ABILENE DIAGNOSTIC CLINIC, PLLC (NPI# 1760482665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760482665 |
| Entity Type | Organization |
| Organization Name | ABILENE DIAGNOSTIC CLINIC, PLLC |
| Other Organization Name | ADC LABORATORY |
| Practice Address |
1665 Antilley Rd Ste 190 Abilene TX 79606-5249 |
| Mailing Address |
Po Box 5409 Abilene TX 79608-5409 |
| Practice Telephone | 3257935158 |
| Practice Fax Number | 3257935192 |
| Mailing Telephone | 3254378655 |
| Mailing Fax Number | 3254378647 |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2019-10-14 |
| Authorized Official Name | ANDREW KOUBA (CEO/AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 3254378645 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246Q00000X | Spec/Tech, Pathology | Technologists, Technicians & Other Technical Service Providers |
| Other Name | Type Code |
|---|---|
| ADC Laboratory | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043725062 | Abilene Diagnostic Clinic, Pllc | Podiatrist | 1665 Antilley Rd Ste 210, Abilene, TX 79606-5276 | 2017-12-13 |
| 1013159854 | Abilene Diagnostic Clinic, Pllc | Podiatrist | 6250 Regional Plz Ste 1016, Abilene, TX 79606-5223 | 2009-03-25 |
| 1346242567 | Abilene Diagnostic Clinic, Pllc | Specialist | 1665 Antilley Rd, # 200, Abilene, TX 79606-5265 | 2005-06-01 |
| 1912149758 | Abilene Diagnostic Clinic, Pllc | Podiatrist | 1665 Antilley Rd Ste 230, Abilene, TX 79606-5291 | 2009-03-25 |
| 1275780744 | Abilene Diagnostic Clinic, Pllc | Clinic/Center | 1665 Antilley Rd, Suite 120, Abilene, TX 79606-5265 | 2008-08-26 |
| 1356341184 | Abilene Diagnostic Clinic, Pllc | Radiologic Technologist | 1665 Antilley Rd, Suite 200, Abilene, TX 79606-5265 | 2005-07-22 |
| 1497755235 | Abilene Diagnostic Clinic, Pllc | Specialist | 1665 Antilley Rd, Suite 200, Abilene, TX 79606-5265 | 2005-07-22 |
| Street Address |
1665 ANTILLEY RD STE 190 |
| City | ABILENE |
| State | TX |
| Zip Code | 79606-5249 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235746793 | Tara Ann Patrick | Social Worker | Veterans Affairs, 3850 Ridgemont, Abilene, TX 79606 | 2020-09-29 |
| 1740815398 | Kevin William Regan | General Practice | 5326 Meadow Dr., Abilene, TX 79606 | 2020-03-04 |
| 1548800725 | Valentina Walls | Registered Nurse | 14 Verbena St., Abilene, TX 79606 | 2020-01-15 |
| 1932649803 | Palo Pinto County Hospital District | Skilled Nursing Facility | 6050 Hospital Drive, Abilene, TX 79606 | 2017-02-27 |
| 1679925127 | Tania Marie Oyola Rosario | Family Medicine | 6300 Regional Plz Ste 260, Abilene, TX 79606 | 2016-07-08 |
| 1972973196 | Brian Stuart | Specialist/Technologist | 4502 Antilley Rd, Abilene, TX 79606 | 2015-09-30 |
| 1255723151 | Megan Blair Greenway | Specialist/Technologist, Other | 7325 Clariece Drive, Abilene, TX 79606 | 2015-03-02 |
| 1215280698 | James T.s. O'neal II | Physician Assistant | 697 Louisianna Drive, Dyess Afb, TX 79606 | 2012-10-22 |
| 1548522675 | Chukwuemeka Charles Ezeoke | Internal Medicine | 1680 Antilley Rd Ste 120, Abilene, TX 79606 | 2012-06-14 |
| 1801152152 | Jeffrey Darren Edwards | Internal Medicine | 5302 Buffalo Gap Road, Suite 104, Abilene, TX 79606 | 2012-04-11 |
| Find all providers in zip 79606 | ||||
| Taxonomy Code | 246Q00000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Spec/Tech, Pathology |
| (1) An individual educated and trained in clinical chemistry, microbiology or other biological sciences; and in gathering data on the blood, tissues, and fluids in the human body. Tests and procedures performed or supervised center on major areas of hematology, microbiology, immunohematology, immunology, clinical chemistry and urinalysis. Education and certification requires the equivalent of an associate degree and alternative combinations of accredited training and experience. (2) A specially trained individual who works under the direction of a pathologist, other physician, or scientist, and performs specialized chemical, microscopic, and bacteriological tests of human blood, tissue, and fluids. Also known as medical technologists, they perform and supervise tests and procedures in clinical chemistry, immunology, serology, bacteriology, hematology, parasitology, mycology, urinalysis, and blood banking. The work requires the correlation of test results with other data, interpretation of test findings, and exercise of independent judgment. The minimum educational requirement (for one of several certification programs in medical technology) is a baccalaureate degree with appropriate science course requirements, plus a twelve-month, structured, AMA approved medical technology program and an examination; or a baccalaureate degree with appropriate science course requirements and experience. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457979890 | Caitlin Callais | Spec/Tech, Pathology | 12708 Riata Vista Circle A106, Austin, TX 78727-7174 | 2020-07-13 |
| 1598249401 | Shibi Philip | Spec/Tech, Pathology | 2625 Ash Crk, Mesquite, TX 75181-4210 | 2018-09-18 |
| 1457854937 | Victoria Nguyen | Spec/Tech, Pathology | 1201 N Watson Rd Ste 220, Arlington, TX 76006-6120 | 2018-03-12 |
| 1235370362 | Justina Obiamaka Ene | Spec/Tech, Pathology | 2904 Creekside Ct, Carrollton, TX 75007-5047 | 2009-03-19 |
| 1619917481 | East Texas Medical Center Healthcare Associates | Spec/Tech, Pathology | 904 S Beckham Ave, Tyler, TX 75701-1906 | 2006-06-08 |
| 1255943692 | Madison Mitford | Spec/Tech, Pathology | 9846 Hwy 31 E, Tyler, TX 75705-2329 | 2020-08-18 |
| 1750992020 | Kaitlyn Godsave | Spec/Tech, Pathology | 9846 Hwy 31 E, Tyler, TX 75705-2329 | 2020-08-11 |
| 1952925620 | Katherine E Connelly | Spec/Tech, Pathology | 1515 Holcombe Blvd, Houston, TX 77030-4000 | 2020-05-29 |
| 1497376933 | Tracey Beazley | Spec/Tech, Pathology | 9846 Highway 31 E, Tyler, TX 75705-2329 | 2020-05-06 |
| 1811534464 | Sadia Qureshi | Spec/Tech, Pathology | 9846 Hwy 31 E, Tyler, TX 75705-2329 | 2019-12-03 |
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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.