Privia Medical Group West Texas, PLLC

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

PRIVIA MEDICAL GROUP WEST TEXAS, PLLC

Doing business as

Abilene Diagnostic Clinics

Practice address

1665 Antilley Rd Ste 210
Abilene, TX 79606-5276

Phone

(325) 437-8647

Fax

(325) 793-5107

NPI assigned

Dec 13, 2017

Last updated

Jul 25, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Andrew Kouba

Title

Ceo/Authorized Official

Phone

(325) 437-8645

Specialties & licenses 1

Addresses

Other names 2

• Abilene Diagnostic Clinics Doing business as
• Podiatry DME Suite 210 Other name

Locations

Practitioners 125

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jason Luis Acevedo, MD

  • Otolaryngology Physician
  • Brownwood, TX
  • NPI 1740380534
  NPD
• Veronica Ann Aguirri, PA

  • Physician Assistant
  • Abilene, TX
  • NPI 1265200075
  NPD
• Kathryn Joann Barton, RN, FNP-C

  • Family Nurse Practitioner
  • Abilene, TX
  • NPI 1275868713
  NPD
• James Gregory Bass, MD

  • Obstetrics & Gynecology Physician
  • Abilene, TX
  • NPI 1992725956
  NPD
• Robert Loyd Beckham, MD

  • Family Medicine Physician
  • Abilene, TX
  • NPI 1851896971
  NPD
• Laura L Bennett, M.D.

  • Plastic Surgery Physician
  • Abilene, TX
  • NPI 1548489677
  NPD
• Abel Eugene Biesman, DO

  • Family Medicine Physician
  • Abilene, TX
  • NPI 1881115442
  NPD
• Beil Cory Brown, D.P.M.

  • Podiatrist
  • Abilene, TX
  • NPI 1003853011
  NPD
• Patrick Bruton, D.P.M.

  • Podiatrist
  • Abilene, TX
  • NPI 1437103074
  NPD
• Zarina M. Calingo, NP-C

  • Family Nurse Practitioner
  • Abilene, TX
  • NPI 1659649234
  NPD
• Jay Donald Capra, M.D.

  • Pediatrics Physician
  • Abilene, TX
  • NPI 1942298872
  NPD
• Peter P. Chang, MD

  • Family Medicine Physician
  • San Angelo, TX
  • NPI 1780688028
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1513123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658707200000",
    "number": "1043725062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5409",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796085409",
            "telephone_number": "325-437-8655",
            "fax_number": "325-437-8647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 ANTILLEY RD STE 210",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796065276",
            "telephone_number": "325-437-8647",
            "fax_number": "325-793-5107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVIA MEDICAL GROUP WEST TEXAS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-13",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A",
        "authorized_official_last_name": "KOUBA",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CEO/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "325-437-8645"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Abilene Diagnostic Clinics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Podiatry DME Suite 210",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Leddy McCall Priddy, PT, DPT
• Primary Nurse Care, Inc (Elara Caring)
• Prime Care Anesthesia, PLLC
• Sky Jean Prince Shafrin
• Privia Medical Group West Texas, PLLC (Abilene Diagnostic Clinics)
• Privia Medical Group West Texas, PLLC
• Privia Medical Group West Texas, PLLC (Abilene Diagnostic Clinic, PLLC)
• Privia Medical Group West Texas, PLLC
• Privia Medical Group West Texas, PLLC
• Privia Medical Group West Texas, PLLC

• Podiatrist in Abilene, TX
• Providers in Abilene, TX by specialty
• Podiatrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.