PARKSIDE FAMILY CLINIC, PA (NPI# 1689645376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689645376 |
| Entity Type | Organization |
| Organization Name | PARKSIDE FAMILY CLINIC, PA |
| Practice Address |
1109 E Broadway St Cuero TX 77954-2108 |
| Practice Telephone | 3612752800 |
| Practice Fax Number | 3612758791 |
| Mailing Telephone | 3612752800 |
| Mailing Fax Number | 3612758791 |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2011-02-14 |
| Authorized Official Name | MICHAEL R MCLEOD (MEDICAL DIRECTOR/OWNER) |
| Authorized Official Telephone | 3612752800 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 179346503 | 05 | |
| TX | 179346501 | 05 | |
| TX | 179346502 | 05 | |
| TX | 164281102 | 05 | |
| TX | 164281101 | 05 | |
| TX | RR MCR | DB6498 | 01 |
| Street Address |
1109 E BROADWAY ST |
| City | CUERO |
| State | TX |
| Zip Code | 77954-2108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285164749 | Hermelinda Fitts | Nurse Practitioner | 1109 E Broadway St, Cuero, TX 77954-2108 | 2017-06-18 |
| 1487009734 | Cody A Walthall | Family Medicine | 1109 E Broadway St, Cuero, TX 77954 | 2016-04-24 |
| 1659770030 | Dewitt Medical District | Family Medicine | 1109 E Broadway St, Cuero, TX 77954-2108 | 2014-08-21 |
| 1063793123 | Summer Laake | Nurse Practitioner | 1109 E Broadway St, Cuero, TX 77954-2108 | 2011-09-02 |
| 1962528778 | Kelly M Sullivan | Social Worker | 1109 E Broadway St, Cuero, TX 77954-2108 | 2007-03-22 |
| 1922196393 | Troy W Lischka | Physician Assistant | 1109 E Broadway St, Cuero, TX 77954-2108 | 2006-10-11 |
| 1861595936 | Judith Ann Krupala | Nurse Practitioner | 1109 E Broadway St, Cuero, TX 77954-2108 | 2006-09-06 |
| 1700893484 | Herbert J Hall | Nurse Practitioner | 1109 E Broadway St, Cuero, TX 77954-2108 | 2006-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649658279 | H-e-b, Lp | Clinical Medical Laboratory | 909 E Broadway St, Cuero, TX 77954 | 2015-05-15 |
| 1558331421 | Dewitt Medical District | Home Health | 615 N Esplanade St, Cuero, TX 77954 | 2006-01-24 |
| 1922367366 | D Ross Braune Ma Lpc and Associates | Counselor | 401 Broadway Ave., 100, Cuero, TX 77954 | 2012-05-04 |
| 1053487868 | Dewitt Medical District | Nursing Care | 615 N Esplanade St, Cuero, TX 77954 | 2006-11-27 |
| 1770699027 | Cuero Medical Associates Pa | Family Medicine | 2500 N Esplanade, Suite 102, Cuero, TX 77954 | 2006-08-21 |
| 1710202098 | David Ronald Polasek | Pharmacist | 515 N Esplanade, Cuero, TX 77954-0270 | 2010-03-30 |
| 1124284500 | Renal Treatment Centers Southeast Lp | Clinic/Center | 1105 E Broadway St, Cuero, TX 77954-2108 | 2008-08-05 |
| 1104843382 | Wal-mart Stores Texas LLC | Durable Medical Equipment & Medical Supplies | 1202 E Broadway St, Cuero, TX 77954-2124 | 2006-07-16 |
| 1376082396 | Kevin Ferrall | Pharmacist | 909 E Broadway St, Cuero, TX 77954-2126 | 2017-02-23 |
| 1104953215 | Dewitt-lavaca Special Education Cooperative | Counselor | 960 E Broadway St, Cuero, TX 77954-2131 | 2007-02-27 |
| Find all providers in zip 77954 | ||||
| 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 |
|---|---|---|---|---|
| 1619055563 | Gracia Medical, LLP | Family Medicine | 2500 N Esplanade St Ste 101, Cuero, TX 77954-4727 | 2006-11-01 |
| 1417041690 | William Kevin Denton | Family Medicine | 2500 N Esplanade St Ste 102, Cuero, TX 77954-4727 | 2006-10-03 |
| 1790789253 | Timothy R Mcfarland | Family Medicine | 2550 N Esplanade St, Cuero, TX 77954-4736 | 2005-06-11 |
| 1457885592 | Nicholas Lemley | Family Medicine | 2500 N Esplanade St Ste 102, Cuero, TX 77954-4727 | 2017-04-15 |
| 1487009734 | Cody A Walthall | Family Medicine | 1109 E Broadway St, Cuero, TX 77954 | 2016-04-24 |
| 1730557026 | Dewitt Medical District | Family Medicine | 2500 N Esplanade St, Suite 102, Cuero, TX 77954-4723 | 2015-09-03 |
| 1659770030 | Dewitt Medical District | Family Medicine | 1109 E Broadway St, Cuero, TX 77954-2108 | 2014-08-21 |
| 1043645955 | Dewitt Medical District | Family Medicine | 2550 N Esplanade St, Cuero, TX 77954-4736 | 2013-09-10 |
| 1740614023 | Dewitt Medical District | Family Medicine | 2500 N Esplanade St, Suite 101, Cuero, TX 77954-4723 | 2013-08-22 |
| 1255625422 | Gary Paul Willers II | Family Medicine | 2500 N Esplanade St Ste 102, Cuero, TX 77954-4727 | 2011-06-06 |
| Find all providers in CUERO | ||||
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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.