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2021 Provider Directory Addendum Through 11/1/2021 El Apéndice del Directorio de Proveedores Hasta el 11/1/2021 H0332_PRDADDV4_2021

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Page 1: Provider Directory Addendum

2021

Provider Directory

AddendumThrough 11/1/2021

El Apéndice del Directorio de

Proveedores

Hasta el 11/1/2021

H0332_PRDADDV4_2021

Page 2: Provider Directory Addendum

KelseyCare Advantage

HMO and HMO-POS Plan

Provider Directory Addendum/

El Apéndice del Directorio de Proveedores

This addendum provides a list of updates to KelseyCare Advantage’s network providers.

This addendum includes updates as of 11/1/2021. Some network providers may have been added or removed

from our network after this addendum was created. We do not guarantee that each provider is still accepting

new members. To get the most up-to-date information about KelseyCare Advantage’s network providers in

your area, you can visit www.kelseycareadvantage.com or call our Member Service Department at

713-442-CARE (2273) or toll-free at 1-866-535-8343 for additional information. From October 1 through

March 31, hours are 8:00 a.m. to 8:00 p.m., seven days a week. Messaging service used on weekends, after

hours, and on federal holidays. From April 1 through September 30, hours are 8:00 a.m. to 8:00 p.m.,

Monday through Friday. Messaging service used on weekends, after hours, and on federal holidays. (TTY

users should call 711).

KelseyCare Advantage is offered by KS Plan Administrators, LLC, a Medicare Advantage HMO with a

Medicare contract. Enrollment in KelseyCare Advantage depends on contract renewal.

ATTENTION: If you speak a language other than English, language assistance services, free of charge, are

available to you. Call 1-866-535-8343 (TTY: 711).

We can also give you information in Braille, in large print or other alternate formats, upon request.

Este apéndice proporciona una lista de cambios a proveedores de la red de KelseyCare Advantage.

Este apéndice incluye actualizaciones a partir del 11/1/2021. Es posible que se hayan agregado o eliminado

algunos proveedores de nuestra red después de que se haya impreso este directorio. No garantizamos que

cada proveedor aun esté aceptando nuevos miembros. Para obtener la información más actualizada acerca

de los proveedores de la red de KelseyCare Advantage en su área, usted puede visitar

www.kelseycareadvantage.com o llamar a nuestro departamento de Servicios para Miembros al

713-442-CARE (2273), o a la línea gratuita 1-866-535-8343. Del 1 de octubre al 31 de marzo, el horario es

de 8:00 a.m. a 8:00 p.m., siete días a la semana. El servicio de mensajería se usa los fines de semana, fuera

de horario y en días feriados nacionales. Del 1 de abril al 30 de septiembre, el horario es de 8:00 a.m. a 8:00

p.m., de lunes a viernes. El servicio de mensajería se usa los fines de semana, fuera de horario y en días

feriados nacionales. (Los usuarios de TTY deben llamar al 711).

KelseyCare Advantage es ofrecido por KS Plan Administrators LLC, un plan Medicare Advantage HMO

que tiene un contrato con Medicare. La inscripción en KelseyCare Advantage depende de la renovación del

contrato.

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al

1-866-535-8343 (TTY: 711).

También podemos proporcionarle información en braille, en tamaño de letra grande o en otros formatos

alternativos, si lo solicita. We can also give you information in Braille, in large print or other alternate

formats, upon request.

Page 3: Provider Directory Addendum

Table of Contents

Additions to the Provider Network (193) ....................................................................................................... 4

Terminations to the Provider Network (137) ................................................................................................ 17

Other Changes to the Provider Network ...................................................................................................... 27

Facility Additions to Provider Network (12) ................................................................................................ 48

Additions to Mental Health Providers (115) ................................................................................................. 49

Terminations to Mental Health Providers (68) ............................................................................................. 59

Additions to Vision Service Providers (122) ................................................................................................ 65

Terminations to Vision Service Providers (57) ............................................................................................ 72

2

Page 4: Provider Directory Addendum

Tabla de Contenidos

Adiciones a la Red de Proveedores (193) ....................................................................................................... 4

Terminaciones a la Red de Proveedores (137) ............................................................................................. 17

Otros cambios a la Red de Proveedores ....................................................................................................... 27

Instalaciones Adiciones de Proveedores (12) ............................................................................................... 48

Adiciones a los Proveedores de Salud Mental (115) .................................................................................... 49

Terminaciones a Proveedores de Salud Mental (68) .................................................................................... 59

Adiciones a Proveedores de servicios visión (122) ...................................................................................... 65

Terminaciones a Proveedores de servicios visión (57) ................................................................................. 72

3

Page 5: Provider Directory Addendum

Additions to the Provider Network

Adiciones a la Red de Proveedores

Allergy and Immunology

Alergia e Inmunología

Harris County / Condado

City of Houston

Ciudad de Houston

Kelsey-Seybold Spring Medical

and Diagnostic Center

15655 Cypress Woods Medical Dr Ste 100Houston, TX 77014(713) 442-1700

Nicole Canon, MD●

Montgomery County

Montgomery Condado

City of Shenandoah

Ciudad de Shenandoah

Kelsey-Seybold Clinic-The

Woodlands

106 Vision Park BlvdShenandoah, TX 77384(713) 442-1800

Nicole Canon, MD●

Cardiology / Cardiología

Brazoria County / Condado

City of Lake Jackson

Ciudad de Lake Jackson

Brazosport Cardiology, PA

215 Oak Dr South Ste LLake Jackson, TX 77566(979) 297-5481

Saleem Raslan, MD

Fort Bend County

Fort Bend Condado

City of Richmond

Ciudad de Richmond

Kelsey-Seybold Clinic-Katy

22121 FM 1093Richmond, TX 77407(713) 442-4100

Maygen Del Castillo, MD●

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor Medicine - Heart Clinic

7200 Cambridge St6th Fl Ste 6 AHouston, TX 77030(713) 798-2545

Stephen J Dolgner, MD●

Kelsey-Seybold Clinic

Berthelsen Main Campus

2727 West Holcombe BlvdHouston, TX 77025(713) 442-0000

Maygen Del Castillo, MD●

Kelsey-Seybold

Clinic-Tanglewood

1111 Augusta DrHouston, TX 77057(713) 442-2400

Maygen Del Castillo, MD●

UT Physicians Cardiology -

Texas Medical Center

6410 Fannin St Ste 600Houston, TX 77030(832) 325-7211

Vernon H Anderson, MD●

UT Physicians Center for

Advanced Heart

Failure-Southeast

11920 Astoria Blvd Ste 400Houston, TX 77089(281) 484-0996

Clarence D Gill, MD●

UT Physicians EP Heart -

Memorial City

925 Gessner Rd Ste 540Houston, TX 77024(713) 486-2400

Bartosz P Jozwik, MD●

City of Katy

Ciudad de Katy

Kelsey-Seybold West Grand

Parkway Clinic

2510 West Grand Pkwy NorthKaty, TX 77449(713) 442-4222

Maygen Del Castillo, MD●

City of Webster

Ciudad de Webster

Bay Area Heart PLLC

450 Blossom St Ste DWebster, TX 77598(832) 905-5940

Francis Uricchio, MD

Jinesh P Shah, MD

Rakesh Shah, MD

Snehalkumar A Patel, MD

Montgomery County

Montgomery Condado

City of Kingwood

Ciudad de Kingwood

Texas Cardiology Associates of

Houston

2627 Chestnut Ridge #100Kingwood, TX 77339(281) 358-1950

Hassan Kamran, MD

City of Shenandoah

Ciudad de Shenandoah

Methodist DeBakey Cardiology

Associates

17189 IH 45 South Ste 475Shenandoah, TX 77385(936) 270-3933

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● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales

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Page 6: Provider Directory Addendum

Additions to the Provider Network

Adiciones a la Red de Proveedores

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Devang S Parikh, MD

Cardiothoracic Surgery

Cirugía cardiotorácica

Harris County / Condado

City of Houston

Ciudad de Houston

Methodist Cardiovascular

Associates

6550 Fannin Ste 1401Houston, TX 77030(713) 441-5200

Lin-Chiang P Chou, MD

Methodist Cardiovascular

Surgery Associates

18220 State Hwy 249 Ste 400Houston, TX 77070(281) 737-2918

Scott E Olsson, MD

UT Physicians Pediatric

Surgery - Texas Medical Center

6410 Fannin St Ste 950Houston, TX 77030(832) 325-7234

Damien J LaPar, MD●

City of Webster

Ciudad de Webster

Texas Oncology

501 Medical Ctr BlvdWebster, TX 77598(281) 332-7505

Melissa L Korb, MD

Montgomery County

Montgomery Condado

City of The Woodlands

Ciudad de The Woodlands

BSLMG Woodlands North

Houston Heart Center

17350 St. Luke's Way Ste 400The Woodlands, TX 77384(281) 444-3278

Mark M Mettauer, MD●

Premier Surgeons Management

17350 St. Luke's Way Ste 290The Woodlands, TX 77384(936) 283-0264

Mark M Mettauer, MD

Chiropractor

Quiropráctico

Harris County / Condado

City of Kingwood

Ciudad de Kingwood

Pagano Clinic, LLC

1526 Kingwood DrKingwood, TX 77339(281) 358-7777

Scott K Pagano, DC

Colon & Rectal Surgery

Cirugía de Colon y Rectal

Harris County / Condado

City of Houston

Ciudad de Houston

Haas ColoRectal & Urology

Group

6560 Fannin St Ste 1404Houston, TX 77030(713) 441-5155

Eric M Haas, MD

Jean-Paul J LeFave, MD

Joshua C Coursey, MD

TMHPO Surgery Department

7900 Fannin Ste 1200Houston, TX 77030(713) 790-0060

Joshua C Coursey, MD

TMHPO Surgery Department

6560 Fannin St Ste 1404Houston, TX 77030(713) 790-0600

Eric M Haas, MD

Jean-Paul J LeFave, MD

Joshua C Coursey, MD

TMHPO Surgery Department

7900 Fannin Ste 1200Houston, TX 77054(713) 790-8020

Jean-Paul J LeFave, MD

Critical Care Medicine

Harris County / Condado

City of Houston

Ciudad de Houston

CHI Baylor Anesthesia and

Critical Care

6720 Bertner Ave Ste O-520Houston, TX 77030(832) 355-2666

Bashar Farjo, MD●

CHI Baylor St. Luke's Medical

Center

6720 Bertner AveHouston, TX 77030(713) 798-1000

Manuel A Vilchez, MD●

Prakruthi Voore, MD●

Dermatology

Dermatología

Harris County / Condado

City of Houston

Ciudad de Houston

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales5

Page 7: Provider Directory Addendum

Additions to the Provider Network

Adiciones a la Red de Proveedores

Heights Dermatology

2120 Ashland StHouston, TX 77008(713) 864-2656

Alpesh Desai, DO

Kelsey-Seybold

Clinic-Meyerland Plaza

560 Meyerland Plaza MallHouston, TX 77096(713) 442-3222

Nary A Hickson, MD●

Montgomery County

Montgomery Condado

City of Shenandoah

Ciudad de Shenandoah

Kelsey-Seybold Clinic The

Woodlands

106 Vision Park BlvdShenandoah, TX 77384(713) 442-1800

Kehinde Ogunmakin, MD●

ENT/Otolaryngology

ENT/Otorrinolaringología

Brazoria County / Condado

City of Lake Jackson

Ciudad de Lake Jackson

Kim Dart, DO PLLC

215 Oak Dr South Ste FLake Jackson, TX 77566(979) 299-1520

Kim Dart, DO

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor Otolaryngology

1977 Butler Blvd Ste E5200Houston, TX 77030(713) 798-5900

Meha G Fox, MD●

Kelsey-Seybold Clinic

Berthelsen Main Campus

2727 West Holcombe BlvdHouston, TX 77025(713) 442-0000

Benjamin Yang, MD●

Samer Fakhri, MD●

TMH Physician Associates

PLLC DBA Houston Methodist

ENT Specialists

6550 Fannin Ste 1723Houston, TX 77030(713) 441-1368

Joshua J Kain, MD●

UT Physicians

Otorhinolaryngology - Texas

Medical Center

6400 Fannin St Ste 2700Houston, TX 77030(713) 486-5000

Andrew G Tritter, MD●

City of Webster

Ciudad de Webster

Kelsey-Seybold Clinic-Clear

Lake

1010 South Ponds DrWebster, TX 77598(713) 442-4300

Samer Fakhri, MD●

Emergency Medicine

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor St. Luke's Medical Center

- Emergency Department

7200 Cambridge St 1st FlHouston, TX 77030(832) 355-4292

Nicole S Hardy, MD●

Sarah Noory, DO●

Endocrinology

Endocrinología

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor Medicine - Heart Clinic

7200 Cambridge St 6th Fl Ste 6 AHouston, TX 77030(713) 798-2545

Layla Abushamat, MD●

UT Physicians - Internal Medicine

6410 Fannin StHouston, TX 77030(832) 325-7161

Salima K Ali, MD●

Family Medicine

Medicina familiar

Brazoria County / Condado

City of Lake Jackson

Ciudad de Lake Jackson

BSLMG Brazosport Lake Road

FMC

210 Lake Rd Ste 300Lake Jackson, TX 77566(979) 285-9455

Kin Yu Wong, MD●

Suhani Bhakta, MD●

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● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales

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Page 8: Provider Directory Addendum

Additions to the Provider Network

Adiciones a la Red de Proveedores

Ad

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Kelsey-Seybold Clinic - Lake

Jackson

201 That WayLake Jackson, TX 77566(979) 285-2100

Susan Jarrell, MD●

City of Pearland

Ciudad de Pearland

Kelsey-Seybold Clinic-

Pearland

2515 Business Ctr DrPearland, TX 77584(713) 442-7200

Ngozi U Okorafor, MD●

Fort Bend County

Fort Bend Condado

City of Missouri City

Ciudad de Missouri City

Kelsey-Seybold Clinic- Sienna

Clinic

7010 Hwy 6Missouri City, TX 77459(713) 442-6700

Nicole Thomas, DO●

Roopa Samant, MD●

City of Sugar Land

Ciudad de Sugar Land

Kelsey-Seybold Fort Bend

Medical and Diagnostic Center

11555 University BlvdSugar Land, TX 77478(713) 442-9100

Madiha Sajid, DO●

Harris County / Condado

City of Baytown

Ciudad de Baytown

Kelsey-Seybold Clinic-Baytown

6300 Garth Rd Ste 200Baytown, TX 77521(713) 442-1240

Kimberlie J Gonzalez, MD●

City of Houston

Ciudad de Houston

Kelsey-Seybold Clinic

Berthelsen Main Campus

2727 West Holcombe BlvdHouston, TX 77025(713) 442-0000

Amber Malik, MD●

Nicole P Mathes, MD●

Ramin Bajoghli, MD●

Satnam Singh Saini Bhondi, MD●

Kelsey-Seybold Clinic-

Berthelsen Main Campus

2727 W Holcombe BlvdHouston, TX 77025(713) 442-0000

Najda A Mujtaba, MD●

Kelsey-Seybold Clinic-Cypress

13105 Wortham Ctr DrHouston, TX 77065(713) 442-4000

Husain Mogri, MD●■

Meherin S Huque, MD●

Kelsey-Seybold Clinic-Greater

Heights

1900 North Loop West 4th FlHouston, TX 77018(713) 442-3800

Xuyen D Phan, MD●

Kelsey-Seybold

Clinic-Meyerland Plaza

560 Meyerland Plaza MallHouston, TX 77096(713) 442-3222

Angie C Sung, MD●

Leila El-Kweifi, DO●

Kelsey-Seybold Clinic-North

Channel

5820 E Sam Houston Pkwy NHouston, TX 77049(713) 442-6000

John E Ruelas, MD●

Kelsey-Seybold Clinic-River Oaks

2040 West Gray St Ste 120 and 200Houston, TX 77019(713) 442-3400

Marian Jacob, DO●

Kelsey-Seybold

Clinic-Tanglewood

1111 Augusta DrHouston, TX 77057(713) 442-2400

Justin J Joseph, DO●

Nicole Thurmond, MD●

Xuyen D Phan, MD●

Kelsey-Seybold Spring Medical

and Diagnostic Center

15655 Cypress Woods Medical Dr Ste 100Houston, TX 77014(713) 442-1700

Momtaz Nahar, MD●

City of Humble

Ciudad de Humble

Kelsey-Seybold Clinic-Summer

Creek

8233 N Sam Houston Pkwy EHumble, TX 77396(713) 442-2000

John E Ruelas, MD●

Michelle Hadi, DO●

City of Pasadena

Ciudad de Pasadena

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales7

Page 9: Provider Directory Addendum

Additions to the Provider Network

Adiciones a la Red de Proveedores

Kelsey-Seybold Clinic-Pasadena

5001 E Sam Houston Pkwy SPasadena, TX 77505(713) 442-7100

Tasnim Choudhury, DO●

City of Webster

Ciudad de Webster

Kelsey-Seybold Clinic-Clear

Lake

1010 South Ponds DrWebster, TX 77598(713) 442-4300

Kenny C Lam, MD●

Montgomery County

Montgomery Condado

City of Porter

Ciudad de Porter

Kelse-Seybold Clinic-Kingwood

25553 US Hwy 59NPorter, TX 77365(713) 442-2100

Oksana Marroquin, MD●

City of Shenandoah

Ciudad de Shenandoah

Kelsey-Seybold Clinic-The

Woodlands

106 Vision Park BlvdShenandoah, TX 77384(713) 442-1800

Shelby F Payne, MD●

Gastroenterology

Gastroenterología

Brazoria County / Condado

City of Lake Jackson

Ciudad de Lake Jackson

Digestive & Liver Center, PA

109 Parking Way StLake Jackson, TX 77566(979) 292-0033

Umari M Siddiqui, MD

Brazos County / Condado

City of Bryan

Ciudad de Bryan

Central Texas Digestive Disease

Association PA

2206 E Villa Maria RdBryan, TX 77802(979) 776-4600

Brent M Gray, MD

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor McNair -

Gastroenterology

7200 Cambridge St 8th Fl Ste 8 BHouston, TX 77030(713) 798-2500

Fasiha Kanwal, MD●

Jessica D Bernica, MD●

Gastroenterology Consultants,

PA

444 FM 1959 RdHouston, TX 77034(281) 481-9400

Meera B Avila, MD

General Surgery

Cirugía general

Harris County / Condado

City of Houston

Ciudad de Houston

CHI Baylor St. Luke's Medical

Center

6720 Bertner AveHouston, TX 77030(713) 798-1000

Feibi Zheng, MD●

Kelsey-Seybold Clinic Berthelsen

Main Campus

2727 West Holcombe BlvdHouston, TX 77025(713) 442-0000

Eric K Rachlin, MD●

TMH Physician Associates PLLC

DBA TMHPO Surgery

Department

13300 Hargrave Rd Ste 450Houston, TX 77070(281) 737-4861

Arthy Yoga, MD

TMHPO Surgery Department

6550 Fannin Ste 1501Houston, TX 77030(713) 363-9236

Nicole M Tapia, MD●

TMHPO Surgery Department

6550 Fannin Ste 1501Houston, TX 77030(713) 441-5141

Feibi Zheng, MD●

TMHPO Surgery Department

6550 Fannin Ste 1601Houston, TX 77030(713) 441-5141

Feibi Zheng, MD●

UT Physicians Pediatric Surgery -

Texas Medical Center

6410 Fannin St Ste 950Houston, TX 77030(832) 325-7234

Megan A Coughlin, MD●

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Page 10: Provider Directory Addendum

