Regional Employee Assistance Program Inc
Organization Active NPI Family Medicine Physician · San Angelo, TX
NPI 1124080320 · NPPES record last updated Sep 24, 2020
Key facts
- NPI
- 1124080320
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- REGIONAL EMPLOYEE ASSISTANCE PROGRAM INC
- Practice address
- 2142 Sunset Dr
San Angelo, TX 76904-6829 - Phone
- (325) 245-4000
- NPI assigned
- Apr 4, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Jennifer L Jackson
- Title
- Sr. Director Provider Enrollment
- Phone
- (615) 465-3334
Other NPIs on the same Medicare enrollment 8
Practitioners 32
-
Hector Acton, MD
-
Sue R Brundrett, NP-C
-
Brandon C Burrage, F.N.P.-C.
-
Megan Sherree Chandler, RN FNP-C
-
Peter P. Chang, MD
-
Tommy Y Chang, NP-C
-
Rebecca Crenshaw, MD
-
Christopher Wayne Davis, NP-C
-
Yotham Fraenkel, D.O.
-
Charles D Harzke, MD
-
Jessie Hoak, ACNS-BC
-
Tresea M Jeter, FNP-C
-
Srikanth Podaralla, M.D., M.B.A
-
Toby Redden, CNP
-
Bradley Stevens, PA-C
-
Kai M Sun, D.O.
-
Stephanie Kay Sun, D.O.
-
Clifton E Thomas, M.D.
-
Leisa Thornhill, RN,BSN,MSN,FNP-C
-
Melissa Watson, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040612000731 | TX | Part B Supplier - Clinic/Group Practice | 1557260064 |
Receives reassigned benefits from 333 practitioners 10 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
National Provider Directory
Locations
2001 Hutchins Ave
Ste C
Ballinger, TX 76821
Phone (325) 365-2531
2510 Crockett Dr
Ste B
Brownwood, TX 76801
Phone (325) 641-8648
400 Hospital Dr
Ste 210
Corsicana, TX 75110
Phone (903) 641-4835
400 Hospital Dr
Ste 101
Corsicana, TX 75110
Phone (903) 641-3800
8607 McPherson Rd
Ste 102
Laredo, TX 78045
Phone (956) 583-0202
2141 Hamilton Way
San Angelo, TX 76904
Phone (325) 747-2480
2142 Sunset Dr
San Angelo, TX 76904
Phone (325) 245-4211
3350 Executive Dr
Ste 100
San Angelo, TX 76904
Phone (325) 245-4501
2141 Hamilton Way
Ste 100
San Angelo, TX 76904
Phone (325) 947-6472
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist |
106H00000X | |||
| Family Medicine Physician |
207Q00000X | Yes | ||
| Internal Medicine Physician |
207R00000X | |||
| Cardiovascular Disease Physician |
207RC0000X | |||
| Gastroenterology Physician |
207RG0100X | |||
| Neurological Surgery Physician |
207T00000X | |||
| Obstetrics & Gynecology Physician |
207V00000X | |||
| Pediatrics Physician |
208000000X | |||
| Podiatrist |
213E00000X | |||
| Physician Assistant |
363A00000X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
2142 Sunset Dr
San Angelo, TX 76904-6829
Mailing address
2403 N Laurent St
Victoria, TX 77901-4119
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 080138312 | Medicaid | TX | |
| 0037HD | Other | TX | BLUE CROSS |
Other providers in San Angelo, TX
- Reeves Rehab
- Iris Susan Reeves
- Richeona Reeves
- Regency IHS of San Angelo LLC San Angelo Nursing and Rehab
- Regional Cancer Treatment Center LTD
- Regional Employee Assistance Program Inc
- Payton Ann Reid
- Luz Elena Reiley
- Leslie Ann Rendon
- Anna Schneeman Reyes
All providers in San Angelo, TX · Family Medicine 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 Sep 24, 2020. 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.