Organization Active NPI

Serve All Medical Killeen, PLLC

  • Internal Medicine Physician
  • Killeen, TX
National Provider Identifier
1700461985
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SERVE ALL MEDICAL KILLEEN, PLLC
Practice address
2804 S W S Young Dr
Killeen, TX 76542-2016
Phone
(254) 236-5575
Fax
(832) 308-1272
NPI assigned
Mar 10, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Authorized official

Name
Jonathon Ingram
Title
Chief Marketing Officer
Phone
(832) 350-1778

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2804 S W S Young Dr
Killeen, TX 76542-2016

Mailing address

PO Box 339
Holland, TX 76534-0339
Phone (281) 864-5656

Other names 1

  • Clinica Hispana Doing business as

National Provider Directory

National Provider Directory

Locations

2804 S W S Young Dr
Killeen, TX 76542
Phone (254) 236-5575

2804 S W S Young Dr
Ste 325
Killeen, TX 76542
Phone (254) 236-5575

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655942400000",
    "number": "1700461985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 339",
            "city": "HOLLAND",
            "state": "TX",
            "postal_code": "765340339",
            "telephone_number": "281-864-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 S W S YOUNG DR",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765422016",
            "telephone_number": "254-236-5575",
            "fax_number": "832-308-1272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERVE ALL MEDICAL KILLEEN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-10",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A",
        "authorized_official_last_name": "INGRAM",
        "authorized_official_first_name": "JONATHON",
        "authorized_official_title_or_position": "CHIEF MARKETING OFFICER",
        "authorized_official_telephone_number": "832-350-1778"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinica Hispana",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Killeen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.