Additions to the Provider Network

Adiciones a la Red de Proveedores

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UT Physicians Women's Center

- Memorial City

929 Gessner Rd Ste 1300Houston, TX 77024(713) 486-6600

Emily K Robinson, MD●

Montgomery County

Montgomery Condado

City of Shenandoah

Ciudad de Shenandoah

TMHPO Surgery Department

17183 IH 45 South Ste 330Shenandoah, TX 77385(936) 270-3660

Robin A Skrine, MD

City of The Woodlands

Ciudad de The Woodlands

Texas Oncology The

Woodlands East

9180 Pinecroft Ste 600The Woodlands, TX 77380(281) 296-0365

Arthy Yoga, MD

Polk County / Condado

City of Livingston

Ciudad de Livingston

Frank S Walker Jr MD PA

400 Bypass Lane Ste 111Livingston, TX 77351(936) 240-9339

Frank S Walker, MD

Gynecologic Oncology

Oncología ginecológica

Harris County / Condado

City of Houston

Ciudad de Houston

UT Physicians Adult

Hematology - Texas Medical

Center

6400 Fannin St Ste 2900Houston, TX 77030(713) 704-3961

Rosa A Guerra, MD●

UT Physicians Gynecologic

Oncology-Southeast

11914 Astoria Blvd Ste 510Houston, TX 77089(713) 486-1170

Abigail S Zamorano, MD●

Rosa A Guerra, MD●

Gynecology, OB/GYN

Ginecología,

Obstetricia/Ginecología

Brazoria County / Condado

City of Lake Jackson

Ciudad de Lake Jackson

BSLMG Brazosport OB/Gyn

210 Lake Rd Ste 200Lake Jackson, TX 77566(979) 299-0011

Michael J DiClemente, MD●

City of Pearland

Ciudad de Pearland

Kelsey-Seybold Clinic-

Pearland

2515 Business Ctr DrPearland, TX 77584(713) 442-7200

Stephanie Ho, MD●

Fort Bend County

Fort Bend Condado

City of Sugar Land

Ciudad de Sugar Land

Kelsey-Seybold Fort Bend

Medical and Diagnostic Center

11555 University BlvdSugar Land, TX 77478(713) 442-9100

Amirhossein Nikahd, MD●

Harris County / Condado

City of Houston

Ciudad de Houston

BSLMG Vintage OB/Gyn

20207 Chasewood Park Dr Ste 204Houston, TX 77070(832) 534-7800

LaToia M Marks, MD●

Stephanie D Smith-Sham, MD●

Kelsey-Seybold

Clinic-Tanglewood

1111 Augusta DrHouston, TX 77057(713) 442-2400

Stephanie Ho, MD●

Privia Medical Group Gulfcoast

7900 Fannin Ste 3012Houston, TX 77054(713) 512-7027

LaToia M Marks, MD●

Texas Children's Pavilion for

Women- Pulmonary CCU

6651 Main St 9th Fl CCUHouston, TX 77030(832) 824-1000

Amir A Shamshirsaz, MD●

UT Physicians Urogynecology

Center-Southeast

11914 Astoria Blvd Ste 510Houston, TX 77089(713) 486-6360

Wiyatta B Freeman, MD●

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales9

Page 11: Provider Directory Addendum

Additions to the Provider Network

Adiciones a la Red de Proveedores

UT Physicians Women's Center

- Texas Medical Center

6410 Fannin St Ste 350Houston, TX 77030(832) 325-7131

Gladys F Rafanan, DO●

Jason L Holliday, MD●

Mason Hui, DO●

Monique D Gillman, MD●

Nicole C Gillman, MD●

UT Physicians Women's Center

- Texas Medical Center

6410 Fannin St Ste 350Houston, TX 77030(832) 325-7133

Krystine M Guerra, MD●

Mateo G Leon Leon, MD●

Montgomery County

Montgomery Condado

City of The Woodlands

Ciudad de The Woodlands

Kelsey-Seybold Clinic-The

Woodlands Ob/Gyn

17198 St. Luke's Way Ste 540The Woodlands, TX 77385(713) 442-1900

Meredith Stocks, MD●

Washington County

Washington Condado

City of Brenham

Ciudad de Brenham

Brenham Family Practice and

Obstertics

601 Medical Pkwy Ste DBrenham, TX 77833(979) 836-2822

Jon E Bode, MD

Internal Medicine

Medicina interna

Brazoria County / Condado

City of Lake Jackson

Ciudad de Lake Jackson

Theory Health Medical Clinic

135 Oyster Creek Dr Ste ELake Jackson, TX 77566(979) 279-3387

Jeevan Gowda, MD

City of Pearland

Ciudad de Pearland

Kelsey-Seybold Clinic-Pearland

2515 Business Ctr DrPearland, TX 77584(713) 442-7200

George Shelton Jr., MD●

Fort Bend County

Fort Bend Condado

City of Sugar Land

Ciudad de Sugar Land

Kelsey-Seybold Fort Bend

Medical and Diagnostic Center

11555 University BlvdSugar Land, TX 77478(713) 442-9100

Matthew Doan, MD●

Harris County / Condado

City of Houston

Ciudad de Houston

BSLMG Houston Northwest

Primary Care

20207 Chasewood Park Dr Ste 300Houston, TX 77070(832) 534-7860

Stephanie A Warfield, DO●

Kelsey-Seybold Clinic -

Tanglewood

1111 AugustaHouston, TX 77057(713) 442-2400

Stella C Yeung-Shi, MD●

Kelsey-Seybold Clinic Berthelsen

Main Campus

2727 West Holcombe BlvdHouston, TX 77025(713) 442-0000

Alexander Constantine, MD●

Desh Mohan, MD●

Ketul R Patel, MD●

Michael A Harms, MD●

Rizwan Ali, MD●

Shalini E Koshy, MD●

Kelsey-Seybold Clinic-Greater

Heights

1900 North Loop West 4th FlHouston, TX 77018(713) 442-3800

Puja B Gandhi, MD●

Kelsey-Seybold Clinic-Spring

Medical and Diagnostic Center

15655 Cypress Woods Medical DrHouston, TX 77014(713) 442-1700

Deepthi R Chiluvuri, DO●

Kelsey-Seybold Clinic-St Luke's

Medical Tower

6624 Fannin 19th FlHouston, TX 77030(713) 442-0000

Hussam Alhasson, MD●

Kelsey-Seybold

Clinic-Tanglewood

1111 Augusta DrHouston, TX 77057(713) 442-2400

Ariana Samani, MD●

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Kelsey-Seybold Clinic-The

Vintage

10701 Vintage Preserve PkwyHouston, TX 77070(713) 442-1500

Renato F Zuniga Rodriguez, MD●

City of Humble

Ciudad de Humble

Northeast Medical Associates,

PA

18648 McKay DrSte 220Humble, TX 77338(281) 548-1210

Iram Ramzan, MD

City of Webster

Ciudad de Webster

Kelsey-Seybold Clinic-Clear

Lake

1010 South Ponds DrWebster, TX 77598(713) 442-4300

Alex Thomas, DO●

Nephrology / Nefrología

Harris County / Condado

City of Houston

Ciudad de Houston

Methodist Academic Medicine

Associates

6550 Fannin Ste 1101Houston, TX 77030(713) 636-8592

Angelina R Edwards, MD●

UT Physicians - Organ

Transplantation Center

6411 Fannin StHouston, TX 77030(713) 704-5200

Angelina R Edwards, MD●

City of Katy

Ciudad de Katy

Renal Clinic of Houston, P.A.

21720 Kingsland Blvd Ste 308Katy, TX 77450(281) 579-5799

Hemanth N Hampole, MD

Neurology / Neurología

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor McNair - Neurology

7200 Cambridge St 9th Fl Ste 9 AHouston, TX 77030(713) 798-2273

Andrew J Billnitzer, MD●

Chi-Ying Lin, MD●

Chintan Shah, MD●

Gabriela Tantillo Sepulveda, MD●

Houston Methodist Neurology

Associates

2060 Space Park Dr Ste 104Houston, TX 77058(832) 873-1999

Bingzhong Chen, MD

Kelsey-Seybold Clinic-Cypress

Clinic

13105 Wortham Ctr DrHouston, TX 77065(713) 442-4000

Carisa S Liew, DO●

TMH Physician Associates PLLC

DBA Houston Methodist

Neurology Associates

18100 Houston Methodist Dr Ste 240Houston, TX 77058(832) 783-1999

Gunjan Narwani, MD●

TMH Physician Associates PLLC

DBA TMHPO Neurology

Department

6560 Fannin Ste 1002Houston, TX 77030(713) 363-8184

Andrew J Billnitzer, MD●

TMH Physician Associates PLLC

DBA TMHPO Neurology

Department

6560 Fannin Ste 802Houston, TX 77030(713) 441-1150

Christine B Rizk, MD

UT Health Neurosciences -

Memorial City

929 Gessner Rd Ste 2410Houston, TX 77024(713) 486-7720

Xinh X Tran, MD●

UT Health Neurosciences -

Neurology

6410 Fannin St Ste 1014Houston, TX 77030(832) 325-7080

Melissa J Christie, MD●

UT Neurosciences - Texas Medical

Center

6400 Fannin St Ste 2800Houston, TX 77030(713) 486-8000

Juan C Martinez-Gutierrez, MD●

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales11

Page 13: Provider Directory Addendum

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Adiciones a la Red de Proveedores

Montgomery County

Montgomery Condado

City of The Woodlands

Ciudad de The Woodlands

BSLMG Woodlands Neurology

17198 St. Luke's Way Ste 600The Woodlands, TX 77384(936) 266-2450

Hormozd Bozorgchami, MD●

Neurosurgery

Neurocirugía

Fort Bend County

Fort Bend Condado

City of Sugar Land

Ciudad de Sugar Land

Methodist Academic Medicine

Associates

16605 Southwest Fwy Ste 220Sugar Land, TX 77479(346) 901-2140

Derrick Y Sun, MD

Methodist Academic Medicine

Associates

16605 Southwest Frwy Ste 220Sugar Land, TX 77479(349) 874-2525

Derrick Y Sun, MD●

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor McNair - Neurosurgery

7200 Cambridge St 9th Fl Ste 9 BHouston, TX 77030(713) 798-4696

Cyrus B King III, MD●

Joey K Grochmal, MD●

Omar Tanweer, MD●

Mischer Neuroscience

Associates

6400 Fannin St Ste 2800Houston, TX 77030(713) 704-7100

Cyrus B King III, MD●

TMH Physician Associates

PLLC DBA TMHPO

Neurosurgery Department

18300 Katy Frwy Ste 135Houston, TX 77094(832) 522-8500

Wyatt Langdon Ramey, MD

TMH Physician Associates

PLLC DBA TMHPO

Neurosurgery Departments

13300 Hargrave Rd Ste 500Houston, TX 77070(281) 737-2932

Einar T Bogason, MD

TMHPO Neurosurgery

Department

6560 Fannin Ste 900Houston, TX 77030(713) 441-3800

Amir H Faraji, MD

UT Neurosciences - Texas

Medical Center

6400 Fannin St Ste 2800Houston, TX 77030(713) 486-8000

Nicholas M Ahye, MD●

Oncology - Medical, Surgical

Oncología - Médica/Quirúrgica

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor McNair - Breast Care

Center

7200 Cambridge St 7th Fl Ste 7 AHouston, TX 77030(713) 798-1999

Demetria J Smith-Graziani, MD●

Baylor McNair - Hematology and

Oncology

7200 Cambridge St 7th Fl Ste 7 BHouston, TX 77030(713) 798-3750

Arpit Rao, MD●

Baylor McNair - Oncology

7200 Cambridge St 7th Fl Ste 7BHouston, TX 77030(713) 798-7710

Meera R Patel, MD●

Kelsey-Seybold Clinic-Main

Campus

2727 W Holcombe BlvdHouston, TX 77025(713) 442-0000

Mohammad A Jafri, MD●

Methodist Academic Medicine

Associates

18220 State Hwy 130Houston, TX 77070(281) 737-0435

Yue Connie Wang, MD

Yue C Wang, MD

TMH Physician Associates PLLC

DBA Methodist Academic

Medicine Associates

6445 Main St OPC 24Houston, TX 77030(713) 441-9948

Siddhartha Ganguly, MD

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TMH Physician Associates

PLLC DBA Methodist

Academic Medicine Associates

18400 Katy Fwy Ste 670Houston, TX 77094(832) 522-5521

Chinemerem F Abanonu, MD

Texas Oncology

7515 S Main St Ste 740Houston, TX 77030(713) 795-0202

Vipal P Durkal, MD

Oncology - Radiation/Radiation

Oncology

Oncología - Radioncología

Harris County / Condado

City of Baytown

Ciudad de Baytown

Methodist Radiation Oncology

Group

4021 Garth Rd Ste 105Baytown, TX 77521(281) 420-8557

Mary S Goswitz, MD

City of Houston

Ciudad de Houston

Kelsey-Seybold Clinic-Main

Campus

2727 W Holcombe BlvdHouston, TX 77025(713) 442-0000

Benjamin Farnia, MD●

Mi K Ko, MD●

St. Luke's Kirby Glen

Outpatient Center

2491 South Braeswood BlvdHouston, TX 77030(832) 355-7118

Alexander N Hanania, MD●

Daniel Hamstra, MD●

Ophthalmology

Oftalmología

Harris County / Condado

City of Houston

Ciudad de Houston

Alkek Eye Center

1977 Butler BlvdHouston, TX 77030(713) 798-6100

Neal Kansara, MD●

Alkek Eye Center

1977 Butler Blvd 2nd FlHouston, TX 77030(713) 798-6100

Daniel J Olson, MD●

Jaafar F El Annan, MD●

Alkek Eye Center

1977 Butler Blvd 3rd FlHouston, TX 77030(713) 798-6100

Allison J Chen, MD●

Houston Eye Associates, P.A.

12121 Richmond Avenue Ste 220Houston, TX 77082(713) 558-8775

Lucy A Bailey, MD

Kelsey-Seybold Clinic-Main

Campus

2727 W Holcombe BlvdHouston, TX 77025(713) 442-0000

Salman Rahman, MD●

Kelsey-Seybold Clinic-Spring

Medical and Diagnostic Center

15655 Cypress Woods Medical DrHouston, TX 77014(713) 442-1700

Richard B Jenkins, MD●

City of Katy

Ciudad de Katy

Berkeley Eye Center

21502 Merchants WayKaty, TX 77449(281) 579-6777

Donna M Talluto, MD

Optometry / Optometría

Fort Bend County

Fort Bend Condado

City of Sugar Land

Ciudad de Sugar Land

Kelsey-Seybold Clinic-Fort Bend

Medical and Diagnostic Center

11555 University BlvdSugar Land, TX 77478(713) 442-9100

Sandra Rajan, OD●

Harris County / Condado

City of Houston

Ciudad de Houston

Berkeley Eye Center

8800 Katy FrwyHouston, TX 77024(713) 827-8311

Anthony R Kruger, OD

Kelsey-Seybold Clinic-Main

Campus

2727 W Holcombe BlvdHouston, TX 77025(713) 442-0000

Rebekah Montes, OD●

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales13

Page 15: Provider Directory Addendum

Additions to the Provider Network

Adiciones a la Red de Proveedores

Kelsey-Seybold-Spring Medical

and Diagnostic Center

15655 Cypress Woods Medical DrHouston, TX 77014(713) 442-1700

Susana C Moreno, OD●

Lighthouse for the Blind of

Houston

3602 W Dallas StHouston, TX 77019(713) 284-8494

Ana M Perez, OD

Montgomery County

Montgomery Condado

City of The Woodlands

Ciudad de The Woodlands

Berkeley Eye Center

17450 St Lukes Way Ste 100The Woodlands, TX 77384(281) 363-3443

Joe D Nguyen, OD

Orthopedic Surgery

Cirugía ortopédica

Brazoria County / Condado

City of Lake Jackson

Ciudad de Lake Jackson

BSLMG Brazosport Bone &

Joint of Lake Jackson

217A Oak Dr SouthLake Jackson, TX 77566(979) 299-6900

Steven D Eggleston, MD●

Steven D. Eggleston, MD PA

208 Oak Dr South Ste 602Lake Jackson, TX 77566(979) 299-3100

Steven D Eggleston, MD●

The Bone and Joint Clinic of

Lake Jackson

120 Flag Lake Dr Ste 1Lake Jackson, TX 77566(979) 299-6900

Charles E Vega, MD

Charles E Vega, MD

Harris County / Condado

City of Baytown

Ciudad de Baytown

Clear Lake Specialties PA

1667A Baker RdBaytown, TX 77521(281) 942-8001

Venkata K Jonna, MD

TMH Physician Associates

PLLC DBA TMHPO

Orthopedics Department

1677 West Baker Rd Ste 1701Baytown, TX 77521(281) 427-7400

Comron Saifi, MD

TMHPO Orthopedics

Department

4201 Garth Rd Ste 111Baytown, TX 77521(281) 427-7400

Venkata K Jonna, MD

City of Houston

Ciudad de Houston

Kelsey-Seybold Clinic

Berthelsen Main Campus

2727 West Holcombe BlvdHouston, TX 77025(713) 442-0000

Jason E Kappa, MD●

Pain Management

Tratamiento del dolor

Harris County / Condado

City of Houston

Ciudad de Houston

Houston Spine & Joint Pain

Consultants

4101 Greenbriar Dr Ste 208Houston, TX 77098(832) 777-7246

Elhady N Dalya, MD

City of Webster

Ciudad de Webster

Clear Lake Specialties PA

600 N Kobayashi RdWebster, TX 77598(281) 724-8180

Moustafa M Ahmed, MD

Plastic Surgery

Cirugía Plástica

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor Plastic Surgery

1977 Butler BlvdHouston, TX 77030(713) 798-6141

Michelle M Nemec, PA●

Shayan A Izaddoost, MD●

Kelsey-Seybold Clinic Berthelsen

Main Campus

2727 West Holcombe BlvdHouston, TX 77025(713) 442-0000

Shayan A Izaddoost, MD●

Podiatry / Podología

Harris County / Condado

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City of Houston

Ciudad de Houston

Foot and Ankle Center of North

Houston

17215 Red Oak Dr Ste 102Houston, TX 77090(281) 444-4114

Jason R Armstrong, DPM

Lawrence S Mactavish, DPM

Michael L Gordon, DPM

Pulmonology

Neumonología

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor McNair - Pulmonary

7200 Cambridge St 8th Fl Ste 8 AHouston, TX 77030(713) 798-2500

Fatima I Adhi, MD●

Maher Baz, MD●

Muralidhar Kondapaneni, MD●

Houston Pulmonary Medicine

Associates (Astoria)

