PECAN GROVE HEALTHCARE (NPI# 1306114277) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306114277 |
| Entity Type | Organization |
| Organization Name | PECAN GROVE HEALTHCARE |
| Practice Address |
805 W Lampasas St Ennis TX 75119-4535 |
| Practice Telephone | 9728759494 |
| Practice Fax Number | 9728780689 |
| Mailing Telephone | 9728759494 |
| Mailing Fax Number | 9728780689 |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2011-12-07 |
| Authorized Official Name | REBECCA L LUCAS (OWNER) |
| Authorized Official Telephone | 9728759494 |
| Authorized Official Credential | DNP,RN,FNPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
517664 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
805 W LAMPASAS ST |
| City | ENNIS |
| State | TX |
| Zip Code | 75119-4535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245477389 | Norma J Fuelberth Md | Obstetrics & Gynecology | 805 W Lampasas St, Ennis, TX 75119-4535 | 2009-01-12 |
| 1073970141 | Ellis County Coalition for Health Options | Clinic/Center | 805 W Lampasas St, Ennis, TX 75119-4535 | 2016-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174121859 | Alexandria Etuk | Pharmacist | 101 Sh-437 Spur, Ennis, TX 75119 | 2020-10-14 |
| 1285279158 | Oluchi Ozumba Md Pa | Pain Medicine | 601 S Cly St, Suite 104, Ennis, TX 75119 | 2019-11-14 |
| 1952806085 | Ikids Pediatric Dentistry Ennis, Pllc | Dentist | 711 S Clay St Ste A, Ennis, TX 75119 | 2018-03-29 |
| 1609382068 | Living Single LLC | Residential Treatment Facility, Physical Disabilities | 809 E. Denton Street, Ennis, TX 75119 | 2017-12-21 |
| 1912363300 | Erin Denise Jackson | Counselor | 219 W. Brown St, Suite A, Ennis, TX 75119 | 2016-01-14 |
| 1164769139 | Matthew Garrett Cooper | Nurse Anesthetist, Certified Registered | 2201 W. Lampasas Street, Ennis, TX 75119 | 2013-01-11 |
| 1922343805 | Braces R Us PC | Dentist | 1012 E. Ennis Ave. Ste. C, Ennis, TX 75119 | 2012-12-04 |
| 1154684355 | Stefanie Nicole Rust | Emergency Medicine | 2201 West Lampasas Street, Ennis, TX 75119 | 2012-06-21 |
| 1265710909 | Traditions Health Care of Ennis, LLC | Home Health | 109 Southwest Main Street, Suite A, Ennis, TX 75119 | 2011-07-29 |
| 1578792370 | Peak Physical Therapy and Rehabilitation LLC | Physical Therapist | 2200 Physicians Blvd, Ste D, Ennis, TX 75119 | 2009-07-14 |
| Find all providers in zip 75119 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447892401 | Muinat Ayinde | Nurse Practitioner | 306 Log Cabin Rd, Ennis, TX 75119-8809 | 2019-10-11 |
| 1609233881 | Susan Lohrman Hogue | Nurse Practitioner | 2203 W Lampasas St Ste 205, Ennis, TX 75119-5644 | 2016-01-19 |
| 1649642497 | Sheletha Renee Bratton | Nurse Practitioner | 601 S Clay St Ste 104, Ennis, TX 75119-5771 | 2015-10-20 |
| 1124394416 | Leslie Elaine Donet | Nurse Practitioner | 805 S Clay St, Ennis, TX 75119-5750 | 2012-03-30 |
| 1831663350 | Lizabeth Carder | Nurse Practitioner | 2203 W Lampasas St, Ennis, TX 75119-5666 | 2019-01-17 |
| 1184109654 | Lemuel Wayne Kemp Jr. | Nurse Practitioner | 2203 W Lampasas St Ste 205, Ennis, TX 75119-5668 | 2018-10-01 |
| 1205355211 | Michael Patrick Joyce | Nurse Practitioner | 717 W Lampasas St, Ennis, TX 75119-4533 | 2017-09-12 |
| 1174062574 | Courtney Aguado | Nurse Practitioner | 2201 W Lampasas St, Ennis, TX 75119-5644 | 2017-02-17 |
| 1669922100 | Susanna Ferguson | Nurse Practitioner | 802 W Lampasas St, Ennis, TX 75119-4536 | 2016-10-07 |
| 1700228004 | April Morgan | Nurse Practitioner | 2200 W Ennis Ave, A, Ennis, TX 75119-8054 | 2013-07-27 |
| Find all providers in ENNIS | ||||
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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.