CREEKSIDE PREMIER MEDICAL GROUP PLLC (NPI# 1487217006) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487217006 |
| Entity Type | Organization |
| Organization Name | CREEKSIDE PREMIER MEDICAL GROUP PLLC |
| Practice Address |
2255 E Mossy Oaks Rd Ste 500 Spring TX 77389-1813 |
| Practice Telephone | 2814405300 |
| Mailing Telephone | 2814405300 |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2019-08-23 |
| Authorized Official Name | DAVID P ELLENT (PRESIDENT) |
| Authorized Official Telephone | 2814405300 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207K00000X | Allergy & Immunology | Allopathic & Osteopathic Physicians | ||
| N | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians | ||
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
Allopathic & Osteopathic Physicians | ||
| N | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207VF0040X |
Obstetrics & Gynecology Specialization: Female Pelvic Medicine and Reconstructive Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers | ||
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| Street Address |
2255 E MOSSY OAKS RD STE 500 |
| City | SPRING |
| State | TX |
| Zip Code | 77389-1813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417952094 | Northwest Diagnostic Clinic, Pa | Internal Medicine | 2255 E Mossy Oaks Rd Ste 500, Spring, TX 77389-1813 | 2005-06-20 |
| 1013525880 | Advanced Gastroenterology and Nutrition of Texas Pllc | Internal Medicine | 2255 E Mossy Oaks Rd Ste 500, Spring, TX 77389-1813 | 2020-07-17 |
| 1689298960 | Gmg Clinically Integrated Network Dba Genesis Ipa | Family Medicine | 2255 E Mossy Oaks Rd Ste 500, Spring, TX 77389-1813 | 2020-06-03 |
| 1740791599 | Theranique Denise Thompson | Registered Nurse | 2255 E Mossy Oaks Rd Ste 500, Spring, TX 77389-1813 | 2017-10-19 |
| 1760737068 | Samaneh Dowlatshahi | Internal Medicine | 2255 E Mossy Oaks Rd Ste 500, Spring, TX 77389-1813 | 2012-07-23 |
| 1689968133 | Laura Elizabeth Durling | Internal Medicine | 2255 E Mossy Oaks Rd Ste 500, Spring, TX 77389-1813 | 2011-06-01 |
| 1386875698 | Jilu J. Varghese | Family Medicine | 2255 E Mossy Oaks Rd Ste 500, Spring, TX 77389-1813 | 2009-08-04 |
| 1700047412 | Samer M Elfallal | Neurological Surgery | 2255 E Mossy Oaks Rd Ste 500, Spring, TX 77389-1813 | 2008-06-24 |
| 1427250349 | Amie Mao Sun-wright | Internal Medicine | 2255 E Mossy Oaks Rd Ste 500, Spring, TX 77389-1813 | 2007-06-04 |
| 1023219862 | Afua S Agyarko | Internal Medicine | 2255 E Mossy Oaks Rd Ste 500, Spring, TX 77389-1813 | 2007-05-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710518550 | Leigh Alanna Todd | Social Worker | 25700 I-45, #415, Spring, TX 77389 | 2020-01-30 |
| 1700378353 | Misturat Adesanya | Family Medicine | 8727 W Rayford Dr, 160, Spring, TX 77389 | 2018-05-30 |
| 1720583800 | Diamond Minniefield | Chiropractor | 26400 Kuykendahl, Suite A #115, The Woodlands, TX 77389 | 2018-03-29 |
| 1154861722 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 6635 N Grand Parkway, Sprint, TX 77389 | 2017-03-02 |
| 1861845703 | Ray Anthony Carlton II | Case Manager/Care Coordinator | 8422 Barmby Ct, Spring, TX 77389 | 2016-07-15 |
| 1750741427 | Melanie Deann Hutton | Occupational Therapist | 24902 Pikecrest Dr., Spring, TX 77389 | 2016-02-24 |
| 1366848251 | Timberwilde Eye Care, Pllc | Optometrist | 24504 Kuykendahl Dr, Suite 500, Spring, TX 77389 | 2014-11-05 |
| 1417359787 | Rcmh, LLC | Clinic/Center | 26500 Kuykendahl Rd., Spring, TX 77389 | 2014-09-18 |
| 1922425982 | Melissa Alice Balk-elliott | Dentist | 6710 Spring Stuebner Rd. Ste 700, Spring, TX 77389 | 2014-03-27 |
| 1881025054 | Erilyn White | Nurse Practitioner | 23155 Ih-45, Spring, TX 77389 | 2013-12-12 |
| Find all providers in zip 77389 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295942530 | Swetha Yadav | Internal Medicine | 9303 Pinecroft Dr, Spring, TX 77380-3181 | 2007-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205399961 | Christus Health Ark-la-tex | Internal Medicine | 5002 Cowhorn Creek Rd Ste 3205, Texarkana, TX 75503-9766 | 2019-04-10 |
| 1861958704 | Thi of Texas At Samaritan Hospice LLC | Internal Medicine | 12001 N Central Expy Ste 550, Dallas, TX 75243-3943 | 2019-02-15 |
| 1417485822 | Ahmad Ghorab | Internal Medicine | 1515 Holcombe Blvd #1445, Houston, TX 77030 | 2017-05-30 |
| 1063952943 | Irfan Jawed Md Pllc | Internal Medicine | 4102 Woodlawn Avenue, Ste 160, Pasadena, TX 77504 | 2017-02-27 |
| 1366981615 | Houston Cancer Treatment Centers Pa. | Internal Medicine | 4102 Woodlawn Ave Ste 160, Pasadena, TX 77504-1922 | 2017-02-20 |
| 1508222720 | Maurizio Bendandi | Internal Medicine | 6722 Mimosa Ln, Dallas, TX 75230-5214 | 2016-01-04 |
| 1245642073 | Juan Francisco Garza | Internal Medicine | 3333 Bayshore Blvd Ste 320, Pasadena, TX 77504-1950 | 2014-05-28 |
| 1124463211 | Oluchi Oke | Internal Medicine | 1515 Holcombe Blvd Unit 463, Division of Cancer Medicine, Houston, TX 77030-4000 | 2013-05-03 |
| 1710229323 | Adaeze Nwosu- Iheme | Internal Medicine | 2700 Citizens Plz Ste 200, Victoria, TX 77901-5756 | 2013-03-21 |
| 1144570599 | Gummadi & Desai LLC | Internal Medicine | 2717 Michael Angelo Ste 302, Edinburg, TX 78539-1409 | 2012-09-13 |
| Find all providers with the same taxonomy | ||||
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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.