DR. KELLY C. HALLMARK (NPI# 1174704373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174704373 |
Entity Type | Individual |
Full Name | DR. KELLY C. HALLMARK |
Credential | MD |
Practice Address |
3501 Knickerbocker Rd San Angelo TX 76904-7610 |
Mailing Address |
3605 Executive Dr San Angelo TX 76904-6884 |
Practice Telephone | 3259499555 |
Mailing Telephone | 3259499555 |
Enumeration Date | 2007-11-16 |
Last Update Date | 2018-12-05 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
N2547 | TX | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | 208718101 | 05 |
Street Address |
3501 KNICKERBOCKER RD |
City | SAN ANGELO |
State | TX |
Zip Code | 76904-7610 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487622403 | Randell Gene Matthews | Specialist/Technologist | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2006-03-08 |
1700231248 | Kyle Mills | Internal Medicine | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2016-05-03 |
1710341508 | Anthony Mcdonald | Internal Medicine | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2016-04-08 |
1972966000 | Yotham Fraenkel | Internal Medicine | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2016-04-05 |
1386012037 | Crystal Sustaita | Nurse Anesthetist, Certified Registered | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2015-09-11 |
1659769198 | Joe Riley Mcfarland | Nurse Anesthetist, Certified Registered | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2015-01-07 |
1154748671 | Caesasonia Pascual Agatep | Nurse Practitioner | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2014-03-21 |
1588009807 | San Angelo Emergency Medicine Associates Pa | Physician Assistant | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2013-04-30 |
1982048682 | Crystal Collin Kirkland | Internal Medicine | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2013-04-24 |
1457606154 | Oasis of West Tx Emergency | Physician Assistant | 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | 2012-07-18 |
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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 | 207ZP0102X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pathology |
Specialization | Anatomic Pathology & Clinical Pathology |
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245299791 | Martin Kulig Md | Pathology | 3501 Knickerbocker Road, Department of Pathology, San Angelo, TX 76904 | 2006-03-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154922235 | Pathology Institute, Pllc | Pathology | 3201 University Dr E Ste 330, Bryan, TX 77802-3484 | 2020-11-04 |
1649893900 | Medical Service Consultation Pa | Pathology | 2613 Sir Percival Ln, Lewisville, TX 75056-5710 | 2020-05-21 |
1578196358 | Carlos M Torres Md Expert Pathology Consultation Servi | Pathology | 2840 Keller Springs Rd Ste 1104, Carrollton, TX 75006-4876 | 2020-02-19 |
1023654191 | Marsha L Eigenbrodt | Pathology | 860 Junction Dr Apt 344, Allen, TX 75013-5244 | 2019-11-22 |
1184274508 | Pathzone LLC | Pathology | 11215 Oudney Ct, Richmond, TX 77407-1883 | 2019-09-17 |
1184285587 | Vipulkumar P Prajapati | Pathology | 7323 Snowden Rd Apt 3206, San Antonio, TX 78240 | 2019-06-26 |
1548793409 | Grant Williams | Pathology | 3551 Roger Brooke Dr # Tx, Jbsa-fort Sam Houston, San Antonio, TX 78234-4504 | 2017-04-07 |
1417307448 | James Gaulding | Pathology | 19 Robledo Dr, Dallas, TX 75230-3055 | 2016-06-21 |
1386006492 | Audra Robinson | Pathology | 5417 Ridgepass Ln, Mckinney, TX 75071-3082 | 2016-03-28 |
1760840730 | Peachy Ridgway Gilmer Jr. | Pathology | 35 Tiel Way, Houston, TX 77019-1509 | 2016-02-05 |
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City | SAN ANGELO |
Zip Code | 76904 |
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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.