Texas a&M University System Health Science Center

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

TEXAS A&M UNIVERSITY SYSTEM HEALTH SCIENCE CENTER

Doing business as

Texas A&M Physicians - Round Rock

Practice address

3950 N Aw Grimes Blvd
Round Rock, TX 78665-3540

Phone

(979) 436-0500

Fax

(979) 776-6905

NPI assigned

Oct 21, 2008

Organization subpart

No

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

Authorized official

Name

Mr. John W. Lewis, CPA

Title

Executive Director

Phone

(979) 436-0500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Texas A&M Physicians - Round Rock Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Texas a&M University System Health Science Center

  dba Texas A&M Physicians

  • Family Medicine Physician
  • Bryan, TX
  • NPI 1063699312

  O20040802001578

  Same enrollment
• Texas a&M University System Health Science Center

  dba Texas A&M Physicians - Houston

  • Rheumatology Physician
  • Houston, TX
  • NPI 1225280290

  O20040802001578

  Same enrollment

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Texas a&M University System Health Science Center

  • Rural Health Clinic/Center
  • Navasota, TX
  • NPI 1558140004

  Member Of

  NPD member

Locations

Practitioners 5

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.

• Shailesh D Dhaduk, M.D.

  • Family Medicine Physician
  • Bryan, TX
  • NPI 1326047259
  NPD (past)
• Sean Holster, M.D.

  • Family Medicine Physician
  • Brenham, TX
  • NPI 1740548676
  NPD (past)
• Eberenne F Igbokwe, D.O.

  • Geriatric Medicine (Family Medicine) Physician
  • Pearland, TX
  • NPI 1003102732
  NPD (past)
• Kelly Maedo, M.D.

  • Dermatology Physician
  • McAllen, TX
  • NPI 1104838887
  NPD (past)
• Laneece Delaine Marley, M.D.

  • Family Medicine Physician
  • College Station, TX
  • NPI 1477849198
  NPD (past)

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443744000000",
    "number": "1992957963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 TAMU COM",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778431114",
            "telephone_number": "979-436-0500",
            "fax_number": "979-776-6905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 N AW GRIMES BLVD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786653540",
            "telephone_number": "979-436-0500",
            "fax_number": "979-776-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS A&M UNIVERSITY SYSTEM HEALTH SCIENCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2015-10-02",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "979-436-0500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200005101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Texas A&M Physicians - Round Rock",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eddie Glenn Tennison, D.D.S.
• Teravista Family Wellness, PLLC (Family Wellness at Teravista)
• Terry C Chambless M.D.,P.a.
• Jasmine Cordieh Tetley, DO
• Texan Eye, P.a.
• Texas Capital Emergency Physicians PLLC
• Texas Cardiac Arrhythmia
• Texas Cardiovascular Consultants, P.a.
• Texas Cardiovascular Consultants, PA
• Texas Diabetes and Endocrinology PA

• General Practice Physician in Round Rock, TX
• Providers in Round Rock, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; 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.