SOUTHEAST OB GYN ASSOCIATES (NPI# 1518082684) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518082684 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST OB GYN ASSOCIATES |
| Practice Address |
4115 E Southcross Blvd Suite 102 San Antonio TX 78222-3729 |
| Practice Telephone | 2103330532 |
| Practice Fax Number | 2103332292 |
| Mailing Telephone | 2103330532 |
| Mailing Fax Number | 2103332292 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2019-11-18 |
| Authorized Official Name | HARMON W KELLEY (PRESIDENT OF COMPANY) |
| Authorized Official Telephone | 2103330532 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | Other Service Providers | ||
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 080320701 | 05 | |
| TX | 098135902 | 05 | |
| TX | 150344301 | 05 |
| Street Address |
4115 E SOUTHCROSS BLVD SUITE 102 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78222-3729 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932197910 | Margaret A Kelley | Specialist | 4115 E Southcross Blvd, Suite 102, San Antonio, TX 78222-3729 | 2005-10-12 |
| 1083602957 | Harmon W Kelley | Obstetrics & Gynecology | 4115 E Southcross Blvd, Suite 102, San Antonio, TX 78222-3729 | 2005-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285164897 | Kimberly Smith | Contractor | 2607 Lakebriar St, San Antonio, TX 78222 | 2017-06-15 |
| 1801045257 | Perly Lee Sheffield | Case Manager/Care Coordinator | 5518 Elk Hunter Tr., San Antonio, TX 78222 | 2008-09-10 |
| 1689822447 | James Edward Williams | Family Medicine | 3859 E Southcross Blvd Ste C, San Antonio, TX 78222 | 2008-09-05 |
| 1508025693 | Southcross Surgical Center, LLC | Clinic/Center | 4025 E. Southcross, Bldg 3 Ste. 15, San Antonio, TX 78222 | 2008-06-04 |
| 1184839235 | Michael C Key | Dentist | 3875 E Southcross, Ste F, San Antonio, TX 78222 | 2007-05-11 |
| 1245359017 | Celia S Faz | Home Health Aide | 5511 Firestar Trail, San Antonio, TX 78222 | 2007-03-29 |
| 1730272501 | Best Fit Prosthetics LLC | Durable Medical Equipment & Medical Supplies | 3859 E Southcross, Ste H, San Antonio, TX 78222 | 2006-10-02 |
| 1326150806 | Angela E Adams | Nurse Practitioner | 4243 E Southcross Blvd Ste 204, San Antonio, TX 78222 | 2006-08-31 |
| 1063435105 | Mark David Mutschink | Physical Therapist | 3875 E Southcross, Ste B, Ryke Physical Therapy & Sports Medicine, San Antonio, TX 78222 | 2006-07-26 |
| 1548210636 | Cameron Brent Elam | Physical Therapist | 3875 East Southcross, Ste B, Ryke Physical Therapy & Sports Medicine, San Antonio, TX 78222 | 2006-05-11 |
| Find all providers in zip 78222 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457972721 | Brynna Lynch | Obstetrics & Gynecology | 11212 State Highway 151 Ste 120, San Antonio, TX 78251-4498 | 2020-04-28 |
| 1174091458 | Community Birth Group | Obstetrics & Gynecology | 216 Tower Rd, San Antonio, TX 78223-6018 | 2018-11-05 |
| 1982184370 | Sarah Lewis | Obstetrics & Gynecology | 502 Madison Oak Dr Ste 440, San Antonio, TX 78258-4189 | 2018-08-15 |
| 1023463981 | Viviana Salom Ellis | Obstetrics & Gynecology | 4458 Medical Center Drive, Suite 705, San Antonio, TX 78229 | 2016-04-28 |
| 1073967642 | Erika Price | Obstetrics & Gynecology | 7711 Louis Pasteur Dr Ste 808, San Antonio, TX 78229-3412 | 2016-04-20 |
| 1639537137 | Alexander Golab | Obstetrics & Gynecology | 3518 Puesta De Sol, San Antonio, TX 78261-2415 | 2016-01-29 |
| 1699157495 | Samantha Gonzalez | Obstetrics & Gynecology | 7430 Barlite Blvd Ste 105, San Antonio, TX 78224 | 2015-06-29 |
| 1457746232 | Amy Johnson Gonzales | Obstetrics & Gynecology | 11212 State Highway 151 Medical Plaza 2, Suite 350, San Antonio, TX 78251 | 2015-03-30 |
| 1043601206 | Abraham A Alecozay Md Pa Phd | Obstetrics & Gynecology | 7430 Barlite Suite 105, San Antonio, TX 78224 | 2015-02-10 |
| 1003228776 | Stephanie Schaefer | Obstetrics & Gynecology | 525 Oak Centre Dr Ste 300, San Antonio, TX 78258-3916 | 2014-05-28 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78222 |
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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.