KELLY DZIERSK (NPI# 1689179376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689179376 |
| Entity Type | Individual |
| Full Name | KELLY DZIERSK |
| Practice Address |
6911 Rr 620 N Austin TX 78732-1920 |
| Mailing Address |
12600 Maidenhair Ln Bee Cave TX 78738-5617 |
| Practice Telephone | 5122198533 |
| Mailing Telephone | 5129094574 |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2018-03-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | 35432 | TX | Student, Health Care |
| Street Address |
6911 RR 620 N |
| City | AUSTIN |
| State | TX |
| Zip Code | 78732-1920 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306175146 | Jason Mance | Pharmacist | 6911 Rr 620 N, Austin, TX 78732-1920 | 2009-12-07 |
| 1629685979 | Jessica Rita Szymanski | Pharmacist | 6911 Rr 620 N, Austin, TX 78732-1920 | 2020-09-29 |
| 1013293711 | Jyoti A Shah | Pharmacist | 6911 Rr 620 N, Austin, TX 78732-1920 | 2011-10-25 |
| 1164751616 | Craig Alan Buchele | Pharmacist | 6911 Rr 620 N, Austin, TX 78732-1920 | 2009-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477181014 | The Doctors Morren, Pllc | Dentist | 3810 N Quinlan Park Rd, Austin, TX 78732 | 2020-03-30 |
| 1851803688 | Lake Travis Emergency Physicians, Pllc | Internal Medicine | 5012 Ranch Road 620 North, Austin, TX 78732 | 2017-11-02 |
| 1679018386 | Joseph Civello | Pharmacist | 6911 Ranch Rd 620 N, Austin, TX 78732 | 2017-01-04 |
| 1619300431 | Rapid Radiology, Inc. | Radiology | 6548 Comanche Trl Ste 501, Austin, TX 78732 | 2013-08-15 |
| 1417395658 | Meagan Lee Scarborough | Dentist | 2900 N Quinlan Park Rd Ste 160, Austin, TX 78732 | 2013-06-10 |
| 1851667729 | Quinlan Park Dental | Dentist | 5145 N. Fm 620 Suite G-150, Austin, TX 78732 | 2012-03-26 |
| 1568611978 | Sumita Chakraborti | Dentist | 5145 N. Fm 620, Suite G-150, Austin, TX 78732 | 2008-09-10 |
| 1376736371 | Alexander Banks | Registered Nurse | 2900 N. Quinlan Park Rd., B240, Austin, TX 78732 | 2007-08-22 |
| 1760602585 | Vista View Dental | Dentist | 4300 N Quinlan Park Blvd, Suite 230, Austin, TX 78732 | 2007-04-26 |
| 1659448876 | Katherine Blum | Preventive Medicine | 3208 Magenta Sky Trail, Austin, TX 78732 | 2006-11-30 |
| Find all providers in zip 78732 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366053175 | Ethan Zimmerman | Student in an Organized Health Care Education/Training Program | 901 Mopac Expressway South, Barton Oaks Plaza 4, Suite 350, Austin, TX 78746 | 2020-08-14 |
| 1144847773 | Rachael Tillman | Student in an Organized Health Care Education/Training Program | 4900 Mueller Blvd Fl 2, Austin, TX 78723-3079 | 2020-06-30 |
| 1497370639 | Patrick Dennis Scholl | Student in an Organized Health Care Education/Training Program | 5205 Backtrail Dr, Austin, TX 78731-2668 | 2020-06-13 |
| 1710501820 | Megan Elise Gittins | Student in an Organized Health Care Education/Training Program | Ut Austin Dell Medical School 1400 Ih-35, Cec 300, Austin, TX 78701 | 2020-06-04 |
| 1437772373 | Sharon Polackal | Student in an Organized Health Care Education/Training Program | Shoal Creek Hospital, 3501 Mills Avenue, 6th Floor, Austin, TX 78731 | 2020-05-27 |
| 1215550025 | Javier Benitez | Student in an Organized Health Care Education/Training Program | Ut Austin Dell Medical School General Surgery, 1500 Red River St., Austin, TX 78712 | 2020-05-27 |
| 1952924276 | Parisa Khosravi | Student in an Organized Health Care Education/Training Program | 1400 N Interstate 35 # Cec300, Austin, TX 78701-1926 | 2020-05-20 |
| 1659993657 | Ayan Monpara | Student in an Organized Health Care Education/Training Program | 6007 Duncanville Pass, Austin, TX 78745-3223 | 2020-05-12 |
| 1215558689 | Margaret Marie Coates | Student in an Organized Health Care Education/Training Program | 1400 N Interstate Highway 35, Cec 2.404, Austin, TX 78701 | 2020-04-27 |
| 1215566856 | Vignesh Ramachandran | Student in an Organized Health Care Education/Training Program | 2110 Cliffs Edge Dr, Austin, TX 78733-6014 | 2020-04-06 |
| Find all providers in AUSTIN | ||||
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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.