11920 Astoria Ste 320Houston, TX 77089(281) 484-4210

Oluwaseun A Davies, MD

Rehabilitation Medicine

Medicina de Rehabilitación

Fort Bend County

Fort Bend Condado

City of Richmond

Ciudad de Richmond

Kelsey-Seybold Clinic-Katy

22121 FM 1093Richmond, TX 77047(713) 442-4100

Vinay Vanodia, MD●

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor McNair - PM&R

7200 Cambridge St 10th Fl Ste 10 BHouston, TX 77030(713) 798-7246

Ming-Chyi Hsieh, MD●

Wiaam O Ahmed, MD●

CHI Baylor St. Luke's Medical

Center

6720 Bertner AveHouston, TX 77030(713) 798-1000

Ming-Chyi Hsieh, MD●

TIRR Outpatient Medical

Clinic

1333 Moursund St 1st FlHouston, TX 77030(713) 799-5000

Matthew J Lin, MD●

Rheumatology

Reumatología

Fort Bend County

Fort Bend Condado

City of Katy

Ciudad de Katy

UT Physicians Multispecialty -

Cinco Ranch

23923 Cinco Ranch BlvdKaty, TX 77494(713) 486-5300

Lauren K Ridley, MD●

Harris County / Condado

City of Houston

Ciudad de Houston

Methodist Academic Medicine

Associates

6550 Fannin Ste 1101Houston, TX 77030(713) 441-0006

Myriam E Guevara, MD

City of Humble

Ciudad de Humble

Kelsey-Seybold Clinic-Summer

Creek

8233 N Sam Houston Pkwy EHumble, TX 77396(713) 442-2000

Nida Z Momin, MD●

Montgomery County

Montgomery Condado

City of Porter

Ciudad de Porter

Kelsey-Seybold Clinic-Kingwood

25553 US Hwy 59Porter, TX 77365(713) 442-2100

Nida Z Momin, MD●

City of Shenandoah

Ciudad de Shenandoah

Kelsey-Seybold Clinic-The

Woodlands

106 Vision Park BlvdShenandoah, TX 77384(713) 442-1800

Nida Z Momin, MD●

Urology / Urología

Brazoria County / Condado

City of Lake Jackson

Ciudad de Lake Jackson

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales15

Page 17: Provider Directory Addendum

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Adiciones a la Red de Proveedores

BSLMG Brazosport Urology

208 Oak Dr South Ste 500Lake Jackson, TX 77566(979) 299-0011

Wilmer B Robert, MD●

BSLMG Brazosport Urology

210 Lake Rd Ste 200Lake Jackson, TX 77566(979) 299-0011

Wilmer B Rober, MD●

Bayler St. Luke's Specialty

210 Lake Rd Ste 200Lake Jackson, TX 77566(979) 299-0011

Wilmer B Robert, MD

Harris County / Condado

City of Houston

Ciudad de Houston

UT Physicians Urology - Texas

Medical Center

6400 Fannin St Ste 2300Houston, TX 77030(832) 325-7280

Travis P Green, MD●

Montgomery County

Montgomery Condado

City of Porter

Ciudad de Porter

Kelsey-Seybold

Clinic-Kingwood

25553 US Hwy 59Porter, TX 77365(713) 442-2100

Michael Pan, MD●

City of The Woodlands

Ciudad de The Woodlands

Texas Oncology

17198 St. Luke's Way Ste 410The Woodlands, TX 77384(281) 351-5174

Edward J Sanchez, MD

Vascular Neurology

Neurología Vascular

Harris County / Condado

City of Houston

Ciudad de Houston

UT Physicians Movement

Disorders and

Neurodegenerative

Diseases-TMC

6410 Fannin St Ste 1014Houston, TX 77030(832) 325-7080

Sishir Mannava, MD●

Vascular Surgery

Cirugía vascular

Harris County / Condado

City of Houston

Ciudad de Houston

Renal Specialists of Houston,

PA

8876 Gulf Frwy Ste 215Houston, TX 77017(713) 791-2648

Gordon H Martin, MD

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Terminaciones a la Red de Proveedores

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Cardiology / Cardiología

Harris County / Condado

City of Houston

Ciudad de Houston

UT Physicians - Advanced

Heart Failure

6400 Fannin StHouston, TX 77030(713) 704-4300

Brian L Walton, MD●

UT Physicians - Cardiology

5420 Dashwood DrHouston, TX 77081(713) 486-1075

Prakash Balan, MD●

UT Physicians Cardiology -

Texas Medical Center

6410 Fannin St Ste 600Houston, TX 77030(713) 798-2545

David Aguilar, DO●

Cardiothoracic Surgery

Cirugía cardiotorácica

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor Clinic Surgery -

Cardiovascular

1101 Bates AvenueHouston, TX 77030(713) 798-1300

George Vasilios Letsou, MD●

Methodist Cardiovascular

Surgery Associates

6550 Fannin Ste 1401Houston, TX 77030(713) 441-6511

Swaminadhan Gnanashanmugam, MD

UT Physicians Cardiothoracic

and Vascular Surgery-

Memorial City

915 Gessner Rd Ste 585Houston, TX 77024(713) 486-6690

Donald M Gibson, MD●

Dermatology

Dermatología

Fort Bend County

Fort Bend Condado

City of Sugar Land

Ciudad de Sugar Land

Kelsey - Seybold Clinic Fort

Bend Medical & Diagnostic

Center

11555 University BlvdSugar Land, TX 77478(713) 442-9100

C Enrique Batres, MD●

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor Dermatology

1977 Butler Blvd Ste E6200Houston, TX 77030(713) 798-6131

Cedar Helen Malone, MD●

Kelsey-Seybold Clinic-The

Vintage

10701 Vintage Preserve PkwyHouston, TX 77070(713) 442-1500

Marie Maurice, MD●

City of Pasadena

Ciudad de Pasadena

Kelsey-Seybold Clinic-Pasadena

5001 E Sam Houston Pkwy SPasadena, TX 77505(713) 442-7100

Sharon Kim, MD●

ENT/Otolaryngology

ENT/Otorrinolaringología

Harris County / Condado

City of Houston

Ciudad de Houston

UT Physicians

Otorhinolaryngology - Texas

Medical Center

6400 Fannin St Ste 2700Houston, TX 77030(713) 486-5000

Ronda E Alexander, MD●

Emergency Medicine

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor St. Luke's Medical Center

- Emergency Department

7200 Cambridge St 1st FlHouston, TX 77030(832) 355-4292

Kristen Robertson, MD●

Endocrinology

Endocrinología

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor McNair - Neurosurgery

7200 Cambridge St 9th Fl Ste 9 BHouston, TX 77030(713) 798-4696

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Page 19: Provider Directory Addendum

Terminations to the Provider Network

Terminaciones a la Red de Proveedores

Susan L Samson, MD●

Family Medicine

Medicina familiar

Brazoria County / Condado

City of Lake Jackson

Ciudad de Lake Jackson

BSLMG Brazosport Lake Road

FMC

210 Lake Rd Ste 300Lake Jackson, TX 77566(979) 285-9455

Kin Yu Wong, DO●

Feaver Family Practice

201 That WayLake Jackson, TX 77566(979) 285-2100

Brian J Feaver, MD

Harris County / Condado

City of Baytown

Ciudad de Baytown

Kelsey-Seybold Clinic-Baytown

6300 Garth Rd Ste 200Baytown, TX 77521(713) 442-1240

Mohammad Ahmed, MD●

City of Houston

Ciudad de Houston

Alan D Tran, MD

13734 State Hwy 249 Ste BHouston, TX 77086(281) 591-0500

Alan Tran, MD

CiBi Family Medicine

12660 Beechnut St Ste 110Houston, TX 77072(281) 564-2242

Bernadette Iguh, MD

Cullen Family Practice

7710 Cullen BlvdHouston, TX 77051(281) 915-7010

Bernadette Iguh, MD

Kelsey - Seybold Clinic Spring

Medical And Diagnostic Center

15655 Cypress Woods Medical DrHouston, TX 77014(713) 442-1700

Harriet N Hilliard, MD●

Kelsey - Seybold

Clinic-Berthelsen Main

Campus

2727 W Holcombe BlvdHouston, TX 77025(713) 442-0000

Lansing Yee, MD●

Kelsey - Seybold

Clinic-Berthelsen Main

Campus

2727 West Holcombe BlvdHouston, TX 77025(713) 442-0000

Silvia Los, MD●

Kelsey - Seybold

Clinic-Meyerland Plaza

560 Meyerland Plaza MallHouston, TX 77096(713) 442-3222

Lee Bar-Eli, MD●

Kelsey-Seybold Clinic

Berthelsen Main Campus

2727 West Holcombe BlvdHouston, TX 77025(713) 442-0000

Nita I Singhal, MD●

MCA West Houston Family

Practice

12245 Richmond AveHouston, TX 77082(281) 558-6700

Bruce Patterson, MD

Memorial Clinical Associates

16001 Park Ten Place Ste 300Houston, TX 77084(713) 407-3000

Saad Shammas, MD

Northshore Medical Association

1140 Westmont Ste 202Houston, TX 77015(281) 457-2236

Donald Hearn, MD

City of Tomball

Ciudad de Tomball

BSLMG Tomball Family

Medicine

602 Lawrence St Ste ETomball, TX 77375(832) 534-7880

Elizabeth Wanner, MD●

G A Valdez and Associates

888 Graham Dr Ste 100Tomball, TX 77375(281) 255-2001

George Valdez, MD

City of Webster

Ciudad de Webster

Kelsey-Seybold Clinic-Clear Lake

1010 South Ponds DrWebster, TX 77598(713) 442-4300

Alfreda L Bell, MD●

Montgomery County

Montgomery Condado

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Terminations to the Provider Network

Terminaciones a la Red de Proveedores

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City of Conroe

Ciudad de Conroe

ETCS Conroe Family Medicine

3251 IH-45 North Ste 100Conroe, TX 77304(936) 494-4430

Martin Caperton, MD●

City of Magnolia

Ciudad de Magnolia

BSLMG Woodlands Magnolia

Family Medicine

827 South Magnolia Blvd Ste 4Magnolia, TX 77355(936) 266-3460

Randall Walker, MD●

City of Porter

Ciudad de Porter

Kelsey - Seybold

Clinic-Kingwood

25553 US Hwy 59Porter, TX 77365(713) 442-2100

Lakebra Glover, MD●

Polk County / Condado

City of Livingston

Ciudad de Livingston

CHI St. Luke's Memorial

Clinics

403 Ogletree Dr Ste 120Livingston, TX 77351(936) 328-3293

Raoul Perez, MD●

Walker County / Condado

City of Huntsville

Ciudad de Huntsville

HMH Medical Clinic

125 Medical Park Lane Ste CHuntsville, TX 77340(936) 291-3219

Fernando Gallegos-Garcia, MD

Gastroenterology

Gastroenterología

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor Family Medicine -

Gastroenterology

3701 Kirby DrHouston, TX 77098(713) 798-2500

Johanna L Chan, MD●

Baylor McNair -

Gastroenterology

7200 Cambridge StHouston, TX 77030(713) 798-2500

Johanna L Chan, MD●

TMHPO Methodist Academic

Medicine Associates

6550 Fannin Ste 1201Houston, TX 77030(713) 741-3372

Fredic Lyone Hochman, MD

Texas International Endoscopy

Center

6620 Main StSte 1500Houston, TX 77030(713) 520-8432

Johanna L Chan, MD●

Polk County / Condado

City of Livingston

Ciudad de Livingston

BSLMG Livingston

Gastroenterology Clinic

403 Ogletree Ste 205Livingston, TX 77351(936) 329-8446

Georg Elias, MD●

General Surgery

Cirugía general

Harris County / Condado

City of Houston

Ciudad de Houston

TMH Physician Associates PLLC

DBA TMHPO Surgery

Department

6550 Fannin Ste 1501Houston, TX 77030(713) 441-5451

Jesse R Conner, MD●

TMHPO Surgery Department

6550 Fannin Ste 1501Houston, TX 77030(713) 441-5141

Feibi Zheng, MD●

TMHPO Surgery Department

6550 Fannin Ste 1601Houston, TX 77030(713) 441-5141

Feibi Zheng, MD●

Montgomery County

Montgomery Condado

City of Conroe

Ciudad de Conroe

Mark A Johnson, MD PA

100 Medical Ctr BlvdConroe, TX 77304(936) 271-0665

Mark A Johnson, MD

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales19

Page 21: Provider Directory Addendum

Terminations to the Provider Network

Terminaciones a la Red de Proveedores

Gynecology, OB/GYN

Ginecología,

Obstetricia/Ginecología

Harris County / Condado

City of Houston

Ciudad de Houston

Kelsey-Seybold

Clinic-Downtown at The Shops

1200 McKinney St Ste 473Houston, TX 77010(713) 442-4700

Devanshi Somaiya, MD●

UT Physicians Multispecialty -

The Heights

925 North Shepherd DrHouston, TX 77008(713) 486-7200

Ha T Nguyen, MD●

UT Physicians Obstetrics and

Gynecology Continuity Clinic

6410 Fannin St Ste 350Houston, TX 77030(832) 325-7278

Conisha M Holloman, MD●

UT Physicians Women's Center

- Texas Medical Center

6410 Fannin St Ste 250Houston, TX 77030(832) 325-7131

Diana K Crabtree Sokol, MD●

UT Physicians Women's Center

- Texas Medical Center

6410 Fannin St Ste 350Houston, TX 77030(832) 325-7131

Diana K Crabtree Sokol, MD●

UT Physicians Women's Center

- Texas Medical Center

6410 Fannin StHouston, TX 77030(832) 325-7278

Corey Clifford, DO●

UT Physicians Women's Center

- Texas Medical Center

6410 Fannin St Ste 350Houston, TX 77030(832) 325-7278

Anne V Gonzalez, MD●

Mary C Haver, MD●

City of Webster

Ciudad de Webster

Southwest Women's Health

Alliance

250 Blossom Ste 350Webster, TX 77598(832) 553-5430

Joy P Leblanc, MD

Infectious Diseases

Enfermedades infecciosas

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor McNair - Infectious

Diseases

7200 Cambridge St 8th Fl Ste 8 BHouston, TX 77030(713) 798-2900

Marion Hemmersbach-Miller, MD●

Methodist Academic Medicine

Associates

6560 Fannin Ste 1540Houston, TX 77030(713) 799-9997

Victor Fainstein, MD■

Internal Medicine

Medicina interna

Brazoria County / Condado

City of Lake Jackson

Ciudad de Lake Jackson

Raj Dalal, M.D., P.A.

192 Abner Jackson PkwyLake Jackson, TX 77566(979) 285-0007

Rajesh V Dalal, MD

Fort Bend County

Fort Bend Condado

City of Sugar Land

Ciudad de Sugar Land

Kelsey-Seybold Clinic-Fort Bend

Medical and Diagnostic Center

11555 University BlvdSugar Land, TX 77478(713) 442-9100

John Tam, MD●

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor Internal Medicine - 1225

6620 Main StHouston, TX 77030(713) 798-2500

Amna Asim, MD●

Baylor McNair - Gastroenterology

7200 Cambridge StHouston, TX 77030(713) 798-2500

Khushboo Munot, MD●

Kelsey - Seybold Clinic Spring

Medical And Diagnostic Center

15655 Cypress Woods Medical DrHouston, TX 77014(713) 442-1700

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Page 22: Provider Directory Addendum

