TEAGAN NICHOLE CHARLES (NPI# 1609366921) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609366921 |
| Entity Type | Individual |
| Full Name | TEAGAN NICHOLE CHARLES |
| Credential | MPAS, PA-C |
| Practice Address |
25723 Old Fredericksburg Rd Boerne TX 78015 |
| Mailing Address |
7703 Floyd Curl Dr # Mc7977 San Antonio TX 78229-3901 |
| Practice Telephone | 2104506800 |
| Practice Fax Number | 2104506801 |
| Mailing Telephone | 2104506800 |
| Mailing Fax Number | 2104506801 |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2018-07-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA11878 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | CSHCN | 385151102 | 01 |
| TX | 385151101 | 05 |
| Street Address |
25723 OLD FREDERICKSBURG RD |
| City | BOERNE |
| State | TX |
| Zip Code | 78015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790993210 | Ladelle Morse | Physical Medicine & Rehabilitation | 25723 Old Fredericksburg Rd, Boerne, TX 78015 | 2007-05-18 |
| 1952758203 | Emily Jean Hood | Physical Therapist | 25723 Old Fredericksburg Rd, Boerne, TX 78015 | 2016-05-17 |
| 1235584400 | Andrew Dinh | Family Medicine | 25723 Old Fredericksburg Rd, Boerne, TX 78015-6605 | 2016-04-25 |
| 1982068755 | Jeff Howard Svec | Family Medicine | 25723 Old Fredericksburg Rd, Boerne, TX 78015-6605 | 2016-04-07 |
| 1275928483 | Crystal Haydee Chavez | Family Medicine | 25723 Old Fredericksburg Rd, Boerne, TX 78015-6605 | 2015-04-03 |
| 1457790131 | Tyler Barreto | Family Medicine | 25723 Old Fredericksburg Rd, Boerne, TX 78015-6605 | 2013-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356845242 | Samantha Royalty | Student in an Organized Health Care Education/Training Program | 31925 Deer Smt, Fair Oaks Ranch, TX 78015 | 2018-03-23 |
| 1124455985 | Charles Kennedy Jr. | Specialist | 8454 Northview Pass, Fair Oak Ranch, TX 78015 | 2013-10-10 |
| 1831448448 | Pamela Kelly Brennan | Registered Nurse | 208 Cibolo Ridge Trail, Boerne, TX 78015 | 2012-08-29 |
| 1508112558 | Tammy Marek Pllc | Counselor | 31525 Post Oak Trl, Fair Oaks Ranch, TX 78015 | 2012-07-27 |
| 1295001360 | Shanna Marie Miller | Speech-Language Pathologist | 8614 Carmel Rose, Boerne, TX 78015 | 2012-03-22 |
| 1184991184 | San Antonio Dental Center | Dentist | 8610 Napa Lndg, Boerne, TX 78015 | 2011-11-19 |
| 1386941227 | Priscilla Diane Diazdeleon | Speech-Language Pathologist | 8701 Cavalry, Fair Oaks Ranch, TX 78015 | 2011-02-11 |
| 1649586678 | Erica Janae Lunsford | Physician Assistant | 29602 Midnight Sun, Fair Oaks Ranch, TX 78015 | 2010-08-27 |
| 1053555953 | Ramon Cancino | Family Medicine | 25723 Old Fredericksburg, Boerne, TX 78015 | 2009-04-23 |
| 1194901744 | Fair Oaks Dental, Pa | Dentist | 9091 Fair Oaks Pkwy, Suite 304, Fair Oaks Ranch, TX 78015 | 2008-01-14 |
| Find all providers in zip 78015 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487122206 | Shivana Tate | Physician Assistant | 136 Old San Antonio Rd Ste 406, Boerne, TX 78006-3341 | 2018-11-09 |
| 1700331436 | Markay Wilson Fluitt | Physician Assistant | 1201 S Main St Ste 114, Boerne, TX 78006 | 2016-08-23 |
| 1235419086 | Justin Michael Hill | Physician Assistant | 134 Menger Spgs Ste 100, Boerne, TX 78006-7218 | 2011-08-25 |
| 1881905321 | Autumn Postell | Physician Assistant | 211 Glenn Oaks Dr, Boerne, TX 78006-5609 | 2010-06-30 |
| 1366770166 | Elizabeth Marie Gardner | Physician Assistant | 1421 Main Street, Suite 111, Boerne, TX 78006-3322 | 2009-12-07 |
| 1881844785 | Richard James Levada | Physician Assistant | 1421 North Main Street, Suite 111, Boerne, TX 78006 | 2008-09-26 |
| 1386890929 | Antonio Ortiz-garcia | Physician Assistant | 1201 S Main St Ste 118, Boerne, TX 78006-2839 | 2008-08-14 |
| 1821278110 | Keith Dayrl Caldwell | Physician Assistant | 216 E Blanco Rd, Ste #205, Boerne, TX 78006-2058 | 2007-11-05 |
| 1124653399 | Erica Marie Giordano | Physician Assistant | 1580 S Main St Ste 101, Boerne, TX 78006-3312 | 2020-03-09 |
| 1346765021 | Tx-i Medical Services Pa | Physician Assistant | 134 Menger Spgs, Boerne, TX 78006-7218 | 2017-08-03 |
| Find all providers in BOERNE | ||||
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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.