Texoma Womens Clinic P.a.
Organization Active NPI Obstetrics & Gynecology Physician · Wichita Falls, TX
NPI 1104854777 · NPPES record last updated Dec 20, 2022
Key facts
- NPI
- 1104854777
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- Legal business name
- TEXOMA WOMENS CLINIC P.A.
- Practice address
- 6 Burnside
Wichita Falls, TX 76310-1128 - Phone
- (940) 723-8151
- Fax
- (940) 723-8815
- NPI assigned
- Jun 30, 2006
- Organization subpart
- No
Authorized official
- Name
- Ryan Jeremy Bannon
- Title
- Authorized Official
- Phone
- (940) 723-8571
Practitioners 19
-
Ryan Jeremy Bannon, M.D.
-
Gradie Elizabeth Moore, M.D.
-
James Van Riper, D.O.
-
Mandy Winfrey, M.D.
-
Brent W Bost, MD
-
Sumi King, M.D.
-
Amy Klein, D.O.
-
Melissa Micallef, MSN, APRN, WHNP-BC
-
Audrey Rachelle Puentes, M.D.
-
Jerry Sinclair, MD
-
Amy Wolfe, NP
-
Tessa Lynn Yates, CNM, WHNP
-
Edward Kirschman, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060929000273 | TX | Part B Supplier - Clinic/Group Practice | 7315942109 |
Receives reassigned benefits from 19 practitioners Practice locations: Graham, TX; Wichita Falls, TX |
National Provider Directory
Locations
6 Burnside
Wichita Falls, TX 76310
Phone (940) 723-8151
1601 9th St
Wichita Falls, TX 76301
Phone 9407238151 ext. 140
1601 9th St
Ste B
Wichita Falls, TX 76301
Phone (817) 723-8151
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician |
207V00000X | Yes |
Addresses
Primary practice location
6 Burnside
Wichita Falls, TX 76310-1128
Mailing address
6 Burnside
Wichita Falls, TX 76310-1128
Phone (940) 723-8151
Other names
- THE WOMENS CLINIC
Other providers in Wichita Falls, TX
- Texoma Rehab PLLC
- Texoma Rheumatology PLLC
- Texoma Specialty Care
- Texoma Surgery Center LLC
- Texoma Urology Center
- Olga I Tezaguic
- Chee-Ah Thao
- The Milk Spot, LLC
- The MRI Center at Ostc
- The Pain Rehabilitation Group of Wichita Falls P.a.
All providers in Wichita Falls, TX · Obstetrics & Gynecology Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.