Terminations to the Provider Network

Terminaciones a la Red de Proveedores

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Maher Abbara, MD●

Kelsey - Seybold

Clinic-Berthelsen Main

Campus

2727 West Holcombe BlvdHouston, TX 77025(713) 442-0000

Dennis Brown, MD●

Kelsey-Seybold Clinic

Berthelsen Main Campus

2727 West Holcombe BlvdHouston, TX 77025(713) 442-0000

Amna Asim, MD●

Bernice D Adu-Gyamfi, MD●

Kelsey-Seybold Spring Medical

and Diagnostic Center

15655 Cypress Woods Medical Dr Ste 100Houston, TX 77014(713) 442-1700

Bernice D Adu-Gyamfi, MD●

Memorial Clinical Associates

16001 Park Ten Place Ste 300Houston, TX 77084(713) 407-3000

Bhakti Gidvani, MD

John Levins, MD

Marsha Hughart, MD

Miguel Franco, MD

Richard Pohil, MD

Roger Schultz, MD

The Torres Center

427 W 20th St Ste 503Houston, TX 77008(713) 863-9200

Anna Torres, MD

UT Physicians - Emergency

Medicine

6411 Fannin StHouston, TX 77030(713) 704-4060

Melissa Reimer, MD●

City of Webster

Ciudad de Webster

Kelsey - Seybold Clinic-Clear

Lake

1010 South Ponds DrWebster, TX 77598(713) 442-4300

Mark MacGregor, MD●

Kelsey-Seybold Clinic-Clear

Lake

1010 South Ponds DrWebster, TX 77598(713) 442-4300

Amna Asim, MD●

Montgomery County

Montgomery Condado

City of The Woodlands

Ciudad de The Woodlands

BSLMG Woodlands Hospital

17200 St. Luke's WayThe Woodlands, TX 77384(000) 000-0000

Syed Ahsun Raza, MD●

Syed Ahsun Raza, MD●

Interventional Pulmonary

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor McNair - Pulmonary

7200 Cambridge StHouston, TX 77030(713) 798-2500

Ali Zul Jiwani, MD●

Nephrology / Nefrología

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor Internal Medicine - 1225

6620 Main St 11th Fl 11B241Houston, TX 77030(713) 798-2500

Venkataraman Ramanathan, MD●

Baylor McNair - Nephrology

7200 Cambridge St 8th Fl Ste 8 BHouston, TX 77030(713) 798-2500

Chandan Vangala, MD●

UT Physicians - Organ

Transplantation Center

6411 Fannin StHouston, TX 77030(713) 704-5200

Angelina R Edwards, MD●

Neurology / Neurología

Harris County / Condado

City of Houston

Ciudad de Houston

Mischer Neuroscience Associates

929 Gessner Rd Ste 2410Houston, TX 77024(713) 242-4410

Eddie L Patton, MD●

Suresh M. Roongta, MD

427 W 20thHouston, TX 77008(713) 861-1331

Suresh M Roontga, MD

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales21

Page 23: Provider Directory Addendum

Terminations to the Provider Network

Terminaciones a la Red de Proveedores

TMH Physician Associates

PLLC DBA TMHPO Neurology

Department

6560 Fannin Ste 802Houston, TX 77030(713) 441-1150

Christine B Rizk, MD

UT Physicians Neurology -

Texas Medical Center

6410 Fannin StHouston, TX 77030(832) 325-7080

Omotola A Hope, MD●

Neurosurgery

Neurocirugía

Fort Bend County

Fort Bend Condado

City of Sugar Land

Ciudad de Sugar Land

Kelsey-Seybold Fort Bend

Medical and Diagnostic Center

11555 University BlvdSugar Land, TX 77478(713) 442-9100

David S Xu, MD●

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor McNair - Neurosurgery

7200 Cambridge St 9th Fl Ste 9 BHouston, TX 77030(713) 798-4696

David S Xu, MD●

Mischer Neuroscience

Associates

925 Gessner Rd Ste 100Houston, TX 77024(713) 242-3500

Wesley H Jones, MD●

TMHPO Neurosurgery

Department

13300 Hargrave Rd Ste 500Houston, TX 77070(281) 737-2932

Glenn B Anderson, MD

TMHPO Neurosurgery

Department

6560 Fannin Ste 900Houston, TX 77030(713) 441-3800

Glenn B Anderson, MD

Oncology - Medical, Surgical

Oncología - Médica/Quirúrgica

Harris County / Condado

City of Houston

Ciudad de Houston

Kelsey-Seybold Clinic

Berthelsen Main Campus

2727 West Holcombe BlvdHouston, TX 77025(713) 442-0000

Vipal P Durkal, MD●

Texas Oncology

925 Gessner Rd Ste 550Houston, TX 77024(713) 467-1722

Monica D Desai, MD

Texas Oncology

7515 S Main Ste 740Houston, TX 77030(713) 795-0202

Yue C Wang, MD●

Oncology - Radiation/Radiation

Oncology

Oncología - Radioncología

Harris County / Condado

City of Houston

Ciudad de Houston

Kelsey-Seybold Clinic Berthelsen

Main Campus

2727 West Holcombe BlvdHouston, TX 77025(713) 442-0000

Benjamin Farnia, MD●■

Millennium Physicians

Association

17323 Red Oak DrHouston, TX 77090(281) 440-5006

Jason Berilgen, MD

Montgomery County

Montgomery Condado

City of The Woodlands

Ciudad de The Woodlands

CHI St. Luke's Woodlands -

Oncology

17198 St. Luke's Way Ste 100The Woodlands, TX 77384(936) 266-4330

Kathryn M Lewis, MD●

Texas Oncology

9323 Pinecroft Dr Ste 110The Woodlands, TX 77380(281) 943-2440

Jason Berilgen, MD

Oncology-Hematology

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor McNair - Breast Care

Center

7200 Cambridge StHouston, TX 77030(713) 798-1999

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Page 24: Provider Directory Addendum

Terminations to the Provider Network

Terminaciones a la Red de Proveedores

Ter

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Jason A Mouabbi, MD●

Ophthalmology

Oftalmología

Harris County / Condado

City of Houston

Ciudad de Houston

Alkek Eye Center

1977 Butler BlvdHouston, TX 77030(713) 798-6100

Bac Tien Nguyen, MD●

Kate Chenlu Xie, MD●

Milton Boniuk, MD●

Houston Eye Associates PA

2855 GramercyHouston, TX 77025(713) 668-6828

Richard L Kimbrough, MD

Houston Eye Associates PA

2855 GrammercyHouston, TX 77025(713) 668-6828

Lowell Watkins, MD

Houston Eye Associates PA

427 W 20th St Ste 100Houston, TX 77008(713) 862-6631

Andrew L Watkins, MD

Houston Eye Associates, P.A.

2855 GramercyHouston, TX 77025(713) 668-6828

Charity H Grannis, MD

Kelsey-Seybold Clinic

Berthelsen Main Campus

2727 West Holcombe BlvdHouston, TX 77025(713) 442-0000

Denise Schatte, MD●

Kelsey-Seybold

Clinic-Tanglewood

1111 Augusta DrHouston, TX 77057(713) 442-2400

Denise Schatte, MD●

Retina & Vitreous of Texas,

PLLC

2727 Gramercy Ste 200Houston, TX 77025(713) 799-9975

Daniel Salisbury, MD

City of Spring

Ciudad de Spring

BCM Ophthalmology

Springwoods Village

2255 E Mossy Oaks Rd Ste 300Spring, TX 77389(713) 986-6100

Bac Tien Nguyen, MD●

Montgomery County

Montgomery Condado

City of The Woodlands

Ciudad de The Woodlands

Avery Eye Clinic

129 Vision Park BlvdThe Woodlands, TX 77384(281) 713-5214

Andrew Dvorak, MD

Avery Eye Clinic

129 Vision Park BlvdThe Woodlands, TX 77384(281) 719-5214

Linda Lin, MD

Mark Wilkerson, MD

Avery Eye Clinic

129 Vision Park Blvd Ste 110The Woodlands, TX 77384(281) 719-5214

Baptiste Dejean, MD

Craig Kuglen, MD

Walker County / Condado

City of Huntsville

Ciudad de Huntsville

Avery Eye Clinic

3361 Montgomery RdHuntsville, TX 77340(936) 294-0218

Paul Black, OD

Optometry / Optometría

Harris County / Condado

City of Houston

Ciudad de Houston

Kelsey-Seybold Spring Medical

and Diagnostic Clinic

15655 Cypress Woods Medical DrHouston, TX 77014(713) 442-1700

Kimberly Menzie, OD●

Montgomery County

Montgomery Condado

City of The Woodlands

Ciudad de The Woodlands

Avery Eye Clinic

129 Vision Park BlvdThe Woodlands, TX 77384(281) 719-5214

Renee Williams, OD

Orthopedic Surgery

Cirugía ortopédica

Harris County / Condado

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales23

Page 25: Provider Directory Addendum

Terminations to the Provider Network

Terminaciones a la Red de Proveedores

City of Baytown

Ciudad de Baytown

TMHPO Orthopedics

Department

4201 Garth Rd Ste 111Baytown, TX 77521(281) 427-7400

Venkata K Jonna, MD

TMHPO Orthopedics

Department

4000 Garth Rd Ste 200Baytown, TX 77521(713) 441-9000

Leland A Winston, MD

City of Houston

Ciudad de Houston

BCM San Felipe Clinic

6363 San Felipe St Ste 150Houston, TX 77057(713) 986-6000

Mark S Adickes, MD●

Baylor McNair - Orthopedic

Surgery

7200 Cambridge StHouston, TX 77030(713) 986-6016

Mark S Adickes, MD●

KSF Orthopaedic Center, PA

17270 Red Oak Dr Ste 200Houston, TX 77090(281) 440-6960

Andrew P Kant, MD

KSF Orthopedic Center, PA

17270 Red Oak Dr Ste 200Houston, TX 77090(281) 440-6960

Andrew Kant, MD

David Sun, MD

Thomas Cartwright, MD

Kelsey - Seybold

Clinic-Berthelsen Main

Campus

2727 West Holcombe BlvdHouston, TX 77025(713) 442-0000

Anup Shah, MD●

TMHPO Orthopedics

Department

14903 El Camino RealHouston, TX 77062(713) 363-9090

Kenneth Brooks Brooks, MD

TMHPO Orthopedics

Department

6445 Main Ste 2500Houston, TX 77030(713) 441-9000

Leland A Winston, MD

Rex A Marco, MD

UT Physicians - Orthopedics -

Trauma Clinic

6414 Fannin StHouston, TX 77030(713) 486-7560

Joshua L Gary, MD●

Physical Medicine and Rehab

Medician física y Rehabilitación

Harris County / Condado

City of Harris

Ciudad de Harris

Bayor McNair - PM&R

7200 Cambridge St 10th Fl Ste 10BHarris, TX 77030(713) 798-7246

Uvieoghene O Ughwanogho, MD●

City of Houston

Ciudad de Houston

Baylor McNair - PM&R

7200 Cambridge StHouston, TX 77030(713) 798-7246

Martin Grabois, MD●

Baylor Physical Medicine and

Rehabilitation

6550 FanninHouston, TX 77030(713) 798-6198

Uvieoghene O Ughwanogho, MD●

Plastic Surgery

Cirugía Plástica

Harris County / Condado

City of Bellaire

Ciudad de Bellaire

UT Physicians Minimally Invasive

Surgeons of Texas (UTMIST)

6700 West Loop South Ste 500Bellaire, TX 77401(713) 486-1330

Jessica F Rose, DO●

City of Houston

Ciudad de Houston

Kelsey - Seybold Clinic-Berthelsen

Main Campus

2727 W Holcombe BlvdHouston, TX 77025(713) 442-0000

Jamal M Bullocks, MD●

Kelsey-Seybold Clinic Berthelsen

Main Campus

2727 West Holcombe BlvdHouston, TX 77025(713) 442-0000

Jamal M Bullocks, MD●

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● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales

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Page 26: Provider Directory Addendum

Terminations to the Provider Network

Terminaciones a la Red de Proveedores

Ter

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TMHPO Institute for

Reconstructive Surgery

13300 Hargrave Rd Ste 450Houston, TX 77070(281) 737-4560

John W Shuck, MD

TMHPO Institute for

Reconstructive Surgery

6560 Fannin Ste 2200Houston, TX 77030(713) 441-6106

John W Shuck, MD

UT Physicians General Surgery

- Texas Medical Center

6410 Fannin St Ste 1400Houston, TX 77030(832) 325-7181

Grigorios A Lamaris, MD●

Jessica F Rose, DO●

Podiatry / Podología

Harris County / Condado

City of Deer Park

Ciudad de Deer Park

S F Hartley, DPM PC

112 W Pasadena BlvdDeer Park, TX 77536(281) 479-5311

Mohammed A Farroqui, DPM

City of Houston

Ciudad de Houston

S F Hartley, DPM PC

1140 Westmont Dr Ste 310Houston, TX 77015(713) 455-5999

Mohammed A Farroqui, DPM

Pulmonology

Neumonología

Fort Bend County

Fort Bend Condado

City of Missouri City

Ciudad de Missouri City

UT Physicians at Sienna Village

8810 Hwy 6 Ste 100Missouri City, TX 77459(713) 486-1200

Farah Akhtar, MD●

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor Internal Medicine - 1225

6620 Main St 11th Fl 11B241Houston, TX 77030(713) 798-2500

James Patrick Herlihy, MD●

Muhammad Asim Siddique, MD●

Ritwick Agrawal, MD●

Baylor McNair - Pulmonary

7200 Cambridge StHouston, TX 77030(713) 798-2500

Amit D Parulekar, MD●

Baylor McNair - Pulmonary

7200 Cambridge St 8th Fl Ste 8 AHouston, TX 77030(713) 798-2500

Dipaben Dhananjay Modi, MD●

Jairo Hernando Barrantes Perez, MD●

Prasad Manian, MD●

Kelsey-Seybold Clinic

Berthelsen Main Campus

2727 West Holcombe BlvdHouston, TX 77025(713) 442-0000

Katie R Jeans, MD●

Rehabilitation Medicine

Medicina de Rehabilitación

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor McNair - PM&R

7200 Cambridge St 10th Fl Ste 10 BHouston, TX 77030(713) 798-7246

Christine Marie Pautler Krull, MD●

Ray Chang, MD●

Kelsey - Seybold Clinic-Berthelsen

Main Campus

2727 W Holcombe BlvdHouston, TX 77025(713) 442-0000

Siddharth V Aranke, MD●

Kelsey-Seybold Clinic Berthelsen

Main Campus

2727 West Holcombe BlvdHouston, TX 77025(713) 442-0000

Elizabeth Pena, DO●

Methodist Rehabilitation

Associates

6560 Fannin Ste 1878Houston, TX 77030(713) 441-5189

Gregory Keith Burton, MD

Rheumatology

Reumatología

Harris County / Condado

City of Bellaire

Ciudad de Bellaire

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales25

Page 27: Provider Directory Addendum

Terminations to the Provider Network

Terminaciones a la Red de Proveedores

UT Physicians Health Center at

Bellaire

6700 West Loop SouthBellaire, TX 77401(713) 572-8122

Jammie K Barnes, MD●

City of Houston

Ciudad de Houston

Kelsey - Seybold

Clinic-Meyerland Plaza

560 Meyerland Plaza MallHouston, TX 77096(713) 442-3222

Francis M Williams, MD●

UT Physicians at Texas Medical

Center

6410 Fannin StHouston, TX 77030(832) 325-7191

Jammie K Barnes, MD●

Surgery, Thoracic

Harris County / Condado

City of Houston

Ciudad de Houston

George Noon, MD

6565 Fannin StHouston, TX 77030(713) 790-3155

George Paul Noon, MD●■

Urology / Urología

Fort Bend County

Fort Bend Condado

City of Sugar Land

Ciudad de Sugar Land

Methodist Urology Associates

16659 Southwest Frwy Ste 401Sugar Land, TX 77479(281) 276-5280

Neel Srikishen, MD

Harris County / Condado

City of Baytown

Ciudad de Baytown

Methodist Urology Associates

4201 Garth Rd Ste 307Baytown, TX 77521(832) 556-6046

Olubayo Daniel Tojuola, MD

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Page 28: Provider Directory Addendum

