DR. LIDIA STANA ILCUS (NPI# 1811950090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811950090 |
| Entity Type | Individual |
| Full Name | DR. LIDIA STANA ILCUS |
| Credential | M.D. |
| Practice Address |
359 Mdg 221 Third Street West Randolph Afb TX 78150 |
| Practice Telephone | 2106528544 |
| Mailing Telephone | 2106528544 |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2019-10-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | ME 75062 | FL | Allopathic & Osteopathic Physicians |
| N | 171000000X | Military Health Care Provider | Other Service Providers |
| Street Address |
359 MDG 221 THIRD STREET WEST |
| City | RANDOLPH AFB |
| State | TX |
| Zip Code | 78150 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427158203 | Mikel M Merritt | Psychologist | 359 Mdg, 221 3rd St W, Randolph Afb, TX 78150 | 2006-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770045833 | Erica Renae Guevara | Physician Assistant | 559 Medial Sq, 221 Third Street West Bldg. 1040, Jbsa-randolph Afb, TX 78150 | 2019-04-05 |
| 1457803868 | Emily Newman | Dietitian, Registered | 221 Third Street West, Bldg. 999 Ste 2, Joint Base San Antonio -randolph, TX 78150 | 2016-11-02 |
| 1922411677 | Amber Drewer | Military Health Care Provider | 3rd Street West Building 1040, Randolph Afb, TX 78150 | 2014-06-10 |
| 1144652975 | Josephine Kimberly Olsen | Family Medicine | 359 Mdos/mdg, Randolph Afb, TX 78150 | 2013-08-02 |
| 1609149681 | Lucky Lusterio | Preventive Medicine | 221 3rd St. W, Randolph Afb, TX 78150 | 2012-02-21 |
| 1417120569 | Joni Hodgson | General Practice | 221 3rd Street West, Jbsa Randolph, TX 78150 | 2008-04-09 |
| 1710095724 | Katherine Justen Adamson | Physician Assistant | 12th Medical Group, 221 3rd Street West, Randolph Air Force Base, TX 78150 | 2006-08-29 |
| 1013970672 | David Hamilton | Social Worker | 12mdos/sgohf, Randolph Afb, TX 78150 | 2006-04-06 |
| 1962465526 | Robert Allan Briggs | Physical Therapist | Randolph Afb Clinic, 221 3rd St W, Randolph Afb, TX 78150 | 2006-04-06 |
| 1982685566 | John Yoonsik Oh | Internal Medicine | 221 Third St, Bldg 1040, Attn: 359 Mdg/sghq, Jbsa Randolph, TX 78150 | 2005-11-09 |
| Find all providers in zip 78150 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295334936 | Samantha H. Goodman, Md, Pllc | Internal Medicine | 3926 S Treadaway Blvd Ste B2, Abilene, TX 79602-6939 | 2020-10-23 |
| 1750989109 | 3d Regeneration LLC | Internal Medicine | 11610 Bee Caves Rd Ste 230, Austin, TX 78738-5457 | 2020-10-16 |
| 1174121552 | Taiwo Kuye, Md Pa | Internal Medicine | 7135 N Expressway 77 Ste C, Olmito, TX 78575-5204 | 2020-10-16 |
| 1760080014 | Stephanie Kennedy | Internal Medicine | 503 E Sonterra Blvd, San Antonio, TX 78258-4058 | 2020-10-09 |
| 1588262711 | Medicus Internal Medicine & Primary Care Pllc | Internal Medicine | 2822 Dogwood Terrace Ln, Katy, TX 77494-7166 | 2020-10-09 |
| 1588261002 | Cardiac Rhythm Center Pllc | Internal Medicine | 2527 Gramercy St, Houston, TX 77030-3107 | 2020-10-07 |
| 1982210571 | Kim L Rowlands | Internal Medicine | 6101 E Oltorf, None, Austin, TX 78704-7875 | 2020-09-18 |
| 1891301438 | Primary Care of Houston Pllc | Internal Medicine | 19255 Park Row Ste 204b, Houston, TX 77084-7310 | 2020-09-18 |
| 1225644065 | Seton Family of Doctors | Internal Medicine | 3001 Palm Way, D1 : 134-138, Austin, TX 78758 | 2020-09-17 |
| 1528674561 | Knight Doctor Pllc | Internal Medicine | 1401 Eva St Apt 304, Austin, TX 78704-3069 | 2020-09-16 |
| Find all providers with the same taxonomy | ||||
| City | RANDOLPH AFB |
| Zip Code | 78150 |
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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.