Elm Ave Waco TX 76704 |
| Mailing Address |
1600 Providence Dr Waco TX 76707-2261 |
| Practice Telephone | 2543136900 |
| Practice Fax Number | 2543136959 |
| Mailing Telephone | 2543134200 |
| Mailing Fax Number | 2543134326 |
| Enumeration Date | 2008-10-03 |
| Last Update Date | 2016-03-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | N0937 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 200061401 | 05 |
| Street Address |
609 ELM AVE |
| City | WACO |
| State | TX |
| Zip Code | 76704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215033725 | Clifton Martin | Dentist | 609 Elm Ave, Waco, TX 76704 | 2006-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780123356 | Scott Kennedy | Dentist | 609 Elm Avenue, Waco, TX 76704 | 2017-02-15 |
| 1023499407 | Cenikor Foundation | Community/Behavioral Health | 2601 Gholson Rd., Waco, TX 76704 | 2015-06-11 |
| 1003085135 | Woodland Springs Healthcare Lp | Skilled Nursing Facility | 1010 Dallas St, Waco, TX 76704 | 2008-02-22 |
| 1649257429 | Floyd Lee Barry | Pediatrics | 1911 Martin Luther King Blvd, Waco, TX 76704 | 2005-12-22 |
| 1245217058 | Lauren Gallemore Barron | Family Medicine | 1911 Martin Luther King Blvd, Waco, TX 76704 | 2005-12-22 |
| 1104123926 | Mclennan County | Social Worker | 2601 Gholson Rd, Waco, TX 76704-1106 | 2011-02-14 |
| 1528625035 | Sherine Amondi Oganga | Registered Nurse | 413 Dearborn St, Waco, TX 76704-1431 | 2019-05-21 |
| 1477837730 | Heart of Texas Community Health Center, Inc. | Family Medicine | 1911 N Martin Luther King Jr Blvd, Waco, TX 76704-1438 | 2011-10-05 |
| 1356781579 | Kathryn Christen Siems | Physician Assistant | 1911 Martin Luther King Blvd, Waco, TX 76704-1438 | 2013-07-02 |
| 1689283764 | Rylee Valtr | Speech-Language Pathologist | 1010 Dallas St, Waco, TX 76704-1711 | 2020-07-24 |
| Find all providers in zip 76704 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548881477 | Gp Medical Services, LLC | Family Medicine | 7200 Westover Rd, Waco, TX 76710-1084 | 2020-05-01 |
| 1265917959 | Martindale Family Medicine Clinic Pa | Family Medicine | 7104 New Sanger Ave, Waco, TX 76712-3928 | 2018-09-27 |
| 1417486812 | Van Kim Nguyen | Family Medicine | 1600 Providence Dr., Waco, TX 76707-2261 | 2017-06-08 |
| 1831596642 | Kerry Irons | Family Medicine | 2712 Cresthill Cir, Waco, TX 76710-1016 | 2014-11-21 |
| 1851730022 | Krystal Ann Estrada | Family Medicine | 1600 Providence Drive, Waco, TX 76707 | 2013-06-20 |
| 1144664061 | Sid Jones X | Family Medicine | 5010 Lakeland Cir Ste A, Waco, TX 76710-2981 | 2013-04-22 |
| 1033450044 | Careconnect Medical Group P.l.l.c | Family Medicine | 1600 Lake Shore Dr Apt 121, Waco, TX 76708-3702 | 2013-03-15 |
| 1942584255 | Heart of Texas Community Health Center, Inc. | Family Medicine | 4601 N 19th St, Waco, TX 76708-1261 | 2011-10-05 |
| 1477837730 | Heart of Texas Community Health Center, Inc. | Family Medicine | 1911 N Martin Luther King Jr Blvd, Waco, TX 76704-1438 | 2011-10-05 |
| 1730478777 | Garret Pool | Family Medicine | 600 Franklin Ave, Suite B-c, Waco, TX 76701-0002 | 2011-03-30 |
| Find all providers in WACO | ||||
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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.