FRED A WALTERS (NPI# 1114951209) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114951209 |
| Entity Type | Individual |
| Full Name | FRED A WALTERS |
| Credential | MD |
| Practice Address |
3000 Herring Avenue Waco TX 76708 |
| Mailing Address |
Po Box 1888 Greenville TX 75403 |
| Practice Telephone | 2542022000 |
| Practice Fax Number | 2547536229 |
| Mailing Telephone | 8009452455 |
| Mailing Fax Number | 9034532541 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2008-05-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
F4646 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 132146505 | 05 | |
| TX | 132146507 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932355534 | Fred Irvin Walters Jr. | Dentist | 1434 Parker Drive, Laurel, MS 39440-1942 | 2008-08-14 |
| Street Address |
3000 HERRING AVENUE |
| City | WACO |
| State | TX |
| Zip Code | 76708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679507768 | Russell L Mcclellan | Radiology | 3000 Herring Avenue, Waco, TX 76708 | 2006-07-11 |
| 1588698674 | Fred H Rader | Radiology | 3000 Herring Avenue, Waco, TX 76708 | 2006-07-11 |
| 1558395640 | Jose Vernon Watson | Radiology | 3000 Herring Avenue, Waco, TX 76708 | 2006-07-11 |
| 1992739080 | Donald L Risinger | Nuclear Medicine | 3000 Herring Avenue, Waco, TX 76708 | 2006-07-11 |
| 1801820998 | Thomas Brian White | Radiology | 3000 Herring Avenue, Waco, TX 76708 | 2006-07-11 |
| 1407880503 | David Owen Risinger | Radiology | 3000 Herring Avenue, Waco, TX 76708 | 2006-07-11 |
| 1790719888 | Henry Julius Boehm | Radiology | 3000 Herring Avenue, Waco, TX 76708 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144868613 | Sarah Bogacz | Behavior Technician | 6824 Logue Lane, Bluesprig Pediatrics, Waco, TX 76708 | 2019-12-16 |
| 1700358215 | Albert Jacob Puente | Specialist/Technologist | 1101 North Q Ave, Clifton, TX 76708 | 2018-12-21 |
| 1437414810 | Cenikor Foundation | Substance Abuse Rehabilitation Facility | 3015 Herring Avenue, Waco, TX 76708 | 2012-07-11 |
| 1922393610 | Betty Hendricks | Nurse Practitioner | 4601 N 19th Street, Waco, TX 76708 | 2011-06-10 |
| 1023239498 | Esc Iv, Lp | Assisted Living Facility | 3801 Martin Luther King Jr Bvd, Waco, TX 76708 | 2007-05-01 |
| 1952429367 | Dod David Moore | Dentist | 10104 Saddle Creek Rd, Waco, TX 76708 | 2007-03-26 |
| 1851400295 | H-e-b, Lp | Clinical Medical Laboratory | 3801 N 19th St, Waco, TX 76708 | 2006-08-30 |
| 1972527257 | Meryl Burchardt | Nurse Practitioner | 2201 Macarthur, Suite 2200, Waco, TX 76708 | 2006-07-27 |
| 1669493292 | Central Texas Anesthesiology Associates Inc | Anesthesiology | 3000 Herring, Waco, TX 76708 | 2006-07-21 |
| 1750340568 | Matthew Brian Bierwirth | Pediatrics | 2201 Macarthur Dr Ste 103, Waco, TX 76708 | 2006-03-21 |
| Find all providers in zip 76708 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| 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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194030544 | Matthew Locke Kendrick | Radiology | 7543 Bosque Blvd Ste H, Waco, TX 76712-3774 | 2010-08-10 |
| 1679507768 | Russell L Mcclellan | Radiology | 3000 Herring Avenue, Waco, TX 76708 | 2006-07-11 |
| 1689608226 | Hillcrest X-ray Physicians | Radiology | 100 Hillcrest Baptist Medical Blvd., Waco, TX 76712-8899 | 2006-07-10 |
| 1417915984 | Central Texas Advanced Medical Imaging Lp | Radiology | 312 Richland West Circle, Waco, TX 76712 | 2006-05-03 |
| 1053376780 | Brian John Risinger | Radiology | 409 Keys Creek Dr, Waco, TX 76708-3762 | 2006-04-18 |
| 1063418929 | Kenneth James Ratajczak | Radiology | 3724 Greenleaf Drive, Waco, TX 76710-1414 | 2005-06-24 |
| 1629242474 | Daniel James Kirzeder | Radiology | 100 Hillcrest Medical Blvd, Waco, TX 76712-8897 | 2008-04-14 |
| 1588698674 | Fred H Rader | Radiology | 3000 Herring Avenue, Waco, TX 76708 | 2006-07-11 |
| 1396779484 | Jeffrey C Gerik | Radiology | 3000 Herring Ave, Waco, TX 76708 | 2006-07-11 |
| 1558395640 | Jose Vernon Watson | Radiology | 3000 Herring Avenue, Waco, TX 76708 | 2006-07-11 |
| Find all providers in WACO | ||||
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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.