Other Changes to the Provider Network

Otros cambios a la Red de Proveedores

Oth

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Allergy and Immunology

Alergia e Inmunología

Montgomery County

Montgomery Condado

City of Shenandoah

Ciudad de Shenandoah

Kelsey-Seybold Clinic-The

Woodlands

Location Added/Lugar Agregado

106 Vision Park BlvdShenandoah, TX 77384(713) 442-1800

Nicole Canon, MD●

Cardiology / Cardiología

Brazoria County / Condado

City of Pearland

Ciudad de Pearland

Memorial Hermann Pearland

Hospital

Location Added/Lugar Agregado

16100 South FrwyPearland, TX 77584(713) 413-5000

Clarence D Gill, MD●

Fort Bend County

Fort Bend Condado

City of Katy

Ciudad de Katy

UT Physicians Multispecialty -

Cinco Ranch

Location Added/Lugar Agregado

23923 Cinco Ranch BlvdKaty, TX 77494(713) 486-2400

Zaka U Khan, MD●

City of Sugar Land

Ciudad de Sugar Land

UT Physicians - EP Heart

Sugar Land

Location Added/Lugar Agregado

17510 West Grand Pkwy SouthSugar Land, TX 77479(713) 486-2400

Siddharth S Mukerji, MD●

UT Physicians - EP Heart

Sugar Land

Location Termed/Lugar

Terminada

17510 West Grand Pkwy SouthSugar Land, TX 77479(713) 486-2400

Siddharth S Mukerji, MD●

UT Physicians EP Heart -

Sugar Land

Location Added/Lugar Agregado

6909 Brisbane Court Ste 300Sugar Land, TX 77479(713) 486-2400

Siddharth S Mukerji, MD●

Zaka U Khan, MD●

Harris County / Condado

City of Bellaire

Ciudad de Bellaire

UT Physicians Health Center at

Bellaire

Location Added/Lugar Agregado

6700 West Loop SouthBellaire, TX 77401(713) 486-1625

Ijeoma U Ekeruo, MD●

UT Physicians Multispecialty -

Bellaire

Location Added/Lugar Agregado

6700 West Loop South Ste 250Bellaire, TX 77401(713) 572-8122

Ijeoma U Ekeruo, MD●

City of Houston

Ciudad de Houston

Hall Garcia Cardiology Associates

Location Added/Lugar Agregado

6624 Fannin StHouston, TX 77030(713) 529-5530

Abdi Rasekh, MD●

Mehdi Razavi, MD●

UT Physicians EP Heart -

Complex Arrhythmia Center

Location Added/Lugar Agregado

6400 Fannin StHouston, TX 77030(713) 486-1625

Khashayar Hematpour, MD●

Siddharth S Mukerji, MD●

UT Physicians EP Heart -

Complex Arrhythmia Center

Location Added/Lugar Agregado

6400 Fannin St Ste 2550Houston, TX 77030(713) 486-2400

Zaka U Khan, MD●

UT Physicians EP Heart -

Memorial City

Location Added/Lugar Agregado

925 Gessner RdHouston, TX 77024(713) 486-2400

Siddharth S Mukerji, MD●

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales27

Page 29: Provider Directory Addendum

Other Changes to the Provider Network

Otros cambios a la Red de Proveedores

UT Physicians EP Heart -

Memorial City

Location Added/Lugar Agregado

925 Gessner Rd Ste 540Houston, TX 77024(713) 486-2400

Zaka U Khan, MD●

UT Physicians EP Heart -

Southeast

Location Added/Lugar Agregado

11920 Astoria BlvdHouston, TX 77089(713) 486-1420

Khashayar Hematpour, MD●

UT Physicians EP Heart -

Vintage Park

Location Added/Lugar Agregado

102 Vintage Park BlvdHouston, TX 77070(713) 486-2400

Zaka U Khan, MD●

UT Physicians EP Heart -

Vintage Park

Location Added/Lugar Agregado

102 Vintage Park Blvd Building L Ste EHouston, TX 77070(713) 486-5280

Khashayar Hematpour, MD●

UT Physicians-Advanced Heart

Failure

Location Added/Lugar Agregado

915 Gessner Rd Ste 301Houston, TX 77024(713) 242-2170

Philip C Haas, DO●

City of Webster

Ciudad de Webster

Hall Garcia Cardiology

Associates - Webster

Location Added/Lugar Agregado

450 W Medical Ctr Blvd Ste 510Webster, TX 77598(713) 529-5530

Abdi Rasekh, MD●

Mehdi Razavi, MD●

UT Physicians EP Heart -

Webster

Location Added/Lugar Agregado

561 Medical Ctr BlvdWebster, TX 77598(713) 486-1480

Khashayar Hematpour, MD●

Montgomery County

Montgomery Condado

City of The Woodlands

Ciudad de The Woodlands

UT Physicians EP Heart - The

Woodlands

Location Added/Lugar Agregado

9180 Pinecroft Ste 420The Woodlands, TX 77380(713) 486-1550

Ijeoma U Ekeruo, MD●

Cardiothoracic Surgery

Cirugía cardiotorácica

Harris County / Condado

City of Houston

Ciudad de Houston

Center for Advanced Heart

Failure

Location Termed/Lugar

Terminada

6400 Fannin StHouston, TX 77030(713) 704-4300

Manish K Patel, MD●

Methodist Cardiovascular

Surgery Associates

Location Added/Lugar Agregado

18400 Katy Frwy Ste 640Houston, TX 77094(281) 737-2918

Scott E Olsson, MD

Methodist Cardiovascular

Surgery Associates

Location Added/Lugar Agregado

18400 Katy Frwy Ste 640Houston, TX 77094(832) 522-8600

Javier A Lafuente, MD

UT Physicians Center for

Advanced Heart Failure -

Memorial City

Location Added/Lugar Agregado

915 Gessner Rd Ste 301Houston, TX 77024(713) 242-2222

Cristian S Sarateanu, MD●

City of Webster

Ciudad de Webster

Clear Lake Regional Medical

Center

Location Termed/Lugar Terminada

500 Medical Ctr BlvdWebster, TX 77598(281) 554-1650

Manish K Patel, MD●

UT Physicians Cardiothoracic and

Vascular Surgery - Webster

Location Termed/Lugar Terminada

561 Medical Ctr Blvd Ste AWebster, TX 77598(713) 486-1160

Manish K Patel, MD●

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Montgomery County

Montgomery Condado

City of The Woodlands

Ciudad de The Woodlands

Center for Advanced

Cardiology - Woodlands

Location Termed/Lugar

Terminada

1120 Medical Plaza Dr Ste 150The Woodlands, TX 77380(713) 897-5122

Cristian S Sarateanu, MD●

Victoria County / Condado

City of Victoria

Ciudad de Victoria

UT Physicians - Cardiothoracic

& Vascular Surgery

Location Termed/Lugar

Terminada

605 East San AntonioVictoria, TX 77901(361) 572-4750

Manish K Patel, MD●

Colon & Rectal Surgery

Cirugía de Colon y Rectal

Harris County / Condado

City of Baytown

Ciudad de Baytown

TMH Physician Associates

PLLC DBA TMHPO Surgery

Department

Location Added/Lugar Agregado

4301 Garth Rd Ste 303Baytown, TX 77521(346) 292-1470

Zaid N Kronfol, MD

TMHPO Surgery Department

Location Termed/Lugar

Terminada

4201 Garth Rd Ste 307Baytown, TX 77521(832) 556-6046

Zaid N Kronfol, MD

City of Houston

Ciudad de Houston

TMH Physician Associates

PLLC DBA TMHPO Surgery

Department

Location Added/Lugar Agregado

18100 St John Dr Ste 300Houston, TX 77058(832) 556-6046

Zaid N Kronfol, MD

Dermatology

Dermatología

Brazoria County / Condado

City of Brazoria

Ciudad de Brazoria

Heights Dermatology

Location Added/Lugar Agregado

215 Oak Dr South Ste CBrazoria, TX 77566(979) 297-6458

Alpesh Desai, DO

Fort Bend County

Fort Bend Condado

City of Rosenberg

Ciudad de Rosenberg

Heights Dermatology

Location Added/Lugar Agregado

5219 Reading RdRosenberg, TX 77471(713) 730-2000

Alpesh Desai, DO

Harris County / Condado

City of Houston

Ciudad de Houston

Heights Dermatology

Location Added/Lugar Agregado

2120 Ashland StHouston, TX 77008(713) 864-2656

Alpesh Desai, DO

Heights Dermatology

Location Added/Lugar Agregado

8203 Willow Place Dr South Ste 165Houston, TX 77070(832) 604-7400

Alpesh Desai, DO

ENT/Otolaryngology

ENT/Otorrinolaringología

Fort Bend County

Fort Bend Condado

City of Sugar Land

Ciudad de Sugar Land

Kelsey-Seybold Fort Bend

Medical and Diagnostic Center

Location Added/Lugar Agregado

11555 University BlvdSugar Land, TX 77478(713) 442-9100

Benjamin Yang, MD●

Harris County / Condado

City of Houston

Ciudad de Houston

Houston Methodist ENT

Specialists

Location Added/Lugar Agregado

6550 Fannin Ste 1723Houston, TX 77030(713) 441-1368

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Jeffrey T Vrabec, MD

Omar G Ahmed, MD●

Yin Yiu, MD

Houston Methodist ENT

Specialists

Location Added/Lugar Agregado

6550 Fannin Ste 1723Houston, TX 77030(713) 441-3223

Anthony Brissett, MD

Fred Bressler Bressler, MD

Houston Methodist ENT

Specialists

Location Added/Lugar Agregado

6550 Fannin Ste 1723Houston, TX 77030(713) 796-2349

Apurva Thekdi Thekdi, MD

TMH Physician Associates

PLLC DBA TMHPO

Neurosurgery Departments

Phone Number Change/Cambio

de número de teléfono

13300 Hargrave Rd Ste 205Houston, TX 77070(281) 737-7261

Gavin J Le Nobel, MD

TMHPO Neurosurgery

Department

Location Added/Lugar Agregado

6550 Fannin Ste 1723Houston, TX 77030(713) 441-1368

Omar G Ahmed, MD

TMHPO Neurosurgery

Departments

Location Termed/Lugar

Terminada

18100 Houston Methodist Dr Ste 240Houston, TX 77058(832) 783-1170

Ryan W Ridley, MD

TMHPO Neurosurgery

Departments

Phone Number Change/Cambio

de número de teléfono

18100 Houston Methodist Dr Ste 220Houston, TX 77058(832) 783-1170

Ryan W Ridley, MD

UT Physicians -

Otorhinolaryngology Texas

Medical Center

Phone Number Change/Cambio

de número de teléfono

6400 Fannin StHouston, TX 77030(713) 486-5000

Amber U Luong, "MD, PhD"●

UT Physicians

Otorhinolaryngology - Texas

Medical Center

Phone Number Change/Cambio

de número de teléfono

6400 Fannin StHouston, TX 77030(713) 486-5000

William C Yao, MD●

City of Tomball

Ciudad de Tomball

TMHPO Neurosurgery

Department

Location Termed/Lugar Terminada

14211 FM 2920 FM Rd Ste 110Tomball, TX 77377(281) 737-1910

Gavin J le Nobel, MD●

City of Webster

Ciudad de Webster

Kelsey-Seybold Clinic-Clear Lake

Location Added/Lugar Agregado

1010 South Ponds DrWebster, TX 77598(713) 442-4300

Benjamin Yang, MD●

Endocrinology

Endocrinología

Harris County / Condado

City of Bellaire

Ciudad de Bellaire

UT Physicians Health Center at

Bellaire

Location Added/Lugar Agregado

6700 West Loop SouthBellaire, TX 77401(713) 572-8122

Salima K Ali, MD●

City of Houston

Ciudad de Houston

Baylor Center for

Cardiometabolic Disease

Prevention

Location Added/Lugar Agregado

6655 Travis St Ste 320Houston, TX 77030(713) 798-5800

Layla Abushamat, MD●

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City of Humble

Ciudad de Humble

Kelsey-Seybold Clinic-Summer

Creek

Location Termed/Lugar

Terminada

8233 N Sam Houston Pkwy EHumble, TX 77396(713) 442-2000

Shahid Muhammad, MD●

Family Medicine

Medicina familiar

Brazoria County / Condado

City of Lake Jackson

Ciudad de Lake Jackson

Kelsey-Seybold Clinic Lake

Jackson

Location Added/Lugar Agregado

201 That WayLake Jackson, TX 77566(979) 285-2100

Kathrynn Tran, MD●

Fort Bend County

Fort Bend Condado

City of Richmond

Ciudad de Richmond

BSLMG Sugar Land Internal

Medicine and Pediatrics

Location Added/Lugar Agregado

10615 West Grand Pkwy SouthRichmond, TX 77407(281) 637-7390

Derek M He, DO●

City of Sugar Land

Ciudad de Sugar Land

BSLMG Sugar Land Internal

Medicine and Pediatrics

Location Added/Lugar Agregado

1327 Lake Pointe Pkwy Ste 410Sugar Land, TX 77478(281) 637-7695

Derek M He, DO●

BSLMG Sugar Land Internal

Medicine and Pediatrics

Location Termed/Lugar

Terminada

1327 Lake Pointe Pkwy Ste 410Sugar Land, TX 77478(281) 637-7695

Derek M He, DO●

Harris County / Condado

City of Baytown

Ciudad de Baytown

Kelsey-Seybold Clinic-Baytown

Location Termed/Lugar

Terminada

6300 Garth Rd Ste 200Baytown, TX 77521(713) 442-1240

Sheldon L Gaines, MD●

City of Houston

Ciudad de Houston

BSLMG Houston Northwest

Primary Care

Location Added/Lugar Agregado

20207 Chasewood Park Dr Ste 300Houston, TX 77070(832) 534-7860

Arlean M Bullard, MD●

Kelsey-Seybold Clinic-North

Channel

Location Added/Lugar Agregado

5820 E Sam Houston Pkwy NHouston, TX 77049(713) 442-6000

John E Ruelas, MD●

Kelsey-Seybold

Clinic-Tanglewood

Location Added/Lugar Agregado

1111 Augusta DrHouston, TX 77057(713) 442-2400

Xuyen D Phan, MD●

City of Humble

Ciudad de Humble

Kelsey-Seybold Clinic-Summer

Creek

Location Added/Lugar Agregado

8233 N Sam Houston Pkwy EHumble, TX 77396(713) 442-2000

John E Ruelas, MD●

City of Katy

Ciudad de Katy

Kelsey-Seybold West Grand

Parkway Clinic

Location Added/Lugar Agregado

2510 West Grand Pkwy NorthKaty, TX 77449(713) 442-4222

Marjorie Broussard, MD●■

City of Spring

Ciudad de Spring

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ETCS Houston Northwest

Primary Care

Location Added/Lugar Agregado

2255 E Mossy Oaks Rd Ste 320Spring, TX 77389(832) 534-7860

Arlean M Bullard, MD●

City of The Woodlands

Ciudad de The Woodlands

BSLMG Creekside

Location Added/Lugar Agregado

8558 Creekside Forest Dr Bldg B-100The Woodlands, TX 77375(832) 534-7700

Irena Liang, MD●

Sam Rolon, DO●

City of Webster

Ciudad de Webster

Kelsey-Seybold Clinic-Clear

Lake

Location Added/Lugar Agregado

1010 South Ponds DrWebster, TX 77598(713) 442-4300

Amy Chen, MD●

Gastroenterology

Gastroenterología

Fort Bend County

Fort Bend Condado

City of Sugar Land

Ciudad de Sugar Land

Baylor McNair -

Gastroenterology

Location Added/Lugar Agregado

1327 Lake Pointe Pkwy Ste 305Sugar Land, TX 77478(713) 798-0950

Kalpesh K Patel, MD●

Mohamed O Othman, MD●

Salmaan A Jawaid, MD●

Wasif M Abidi, MD●

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor Clinic -

Gastroenterology

Location Added/Lugar Agregado

6620 Main St Ste 1500Houston, TX 77030(713) 798-2500

Manreet Kaur, MD●

Baylor Family

Medicine-Gastroenterology

Location Added/Lugar Agregado

3701 Kirby DrHouston, TX 77098(713) 798-2500

Johanna L Chan, MD●

Baylor Internal Medicine - 1225

Location Added/Lugar Agregado

6620 Main St Ste 1500Houston, TX 77030(713) 798-2500

Waqar A Qureshi, MD●

Baylor Internal Medicine - 1225

(Gastro)

Location Added/Lugar Agregado

6620 Main St Ste 1500Houston, TX 77030(713) 798-0950

Kalpesh K Patel, MD●

Baylor McNair - Gastroenterology

Location Added/Lugar Agregado

7200 Cambridge St 8th Fl Ste 8 BHouston, TX 77030(713) 798-2500

Lukasz Kwapisz, MD●

Manreet Kaur, MD●

Salmaan A Jawaid, MD●

Baylor McNair - Gastroenterology

Location Added/Lugar Agregado

7200 Cambridge St 8th Fl Ste 8BHouston, TX 77030(713) 798-2500

Johanna L Chan, MD●

Kalpesh K Patel, MD●

Mohamed O Othman, MD●

Nabil M Mansour, MD●

Richa Shukla, MD●

Suneal K Agarwal, MD●

Waqar A Qureshi, MD●

Wasif M Abidi, MD●

Ertan Digestive Disease Center

Location Added/Lugar Agregado

6400 Fannin StHouston, TX 77030(713) 704-3450

Reena V Chokshi, MD●

Texas International Endoscopy

Center

Location Added/Lugar Agregado

6620 Main StSte 1500Houston, TX 77030(713) 520-8432

Johanna L Chan, MD●

Kalpesh K Patel, MD●

Lukasz Kwapisz, MD●

Manreet Kaur, MD●

Mohamed O Othman, MD●

Nabil M Mansour, MD●

Reena V Chokshi, MD●

Rehman A Sheikh, MD●

Richa Shukla, MD●

Salmaan A Jawaid, MD●

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Suneal K Agarwal, MD●

Waqar A Qureshi, MD●

Wasif M Abidi, MD●

UT Physicians

Gastroenterology - Greater

Heights

Phone Number Change/Cambio

de número de teléfono

6400 Fannin StHouston, TX 77030(713) 704-3450

Roy T DaVee, MD●

City of Humble

Ciudad de Humble

UT Physicians

Gastroenterology - Northeast

Location Added/Lugar Agregado

18980 N Memorial Dr Ste 280Humble, TX 77338(713) 486-8180

Moises I Nevah Rubin, MD●

General Surgery

Cirugía general

Brazoria County / Condado

City of Pearland

Ciudad de Pearland

TMHPO Surgery Department

Location Added/Lugar Agregado

8525 Broadway St Ste 220Pearland, TX 77584(713) 441-5141

Robert A Ochoa, MD

TMHPO Surgery Department

Location Termed/Lugar

Terminada

8525 Broadway St Ste 220Pearland, TX 77584(713) 441-5141

Robert A Ochoa, MD

Fort Bend County

Fort Bend Condado

City of Sugar Land

Ciudad de Sugar Land

UT Physicians General Surgery

- Sugar Land

Location Added/Lugar Agregado

17510 West Grand Pkwy South Ste 450Sugar Land, TX 77479(713) 486-3950

Peter A Walker, MD●

Peter A Walker, MD●

Harris County / Condado

City of Baytown

Ciudad de Baytown

TMH Physician Associates

PLLC DBA TMHPO Surgery

Department

Location Added/Lugar Agregado

4301 Garth Rd Ste 303Baytown, TX 77521(346) 292-1470

Boutros P Kahla, MD

Kendell J Sowards, MD

Laura H Choi, MD

Robert A Ochoa, MD

TMH Physician Associates

PLLC DBA TMHPO Surgery

Department

Location Added/Lugar Agregado

4201 Garth Rd Ste 307Baytown, TX 77521(832) 556-6046

Robert A Ochoa, MD

TMH Physician Associates PLLC

DBA TMHPO Surgery

Department

Location Termed/Lugar Terminada

4201 Garth Rd Ste 307Baytown, TX 77521(832) 556-6046

Robert A Ochoa, MD

TMHPO Surgery Department

Location Added/Lugar Agregado

4201 Garth Rd Ste 307Baytown, TX 77521(832) 556-6046

Boutros P Kahla, MD

Laura H Choi, MD

TMHPO Surgery Department

Location Termed/Lugar Terminada

4201 Garth Rd Ste 307Baytown, TX 77521(832) 556-6046

Boutros P Kahla, MD

City of Bellaire

Ciudad de Bellaire

UT Physicians General Surgery

Location Termed/Lugar Terminada

6700 West Loop South Ste 500Bellaire, TX 77401(713) 892-5500

John C Cowling, MD●

UT Physicians Minimally Invasive

Surgeon of Texas - (UTMIST)

Location Added/Lugar Agregado

6700 West Loop SouthBellaire, TX 77401(713) 486-1330

Emily K Robinson, MD●

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales33

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Otros cambios a la Red de Proveedores

UT Physicians Minimally

Invasive Surgeons of Texas

Location Added/Lugar Agregado

6700 West Loop South Ste 500Bellaire, TX 77401(713) 486-1330

Peter A Walker, MD●

UT Physicians Minimally

Invasive Surgeons of Texas

(UTMIST)

Location Termed/Lugar

Terminada

6700 West Loop South Ste 500Bellaire, TX 77401(713) 486-1330

Brad E Snyder, MD●

UT Physicians Minimally

Invasive Surgeons of Texas

(UTMIST)

Location Added/Lugar Agregado

6700 West Loop SouthBellaire, TX 77401(713) 892-5500

Kendell J Sowards, MD●

UT Physicians Minimally

Invasive Surgeons of Texas

(UTMIST)

