MELODY J A DESANTIAGO (NPI# 1982624193) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982624193 |
| Entity Type | Individual |
| Full Name | MELODY J A DESANTIAGO |
| Credential | CPNP |
| Practice Address |
4102 S Clear Creek Rd Ste 107 Killeen TX 76549-5954 |
| Mailing Address |
503 W Vardeman Ave Killeen TX 76541-7962 |
| Practice Telephone | 2545268300 |
| Practice Fax Number | 2545264828 |
| Mailing Telephone | (254) 501-3793 |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2018-06-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | AP113575 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 367312101 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2301 S Clear Creek Rd, Suite 226, Killeen, TX 765494143 | 2545268300 | 2545264828 |
| Street Address |
4102 S CLEAR CREEK RD STE 107 |
| City | KILLEEN |
| State | TX |
| Zip Code | 76549-5954 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316487127 | Debra Jeanette Lynch | Nurse Practitioner | 4102 S Clear Creek Rd Ste 107, Killeen, TX 76549-5954 | 2017-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023630191 | Joy Angolo | Registered Nurse | 1403 Chips Drive, Unit A, Killeen, TX 76549 | 2020-05-12 |
| 1215587308 | Jacqueline Nicole Estrella | Nurse Practitioner | Med Options Killeen Nursing Homes, Kileen, TX 76549 | 2019-09-19 |
| 1366924052 | Barbara Ann Vaughn | Licensed Vocational Nurse | 413 Apt A Study Hall Loop, Killeen, TX 76549 | 2018-08-30 |
| 1124505359 | Carl R Darnall Army Medical Center | Clinic/Center | 5200 Bunny Trail, Killeen, TX 76549 | 2018-07-20 |
| 1518456961 | Robert Brott | Counselor | 1103west Stan Schuleter Loop, Building A, Suite 100, Killeen, TX 76549 | 2018-05-01 |
| 1922507417 | Family Endeavors, Inc. | Community/Behavioral Health | 1103 West Stan Schlueter Loop, Building A Suite 100, Killeen, TX 76549 | 2018-02-09 |
| 1285143859 | Jennifer Dawn Rothman | Behavioral Analyst | 4506 The Searchers Dr, Killeen, TX 76549 | 2017-09-26 |
| 1700307964 | City of Ennis | Skilled Nursing Facility | 5000 Thayer Dr, Killeen, TX 76549 | 2017-06-28 |
| 1790216190 | Neysa Stegmeyer | Nurse Practitioner | 4102 S. Clear Creek Road, Ste 107, Killeen, TX 76549 | 2017-03-27 |
| 1740721471 | Lspd At Killeen, Pllc | Dentist | 1103 West Stan Schlueter Loop Suite B-800, Killeen, TX 76549 | 2017-03-14 |
| Find all providers in zip 76549 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134132442 | Santha M. Chamberlin | Pediatrics | 2300 S Clear Creek Rd Ste 105, Killeen, TX 76549-4985 | 2006-08-15 |
| 1821098534 | Manzoor S Farooqi | Pediatrics | 3004 S W S Young Dr, Killeen, TX 76542-2023 | 2005-07-22 |
| 1033525571 | Edgar Noe Navarro Garza | Pediatrics | 2300 S Clear Creek Rd Ste 105, Killeen, TX 76549-4985 | 2014-07-04 |
| 1073958146 | David Dickinson | Pediatrics | 3801 Scott and White Dr, Killeen, TX 76543-5252 | 2013-05-02 |
| 1831533561 | Kathleen Kirksey | Pediatrics | 2405 S Clear Creek Rd, Killeen, TX 76549-5775 | 2013-04-24 |
| 1881944718 | Ahmad E Qawasmi | Pediatrics | 2201 S Clear Creek Rd, Killeen, TX 76549-4110 | 2012-09-18 |
| 1093077539 | Lisa Ann Minsloff | Pediatrics | 3801 Scott and White Dr, Killeen, TX 76543-5252 | 2012-06-11 |
| 1649559188 | Shivani Patel | Pediatrics | 2300 S Clear Creek Rd, Suite 105, Killeen, TX 76549-4984 | 2011-08-15 |
| 1295023653 | Jamie Avila | Pediatrics | 3801 Scott and White Dr, Killeen, TX 76543-5252 | 2011-07-19 |
| 1891003398 | Pamela Cate Gregerson | Pediatrics | 2201 S Clear Creek Rd, Killeen, TX 76549-4110 | 2010-09-17 |
| Find all providers in KILLEEN | ||||
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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.