LYDIA G AVILA (NPI# 1982825964) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982825964 |
| Entity Type | Individual |
| Full Name | LYDIA G AVILA |
| Credential | M.D. |
| Practice Address |
124e Bandera Rd 102 Boerne TX 78006-2849 |
| Practice Telephone | 8308162312 |
| Practice Fax Number | 8308162349 |
| Mailing Telephone | 8308162312 |
| Mailing Fax Number | 8308162349 |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2016-10-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | P4629 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | WELLMED MEDICARE | 319970YLPS | 01 |
| TX | WELLMED MEDICAID | 3294894-02 | 01 |
| Street Address |
124E BANDERA RD 102 |
| City | BOERNE |
| State | TX |
| Zip Code | 78006-2849 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982218517 | Boerne Mens Clinic | Family Medicine | 138 Tx-46, Boerne, TX 78006 | 2020-09-01 |
| 1700431798 | Methodist Ambulatory Surgery Center of Boerne, LLC | Clinic/Center | 110 Menger Springs, Boerne, TX 78006 | 2019-08-06 |
| 1144704156 | Lauren Elizabeth Settle | Counselor | 26254 Interstate 10, Suite 224, Boerne, TX 78006 | 2018-09-17 |
| 1265914600 | Shana North | Physical Therapy Assistant | 200 Ryan Street, Boerne, TX 78006 | 2018-09-02 |
| 1598258352 | Alamo Prosthetics LLC | Durable Medical Equipment & Medical Supplies | 28711 I 10 W, Boerne, TX 78006 | 2018-06-07 |
| 1578052312 | Premium Pharma, LLC | Pharmacy | 1 Fm 3351 S Ste 115, Boerne, TX 78006 | 2018-05-08 |
| 1952814386 | Advanced Surgical Care of Boerne, LLC | Clinic/Center | 138 Old San Antonio Rd # 400, Boerne, TX 78006 | 2017-11-07 |
| 1184151532 | River Road Pharmacy | Pharmacy | 910 River Rd Ste 103, Boerne, TX 78006 | 2017-05-16 |
| 1487191565 | Olive Branch Hope Center, Inc | Counselor | 215 W Bandera Rd 114 Pmb 239, Boerne, TX 78006 | 2017-01-26 |
| 1063955367 | Leigh Ann Grasso | Pharmacist | 31007 Ih 10 W, Ste 108, Boerne, TX 78006 | 2016-11-18 |
| Find all providers in zip 78006 | ||||
| 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 |
|---|---|---|---|---|
| 1982218517 | Boerne Mens Clinic | Family Medicine | 138 Tx-46, Boerne, TX 78006 | 2020-09-01 |
| 1558653790 | Jennifer Riedel Brockington | Family Medicine | 117 W Highland Dr, Suite 201, Boerne, TX 78006-2651 | 2011-05-06 |
| 1821390204 | Charles Woodrow Mccurley Iv | Family Medicine | 136 Old San Antonio Rd, Ste 406, Boerne, TX 78006-3413 | 2010-11-17 |
| 1811225071 | Sylvia Proctor Adams | Family Medicine | 134 Cascade Caverns Rd, Boerne, TX 78015-8309 | 2009-11-30 |
| 1053555953 | Ramon Cancino | Family Medicine | 25723 Old Fredericksburg, Boerne, TX 78015 | 2009-04-23 |
| 1912162033 | Bertha Gaytan | Family Medicine | 1580 S Main St Ste 101, Boerne, TX 78006 | 2008-07-29 |
| 1487817102 | Michael Konopacki | Family Medicine | 105 Falls Ct, Ste 100, Boerne, TX 78006-2985 | 2008-07-02 |
| 1730366527 | Bradly Bundrant, M.d. | Family Medicine | 1414 E. Blanco Rd., Suite 5, Boerne, TX 78006-1832 | 2008-01-24 |
| 1346423688 | Ranjitha Gampala | Family Medicine | 1580 S Main St, Suite 101, Boerne, TX 78006-3311 | 2007-12-10 |
| 1104958230 | Benjamin Adam Stahl | Family Medicine | 1430 South Main Street, Suite 111, Boerne, TX 78006 | 2007-03-12 |
| Find all providers in BOERNE | ||||
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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.