Garry James Kennebrew Jr. (NPI# 1255605952, PAC ID# 7214271006) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
| Nation Provider ID (NPI) | 1255605952 |
| PAC ID by PECOS | 7214271006 |
| Professional Enrollment ID | I20181205001511 |
| Full Name | Garry James Kennebrew Jr. |
| Organization Legal Name | BASIN EMERGENCY PHYSICIANS PLLC |
| Address |
500 W 4th Medical Center Hospital Odessa TX 79761-5001 |
| Phone Number | 4326404000 |
| Gender | M |
| Medical School | LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE |
| Graduation Year | 2012 |
| Primary Specialty | EMERGENCY MEDICINE |
| Group Practice PAC ID | 0244397826 |
| Number of Group Practice Members | 17 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 451389 | PECOS COUNTY MEMORIAL HOSPITAL |
| 450132 | MEDICAL CENTER HOSPITAL |
| 210015 | MEDSTAR FRANKLIN SQUARE MEDICAL CENTER |
| 670047 | THE HOSPITALS OF PROVIDENCE - EAST CAMPUS |
| Address | Phone | Organization |
|---|---|---|
| 12101 Edgemere Blvd, El Paso, TX 79938-4746 | 9159216610 | BLUFF CREEK EMERGENCY MEDICINE ASSOCIATES, PA |
| 2400 Trawood Dr, El Paso, TX 79936-4168 | 9155778100 | BLUFF CREEK EMERGENCY MEDICINE ASSOCIATES, PA |
| 500 W, 4th Medical Center Hospital, Odessa, TX 79761-5001 | 4326404000 | BASIN EMERGENCY PHYSICIANS PLLC |
| Organization Legal Name | BASIN EMERGENCY PHYSICIANS PLLC |
| Physicians | 19 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Scott R Stout | Nurse Practitioner | Basin Emergency Physicians Pllc | 500 W, 4th Medical Center Hospital, Odessa, TX 79761-5001 |
| Michael A Heidlebaugh | Emergency Medicine | Basin Emergency Physicians Pllc | 500 W, 4th Medical Center Hospital, Odessa, TX 79761-5001 |
| Royce M Joseph | Emergency Medicine | Basin Emergency Physicians Pllc | 500 W, 4th Medical Center Hospital, Odessa, TX 79761-5001 |
| Hayleyesus P Gulilat | Nurse Practitioner | Basin Emergency Physicians Pllc | 500 W, 4th Medical Center Hospital, Odessa, TX 79761-5001 |
| Brian T Taylor | Emergency Medicine | Basin Emergency Physicians Pllc | 500 W, 4th Medical Center Hospital, Odessa, TX 79761-5001 |
| Stephen P Stewart | Emergency Medicine | Basin Emergency Physicians Pllc | 500 W, 4th Medical Center Hospital, Odessa, TX 79761-5001 |
| Montadher M Alwazni | Family Medicine | Basin Emergency Physicians Pllc | 500 W, 4th Medical Center Hospital, Odessa, TX 79761-5001 |
| Joseph A Cox | Nurse Practitioner | Basin Emergency Physicians Pllc | 500 W, 4th Medical Center Hospital, Odessa, TX 79761-5001 |
| Joshua L Houser | Emergency Medicine | Basin Emergency Physicians Pllc | 500 W, 4th Medical Center Hospital, Odessa, TX 79761-5001 |
| Wesley H Hamilton | Emergency Medicine | Basin Emergency Physicians Pllc | 500 W, 4th Medical Center Hospital, Odessa, TX 79761-5001 |
| Street Address |
500 W 4TH MEDICAL CENTER HOSPITAL |
| City | ODESSA |
| State | TX |
| Zip | 79761-5001 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Scott R Stout | Nurse Practitioner | Basin Emergency Physicians Pllc | 500 W, 4th Medical Center Hospital, Odessa, TX 79761-5001 |
| Michael A Heidlebaugh | Emergency Medicine | Basin Emergency Physicians Pllc | 500 W, 4th Medical Center Hospital, Odessa, TX 79761-5001 |
| Royce M Joseph | Emergency Medicine | Basin Emergency Physicians Pllc | 500 W, 4th Medical Center Hospital, Odessa, TX 79761-5001 |
| Hayleyesus P Gulilat | Nurse Practitioner | Basin Emergency Physicians Pllc | 500 W, 4th Medical Center Hospital, Odessa, TX 79761-5001 |
| Brian T Taylor | Emergency Medicine | Basin Emergency Physicians Pllc | 500 W, 4th Medical Center Hospital, Odessa, TX 79761-5001 |
| Stephen P Stewart | Emergency Medicine | Basin Emergency Physicians Pllc | 500 W, 4th Medical Center Hospital, Odessa, TX 79761-5001 |
| Montadher M Alwazni | Family Medicine | Basin Emergency Physicians Pllc | 500 W, 4th Medical Center Hospital, Odessa, TX 79761-5001 |
| Joseph A Cox | Nurse Practitioner | Basin Emergency Physicians Pllc | 500 W, 4th Medical Center Hospital, Odessa, TX 79761-5001 |
| Joshua L Houser | Emergency Medicine | Basin Emergency Physicians Pllc | 500 W, 4th Medical Center Hospital, Odessa, TX 79761-5001 |
| Wesley H Hamilton | Emergency Medicine | Basin Emergency Physicians Pllc | 500 W, 4th Medical Center Hospital, Odessa, TX 79761-5001 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert F Demuro Jr. | Physician Assistant | Acute Orthopedic Care Specialists Pllc | 540 W 5 Th St, Suite 350, Odessa, TX 79761 |
| Ravi Medi | Psychiatry | 2626 Jbs Pkwy, C129, Odessa, TX 79761 | |
| Benjamin J Turnbow | Orthopedic Surgery | Acute Orthopedic Care Specialists Pllc | 540 W 5 Th St, Suite 350, Odessa, TX 79761 |
| Andrew M Allbright | Nurse Practitioner | Acute Orthopedic Care Specialists Pllc | 540 W 5 Th St, Suite 350, Odessa, TX 79761 |
| Brian W Griffin | Nurse Practitioner | Acute Orthopedic Care Specialists Pllc | 540 W 5 Th St, Suite 350, Odessa, TX 79761 |
| Brandon Joseph Pepper | Physical Therapy | Phytex Rehabilitation, LLC | 2525 N Grandview Ave, Suite 400, Odessa, TX 79761-1600 |
| David R Godino | Physical Therapy | Phytex Rehabilitation, LLC | 2525 N Grandview Ave, Suite 400, Odessa, TX 79761-1600 |
| Amber G Mcmullan | Physical Therapy | Phytex Rehabilitation, LLC | 2525 N Grandview Ave, Suite 400, Odessa, TX 79761-1600 |
| Joanie Marie Weber | Physical Therapy | Phytex Rehabilitation, LLC | 2525 N Grandview Ave, Suite 400, Odessa, TX 79761-1600 |
| Megan Leonard | Physical Therapy | Phytex Rehabilitation, LLC | 2525 N Grandview Ave, Suite 400, Odessa, TX 79761-1600 |
| Find all physicians in zip 79761 | |||
| City | ODESSA |
| Zip Code | 79761 |
| Specialty | EMERGENCY MEDICINE |
| City + Specialty | ODESSA + EMERGENCY MEDICINE |
Please comment or provide details below to improve the information on Garry James Kennebrew Jr..
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.