JACK A MAXWELL (NPI# 1679585087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679585087 |
| Entity Type | Individual |
| Full Name | JACK A MAXWELL |
| Credential | DO |
| Practice Address |
3600 Fm 2181 Ste 100 Hickory Creek TX 75065-7636 |
| Practice Telephone | 9404972204 |
| Practice Fax Number | 9403214977 |
| Mailing Telephone | 9404972204 |
| Mailing Fax Number | 9403214977 |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2012-02-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | G9368 | TX | Allopathic & Osteopathic Physicians |
| N | 207QS1201X |
Family Medicine Specialization: Sleep Medicine |
2869 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 124499802 | 05 | |
| TX | 124499806 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871949792 | Jack Maxwell IIi | Counselor | 627 Ne Evans St, Mcminnville, OR 97128-3923 | 2016-05-10 |
| Street Address |
3600 FM 2181 STE 100 |
| City | HICKORY CREEK |
| State | TX |
| Zip Code | 75065-7636 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174016539 | Emily Bengston | Physician Assistant | 3600 Fm 2181 Ste 100, Hickory Creek, TX 75065-7636 | 2018-06-11 |
| 1932611951 | Lauren Harkrider | Physician Assistant | 3600 Fm 2181 Ste 100, Hickory Creek, TX 75065-7636 | 2017-10-31 |
| 1457726531 | Amber Durani | Physician Assistant | 3600 Fm 2181 Ste 100, Hickory Creek, TX 75065-7636 | 2015-12-01 |
| 1235565862 | Tony George | Physician Assistant | 3600 Fm 2181 Ste 100, Hickory Creek, TX 75065-7636 | 2013-09-14 |
| 1932407244 | Trudy L Joy | Physician Assistant | 3600 Fm 2181 Ste 100, Hickory Creek, TX 75065-7636 | 2011-03-10 |
| 1821100017 | Kimberly M Cumings | Physician Assistant | 3600 Fm 2181 Ste 100, Hickory Creek, TX 75065-7636 | 2006-08-31 |
| 1063525806 | Stephen A Glaser | Family Medicine | 3600 Fm 2181 Ste 100, Hickory Creek, TX 75065-7636 | 2006-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538650924 | Nalani M Newton | Physical Therapy Assistant | 300 E Swisher Rd Apt 3101, Lake Dallas, TX 75065 | 2018-05-22 |
| 1174801880 | Christin Danielle Vaello | Dentist | 2020 Fm 2181, Hickory Creek, TX 75065 | 2011-07-29 |
| 1912934167 | Thuan N Pham | Dentist | 4550 Swisher Road, Hickory Creek, TX 75065 | 2006-06-26 |
| 1346718111 | Stephanie Mouser | Counselor | 211 Main Street, #150, Lake Dallas, TX 75065 | 2018-11-09 |
| 1104100361 | America Dental | Dentist | 4550 Swisher Road, Hickory Creek, TX 75065 | 2011-10-06 |
| 1447817465 | One Reach LLC | Counselor | 211 Saratoga Dr, Lake Dallas, TX 75065-0320 | 2019-05-24 |
| 1710184296 | Family Chiropractic & Wellness Center | Chiropractor | Po Box 760, Lake Dallas, TX 75065-0760 | 2007-06-28 |
| 1184984403 | K2 Home Healthcare, Inc. | Home Health | 318 Sweet Leaf Ln, Lake Dallas, TX 75065-2275 | 2012-05-21 |
| 1598042657 | Jerome P. Kralka I | Hearing Instrument Specialist | 514 Meadowbrook St, Lake Dallas, TX 75065-2312 | 2011-11-03 |
| 1518354000 | Sloane Garrett | Developmental Therapist | 506 Ridgewood St, Lake Dallas, TX 75065-2320 | 2015-04-22 |
| Find all providers in zip 75065 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063525806 | Stephen A Glaser | Family Medicine | 3600 Fm 2181 Ste 100, Hickory Creek, TX 75065-7636 | 2006-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669073599 | Julie Suzanne Rodriguez | Family Medicine | 421 W Wadley Ave Ste B, Midland, TX 79705-5368 | 2020-11-06 |
| 1871194670 | Priscilla Tehrani | Family Medicine | 615 North Loop E Unit 100, Houston, TX 77022-5934 | 2020-11-06 |
| 1821699976 | Dr. G Medical Solutions | Family Medicine | 4840 W Panther Creek Dr Ste 211, The Woodlands, TX 77381-3542 | 2020-11-05 |
| 1124629522 | Jose Reynaldo Carcamo Jr. | Family Medicine | 18568 Texas 46, Suite 1001, Spring Branch, TX 78070 | 2020-11-03 |
| 1205437662 | Angela Ekern | Family Medicine | 7421 Cordoba Dr, Austin, TX 78724-6252 | 2020-11-03 |
| 1770184020 | Kara Fenceroy | Family Medicine | 5425 Rolling Meadows Dr, Fort Worth, TX 76123-2836 | 2020-11-03 |
| 1881295327 | Courtney L Buchmeier | Family Medicine | 16620 San Pedro Ave, San Antonio, TX 78232-2327 | 2020-11-02 |
| 1003416207 | Adeline Galvez | Family Medicine | 1300 W Terrell Ave Ste 270, Fort Worth, TX 76104-2820 | 2020-10-27 |
| 1710585229 | Megan Alyse Loyd | Family Medicine | 2101 Kingsley Dr Apt 3106, Pearland, TX 77584-4118 | 2020-10-16 |
| 1104424795 | Rachel Elizabeth Whitten | Family Medicine | 614 S Business Ih 35 Ste A, New Braunfels, TX 78130-4748 | 2020-10-15 |
| Find all providers with the same taxonomy | ||||
| City | HICKORY CREEK |
| Zip Code | 75065 |
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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.