MR. SAMUEL LUEDECKE (NPI# 1043762149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043762149 |
| Entity Type | Individual |
| Full Name | MR. SAMUEL LUEDECKE |
| Credential | RN, MSN, FNP-BC |
| Practice Address |
3001 S Jackson St San Angelo TX 76904-5129 |
| Practice Telephone | 3252456203 |
| Practice Fax Number | 3252236377 |
| Mailing Telephone | 3252236347 |
| Mailing Fax Number | 3252236377 |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2016-10-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP132124 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3001 S JACKSON ST |
| City | SAN ANGELO |
| State | TX |
| Zip Code | 76904-5129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316920200 | Gina Karr | Physical Therapist | 3001 S Jackson St, San Angelo, TX 76904-5129 | 2005-11-23 |
| 1083246755 | Brady Burks | Occupational Therapist | 3001 S Jackson St, San Angelo, TX 76904-5129 | 2020-02-10 |
| 1922641497 | Laura A Sykora | Occupational Therapist | 3001 S Jackson St, San Angelo, TX 76904-5129 | 2019-10-28 |
| 1477100923 | J Concepcion Trejo Godoy | Physical Therapist | 3001 S Jackson St, San Angelo, TX 76904-5129 | 2019-08-20 |
| 1184279143 | Michael J Wicks | Physical Therapist | 3001 S Jackson St, San Angelo, TX 76904-5129 | 2019-08-07 |
| 1083267140 | Madeleine Harmon | Speech-Language Pathologist | 3001 S Jackson St, San Angelo, TX 76904-5129 | 2019-07-18 |
| 1124688585 | Jacob Burtch | Physical Therapist | 3001 S Jackson St, San Angelo, TX 76904-5129 | 2019-06-18 |
| 1760049175 | Cevan C Smithson | Physical Therapist | 3001 S Jackson St, San Angelo, TX 76904-5129 | 2019-05-21 |
| 1447816228 | Tamara A Calcote | Occupational Therapy Assistant | 3001 S Jackson St, San Angelo, TX 76904-5129 | 2019-05-16 |
| 1801452966 | Ngozi Oby Agwuenu | Occupational Therapist | 3001 S Jackson St, San Angelo, TX 76904-5129 | 2019-05-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407342702 | Mark Wandal Duncan | Specialist/Technologist | 2237 South Jackson, San Angelo, TX 76904 | 2018-07-10 |
| 1700267259 | Sheila Patterson | Nurse Practitioner | 4251 Sunset Drive, San Angelo, TX 76904 | 2015-06-10 |
| 1346649316 | Mason William Mcclintock | Dentist | 2402 College Hills Blvd. Building 1, Building 1, San Angelo, TX 76904 | 2014-08-15 |
| 1265855712 | Lynn M. Thebo, Lcsw, Pllc | Social Worker | 3109 Southwest Blvd. Ste. B, San Angelo, TX 76904 | 2014-02-03 |
| 1487077459 | Lynn Marie Thebo | Social Worker | 3109 Southwest Blvd., Ste. B, San Angelo, TX 76904 | 2014-01-28 |
| 1558646521 | John Porter Parker Jr. | Pharmacist | 3705 Threewn Trail, San Angelo, TX 76904 | 2011-10-20 |
| 1568772036 | Medical Alliance Group of Texas, LLC | Durable Medical Equipment & Medical Supplies | 2525 S Johnson Ste A, San Angelo, TX 76904 | 2010-10-18 |
| 1578796710 | Jennifer L White | Physical Therapist | 2237 S. Jackson, San Angelo, TX 76904 | 2009-09-03 |
| 1548443203 | Kelly K. Sawyer, D.d.s., P.a. | Dentist | 3013 W. Loop 306, San Angelo, TX 76904 | 2007-12-17 |
| 1023224789 | D&s Residential Services | Intermediate Care Facility, Mentally Retarded | 1706 Idaho Avenue, San Angelo, TX 76904 | 2007-05-16 |
| Find all providers in zip 76904 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992515 | Stacie A Gregg | Nurse Practitioner | 1229 Johnny Ln, San Angelo, TX 76905-2331 | 2020-11-07 |
| 1487269064 | Delilah Deguire-guerra | Nurse Practitioner | 143 Oakwood St, San Angelo, TX 76903-8631 | 2020-09-10 |
| 1215571914 | Dawn Cumbie Burwick | Nurse Practitioner | 431 W 34th St, San Angelo, TX 76903-2323 | 2019-11-05 |
| 1033767504 | Kate Elizabeth Young | Nurse Practitioner | 1621 Iowa Ave, San Angelo, TX 76904-6888 | 2019-08-28 |
| 1760034698 | Lisbet Ivicic | Nurse Practitioner | 351 Kearney Blvd, San Angelo, TX 76908-3215 | 2019-07-11 |
| 1033549670 | Tina Faye Luck | Nurse Practitioner | 36 E Twohig Ave Ste 1100, San Angelo, TX 76903 | 2013-11-18 |
| 1487096665 | Mary Beth Luttrell | Nurse Practitioner | 1610s Chadbourne St, San Angelo, TX 76903-8510 | 2013-07-29 |
| 1336490614 | Toyha Drew Harper | Nurse Practitioner | 1601 S Chadbourne St, San Angelo, TX 76903-8509 | 2012-09-26 |
| 1992944565 | Kathe Ann Conner | Nurse Practitioner | 1901 Johnson St, San Angelo, TX 76909-0001 | 2009-02-05 |
| 1083859946 | David Earl Cooper | Nurse Practitioner | 1825 Christoval Rd, San Angelo, TX 76903-8602 | 2008-12-06 |
| Find all providers in SAN ANGELO | ||||
| City | SAN ANGELO |
| Zip Code | 76904 |
Please comment or provide details below to improve the information on MR. SAMUEL LUEDECKE.
| 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.