Location Termed/Lugar

Terminada

6700 West Loop South Ste 500Bellaire, TX 77401(713) 892-5500

Ekatarina S Elliott, DO●

Michelle Scerbo, MD●

Peter A Walker, MD●

UT Physicians Orthopedics at

Memorial Hermann Orthopedic

and Spine Hospital

Location Termed/Lugar

Terminada

5420 West Loop South Ste 2400Bellaire, TX 77401(713) 486-3550

Casey B Duncan, MD●

City of Cypress

Ciudad de Cypress

UT Physicians Minimally

Invasive Surgeons of Texas

(UTMIST) - Cypress

Location Added/Lugar Agregado

27700 Northwest Frwy Ste 200Cypress, TX 77433(713) 486-1330

Michelle Scerbo, MD●

City of Houston

Ciudad de Houston

Baylor Medicine - Bariatric

Surgery Center

Location Added/Lugar Agregado

1977 Butler Blvd Ste E6100Houston, TX 77030(713) 798-6673

Juliet Georgia Holder-Haynes, MD●

Samer G Mattar, MD●

Kelsey-Seybold Clinic

Berthelsen Main Campus

Location Added/Lugar Agregado

2727 West Holcombe BlvdHouston, TX 77025(713) 442-0000

Eric K Rachlin, MD●

Kelsey-Seybold Clinic Memorial

City

Location Added/Lugar Agregado

929 Gessner Ste 1450Houston, TX 77024(713) 442-5200

Eric K Rachlin, MD●

Memorial Hermann Cancer

Center - Texas Medical Center

Location Added/Lugar Agregado

6400 Fannin St Ste 2900Houston, TX 77030(713) 704-3961

Emily K Robinson, MD●

Memorial Hermann Cancer

Center - Texas Medical Center

Location Termed/Lugar Terminada

6401 Fannin StHouston, TX 77030(713) 704-3961

Tamara E Saunders, MD●

TMHPO Surgery Department

Location Added/Lugar Agregado

6550 Fannin St Ste 1601Houston, TX 77030(713) 441-5141

Robert A Ochoa, MD

TMHPO Surgery Department

Location Added/Lugar Agregado

6550 Fannin Ste 1501Houston, TX 77030(713) 441-5141

Robert A Ochoa, MD

TMHPO Surgery Department

Location Termed/Lugar Terminada

18220 St Hwy 249 Ste 400Houston, TX 77070(713) 441-5141

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Todd Anthony Worley, MD

TMHPO Surgery Department

Location Termed/Lugar

Terminada

6550 Fannin Ste 1501Houston, TX 77030(713) 441-5141

Robert A Ochoa, MD

TMHPO Surgery Department

Phone Number Change/Cambio

de número de teléfono

6550 Fannin Ste 1501Houston, TX 77030(713) 441-5141

Ashish Saharia, MD

Michael Maurie Reader, MD

Nicole Marie Tapia, MD

Wade Ronald Rosenberg, MD

TMHPO Surgery Department

Location Added/Lugar Agregado

6445 Main St Ste OPC26-100Houston, TX 77030(713) 441-5451

Richard J Knight, MD

Richard J Knight, MD

TMHPO Surgery Department

Location Added/Lugar Agregado

6550 Fannin St Ste 1601Houston, TX 77030(713) 441-5451

Richard J Knight, MD

Richard J Knight, MD

TMHPO Surgery Department

Location Added/Lugar Agregado

6550 Fannin Ste 1501Houston, TX 77030(713) 441-5451

Richard J Knight, MD

Richard J Knight, MD

TMHPO Surgery Department

Phone Number Change/Cambio

de número de teléfono

6445 Main St Ste OPC 26-100Houston, TX 77030(713) 441-5451

Rafik Mark Ghobrial, MD

TMHPO Surgery Department

Phone Number Change/Cambio

de número de teléfono

6550 Fannin Ste 1501Houston, TX 77030(713) 441-5451

Jesse Ryan Conner, MD

Mike Kuo Liang, MD

Rafik Mark Ghobrial, MD

Rodolfo Jose Oviedo, MD

Sherry Ji Lim, MD

TMHPO Surgery Department

Location Added/Lugar Agregado

6445 Main St Ste OPC 26-10Houston, TX 77030(713) 791-5451

Richard J Knight, MD

Richard J Knight, MD

TMHPO Surgery Department

Location Added/Lugar Agregado

18300 Katy Frwy Ste 265Houston, TX 77094(832) 522-8155

Laura H Choi, MD

TMHPO Surgery Department

Location Added/Lugar Agregado

4201 Garth Rd Ste 307Houston, TX 77521(832) 556-6046

Kendell J Sowards, MD

TMHPO Surgery Department

Location Termed/Lugar Terminada

4201 Garth Rd Ste 307Houston, TX 77521(832) 556-6046

Kendell J Sowards, MD

UT Physicians Breast Surgery at

One Fannin - Texas Medical

Center

Location Added/Lugar Agregado

7400 Fannin StHouston, TX 77054(713) 892-5500

Emily K Robinson, MD●

UT Physicians Breast Surgery at

One Fannin - Texas Medical

Center

Location Termed/Lugar Terminada

7400 Fannin StHouston, TX 77054(713) 892-5500

Emily K Robinson, MD●

UT Physicians Breast Surgery at

One Fannin - Texas Medical

Center

Location Termed/Lugar Terminada

7400 Fannin St Ste 940Houston, TX 77054(713) 892-5500

Tamara E Saunders, MD●

UT Physicians General Surgery -

Southeast

Location Added/Lugar Agregado

11920 Astoria BlvdHouston, TX 77089(713) 486-7650

Emily K Robinson, MD●

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales35

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Other Changes to the Provider Network

Otros cambios a la Red de Proveedores

UT Physicians General Surgery

- Southeast

Location Termed/Lugar

Terminada

11920 Astoria BlvdHouston, TX 77089(713) 486-7650

Emily K Robinson, MD●

UT Physicians General Surgery

- Southeast

Location Termed/Lugar

Terminada

11920 Astoria Blvd Ste 460Houston, TX 77089(713) 486-7650

Casey B Duncan, MD●

UT Physicians Minimally

Invasive Surgeons of Texas

(UTMIST) - Southwest

Location Added/Lugar Agregado

3525 W Holcombe Blvd 1st FlHouston, TX 77025(713) 486-3950

Peter A Walker, MD●

City of Katy

Ciudad de Katy

UT Physicians Minimally

Invasive Surgeons of Texas

(UTMIST) - Katy

Location Added/Lugar Agregado

23920 Katy Frwy Ste 150Katy, TX 77494(713) 486-1330

Tamara E Saunders, MD●

UT Physicians Minimally

Invasive Surgeons of Texas

(UTMIST) - Katy

Location Termed/Lugar

Terminada

23920 Katy Frwy Ste 150Katy, TX 77494(713) 486-1330

Brad E Snyder, MD●

UT Physicians Minimally

Invasive Surgeons of Texas

(UTMIST) - Katy

Location Termed/Lugar

Terminada

23920 Katy Frwy Ste 400Katy, TX 77494(713) 486-1330

Brad E Snyder, MD●

UT Physicians Minimally

Invasive Surgeons of

Texas-Katy

Location Added/Lugar Agregado

23920 Katy FrwyKaty, TX 77494(713) 892-5500

Peter A Walker, MD●

UT Physicians Minimally

Invasive Surgeons of

Texas-Katy

Location Termed/Lugar

Terminada

23920 Katy FrwyKaty, TX 77494(713) 892-5500

Peter A Walker, MD●

Gynecologic Oncology

Oncología ginecológica

Harris County / Condado

City of Houston

Ciudad de Houston

UT Physicians Adult Hematology

- Texas Medical Center

Location Added/Lugar Agregado

6400 Fannin St Ste 2900Houston, TX 77030(713) 704-3961

Abigail S Zamorano, MD●

Rosa A Guerra, MD●

UT Physicians Gynecologic

Oncology-Southeast

Location Added/Lugar Agregado

11914 Astoria Blvd Ste 510Houston, TX 77089(713) 486-1170

Abigail S Zamorano, MD●

Rosa A Guerra, MD●

Gynecology, OB/GYN

Ginecología,

Obstetricia/Ginecología

Brazoria County / Condado

City of Pearland

Ciudad de Pearland

Kelsey-Seybold Clinic- Pearland

Location Added/Lugar Agregado

2515 Business Ctr DrPearland, TX 77584(713) 442-7200

Stephanie Ho, MD●

Fort Bend County

Fort Bend Condado

City of Missouri City

Ciudad de Missouri City

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Kelsey-Seybold Clinic- Sienna

Clinic

Location Added/Lugar Agregado

7010 Hwy 6Missouri City, TX 77459(713) 442-6700

Amirhossein Nikahd, MD●

City of Sugar Land

Ciudad de Sugar Land

Kelsey-Seybold Fort Bend

Medical and Diagnostic Center

Location Added/Lugar Agregado

11555 University BlvdSugar Land, TX 77478(713) 442-9100

Amirhossein Nikahd, MD●

Harris County / Condado

City of Houston

Ciudad de Houston

Houston Methodist Obstetrics

& Gynecology Associates

Location Added/Lugar Agregado

18400 Katy Frwy Ste 360Houston, TX 77094(281) 275-0880

Tarrik Zaid, MD

Houston Methodist Obstetrics

& Gynecology Associates

Location Added/Lugar Agregado

18400 Katy Frwy Ste 360Houston, TX 77094(713) 441-5800

Danielle Dewi Antosh, MD

Kelsey-Seybold

Clinic-Tanglewood

Location Added/Lugar Agregado

1111 Augusta DrHouston, TX 77057(713) 442-2400

Stephanie Ho, MD●

Kelsey-Seybold Spring Medical

and Diagnostic Center

Location Added/Lugar Agregado

15655 Cypress Woods Medical Dr Ste 100Houston, TX 77014(713) 442-1700

Asma Ali, MD●

UT Physicians Advanced

Minimally Invasive Gynecologic

Surgery Center

Location Added/Lugar Agregado

6410 Fannin StHouston, TX 77030(713) 486-7700

Allan R Katz, MD●

UT Physicians Community

Health & Wellness Center -

Victory

Location Termed/Lugar

Terminada

7364 Antoine DrHouston, TX 77088(713) 486-7350

Comfort N Ughanze, MD●

UT Physicians Multispecialty -

Bayshore

Location Added/Lugar Agregado

11476 Space Ctr Blvd Ste 100Houston, TX 77059(713) 486-6325

Wiyatta B Freeman, MD●

UT Physicians Urogynecology

Center-Southeast

Location Added/Lugar Agregado

11914 Astoria Blvd Ste 510Houston, TX 77089(713) 486-6360

Wiyatta B Freeman, MD●

UT Physicians Women's Center -

Texas Medical Center

Location Added/Lugar Agregado

6410 Fannin StHouston, TX 77030(713) 500-5490

Alexander Wainwright, MD●

UT Physicians Women's Center -

Texas Medical Center

Location Added/Lugar Agregado

6410 Fannin StHouston, TX 77030(832) 325-7131

Pamela A Promecene-Cook, MD●

UT Physicians Women's Center -

Texas Medical Center

Location Termed/Lugar Terminada

6410 Fannin StHouston, TX 77030(832) 325-7131

Comfort N Ughanze, MD●

City of Pasadena

Ciudad de Pasadena

Kelsey-Seybold Clinic-Pasadena

Location Added/Lugar Agregado

5001 E Sam Houston Pkwy SPasadena, TX 77505(713) 442-7100

Melanie E Levy-Meeks, MD●

Monica Maged Suliman, MD●

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Page 39: Provider Directory Addendum

Other Changes to the Provider Network

Otros cambios a la Red de Proveedores

City of Webster

Ciudad de Webster

Kelsey-Seybold Clinic-Clear

Lake

Location Added/Lugar Agregado

1010 South Ponds DrWebster, TX 77598(713) 442-4300

Melanie E Levy-Meeks, MD●

Internal Medicine

Medicina interna

Fort Bend County

Fort Bend Condado

City of Richmond

Ciudad de Richmond

BSLMG Sugar Land Internal

Medicine and Pediatrics

Location Added/Lugar Agregado

10615 West Grand Pkwy SouthRichmond, TX 77407(281) 637-7390

Co-May D Pasdar-Shirazi, MD●

City of Sugar Land

Ciudad de Sugar Land

BSLMG Sugar Land Internal

Medicine and Pediatrics

Location Added/Lugar Agregado

1327 Lake Pointe Pkwy Ste 410Sugar Land, TX 77478(281) 637-7695

Co-May D Pasdar-Shirazi, MD●

BSLMG Sugar Land Internal

Medicine and Pediatrics

Location Termed/Lugar

Terminada

1327 Lake Pointe Pkwy Ste 410Sugar Land, TX 77478(281) 637-7695

Co-May D Pasdar-Shirazi, MD●

Harris County / Condado

City of Houston

Ciudad de Houston

Kelsey-Seybold Clinic

Berthelsen Main Campus

Location Termed/Lugar

Terminada

2727 West Holcombe BlvdHouston, TX 77025(713) 442-0000

Bazgha Khalid, MD●

Kelsey-Seybold Clinic-Gulfgate

Location Added/Lugar Agregado

1900 North Loop West 4th FlHouston, TX 77087(713) 442-0000

Alex Thomas, DO●

Kelsey-Seybold

Clinic-Memorial City

Location Added/Lugar Agregado

929 Gessner Rd Ste 1450Houston, TX 77024(713) 442-5200

Jessica Stull, MD●

Kelsey-Seybold

Clinic-Meyerland Plaza

Location Termed/Lugar

Terminada

560 Meyerland Plaza MallHouston, TX 77096(713) 442-3222

Bazgha Khalid, MD●

City of The Woodlands

Ciudad de The Woodlands

BSLMG Creekside

Location Added/Lugar Agregado

8558 Creekside Forest Dr Bldg B-100The Woodlands, TX 77375(832) 534-7700

Julio R Rivera, MD●

City of Webster

Ciudad de Webster

Kelsey-Seybold Clinic-Clear Lake

Location Added/Lugar Agregado

1010 South Ponds DrWebster, TX 77598(713) 442-4300

Alex Thomas, DO●

Montgomery County

Montgomery Condado

City of Porter

Ciudad de Porter

Kelsey-Seybold Clinic-Kingwood

Location Added/Lugar Agregado

25553 US Hwy 59Porter, TX 77365(713) 442-2100

Bazgha Khalid, MD●

Nephrology / Nefrología

Fort Bend County

Fort Bend Condado

City of Sugar Land

Ciudad de Sugar Land

CHI Sugar Land Hospitalist

Location Added/Lugar Agregado

1327 Lake Pointe PkwySugar Land, TX 77478(713) 798-3520

Ahmed A Awan, MD●

Harris County / Condado

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City of Houston

Ciudad de Houston

Baylor McNair - Nephrology

Location Added/Lugar Agregado

7200 Cambridge St 8th Fl Ste 8 BHouston, TX 77030(713) 798-2500

Ahmed A Awan, MD●

CHI Baylor Hospitalist

Location Added/Lugar Agregado

6720 Bertner AveHouston, TX 77030(713) 798-2222

Ahmed A Awan, MD●

CHI St. Luke's Health - The

Vintage Hospital

Location Added/Lugar Agregado

20171 Chasewood Park DrHouston, TX 77070(832) 534-5000

Ahmed A Awan, MD●

UT Physicians - Nephrology

Phone Number Change/Cambio

de número de teléfono

6410 Fannin StHouston, TX 77030(832) 325-6545

Dia R Waguespack, MD●

Neurology / Neurología

Harris County / Condado

City of Baytown

Ciudad de Baytown

TMHPO Neurology

Department

Location Added/Lugar Agregado

4201 Garth Rd Ste 313Baytown, TX 77521(832) 556-6535

Olga O Brusil, MD

City of Bellaire

Ciudad de Bellaire

TMHPO Neurology

Department

Location Termed/Lugar

Terminada

6750 Bellaire Ste 420Bellaire, TX 77401(713) 363-7130

Cuie Qiu, MD

City of Houston

Ciudad de Houston

Houston Methodist Neurology

Associates

Location Added/Lugar Agregado

13300 Hargrave Rd Ste 500Houston, TX 77070(281) 737-1167

Amy Lynette Naquin-Chappel, MD

Kasey L Gildersleeve, MD

Susanne Gonzalez Gallardo, MD

Kelsey-Seybold Clinic-Spring

Medical and Diagnostic Center

Location Added/Lugar Agregado

15655 Cypress Woods Medical DrHouston, TX 77014(713) 442-1700

Carisa S Liew, DO●

Kelsey-Seybold Clinic-The

Vintage

Location Added/Lugar Agregado

10701 Vintage Preserve PkwyHouston, TX 77070(713) 442-1500

Carisa S Liew, DO●

TMH Physician Associates PLLC

DBA Houston Methodist

Neurology Associates

Phone Number Change/Cambio de

número de teléfono

18100 Houston Methodist Dr Ste 240Houston, TX 77058(832) 783-1999

Gunjan Narwani, MD●

TMHPO Neurology Department

Location Added/Lugar Agregado

4191 Bellaire Blvd Ste 250Houston, TX 77025(346) 356-7000

Cuie Qiu, MD

TMHPO Neurology Department

Phone Number Change/Cambio de

número de teléfono

6560 Fannin Ste 802Houston, TX 77030(713) 441-3760

Stanley Appel, MD

TMHPO Neurology Department

Location Termed/Lugar Terminada

6560 Fannin Ste 802Houston, TX 77030(713) 441-3780

Amy Lynette Naquin-Chappel, MD

Neurosurgery

Neurocirugía

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Page 41: Provider Directory Addendum

Other Changes to the Provider Network

Otros cambios a la Red de Proveedores

Fort Bend County

Fort Bend Condado

City of Sugar Land

Ciudad de Sugar Land

TMH Physician Associates

PLLC DBA Methodist

Academic Medicine Associates

Phone Number Change/Cambio

de número de teléfono

16605 Southwest Frwy Ste 220Sugar Land, TX 77479(349) 874-2525

Derrick Y Sun, MD●

Harris County / Condado

City of Houston

Ciudad de Houston

TMHPO Neurosurgery

Department

Location Added/Lugar Agregado

13300 Hargrave Rd Ste 500Houston, TX 77070(281) 737-1141

Mickey Lee Smith, MD

TMHPO Surgery Department

Location Added/Lugar Agregado

6550 Fannin Ste 1501Houston, TX 77030(281) 737-1141

Mickey L Smith, MD

Montgomery County

Montgomery Condado

City of Shenandoah

Ciudad de Shenandoah

TMHPO Neurosurgery

Department

Location Added/Lugar Agregado

17183 IH 45 South Ste 650Shenandoah, TX 77385(936) 270-3905

Mickey L Smith, MD

City of The Woodlands

Ciudad de The Woodlands

CHI St. Luke's Woodlands -

Neurosurgery

Location Termed/Lugar

Terminada

17198 St. Luke's Way Ste 600The Woodlands, TX 77384(936) 266-2450

Gareth John Adams, MD●

Oncology - Medical, Surgical

Oncología - Médica/Quirúrgica

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor McNair - Hematology

Location Added/Lugar Agregado

7200 Cambridge St 7th Fl Ste 7BHouston, TX 77030(713) 798-3750

Premal D Lulla, MD●

Baylor McNair - Hematology

and Oncology

Phone Number Change/Cambio

de número de teléfono

7200 Cambridge St 7th Fl Ste 7BHouston, TX 77030(713) 798-3750

Akiva Diamond, MD●

Anita Lyn Sabichi, MD●

Gustavo A Rivero, MD●

Jahnavi Gollamudi, MD●

Baylor McNair - Oncology

Phone Number Change/Cambio de

número de teléfono

7200 Cambridge St 7th Fl Ste 7BHouston, TX 77030(713) 798-7710

Ai-Hua Edward Yen, MD●

Arpit Rao, MD●

Daniel Ying Wang, MD●

Tannaz Armaghany, MD●

Center for Cell and Gene Therapy

Location Added/Lugar Agregado

6551 Bertner Ave WT 15th FlHouston, TX 77030(713) 441-1450

Premal D Lulla, MD●

Center for Cell and Gene Therapy

Location Termed/Lugar Terminada

6565 Fannin StHouston, TX 77030(713) 441-1450

Premal D Lulla, MD●

Center for Cell and Gene Therapy

Phone Number Change/Cambio de

número de teléfono

6551 Bertner Ave WT 15th FlHouston, TX 77030(713) 441-1450

Premal D Lulla, MD●

Dan L. Duncan Cancer Center -

Hematology/Oncology

Location Termed/Lugar Terminada

6620 Main StHouston, TX 77030(713) 798-3750

Ai-Hua Edward Yen, MD●

Benjamin Musher, MD●

Premal D Lulla, MD●

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Dan L. Duncan Cancer Center -

Hematology/Oncology

Location Termed/Lugar

Terminada

6620 Main St Ste 1350Houston, TX 77030(713) 798-3750

Daniel Ying Wang, MD●

Dan L. Duncan Cancer Center -

Hematology/Oncology

Phone Number Change/Cambio

de número de teléfono

6620 Main StHouston, TX 77030(713) 798-3750

Mark M Udden, MD●

Dan L. Duncan Cancer Center -

Hematology/Oncology

Phone Number Change/Cambio

de número de teléfono

6620 Main St Ste 1350Houston, TX 77030(713) 798-3750

Purnima Sravanti Teegavarapu, MD●

Kelsey-Seybold-Spring Medical

and Diagnostic Center

Location Added/Lugar Agregado

15655 Cypress Woods Medical DrHouston, TX 77014(713) 442-1700

Mohammad A Jafri, MD●

City of Humble

Ciudad de Humble

Memorial Hermann Northeast

Hospital

Location Added/Lugar Agregado

18960 North Memorial DrHumble, TX 77338(281) 540-7905

Anneliese O Gonzalez, MD●

Ophthalmology

Oftalmología

Brazoria County / Condado

City of Pearland

Ciudad de Pearland

Houston Eye Associates, P.A.

