Provider Demographics
NPI:1376505925
Name:KERR COUNTY OB/GYN ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:KERR COUNTY OB/GYN ASSOCIATES, P.A.
Other - Org Name:OB/GYN ASSOCIATES, P.A.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:G
Authorized Official - Last Name:WAMPLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-895-7755
Mailing Address - Street 1:1331 BANDERA HIGHWAY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-9535
Mailing Address - Country:US
Mailing Address - Phone:830-895-7755
Mailing Address - Fax:830-895-7757
Practice Address - Street 1:708 HILL COUNTRY DR STE 300A
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-6079
Practice Address - Country:US
Practice Address - Phone:830-895-7755
Practice Address - Fax:830-895-7757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207V00000X
TX747538363LW0102X
TX501903367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX081002003Medicaid
TX0092DEOtherBCBS
TX081002002Medicaid
TX081002002Medicaid