COURTYARD PRIMARY CARE & MEDICAL SPA,PA (NPI# 1639329949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639329949 |
| Entity Type | Organization |
| Organization Name | COURTYARD PRIMARY CARE & MEDICAL SPA,PA |
| Practice Address |
4410 N Midkiff Rd Ste D6 Midland TX 79705-4249 |
| Practice Telephone | 4326896000 |
| Practice Fax Number | 4326896003 |
| Mailing Telephone | 4326896000 |
| Mailing Fax Number | 4326896003 |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2012-10-09 |
| Authorized Official Name | DR. EDWIN BRADY LOCKE (CEO/OWNER) |
| Authorized Official Telephone | 4326992370 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
K5608 | TX | Ambulatory Health Care Facilities |
| Street Address |
4410 N MIDKIFF RD STE D6 |
| City | MIDLAND |
| State | TX |
| Zip Code | 79705-4249 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164066387 | Devin Duane Knapp | Nurse Practitioner | 4410 N Midkiff Rd Ste D6, Midland, TX 79705-4249 | 2019-10-31 |
| 1851865067 | Jeffery Thomas Dickson | Family Medicine | 4410 N Midkiff Rd Ste D6, Midland, TX 79705-4249 | 2019-01-22 |
| 1497166045 | Kevin Edward Salas | Nurse Practitioner | 4410 N Midkiff Rd Ste D6, Midland, TX 79705 | 2014-05-16 |
| 1881842854 | Tiffany Goran Locke | Physician Assistant | 4410 N Midkiff Rd Ste D6, Midland, TX 79705-4249 | 2008-09-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154949915 | Diyora Amanova | Dentist | 2817-b, Loop 250 Frontage Rd, Midland, TX 79705 | 2020-07-08 |
| 1821610205 | Winners Circle Group of Tx | Community/Behavioral Health | 4405 N Garfield Street, Apt. 1005, Midland, TX 79705 | 2020-05-08 |
| 1619523644 | Lillian Moreno | Physician Assistant | 3600 N Garfield St., Midland, TX 79705 | 2019-08-15 |
| 1689229429 | Michelle Ray | Student in an Organized Health Care Education/Training Program | Texas Tech University Health Science Center, 3600 N. Garfield, Midland, TX 79705 | 2019-08-08 |
| 1649825001 | Marlene Cereceres | Student in an Organized Health Care Education/Training Program | 3600 N. Garfield, Midland, TX 79705 | 2019-08-02 |
| 1194370627 | Brianne Marie Hanson | Student in an Organized Health Care Education/Training Program | 3600 North Garfield, Midland, TX 79705 | 2019-08-01 |
| 1841844685 | Stephanie Ann Johnson | Student in an Organized Health Care Education/Training Program | Texas Tech University Health Sciences Center, 3600 N. Garfield, Midland, TX 79705 | 2019-07-30 |
| 1013560093 | Andrea Silva | Licensed Practical Nurse | 2903 Ncr 1140, Midland, TX 79705 | 2019-07-19 |
| 1417509332 | Ananya Das | Physician Assistant | 3600 North Garfield St., Midland, TX 79705 | 2019-07-11 |
| 1023571767 | Wecare Tlc- Pioneer Mco | Clinic/Center | 3617 N Big Sping, Midland, TX 79705 | 2019-04-10 |
| Find all providers in zip 79705 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487252458 | Midland Express Urgent and Family Care | Clinic/Center | 600 Cambridge St Ste 1, Midland, MI 48642-4508 | 2020-10-13 |
| 1194852400 | Midland Minor Pa | Clinic/Center | 2310 W Ohio Ave, Midland, TX 79701-5844 | 2007-02-27 |
| 1740841451 | Pro-health Medical Fp-midland | Clinic/Center | 111 E Wackerly St Ste D, Midland, MI 48642-7043 | 2019-06-24 |
| 1417429028 | Medical Care Innovation, P.C. | Clinic/Center | 715 East Main Street, Midland, MI 48640 | 2018-12-20 |
| 1740701184 | Ogeda Family Care, Pllc | Clinic/Center | 4506 Briarwood Ave Ste A, Midland, TX 79707-2642 | 2017-07-06 |
| 1528451101 | Tall City Convenient Primary Care | Clinic/Center | 4519 N Garfield St, Suite 6, Midland, TX 79705-3415 | 2015-03-06 |
| 1316363187 | Kristen J Kozma Do Pa | Clinic/Center | 1304 W Texas Ave, Midland, TX 79701-6176 | 2014-03-17 |
| 1942621990 | Great Lakes Health, LLC | Clinic/Center | 2726 N Saginaw Rd, Midland, MI 48640-2633 | 2013-12-18 |
| 1316218597 | T.j. Nugent D.c., P.l.c. | Clinic/Center | 2931 Manor Dr, Midland, MI 48640-4476 | 2012-01-20 |
| 1497047781 | Four Seasons Health and Wellness | Clinic/Center | 2200 W Wadley Ave, Suite 10, Midland, TX 79705-6438 | 2011-05-05 |
| Find all providers in MIDLAND | ||||
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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.