Location Added/Lugar Agregado

10907 Memorial Hermann Dr Ste 150Pearland, TX 77584(281) 582-9100

Ravi S Shah, MD

Sandip Suresh, MD

William C Stewart, MD

Fort Bend County

Fort Bend Condado

City of Sugar Land

Ciudad de Sugar Land

Houston Eye Associates PA

Location Added/Lugar Agregado

1447 Hwy 6 Ste 110Sugar Land, TX 77478(281) 565-2020

William C Stewart, MD

Houston Eye Associates, P.A.

Location Added/Lugar Agregado

1447 Hwy 6 Ste 110Sugar Land, TX 77478(281) 565-2020

William C Stewart, MD

Galveston County

Galveston Condado

City of League City

Ciudad de League City

Houston Eye Associates, P.A.

Location Added/Lugar Agregado

1100 Gulf Frwy Ste 114League City, TX 77573(281) 332-3937

Ravi S Shah, MD

Sandip Suresh, MD

Harris County / Condado

City of Houston

Ciudad de Houston

Alkek Eye Center

Location Added/Lugar Agregado

1977 Butler BlvdHouston, TX 77030(713) 798-6100

Ravi S Shah, MD●

Houston Eye Associates PA

Location Added/Lugar Agregado

1415 North Loop West Ste 400Houston, TX 77008(713) 869-6400

William C Stewart, MD

Houston Eye Associates, P.A.

Location Added/Lugar Agregado

1250 Cypress Station Dr Ste AHouston, TX 77090(281) 444-1677

Kristin A Minkowski, MD

Sandip Suresh, MD

Houston Eye Associates, P.A.

Location Added/Lugar Agregado

1229 Campbell RdHouston, TX 77055(713) 467-6600

William C Stewart, MD

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Page 43: Provider Directory Addendum

Other Changes to the Provider Network

Otros cambios a la Red de Proveedores

Houston Eye Associates, P.A.

Location Added/Lugar Agregado

9230 Katy Frwy Ste 550Houston, TX 77025(713) 467-6600

Kristin A Minkowski, MD

Houston Eye Associates, P.A.

Location Added/Lugar Agregado

12121 Richmond Avenue Ste 220Houston, TX 77082(713) 558-8775

Lucy A Bailey, MD

Houston Eye Associates, P.A.

Location Added/Lugar Agregado

2855 GramercyHouston, TX 77025(713) 665-7600

Lucy A Bailey, MD

Houston Eye Associates, P.A.

Location Added/Lugar Agregado

2855 GramercyHouston, TX 77025(713) 668-6828

Kristin A Minkowski, MD

Ravi S Shah, MD

Sandip Suresh, MD

William C Stewart, MD

Houston Eye Associates, P.A.

Location Added/Lugar Agregado

1415 N Loop West Ste 400Houston, TX 77008(713) 869-6400

Kristin A Minkowski, MD

William C Stewart, MD

Kelsey-Seybold Clinic

Berthelsen Main Campus

Location Added/Lugar Agregado

2727 West Holcombe BlvdHouston, TX 77025(713) 442-0000

Charlene Hong Crockett, MD●

Montgomery County

Montgomery Condado

City of Kingwood

Ciudad de Kingwood

Houston Eye Associates, P.A.

Location Added/Lugar Agregado

22659 Hwy 59 North Ste 100Kingwood, TX 77339(281) 858-3937

Kristin A Minkowski, MD

City of Shenandoah

Ciudad de Shenandoah

Houston Eye Associates, P.A.

Location Added/Lugar Agregado

1699 Research Forest Dr Ste 150Shenandoah, TX 77380(281) 363-2155

Kristin A Minkowski, MD

William C Stewart, MD

Kelsey-Seybold Clinic-The

Woodlands

Location Added/Lugar Agregado

106 Vision Park BlvdShenandoah, TX 77384(713) 442-1800

Salman A Rahman, MD●

Orthopedic Surgery

Cirugía ortopédica

Brazoria County / Condado

City of Lake Jackson

Ciudad de Lake Jackson

BSLMG Brazosport Bone & Joint

of Lake Jackson

Location Added/Lugar Agregado

217A Oak Dr SouthLake Jackson, TX 77566(979) 299-6900

Charles E Vega, MD●

City of Pearland

Ciudad de Pearland

Kelsey-Seybold Clinic- Pearland

Location Added/Lugar Agregado

2515 Business Ctr DrPearland, TX 77584(713) 442-7200

Jason E Kappa, MD●

Fort Bend County

Fort Bend Condado

City of Sugar Land

Ciudad de Sugar Land

Kelsey-Seybold Fort Bend

Medical and Diagnostic Center

Location Added/Lugar Agregado

11555 University BlvdSugar Land, TX 77478(713) 442-9100

Jason E Kappa, MD●

Galveston County

Galveston Condado

City of League City

Ciudad de League City

UT Physicians Orthopedics -

League City

Location Added/Lugar Agregado

2555 S Gulf Frwy Ste 500League City, TX 77573(713) 486-6000

David A Crumbie, MD●

Eddie H Huang, MD●

Taggart T Gauvain, MD●

Zayde A Radwan, MD●

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Harris County / Condado

City of Bellaire

Ciudad de Bellaire

UT Physicians Orthopedics at

Memorial Hermann Orthopedic

and Spine Hospital

Location Added/Lugar Agregado

5420 West Loop South Ste 2400Bellaire, TX 77401(713) 486-3550

Kyle R Woerner, MD●

UT Physicians Orthopedics at

Memorial Hermann Orthopedic

and Spine Hospital

Location Termed/Lugar

Terminada

5420 West Loop SouthBellaire, TX 77401(713) 486-3550

Adam M Freedhand, MD●

City of Houston

Ciudad de Houston

Ironman Sports Medicine

Institute - Texas Medical

Center

Location Termed/Lugar

Terminada

6400 Fannin StHouston, TX 77030(713) 486-7860

Shah-Nawaz Dodwad, MD●

TMHPO Orthopedics

Department

Location Added/Lugar Agregado

14906 El Camino RealHouston, TX 77062(713) 363-9090

Jamie Alexander, MD

TMHPO Orthopedics

Department

Location Added/Lugar Agregado

2020 Nasa Pkwy Ste 200Houston, TX 77058(713) 363-9090

Michael A Monmouth, MD

TMHPO Orthopedics

Department

Location Added/Lugar Agregado

2020 Nasa Pkwy Ste 230Houston, TX 77058(713) 363-9090

Jamie Alexander, MD

Jason T Leaseburg, MD

TMHPO Orthopedics

Department

Location Termed/Lugar

Terminada

2020 Nasa Pkwy Ste 230Houston, TX 77058(713) 363-9090

Jay S Croley, MD

Juan Antonio Serrato, MD

Kenneth Brooks Brooks, MD

TMHPO Orthopedics

Department

Phone Number Change/Cambio

de número de teléfono

6445 Main St Ste 2500Houston, TX 77030(713) 441-9499

Darrell S Hanson, MD

UT Physicians Orthopedics -

Texas Medical Center

Location Added/Lugar Agregado

6400 Fannin St Ste 2250Houston, TX 77030(713) 486-7500

Ran Lador, MD●

UT Physicians Orthopedics at

Ironman Sports Medicine

Institute - Texas Medical Center

Location Added/Lugar Agregado

6400 Fannin St Ste 1700Houston, TX 77030(713) 486-4880

Ran Lador, MD●

UT Physicians Orthopedics at

Ironman Sports Medicine

Institute-TMC

Location Added/Lugar Agregado

6400 Fannin StHouston, TX 77030(713) 486-7500

Kyle R Woerner, MD●

City of Pasadena

Ciudad de Pasadena

BSLMG East Houston

Orthopedics

Phone Number Change/Cambio de

número de teléfono

4500 E Sam Houston Pkwy SPasadena, TX 77505(281) 487-7300

David C Randall, MD●

BSLMG East Houston

Orthopedics

Phone Number Change/Cambio de

número de teléfono

4500 E Sam Houston Pkwy SPasadena, TX 77505(713) 378-8230

Edward Brooke Roberts, MD●

Kelsey-Seybold Clinic-Pasadena

Location Added/Lugar Agregado

5001 E Sam Houston Pkwy SPasadena, TX 77505(713) 442-7100

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Page 45: Provider Directory Addendum

Other Changes to the Provider Network

Otros cambios a la Red de Proveedores

Catherine Wynne Cahill, MD●

Montgomery County

Montgomery Condado

City of The Woodlands

Ciudad de The Woodlands

UT Physicians - Orthopaedics

Location Termed/Lugar

Terminada

9305 Pinecroft DrThe Woodlands, TX 77380(713) 486-8800

Shah-Nawaz Dodwad, MD●

Orthopedics - Sports Medicine

Ortopedia - Medicina del

Deporte

Brazoria County / Condado

City of Pearland

Ciudad de Pearland

TMHPO Department of

Orthopedics

Phone Number Change/Cambio

de número de teléfono

8520 West Broadway Ste 100Pearland, TX 77584(832) 736-9779

Taylor D Brown, MD

Harris County / Condado

City of Houston

Ciudad de Houston

TMHPO Department of

Orthopedics

Phone Number Change/Cambio

de número de teléfono

6550 Fannin St Ste 2601Houston, TX 77030(713) 790-1818

Taylor D Brown, MD

Otolaryngology

Otorrinolaringología

Harris County / Condado

City of Houston

Ciudad de Houston

Houston Methodist ENT

Specialists

Location Added/Lugar Agregado

6550 Fannin Ste 1723Houston, TX 77030(713) 441-1368

Nadia Gul Mohyuddin, MD

Pain Management

Tratamiento del dolor

Harris County / Condado

City of Houston

Ciudad de Houston

TMHPO Neurosurgery

Department

Location Termed/Lugar

Terminada

2020 Nasa Pkwy Ste 230Houston, TX 77058(713) 363-9090

Heather D Colmenter, MD

Pain Medicine

Medicina del dolor

Harris County / Condado

City of Harris

Ciudad de Harris

Baylor McNair - PM&R

Location Added/Lugar Agregado

7200 Cambridge St 10th Fl Ste 10 BHarris, TX 77030(713) 798-7246

Emanuel N Husu, MD●

City of Houston

Ciudad de Houston

Baylor Medicine - Pain

Management

Location Added/Lugar Agregado

7200 Cambridge St 9th Fl Ste 9 BHouston, TX 77030(713) 798-4357

Emanuel N Husu, MD●

Plastic Surgery

Cirugía Plástica

Harris County / Condado

City of Houston

Ciudad de Houston

Kelsey-Seybold Spring Medical

and Diagnostic Center

Location Termed/Lugar Terminada

15655 Cypress Woods Medical Dr Ste 100Houston, TX 77014(713) 442-1700

Yoav Kaufman, MD●

City of Katy

Ciudad de Katy

UT Physicians Pediatric Center -

Katy

Location Termed/Lugar Terminada

23920 Katy Frwy Ste 220Katy, TX 77494(713) 486-7950

Phuong D Nguyen, MD●

Pulmonology

Neumonología

Harris County / Condado

City of Houston

Ciudad de Houston

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Kelsey-Seybold Clinic

Memorial City

Location Added/Lugar Agregado

929 Gessner Ste 1450Houston, TX 77024(713) 442-5200

Justo A Montalvo, MD●■

City of Katy

Ciudad de Katy

Kelsey-Seybold West Grand

Parkway Clinic

Location Added/Lugar Agregado

2510 West Grand Pkwy NorthKaty, TX 77449(713) 442-4222

Justo A Montalvo, MD●■

Rehabilitation Medicine

Medicina de Rehabilitación

Harris County / Condado

City of Bellaire

Ciudad de Bellaire

UT Physicians Physical

Medicine & Rehabilitation

Sports Medicine & Spine Clinic

Location Added/Lugar Agregado

5420 West Loop South Ste 1100Bellaire, TX 77401(713) 486-5590

Matthew J Lin, MD●

City of Houston

Ciudad de Houston

Baylor McNair - PM&R

Location Added/Lugar Agregado

7200 Cambridge St 10th Fl Ste 10 BHouston, TX 77030(713) 798-7246

Angela N Cortez, MD●

Michael Y Lee, MD●

Ming-Chyi Hsieh, MD●

Yonghoon Lee, DO●

Baylor Medicine - Pain

Management

Location Added/Lugar Agregado

7200 Cambridge St 9th Fl Ste 9 BHouston, TX 77030(713) 798-4357

Michael Y Lee, MD●

Yonghoon Lee, DO●

Kelsey-Seybold Clinic

Berthelsen Main Campus

Location Added/Lugar Agregado

2727 West Holcombe BlvdHouston, TX 77025(713) 442-0000

Miguel E Velez, MD●

Kelsey-Seybold Clinic-Cypress

Location Added/Lugar Agregado

13105 Wortham Ctr DrHouston, TX 77065(713) 442-4000

Joslyn John, MD●

Kelsey-Seybold

Clinic-Tanglewood

Location Added/Lugar Agregado

1111 Augusta DrHouston, TX 77057(713) 442-2400

Vinay Vanodia, MD●

Kelsey-Seybold Clinic-The

Vintage

Location Added/Lugar Agregado

10701 Vintage Preserve PkwyHouston, TX 77070(713) 442-1500

Vinay Vanodia, MD●

Kelsey-Seybold Spring Medical

and Diagnostic Center

Location Added/Lugar Agregado

15655 Cypress Woods Medical Dr Ste 100Houston, TX 77014(713) 442-1700

Miguel E Velez, MD●

TIRR Outpatient Medical Clinic

Location Added/Lugar Agregado

1333 Moursund St 1st FlHouston, TX 77030(713) 799-5000

Matthew J Lin, MD●

UT Physicians Physical Medicine

and Rehabilitation - TIRR

Memorial Hermann

Phone Number Change/Cambio de

número de teléfono

1333 Moursund StHouston, TX 77030(713) 797-5929

Radha Korupolu, MD●

UTHealth COVID-19 Center of

Excellence

Location Added/Lugar Agregado

6410 Fannin St Ste 1220Houston, TX 77030(713) 486-2619

Matthew J Lin, MD●

City of Katy

Ciudad de Katy

Kelsey-Seybold West Grand

Parkway Clinic

Location Added/Lugar Agregado

2510 West Grand Pkwy NorthKaty, TX 77449(713) 442-4222

Vinay Vanodia, MD●

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales45

Page 47: Provider Directory Addendum

Other Changes to the Provider Network

Otros cambios a la Red de Proveedores

Montgomery County

Montgomery Condado

City of The Woodlands

Ciudad de The Woodlands

Memorial Hermann Hospital-

The Woodlands

Location Added/Lugar Agregado

9250 Pinecroft DrThe Woodlands, TX 77380(713) 897-4908

Mary E Russell, DO●

UT Physicians Physical

Medicine and Rehabilitation -

The Woodlands

Location Termed/Lugar

Terminada

9180 Pinecroft Ste 420The Woodlands, TX 77380(713) 486-5590

Mary E Russell, MD●

Rheumatology

Reumatología

Brazoria County / Condado

City of Pearland

Ciudad de Pearland

Methodist Academic Medicine

Associates

Phone Number Change/Cambio

de número de teléfono

8520 Broadway St Ste 220Pearland, TX 77584(713) 363-8600

Hiba Ali, MD●

Sleep Medicine

Medician del sueño

Brazoria County / Condado

City of Pearland

Ciudad de Pearland

Kelsey-Seybold Clinic-

Pearland

Location Added/Lugar Agregado

2515 Business Ctr DrPearland, TX 77584(713) 442-7200

Suresh Daniel, MD●

Harris County / Condado

City of Houston

Ciudad de Houston

Kelsey-Seybold Clinic

Berthelsen Main Campus

Location Added/Lugar Agregado

2727 West Holcombe BlvdHouston, TX 77025(713) 442-0000

Ali Al-Himyary, MD●

Suresh Daniel, MD●

Kelsey-Seybold

Clinic-Tanglewood

Location Added/Lugar Agregado

1111 Augusta DrHouston, TX 77057(713) 442-2400

Ali Al-Himyary, MD●

Montgomery County

Montgomery Condado

City of Shenandoah

Ciudad de Shenandoah

Kelsey-Seybold Clinic-The

Woodlands

Location Added/Lugar Agregado

106 Vision Park BlvdShenandoah, TX 77384(713) 442-1800

Ali Al-Himyary, MD●

Sports Medicine

Medicina deportiva

Harris County / Condado

City of Houston

Ciudad de Houston

TMHPO Orthopedics Department

Location Added/Lugar Agregado

2020 Nasa Pkwy Ste 230Houston, TX 77058(713) 363-9090

Javier Rios, MD

Urology / Urología

Fort Bend County

Fort Bend Condado

City of Sugar Land

Ciudad de Sugar Land

Baylor McNair - Urology

Location Termed/Lugar Terminada

1327 Lake Pointe PkwySugar Land, TX 77478(713) 798-4001

Victor M Lizarraga, MD●

Harris County / Condado

City of Houston

Ciudad de Houston

Baylor McNair - Urology

Location Termed/Lugar Terminada

7200 Cambridge St 10th Fl Ste 10BHouston, TX 77030(713) 798-4001

Victor M Lizarraga, MD●

Kelsey-Seybold Clinic-Cypress

Location Added/Lugar Agregado

13105 Wortham Ctr DrHouston, TX 77065(713) 442-4000

Evan P Wenker, MD●

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Other Changes to the Provider Network

