TEXAS A&M UNIVERSITY


Address: 12 John David Crow Blvd, College Station, TX 77843
Phone: 9798453121

TEXAS A&M UNIVERSITY (NPI# 1588030241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1588030241
Entity Type Organization
Organization Name TEXAS A&M UNIVERSITY
Practice Address 12 John David Crow Blvd
College Station
TX 77843
Mailing Address Po Box 30017
College Station
TX 77842-3017
Practice Telephone 9798453121
Enumeration Date 2015-08-18
Last Update Date 2015-08-18
Authorized Official Name PHIL HEDRICK (ASSISTANT A.D. ATHLETIC TRAINING)
Authorized Official Telephone 9798622930
Authorized Official Credential ATC, LAT
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2083S0010X Preventive Medicine
Specialization: Sports Medicine
AT5667 TX Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
TX ATHLETIC TRAINING AT5667 01

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1235521121 Texas A&m University Family Medicine 161 Wellborn Roard, Bright Complex, College Station, TX 77843-0001 2015-03-02
1578605952 Texas A&m University Pharmacy Texas A M University, 1264 Tamu, College Station, TX 77843-1264 2007-02-13
1134356231 Texas A&m University Clinic/Center 161 Wellborn Rd, Bright Football Complex, College Station, TX 77843-0001 2009-06-16
1528108826 Texas A&m University Clinic/Center 1264 Tamu, College Station, TX 77843-1264 2007-02-07

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities TEXAS A&M UNIVERSITY Corner of Spence / University St. Mail Stop 3366, College Station, TX 77843-0001
System for Award Management (SAM) Entities TEXAS A&M UNIVERSITY SYSTEM,THE 200 Technology Way, College Station, TX 77845-3424
System for Award Management (SAM) Entities TEXAS A&M UNIVERSITY-CENTRAL TEXAS 1001 Leadership Place, Killeen, TX 76549-5901
System for Award Management (SAM) Entities TEXAS A&M UNIVERSITY-CORPUS CHRISTI 6300 Ocean Dr Unit 5840, Corpus Christi, TX 78412-5503
System for Award Management (SAM) Entities TEXAS A&M UNIVERSITY-SAN ANTONIO 1 University Way, San Antonio, TX 78224-3134

Office Location

Street Address 12 JOHN DAVID CROW BLVD
City COLLEGE STATION
State TX
Zip Code 77843

Providers in the same location

NPI Name Taxonomy Address Enumeration
1265989099 Justin Donald Mullinnix Specialist/Technologist 12 John David Crow Blvd, College Station, TX 77843-0001 2016-09-09

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1699024919 Elizabeth Arnell Harrison Nurse Practitioner Tamu 1264, College Station, TX 77843 2012-08-31
1801457981 Emma Marie Themel Specialist/Technologist 801 Harrington Tower, College Station, TX 77843-0001 2019-06-27
1730664335 Allison Laree Andrews Nurse Practitioner 311 Houston Street, College Station, TX 77843-0001 2018-09-28
1770064727 Kourtney Shey Higgins Student in an Organized Health Care Education/Training Program 400 Bizzel, College Station, TX 77843-0001 2018-08-28
1730684770 Daniel Jacobi Specialist/Technologist 756 Houston St, College Station, TX 77843-0001 2018-03-29
1548774540 Tonya Spradlin Specialist/Technologist 400 Bizzell Street, College Station, TX 77843-0001 2017-11-29
1477067536 Kaitlyn Elizabeth Carter Specialist/Technologist Rudder Tower 401 Joe Routt Blvd, College Station, TX 77843-0001 2017-11-28
1003328212 Cross Donald Klemko Specialist/Technologist 400 Bizzell St, College Station, TX 77843-0001 2017-10-27
1215449780 Sonia Barrad Specialist/Technologist 1228 Texas A&m University, College Station, TX 77843-0001 2017-10-24
1538535604 Devon Bowie Specialist/Technologist 905 Olsen Rd, College Station, TX 77843-0001 2015-08-12
Find all providers in zip 77843

Taxonomy Information

Taxonomy Code 2083S0010X
Grouping Allopathic & Osteopathic Physicians
Classification Preventive Medicine
Specialization Sports Medicine

Taxonomy Definition

A preventive medicine physician who specializes in the diagnosis and treatment of sports related conditions and injuries.
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Preventive Medicine.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1811506538 Regenerate Atx Pllc Preventive Medicine 11610 Fm 2244 Rd Ste 230, Austin, TX 78738-5457 2020-07-28
1063057602 Heather Penka Preventive Medicine 820 Holiday Ln, North Richland Hills, TX 76180 2019-11-07
1952378556 David B. Tsai, M.d., P.a. Preventive Medicine 210 Barton Springs Rd, Suite 200, Austin, TX 78704-1254 2006-03-02
1013526201 Kimberly Moore Preventive Medicine 1333 W Washington St, Stephenville, TX 76401-4168 2020-07-24
1104382936 Ashley Christine Wagner Preventive Medicine 3724 Executive Center Dr Ste G10, Austin, TX 78731-1665 2019-02-18
1891269056 Deidre Bibb Preventive Medicine 1814 Roseland Blvd Ste 100, Tyler, TX 75701-4262 2019-01-21
1891169686 Tracy Coleman IIi Preventive Medicine 6000 Eldorado Pkwy, Apt# 222, Frisco, TX 75033-3573 2015-11-17

Competitor

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City COLLEGE STATION
Zip Code 77843

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Dataset Information

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.

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