SAKULSAK PHOONSAWAT (NPI# 1629678446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629678446 |
| Entity Type | Individual |
| Full Name | SAKULSAK PHOONSAWAT |
| Practice Address |
1100 Wilford Hall Loop San Antonio TX 78236-5638 |
| Mailing Address |
7727 Potranco Rd Apt 1304 San Antonio TX 78251-2001 |
| Practice Telephone | 2102927412 |
| Mailing Telephone | 7022416475 |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2020-10-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1003X |
Military Health Care Provider Specialization: Independent Duty Medical Technicians |
Other Service Providers |
| Street Address |
1100 WILFORD HALL LOOP |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78236-5638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881209658 | Thomas Trongnhan Nguyen | Physical Therapist | 1100 Wilford Hall Loop, San Antonio, TX 78236-5638 | 2020-09-09 |
| 1316505514 | Jeagan Luna | Social Worker | 1100 Wilford Hall Loop, San Antonio, TX 78236-5638 | 2019-06-03 |
| 1598268773 | Jessop Bawek | Military Health Care Provider | 1100 Wilford Hall Loop, San Antonio, TX 78236-5638 | 2018-03-14 |
| 1013436997 | Timothy Ray Corbin | Pharmacist | 1100 Wilford Hall Loop, San Antonio, TX 78236-5638 | 2017-09-12 |
| 1063940054 | Subodh Arora | Pediatrics | 1100 Wilford Hall Loop, San Antonio, TX 78236-5638 | 2017-06-02 |
| 1053763912 | Karena Lehman | Occupational Therapist | 1100 Wilford Hall Loop, San Antonio, TX 78236-5638 | 2016-07-04 |
| 1821459884 | Sarah Elizabeth Schall | Internal Medicine | 1100 Wilford Hall Loop, Jbsa-lackland Afb, San Antonio, TX 78236-0000 | 2016-03-17 |
| 1154718971 | Rajen Patel | Family Medicine | 1100 Wilford Hall Loop, San Antonio, TX 78236-5638 | 2015-04-20 |
| 1023404803 | Christina Awad | Internal Medicine | 1100 Wilford Hall Loop, San Antonio, TX 78236 | 2015-04-08 |
| 1609260744 | Amanda Batten | General Practice | 1100 Wilford Hall Loop, San Antonio, TX 78236 | 2015-03-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063047363 | Arnoldo Arturo Gonzalez Jr. | Specialist/Technologist | 1033 Truemper St, Lackland Afb, TX 78236 | 2020-03-06 |
| 1023643343 | Meredith Grace Cockerell | Specialist/Technologist | W Military Drive, San Antonio, TX 78236 | 2020-03-06 |
| 1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
| 1952967077 | Paul Fianza Boseman | Nurse Practitioner | 1106 Wilford Hall Loop, San Antonio, TX 78236 | 2019-05-14 |
| 1689161978 | Kelly Jones Buckshire | Dentist | Dunn Dental Clinic, 1615 Truemper Rd, San Antonio, TX 78236 | 2018-04-23 |
| 1902308570 | Roger Louis Farney | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-28 |
| 1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
| 1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
| 1376906958 | David Kephart Jr. | General Practice | 1100 Wilford Hall Loop Bldg 4454, Jbsa Lackland, TX 78236 | 2016-04-01 |
| 1184084089 | Olivia Arballo | Dermatology | Wilford Hall Asc, Attn: Dept of Dermatology, 1100 Wilford Hall Loop Bldg 4554, Jbsa-lackland, TX 78236 | 2016-03-04 |
| Find all providers in zip 78236 | ||||
| Taxonomy Code | 1710I1003X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Medical Technicians |
| An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians. |
| Notes: Source: Air Force Surgeon General Office [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453145 | Ian Frogley | Military Health Care Provider | Jbsa 2230 Hughes Ave, San Antonio, TX 78236-8404 | 2020-10-06 |
| 1861099939 | Andrew Goebel | Military Health Care Provider | 1800 Truemper St, San Antonio, TX 78236-5510 | 2020-10-02 |
| 1376169086 | Colton Wayne Dickens | Military Health Care Provider | 5415 N Foster Rd Apt 8306, San Antonio, TX 78244-2405 | 2020-06-18 |
| 1588135719 | Alejandro Daniel Perez | Military Health Care Provider | Wilderness Trl & Camp Bullis, San Antonio, TX 78257 | 2018-12-16 |
| 1861969271 | Jose A Sanchez | Military Health Care Provider | 15425 Bobwhite Quail, San Antonio, TX 78253-6621 | 2018-10-24 |
| 1205303617 | Sean Patrick Kearns | Military Health Care Provider | 1980 Horal St Apt 1218, San Antonio, TX 78227-3939 | 2018-10-24 |
| 1730663477 | Glen Snyder | Military Health Care Provider | 3488 Garden Ave Anderson Hall, Fort Sam Houston, San Antonio, TX 78234 | 2018-09-19 |
| 1265919336 | Ashley Elizabeth Malawey | Military Health Care Provider | 3222 Cpl Johnson Road, San Antonio, TX 78234 | 2018-07-23 |
| 1083191159 | Chance Daren Riley | Military Health Care Provider | 8838 Dugas Dr Apt 2202, San Antonio, TX 78251-4518 | 2018-07-23 |
| 1235622333 | Melanie Edith Rivera | Military Health Care Provider | 3600 Roger Brooke Drive, San Antonio, TX 78234 | 2018-06-13 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78236 |
Please comment or provide details below to improve the information on SAKULSAK PHOONSAWAT.
| 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.