KLEMENS ELDEN GUSTAFSON (NPI# 1841250404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841250404 |
| Entity Type | Individual |
| Full Name | KLEMENS ELDEN GUSTAFSON |
| Credential | MD |
| Practice Address |
989 Elkin Ln Roanoke TX 76262 |
| Practice Telephone | 8173794488 |
| Mailing Telephone | 8173794488 |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2009-06-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
G4300 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 133986305 | 05 |
| Street Address |
989 ELKIN LN |
| City | ROANOKE |
| State | TX |
| Zip Code | 76262 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861025611 | Freeform Chiropractic Trophy Club LLC | Chiropractor | 2240 Sh 114, Suite 650, Trophy Club, TX 76262 | 2020-02-20 |
| 1932748498 | Legacy Physical Therapy and Wellness | Physical Therapist | 351 N Byron Nelson Blvd, Suite 110, Roanoke, TX 76262 | 2020-01-02 |
| 1497399687 | Roanoke Foot & Ankle Institute, Pllc | Podiatrist | 351 W Byron Nelson Blvd, Suite 100, Roanoke, TX 76262 | 2019-10-31 |
| 1710470810 | Maria Guadalupe Madera | Dentist | 5000 Highway 114, Unit 130, Northlake, TX 76262 | 2018-06-13 |
| 1912414251 | 6 Day Dental Group - Roanoke, Pllc | Clinic/Center | 200 Tx-114, Roanoke, TX 76262 | 2018-01-09 |
| 1144746561 | Lone Star Neurosurgical Assistants | Physician Assistant | 1270 Casa Bella Ct, Westlake, TX 76262 | 2017-08-17 |
| 1710347562 | Randolph R West Dds Pllc | Dentist | 295 W. Byron Nelson Blvd, Ste 304, Roanoke, TX 76262 | 2016-03-07 |
| 1912367228 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 35 Arta Dr, Westlake, TX 76262 | 2016-02-29 |
| 1952760050 | Roanoke Dental Group,pc | Dentist | 1320 N Hwy 377 Suite 100, Roanoke, TX 76262 | 2016-02-17 |
| 1942683115 | Fatima Naurose Siraj | Dentist | 860 East Highway 114 Ideal Dental, Suite 200, Roanoke, TX 76262 | 2015-07-07 |
| Find all providers in zip 76262 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306257803 | Michelle A Clements | Family Medicine | 5415 Airport Rd, Roanoke, VA 24012-1303 | 2014-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720686496 | Hill Country Health Pllc | Family Medicine | 1010 Ranch Road 620 S Ste 107, Lakeway, TX 78734-5638 | 2020-10-14 |
| 1174139471 | Stacie Leann Herring | Family Medicine | 1300 Tx-107, La Villa, TX 78562 | 2020-09-22 |
| 1336753508 | Woodlands Diagnostic Clinic, Pa | Family Medicine | 9201 Pinecroft Dr Ste 200, Shenandoah, TX 77380-3889 | 2020-09-03 |
| 1932738465 | Arlington Integrative Medicine LLC | Family Medicine | 1420 N Cooper St Ste 109, Arlington, TX 76011-8530 | 2020-04-06 |
| 1396379772 | Heights Total Wellness Clinic, Pllc | Family Medicine | 1801 Durham Dr Ste 4, Houston, TX 77007-2272 | 2020-02-25 |
| 1063043271 | Katie Lianne Jubala | Family Medicine | 129 Park Place Cir, Iowa Park, TX 76367-1064 | 2020-01-28 |
| 1558909879 | Forrest Duane Giles | Family Medicine | 152 Mcvoid Rd, Springtown, TX 76082-5929 | 2019-12-17 |
| 1710525225 | Mary Osawe | Family Medicine | 1308 Winecup Ct, Allen, TX 75002-0983 | 2019-12-16 |
| 1609411735 | Sara E Bellard | Family Medicine | 4735 Ridgewood Ave, Port Arthur, TX 77642-6612 | 2019-11-13 |
| 1528600574 | Shearren Johnson | Family Medicine | 2162 Us Highway 259 S, Diana, TX 75640-3510 | 2019-10-10 |
| Find all providers with the same taxonomy | ||||
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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.