SPACE CENTER IPA PA (NPI# 1891900981) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891900981 |
| Entity Type | Organization |
| Organization Name | SPACE CENTER IPA PA |
| Practice Address |
12902 Cloud Dr Santa Fe TX 77510-9345 |
| Mailing Address |
Po Box 525 Santa Fe TX 77510-0525 |
| Practice Telephone | 4093161928 |
| Practice Fax Number | 7133449421 |
| Mailing Telephone | 4093161928 |
| Mailing Fax Number | 7133449421 |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JOE E POUZAR (PRESIDENT) |
| Authorized Official Telephone | 4093161928 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Street Address |
12902 CLOUD DR |
| City | SANTA FE |
| State | TX |
| Zip Code | 77510-9345 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295940393 | Texas Professional Healthcare Alliance, Inc. | General Practice | 12902 Cloud Dr, Santa Fe, TX 77510-9345 | 2007-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629587035 | Tonya Bowman | Counselor | 39 Prarie Oaks Drive, Santa Fe, TX 77510 | 2017-09-28 |
| 1144622259 | 518 Pharmaceutical Services LLC | Pharmacy | 4111 Fm 1764 Rd, Ste F, Santa Fe, TX 77510 | 2014-09-19 |
| 1619988201 | Ralleen Fay Glasin-barfoot | Chiropractor | 12122 Hwy 6, Santa Fe, TX 77510-0987 | 2006-08-10 |
| 1316989668 | Santa Fe Chiropractic Center, Inc | Chiropractor | 12122 Highway 6, Santa Fe, TX 77510-2021 | 2006-06-12 |
| 1023233608 | Barbara S Brown | Chiropractor | 12122 Highway 6, Santa Fe, TX 77510-2021 | 2007-04-17 |
| 1700812542 | Jerry Wayne Vitek | Chiropractor | 12122 Highway 6, Santa Fe, TX 77510-2021 | 2006-06-23 |
| 1942523154 | Eloise Catrett | Nurse Practitioner | 11839 15th St, Santa Fe, TX 77510-2155 | 2010-03-03 |
| 1255659991 | Angela Marie Ryan | Rehabilitation Counselor | 4106 Twin Dr E, Santa Fe, TX 77510-3104 | 2010-05-05 |
| 1477037919 | Karlee Alayne Mcbride | Registered Nurse | 12222 Vista Real, Santa Fe, TX 77510-4036 | 2018-09-20 |
| 1689966269 | Frank Joesph Klementich | Pharmacist | 4218 Castle Dr, Santa Fe, TX 77510-6603 | 2011-05-13 |
| Find all providers in zip 77510 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275976284 | Clive Levine | General Practice | 508 Los Nidos Dr, Santa Fe, NM 87501-8356 | 2013-04-09 |
| 1851595326 | Cynthia Ann Knudson | General Practice | 1114 Hickox, Santa Fe, NM 87501 | 2007-06-11 |
| 1346469616 | John Sullivan Stafford | General Practice | 4226 Warpath Ave, Santa Fe, TX 77510-8615 | 2007-04-25 |
| 1255471926 | Ann Mccampbell | General Practice | 11 Esquila Rd, Santa Fe, NM 87508-8739 | 2007-02-08 |
| 1396704565 | Jeffrey J Hawkins | General Practice | 73 Paseo Del Paisano, Santa Fe, NM 87506-7984 | 2006-03-17 |
| 1447238159 | Andrew Langsam | General Practice | 3450 Zafarano Dr, Suite C, Santa Fe, NM 87507-2669 | 2006-01-03 |
| 1144627332 | St. Vincent Hospital | General Practice | 5501 Herrera Dr, Santa Fe, NM 87507-2684 | 2014-12-03 |
| 1790045839 | Joan Baumbach | General Practice | 1190 S Saint Francis Dr, N1350, Santa Fe, NM 87505-4173 | 2012-05-23 |
| 1457583049 | Tieraona Low Dog | General Practice | 3600 Cerrillos Rd, Suite 712, Santa Fe, NM 87507-2612 | 2009-08-14 |
| 1215173000 | New Mexico Pain Management, LLC | General Practice | 460 Saint Michaels Dr, Building 200, Santa Fe, NM 87505-7619 | 2008-12-28 |
| Find all providers in SANTA FE | ||||
Please comment or provide details below to improve the information on SPACE CENTER IPA PA.
| 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.