ABILENE DIAGNOSTIC CLINIC, PLLC (NPI# 1912149758) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912149758 |
| Entity Type | Organization |
| Organization Name | ABILENE DIAGNOSTIC CLINIC, PLLC |
| Other Organization Name | PODIATRY DME SUITE 230 |
| Practice Address |
1665 Antilley Rd Ste 230 Abilene TX 79606-5291 |
| Mailing Address |
Po Box 5409 Abilene TX 79608-5409 |
| Practice Telephone | 3254372001 |
| Practice Fax Number | 3254372011 |
| Mailing Telephone | 3257935375 |
| Mailing Fax Number | 3257935357 |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2019-10-14 |
| Authorized Official Name | ANDREW KOUBA (CEO) |
| Authorized Official Telephone | 3254378645 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers |
| Other Name | Type Code |
|---|---|
| Abilene Diagnostic Podiatry Clinic | Other Name - Individual/Organization |
| Podiatry DME Suite 230 | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043725062 | Abilene Diagnostic Clinic, Pllc | Podiatrist | 1665 Antilley Rd Ste 210, Abilene, TX 79606-5276 | 2017-12-13 |
| 1013159854 | Abilene Diagnostic Clinic, Pllc | Podiatrist | 6250 Regional Plz Ste 1016, Abilene, TX 79606-5223 | 2009-03-25 |
| 1760482665 | Abilene Diagnostic Clinic, Pllc | Spec/Tech, Pathology | 1665 Antilley Rd Ste 190, Abilene, TX 79606-5249 | 2005-07-21 |
| 1346242567 | Abilene Diagnostic Clinic, Pllc | Specialist | 1665 Antilley Rd, # 200, Abilene, TX 79606-5265 | 2005-06-01 |
| 1275780744 | Abilene Diagnostic Clinic, Pllc | Clinic/Center | 1665 Antilley Rd, Suite 120, Abilene, TX 79606-5265 | 2008-08-26 |
| 1356341184 | Abilene Diagnostic Clinic, Pllc | Radiologic Technologist | 1665 Antilley Rd, Suite 200, Abilene, TX 79606-5265 | 2005-07-22 |
| 1497755235 | Abilene Diagnostic Clinic, Pllc | Specialist | 1665 Antilley Rd, Suite 200, Abilene, TX 79606-5265 | 2005-07-22 |
| Street Address |
1665 ANTILLEY RD STE 230 |
| City | ABILENE |
| State | TX |
| Zip Code | 79606-5291 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437103074 | Patrick Bruton | Podiatrist | 1665 Antilley Rd Ste 230, Abilene, TX 79606 | 2006-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235746793 | Tara Ann Patrick | Social Worker | Veterans Affairs, 3850 Ridgemont, Abilene, TX 79606 | 2020-09-29 |
| 1740815398 | Kevin William Regan | General Practice | 5326 Meadow Dr., Abilene, TX 79606 | 2020-03-04 |
| 1548800725 | Valentina Walls | Registered Nurse | 14 Verbena St., Abilene, TX 79606 | 2020-01-15 |
| 1932649803 | Palo Pinto County Hospital District | Skilled Nursing Facility | 6050 Hospital Drive, Abilene, TX 79606 | 2017-02-27 |
| 1679925127 | Tania Marie Oyola Rosario | Family Medicine | 6300 Regional Plz Ste 260, Abilene, TX 79606 | 2016-07-08 |
| 1972973196 | Brian Stuart | Specialist/Technologist | 4502 Antilley Rd, Abilene, TX 79606 | 2015-09-30 |
| 1255723151 | Megan Blair Greenway | Specialist/Technologist, Other | 7325 Clariece Drive, Abilene, TX 79606 | 2015-03-02 |
| 1215280698 | James T.s. O'neal II | Physician Assistant | 697 Louisianna Drive, Dyess Afb, TX 79606 | 2012-10-22 |
| 1548522675 | Chukwuemeka Charles Ezeoke | Internal Medicine | 1680 Antilley Rd Ste 120, Abilene, TX 79606 | 2012-06-14 |
| 1801152152 | Jeffrey Darren Edwards | Internal Medicine | 5302 Buffalo Gap Road, Suite 104, Abilene, TX 79606 | 2012-04-11 |
| Find all providers in zip 79606 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043725062 | Abilene Diagnostic Clinic, Pllc | Podiatrist | 1665 Antilley Rd Ste 210, Abilene, TX 79606-5276 | 2017-12-13 |
| 1013159854 | Abilene Diagnostic Clinic, Pllc | Podiatrist | 6250 Regional Plz Ste 1016, Abilene, TX 79606-5223 | 2009-03-25 |
| 1003853011 | Beil Cory Brown | Podiatrist | 1665 Antilley Rd., Suite 210, Abilene, TX 79606-5223 | 2006-05-31 |
| 1437103074 | Patrick Bruton | Podiatrist | 1665 Antilley Rd Ste 230, Abilene, TX 79606 | 2006-05-19 |
| 1871589713 | Danny Wheat | Podiatrist | 1401 Ambler Ave, Suite 102, Abilene, TX 79601-2216 | 2005-09-26 |
| 1639178387 | Martin Van Sloan | Podiatrist | 1150 N 18th St, Ste 206, Abilene, TX 79601 | 2005-07-15 |
| 1134123698 | Abilene Family Foot Center, P.a. | Podiatrist | 2501 S Willis St, Ste A, Abilene, TX 79605-6249 | 2005-06-11 |
| 1194144139 | Podiatric Medical Partners of Texas, Pa | Podiatrist | 1150 N 18th St, Suite 206, Abilene, TX 79601-2948 | 2014-04-07 |
| 1104000686 | Danny E Wheat | Podiatrist | 1401 Ambler Ave, Suite 102, Abilene, TX 79601-2216 | 2007-12-20 |
| 1265574602 | Abilene Footcare Associates | Podiatrist | 1401 Ambler Ave, Suite 102, Abilene, TX 79601-2216 | 2007-02-13 |
| Find all providers in ABILENE | ||||
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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.