DR. SHANE MCENTIRE (NPI# 1932224912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932224912 |
| Entity Type | Individual |
| Full Name | DR. SHANE MCENTIRE |
| Credential | M.D. |
| Practice Address |
3551 Roger Brooke Dr Fort Sam Houston TX 78234-4504 |
| Mailing Address |
1639 Thrush Court Cir San Antonio TX 78248-1756 |
| Practice Telephone | 2105399361 |
| Mailing Telephone | 8083541667 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-10-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
R9255 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
3551 ROGER BROOKE DR |
| City | FORT SAM HOUSTON |
| State | TX |
| Zip Code | 78234-4504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861093338 | Aneesh N/a Benoy | Nurse Practitioner | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-11-02 |
| 1164021580 | William Edward Vick | Pharmacist | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-10-19 |
| 1548868003 | Julia D Coffey | Pharmacist | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-10-15 |
| 1801493465 | Emiri Elliott | Registered Nurse | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-10-07 |
| 1437756574 | Clarence Michael Sullivan | Military Health Care Provider | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-10-01 |
| 1093320350 | Natalie Marie Greene | Physical Therapist | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-09-14 |
| 1033722509 | Kody Vallejo | Pharmacist | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-08-25 |
| 1558972620 | Renee Therese Hart | Nurse Practitioner | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-08-12 |
| 1235749722 | Emily Ann Robinson | Nurse Practitioner | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-08-09 |
| 1902415367 | Hannah Daniel | Pharmacist | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255942884 | Thomas Ballas | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Drive Jbsa-fort Sam Houston, Department of Behavioral Medicine-mche-dbm, San Antonio, TX 78234 | 2020-08-17 |
| 1124657366 | Wendy Harris | Pharmacist | 3041 Garden Ave, Fort Sam Houston, TX 78234 | 2020-04-08 |
| 1215564729 | Travis Frantz | Student in an Organized Health Care Education/Training Program | 3551 Rodger Brooke Drive, Jbsa Fort Sam Houston, TX 78234 | 2020-03-25 |
| 1508492695 | Matthew Grossmann | Student in an Organized Health Care Education/Training Program | San Antonio Military Medical Center, Mche-zdm-m, Internal Medicine Residency, 3551 Roger Brooke Dr., Jbsa-fort Sam Houston, TX 78234 | 2020-03-20 |
| 1235793407 | Jessica Maria May Franklin | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Drive Jbsa Fort Sam Houston, San Antonio, TX 78234 | 2019-04-23 |
| 1730663477 | Glen Snyder | Military Health Care Provider | 3488 Garden Ave Anderson Hall, Fort Sam Houston, San Antonio, TX 78234 | 2018-09-19 |
| 1265919336 | Ashley Elizabeth Malawey | Military Health Care Provider | 3222 Cpl Johnson Road, San Antonio, TX 78234 | 2018-07-23 |
| 1053805515 | Rene Espinosa | Social Worker | San Antonio Medical Center, 3551 Roger Brooke Dr, Jbsa, TX 78234 | 2018-06-19 |
| 1235622333 | Melanie Edith Rivera | Military Health Care Provider | 3600 Roger Brooke Drive, San Antonio, TX 78234 | 2018-06-13 |
| 1063909158 | Benjamin Walker Appelo | General Practice | San Antonio Mil Med Center 3551 Roger Brooke Dr, Mche-zdm-m, San Antonio, TX 78234 | 2018-04-16 |
| Find all providers in zip 78234 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881955029 | Kevin Ryan Kniery | Surgery | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2012-06-05 |
| 1710151733 | Elizabeth Hatcher Hartmann | Surgery | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2008-04-22 |
| 1477543478 | Mary Virginia Parker | Surgery | Brooke Army Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234-6200 | 2005-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407482003 | Endovascular Lab Pllc | Surgery | 612 N Washington Avenue, Suite 100, Odessa, TX 79761 | 2020-03-16 |
| 1356980163 | Jeffrey M. Martinez, M.d., P.a. | Surgery | 525 Centre Oak Drive, Suite 140, San Antonio, TX 78258 | 2019-12-26 |
| 1245875061 | Usa Vascular Center of Dallas Pllc | Surgery | 2300 W Fm 544 Ste B, Wylie, TX 75098-4931 | 2019-11-15 |
| 1740830959 | Coastal Plains Endeavors LLC | Surgery | 1602 E Houston St Ste A, Beeville, TX 78102-5335 | 2019-09-19 |
| 1205488632 | Usa Vein Clinics of Dallas Pllc | Surgery | 3128 Forest Ln Ste 320, Dallas, TX 75234-7761 | 2019-07-16 |
| 1558922625 | Sudad Kareem Al Hadad | Surgery | 12579 Richmond Ave Ste 800, Houston, TX 77082-2555 | 2019-06-27 |
| 1043782907 | Timothy C. Pringle Md Pa | Surgery | 4541 N. Josey Lane, Suite 140, Carrollton, TX 75010 | 2018-12-17 |
| 1518449701 | Kenton Lee Rommens | Surgery | 6400 Fannin St. Suite 2850, Houston, TX 77030 | 2018-09-04 |
| 1336633999 | Total Vein Treatment Centers | Surgery | 2301 Marsh Ln Ste 210, Plano, TX 75093-8497 | 2018-06-18 |
| 1508384652 | Jcm Vein Pllc Vein Care Coastal Bend | Surgery | 3301 S Alameda St Ste 402, Corpus Christi, TX 78411-1882 | 2017-09-08 |
| Find all providers with the same taxonomy | ||||
| City | FORT SAM HOUSTON |
| Zip Code | 78234 |
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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.