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CROCKETT MEDICAL CENTER CLINIC
NPI 1487155990
Family Medicine in Crockett, TX

Active since February 21, 2018
1050 E LOOP 304, CROCKETT, TX 75835(936) 546-3890 Get Directions Write a Review

NPPES record last updated: August 28, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 28, 2018, Feb 21, 2018 (2 updates tracked since 2018).

About Crockett Medical Center Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CROCKETT MEDICAL CENTER CLINIC (NPI 1487155990) is a healthcare organization registered as a family medicine in Crockett, Texas and active in the NPI registry since February 2018. The organization lists Kelly Eugene Tjelmeland, Ceo, as its authorized official.

NPPES Registry Identity

NPI1487155990
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCROCKETT MEDICAL CENTER, LLC
Location Address1050 E LOOP 304Crockett, TX 75835
Mailing Address4220 Bull Creek RdAustin, TX 78731-6026 · (512) 617-7500
Phone(936) 546-3890
Organization SubpartNo
Authorized OfficialKelly Eugene TjelmelandCeo · (512) 617-7500
Enumeration DateFebruary 21, 2018
Last NPPES UpdateAugust 28, 20182 updates tracked since enumeration
✔ NPI 1487155990 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X
Also ListedInternal Medicine · Interventional CardiologyTaxonomy 207RI0011X
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X
Also ListedUrologyTaxonomy 208800000X
1050 E LOOP 304, Crockett, TX 75835
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Other Names 1

Doing Business AsCrockett Medical Center Clinic

Other Identifiers 3

Medicaid385139602TX
Medicaid385139603TX
Medicaid385139601TX

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAVI KONIDALA MD
Family Medicine
1050 E LOOP 304, SUITE 200, ETMC RURAL HEALTH CLINIC
CROCKETT, TX 75835
Houston County (936) 544-5132
CHRISTOPHER R HAECKLER MD
Family Medicine
1050 E LOOP 304, STE 200
CROCKETT, TX 75835
Houston County (936) 544-5132
TIMBERLANDS HEALTHCARE, LLC
Clinic/Center (Rural Health)
1050 E LOOP 304, SUITE 200
CROCKETT, TX 75835
Houston County (936) 544-5132
RICHARD JOSEPH KELLY MD
Family Medicine
1050 E LOOP 304, STE 200
CROCKETT, TX 75835
Houston County (936) 544-5132
BRYAN SCOTT SHAVER PA
Physician Assistant
1050 E LOOP 304, SUITE 200
CROCKETT, TX 75835
Houston County (936) 544-5132
ROBERT CARLSON MD PLLC
Surgery
1050 E LOOP 304
CROCKETT, TX 75835
Houston County (936) 568-9600
DR. JOSEPH HENDERSON HOLCOMB DDS
Dentist (General Practice)
1050 E LOOP 304, SUITE #120
CROCKETT, TX 75835
Houston County (936) 544-3554
HURLBURT FAMILY PRACTICE PLLC
Family Medicine
1050 E LOOP 304, SUITE 210
CROCKETT, TX 75835
Houston County (936) 544-2236

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Crockett Medical Center, LLC's NPI number?

The NPI number for Crockett Medical Center, LLC is 1487155990. It was assigned to this organization in the NPPES registry on February 21, 2018. The provider is doing business as Crockett Medical Center Clinic.

Where is Crockett Medical Center, LLC located?

Crockett Medical Center, LLC is located at 1050 E Loop 304, Crockett, TX 75835. The listed phone number is (936) 546-3890.

What is Crockett Medical Center, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

What insurance does Crockett Medical Center, LLC accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Crockett Medical Center, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Crockett Medical Center, LLC was last updated on August 28, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.