Privia Medical Group West Texas, PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

PRIVIA MEDICAL GROUP WEST TEXAS, PLLC

Doing business as

Abilene Diagnostic Clinic, PLLC

Practice address

1665 Antilley Rd
# 200
Abilene, TX 79606-5265

Phone

(325) 793-5375

Fax

(325) 793-5384

NPI assigned

Jun 1, 2005

Last updated

Sep 7, 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 1

• Abilene Diagnostic Clinic, PLLC Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Privia Medical Group West Texas, PLLC

  dba Abilene Diagnostic Clinics

  • Podiatrist
  • Abilene, TX
  • NPI 1912149758

  5597747378

  Same PAC ID

Locations

Practitioners 182

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
  Medicare reassignment Care Compare group NPD
• Veronica Ann Aguirri, PA

  • Physician Assistant
  • Abilene, TX
  • NPI 1265200075
  Medicare reassignment Care Compare group NPD
• Kathryn Joann Barton, RN, FNP-C

  • Family Nurse Practitioner
  • Abilene, TX
  • NPI 1275868713
  Medicare reassignment Care Compare group NPD
• Robert Loyd Beckham, MD

  • Family Medicine Physician
  • Abilene, TX
  • NPI 1851896971
  Medicare reassignment Care Compare group NPD
• Laura L Bennett, M.D.

  • Plastic Surgery Physician
  • Abilene, TX
  • NPI 1548489677
  Medicare reassignment Care Compare group NPD
• Abel Eugene Biesman, DO

  • Family Medicine Physician
  • Abilene, TX
  • NPI 1881115442
  Medicare reassignment Care Compare group NPD
• Beil Cory Brown, D.P.M.

  • Podiatrist
  • Abilene, TX
  • NPI 1003853011
  Medicare reassignment Care Compare group NPD
• Patrick Bruton, D.P.M.

  • Podiatrist
  • Abilene, TX
  • NPI 1437103074
  Medicare reassignment Care Compare group NPD
• Zarina M. Calingo, NP-C

  • Family Nurse Practitioner
  • Abilene, TX
  • NPI 1659649234
  Medicare reassignment Care Compare group NPD
• Peter P. Chang, MD

  • Family Medicine Physician
  • San Angelo, TX
  • NPI 1780688028
  Medicare reassignment Care Compare group NPD
• Brenda Yesenia Chavez, MD

  • Family Medicine Physician
  • Abilene, TX
  • NPI 1427545474
  Medicare reassignment Care Compare group NPD
• Allison Dallas, FNP-C

  • Family Nurse Practitioner
  • Abilene, TX
  • NPI 1144005620
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662508800000",
    "number": "1346242567",
    "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",
            "address_2": "# 200",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796065265",
            "telephone_number": "325-793-5375",
            "fax_number": "325-793-5384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVIA MEDICAL GROUP WEST TEXAS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-01",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "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": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Abilene Diagnostic Clinic, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Prime Care Anesthesia, PLLC
• Sky Jean Prince Shafrin
• Privia Medical Group West Texas, PLLC (Abilene Diagnostic Clinics)
• Privia Medical Group West Texas, PLLC (Abilene Diagnostic Clinics)
• Privia Medical Group West Texas, PLLC
• Privia Medical Group West Texas, PLLC
• Privia Medical Group West Texas, PLLC
• Privia Medical Group West Texas, PLLC
• Privia Medical Group West Texas, PLLC (Abilene Diagnostic Clinics)
• Christopher William Proctor, DDS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.