Otros cambios a la Red de Proveedores

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Kelsey-Seybold Spring Medical

and Diagnostic Center

Location Added/Lugar Agregado

15655 Cypress Woods Medical Dr Ste 100Houston, TX 77014(713) 442-1700

Evan P Wenker, MD●

Michael Pan, MD●

Scott Department of Urology

Location Added/Lugar Agregado

6624 Fannin StHouston, TX 77030(713) 798-4001

Larry I Lipshultz, MD●

Scott Department of Urology

Location Added/Lugar Agregado

6624 Fannin St Ste 1700Houston, TX 77030(713) 798-4001

Larry I Lipshultz, MD●

City of Humble

Ciudad de Humble

Kelsey-Seybold Clinic-Summer

Creek

Location Added/Lugar Agregado

8233 N Sam Houston Pkwy EHumble, TX 77396(713) 442-2000

Michael Pan, MD●

City of Tomball

Ciudad de Tomball

Texas Oncology

Phone Number Change/Cambio

de número de teléfono

506 Graham Dr Ste 150Tomball, TX 77375(281) 351-5174

Steven W Sukin, MD■

Montgomery County

Montgomery Condado

City of Conroe

Ciudad de Conroe

Texas Oncology

Location Termed/Lugar

Terminada

17198 St. Luke's Way Ste 305Conroe, TX 77384(281) 351-5174

Steven W Sukin, MD■

City of Porter

Ciudad de Porter

Kelsey-Seybold

Clinic-Kingwood

Location Added/Lugar Agregado

25553 US Hwy 59Porter, TX 77365(713) 442-2100

Michael Pan, MD●

City of Shenandoah

Ciudad de Shenandoah

Kelsey-Seybold Clinic-The

Woodlands

Location Added/Lugar Agregado

106 Vision Park BlvdShenandoah, TX 77384(713) 442-1800

Evan P Wenker, MD●

Vascular Neurology

Neurología Vascular

Harris County / Condado

City of Houston

Ciudad de Houston

TMHPO Neurology Department

Phone Number Change/Cambio de

número de teléfono

6560 Fannin Ste 802Houston, TX 77030(713) 441-5066

David Chiu, MD

Vascular Surgery

Cirugía vascular

Fort Bend County

Fort Bend Condado

City of Sugar Land

Ciudad de Sugar Land

St. Luke's Sugar Land Medical

Plaza Building

Location Termed/Lugar Terminada

1327 Lake Pointe PkwySugar Land, TX 77478(713) 798-8412

Jayer Chung, MD●

Harris County / Condado

City of Houston

Ciudad de Houston

Methodist Cardiovascular

Surgery Associates

Location Added/Lugar Agregado

18400 Katy Frwy Ste 640Houston, TX 77094(832) 522-8600

Ahmed S Mohamed, MD

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales47

Page 49: Provider Directory Addendum

Facility Additions to Provider Network

Instalaciones Adiciones de Proveedores

Ambulance Transport

Transporte en ambulancia

Harris County / Condado

City of Houston

Ciudad de Houston

Zap Medical Serivces, Inc.

1316 S Loop W

Houston, TX 77054

(281) 914-4635

Durable Medical Equipment

Equipo médico duradero

Tarrant County / Condado

City of South Lake

Ciudad de South Lake

Byram Healthcare Centers, Inc.

1080 S Kimball Ste 140

South Lake, TX 76092

(877) 902-9726

Outpatient Dialysis

Diálisis ambulatoria

Galveston County

Galveston Condado

City of Texas City

Ciudad de Texas City

Fresenius Kidney Care Sandcastle Dialysis Center

8900 Emmett F Lowry Expy Ste 201

Texas City, TX 77591

(409) 933-0406

Fresenius Kidney Care Texas City Dialysis Center

3567 Palmer Hwy Ste C

Texas City, TX 77590

(409) 948-9300

Harris County / Condado

City of Cypress

Ciudad de Cypress

Fresenius Kidney Care Fairfield

20435 Cypresswod Dr

Cypress, TX 77433

(346) 254-6687

City of Houston

Ciudad de Houston

USRenal Care Gulfgate, LLC

2916 Woodridge Dr

Houston, TX 77087

(346) 772-0517

Fresenius Kidney Care Hillcroft Dialysis Center

6015 Hillcroft Ste 300

Houston, TX 77081

(713) 772-0992

Fresenius Kidney Care North Shepherd

7112 Stuebner Airline Rd

Houston, TX 77091

(713) 490-7382

City of Pasadena

Ciudad de Pasadena

Fresenius Kidney Care Pasadena-Crenshaw

5040 Crenshaw Rd Ste 200

Pasadena, TX 77505

(832) 703-0450

Montgomery County

Montgomery Condado

City of Conroe

Ciudad de Conroe

US Renal Care Conroe Dialysis

200 S Rivershire Dr Ste 100

Conroe, TX 77304

(936) 270-8400

Surgical Services

Servicios Quirúrgicos

Brazoria County / Condado

City of Lake Jackson

Ciudad de Lake Jackson

Meah ASC Management , LLC

109 Parking Way St

Lake Jackson, TX 77566

(979) 292-0033

Harris County / Condado

City of Houston

Ciudad de Houston

Memorial Hermann Surgery Center Main Street

7515 S Main St Ste 800

Houston, TX 77030

(713) 799-9790

Facility

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Adiciones a los Proveedores de Salud Mental

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Counselor / Consejero

Brazoria County / Condado

City of Alvin

Ciudad de Alvin

Stephen F Austin Community

Health Center Inc

1111 W Adoue StAlvin, TX 77511(281) 824-1480

Faith Worley, MSW

Stephen F Austin Community

Health Center Inc

1612 Callaway DrAlvin, TX 77511(281) 824-1480

Faith Worley, MSW

Stephen F Austin Community

Health Center Inc

218 E House StAlvin, TX 77511(281) 824-1480

Faith Worley, MSW

The Gulf Coast Center

101 Brennen LnAlvin, TX 77511(800) 643-0967

Christen D Dobbs, MSW

City of Angleton

Ciudad de Angleton

Stephen F Austin Community

Health Center Inc

2020 E Mulberry StAngleton, TX 77515(281) 824-1480

Faith Worley, MSW

The Gulf Coast Center

101 Tigner StAngleton, TX 77515(800) 643-0967

Christen D Dobbs, MSW

The Gulf Coast Center

101 Tigner St Bldg 2Angleton, TX 77515(800) 643-0967

Christen D Dobbs, MSW

The Gulf Coast Center

2352 E Mulberry StAngleton, TX 77515(800) 643-0967

Christen D Dobbs, MSW

City of Clute

Ciudad de Clute

Stephen F Austin Community

Health Center Inc

792 N Hwy 288BClute, TX 77531(281) 824-1480

Faith Worley, MSW

City of Freeport

Ciudad de Freeport

Stephen F Austin Community

Health Center Inc

905 N Gulf BlvdFreeport, TX 77541(281) 824-1480

Faith Worley, MSW

City of Lake Jackson

Ciudad de Lake Jackson

Stephen F Austin Community

Health Center Inc

500 College Dr Rm B112Lake Jackson, TX 77566(281) 824-1480

Faith Worley, MSW

City of Pearland

Ciudad de Pearland

Happier Living

11200 Broadway St Ste 2743Pearland, TX 77584(888) 684-2779

Jacquelyn Hafford, MSW

Malinda P Bickham Logan, MSW

Mark W Chapman, MSW

Tonya Norman, MSW

Pearland Psychiatric Associates

PLLC

2743 Smith Ranch Rd Unit 101Pearland, TX 77584(281) 778-9530

Cicely M Betts, MSW

Stephen F Austin Community

Health Center Inc

2552 Broadway St Ste 102Pearland, TX 77581(281) 824-1480

Faith Worley, MSW

Texas Behavioral Health

12234 Shadow Creek Pkwy Ste 4104Pearland, TX 77584(281) 315-9508

Kathleen Lanini, MSW

Fort Bend County

Fort Bend Condado

City of Katy

Ciudad de Katy

Happier Living

2717 Commercial Ctr Blvd Ste E200Katy, TX 77494(888) 684-2779

Jacquelyn Hafford, MSW

Malinda P Bickham Logan, MSW

Mark W Chapman, MSW

Tonya Norman, MSW

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales49

Page 51: Provider Directory Addendum

Additions to Mental Health Providers

Adiciones a los Proveedores de Salud Mental

City of Missouri City

Ciudad de Missouri City

Solace Center Sienna

5777 Sienna Pkwy Ste 350Missouri City, TX 77459(281) 778-8715

Raymond St Germain, MSW

Solace Psychiatry Clinic PLLC

4502 Riverstone Blvd Ste 601Missouri City, TX 77459(281) 778-9530

Cicely M Betts, MSW

City of Rosenberg

Ciudad de Rosenberg

Supportive Care LLC

1419 Mahlmann StRosenberg, TX 77471(718) 506-1115

Sharen Torrence, MSW

UT Physicians

5115 Avenue H Ste 701Rosenberg, TX 77471(713) 486-1950

Eric D McClure, MSW

City of Sugar Land

Ciudad de Sugar Land

Happier Living

14090 Southwest Fwy Ste 300Sugar Land, TX 77478(888) 684-2779

Jacquelyn Hafford, MSW

Malinda P Bickham Logan, MSW

Mark W Chapman, MSW

Tonya Norman, MSW

Rhema Therapeutic Counseling

and Consulting, LLC

17424 W Grand Pkwy S 132Sugar Land, TX 77479(720) 585-1295

April R Thomas Kenney, MSW

Galveston County

Galveston Condado

City of Bacliff

Ciudad de Bacliff

Stephen F Austin Community

Health Center Inc

1136 Grand AveBacliff, TX 77518(281) 824-1480

Faith Worley, MSW

City of Dickinson

Ciudad de Dickinson

UTMB Faculty Group Practice

2401 FM 646 Rd W Ste CDickinson, TX 77539(281) 614-1256

Elizabeth C Latiolais, MSW

City of Friendswood

Ciudad de Friendswood

Progressive Behavioral Health

PLLC

308 S Friendswood Dr Ste 110Friendswood, TX 77546(281) 993-3733

Patricia Figueroa-Cruz, MSW

City of Galveston

Ciudad de Galveston

The Gulf Coast Center

123 Rosenberg St Ste 4Galveston, TX 77550(800) 643-0967

Christen D Dobbs, MSW

UTMB Faculty Group Practice

6710 Stewart Rd Ste 100Galveston, TX 77551(409) 744-4030

Elizabeth C Latiolais, MSW

UTMB Faculty Group Practice

400 Harborside Dr Ste 104Galveston, TX 77550(409) 772-2166

Elizabeth C Latiolais, MSW

City of League City

Ciudad de League City

Happier Living

2600 S Shore Blvd Ste 300League City, TX 77573(888) 684-2779

Jacquelyn Hafford, MSW

Malinda P Bickham Logan, MSW

Mark W Chapman, MSW

Tonya Norman, MSW

Stephen F Austin Community

Health Center Inc

2360 Gulf Fwy SLeague City, TX 77573(281) 824-1480

Faith Worley, MSW

City of Texas City

Ciudad de Texas City

The Gulf Coast Center

3201 FM 2004 RdTexas City, TX 77591(800) 643-0967

Christen D Dobbs, MSW

The Gulf Coast Center

7510 FM 1765Texas City, TX 77591(800) 643-0967

Christen D Dobbs, MSW

Harris County / Condado

City of Atascocita

Ciudad de Atascocita

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Additions to Mental Health Providers

Adiciones a los Proveedores de Salud Mental

Ad

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SonderMind Provider Network

18700 W Lake Houston Pkwy Ste A102Atascocita, TX 77346(844) 843-7279

Alexander MacDonald, MSW

City of Baytown

Ciudad de Baytown

Deer Oaks Consultation

Services PC

2000 W Baker RdBaytown, TX 77521(210) 569-8605

April Micheau, MSW

City of Bellaire

Ciudad de Bellaire

Happier Living

6575 West Loop S Ste 500Bellaire, TX 77401(888) 684-2779

Jacquelyn Hafford, MSW

Malinda P Bickham Logan, MSW

Mark W Chapman, MSW

Tonya Norman, MSW

St Hope Foundation Inc

6800 West Loop S Ste 560Bellaire, TX 77401(713) 839-7111

Priscilla A Francis, MSW

City of Houston

Ciudad de Houston

Bayou Behavioral Healthcare

Services Inc

2922 Rosedale StHouston, TX 77004(713) 874-1234

David Lee, MSW

Better Now LLC

2705 Cohn Arbor LnHouston, TX 77007(248) 914-2675

Marian Aguwa, MSW

Bright Heart Health Inc

1700 Post Oak Blvd Ste 600Houston, TX 77056(800) 892-2695

Katherine B Myers, MSW

Community Care Counseling

INC

340 N Sam Houston Pkwy E Ste A232Houston, TX 77060(877) 306-4600

Sara D Lewis, MSW

Deblin Health Concepts and

Associates

13201 Northwest Fwy Ste 800Houston, TX 77040(713) 686-9194

Erica N Madlock, MSW

Deblin Health Concepts and

Associates

6110 Pinemont Dr Ste 106Houston, TX 77092(713) 686-9194

Callie M Mackenzie, MSW

Eduardo A Vargas, MSW

Erica N Madlock, MSW

Family Service Center At

Houston and Harris County

4625 Lillian StHouston, TX 77007(713) 861-4849

Kathryn Foster, MSW

Happier Living

363 N Sam Houston Pkwy E Ste 1100Houston, TX 77060(888) 684-2779

Jacquelyn Hafford, MSW

Malinda P Bickham Logan, MSW

Mark W Chapman, MSW

Tonya Norman, MSW

Heights Anxiety and Depression

Center INC

1415 North Loop W Ste 940Houston, TX 77008(832) 940-2352

Maggie Gremillion, MSW

Hopeful Texas PLLC

1100 Nasa Pkwy Ste 110Houston, TX 77058(713) 965-3801

Tara L Greer, MSW

Karitas Counseling PLLC

18506 Green Land Way Ste AHouston, TX 77084(832) 995-2016

Oscar A Guevara, MSW

Kinghaven Counseling Group

6315 Gulfton StHouston, TX 77081(713) 457-4372

Wilma Davis, MSW

Kinghaven Counseling Group

6315 Gulfton St Ste 100Houston, TX 77081(713) 457-4372

Judith A Miller, MSW

Wilma Davis, MSW

Legacy Community Health

Services

1415 California StHouston, TX 77006(713) 351-7360

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales51

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Additions to Mental Health Providers

Adiciones a los Proveedores de Salud Mental

Susan R Loredo, MSW

Legacy Community Health

Services

5620 W Tidwell RdHouston, TX 77091(713) 351-7360

Amber Lane, MSW

Amber Lane, MSW

Legacy Community Health

Services

6500 Rookin St Ste 200Houston, TX 77074(713) 351-7360

Asmait T Gebrekristos, MSW

Legacy Community Health

Services

6550 Mapleridge St Ste 106Houston, TX 77081(713) 351-7360

Sharon R Akinyi Jones, MSW

LifeStance Health PBH

2222 Greenhouse Rd Ste 200BHouston, TX 77084(281) 993-3733

Shaneice Branch, MSW

LifeStance Health PBH

8588 Katy Fwy Ste 350Houston, TX 77024(281) 993-3733

Ann K Johnson, MSW

Sophie Gluzkater, MSW

Minute Clinic, Located Inside

CVS

9101 Hwy 6 NHouston, TX 77095(855) 417-2486

Julie J Strunk, MSW

Sereathia Kesee, MSW

Order My Steps Counseling,

PLLC

16318 Blue Rock Springs DrHouston, TX 77073(281) 948-5055

Kenethia Morgan, MSW

Progressive Behavioral Health

PLLC

3355 W Alabama St Ste 195Houston, TX 77098(281) 993-3733

Ethel M Richard Peterson, MSW

Senior Psychological Care

Dallas I LLC

4635 Southwest Fwy Ste 635Houston, TX 77027(713) 850-0049

Ashly N Huffstatler, MSW

Michelle Hernandez, MSW

Randal Voss, MSW

Senior Psychological Care SA I

LLC

4635 Southwest Fwy Ste 635Houston, TX 77027(713) 850-0049

Twyla H Oliva, MSW

SonderMind Provider Network

9434 Katy Fwy Ste 230Houston, TX 77055(844) 843-7279

Andrea N Steward, MSW

Spring Branch Community

Health Center

8575 Pitner RdHouston, TX 77080(713) 462-6545

Emiliano Herrera, MSW

Spring Branch Community

Health Center

1615 Hillendahl Blvd Ste 100Houston, TX 77055(713) 462-6565

Emiliano Herrera, MSW

Stephen F Austin Community

Health Center Inc

10851 Scarsdale Blvd Ste 160Houston, TX 77089(281) 824-1480

Faith Worley, MSW

Supportive Care LLC

7505 Bellerive DrHouston, TX 77036(718) 506-1115

Sharen Torrence, MSW

The Harris Center for Mental

Health and IDD

1502 Taub LoopHouston, TX 77030(713) 970-7000

Denise A Fenwick, MSW

The Harris Center for Mental

Health and IDD

2627 Caroline StHouston, TX 77004(713) 970-7000

Denise A Fenwick, MSW

The Harris Center for Mental

Health and IDD

3737 Dacoma StHouston, TX 77092(713) 970-7000

Denise A Fenwick, MSW

The Harris Center for Mental

Health and IDD

5901 Long DrHouston, TX 77087(713) 970-7000

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Adiciones a los Proveedores de Salud Mental

Ad

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Denise A Fenwick, MSW

The Harris Center for Mental

Health and IDD

6032 Airline DrHouston, TX 77076(713) 970-7000

Denise A Fenwick, MSW

The Harris Center for Mental

Health and IDD

7200 North Loop EHouston, TX 77028(713) 970-7000

Denise A Fenwick, MSW

The Harris Center for Mental

Health and IDD

9401 Southwest FwyHouston, TX 77074(713) 970-7000

Denise A Fenwick, MSW

Mai Spickelmier Engel, MSW

UT Physicians

818 Ringold StHouston, TX 77088(281) 448-6391

Kendra R Bailey, MSW

UT Physicians

6410 Fannin St Ste 600Houston, TX 77030(713) 704-4000

Eric D McClure, MSW

UT Physicians

6410 Fannin St Ste 500Houston, TX 77030(832) 325-6515

Johanna Pule, MSW

City of Humble

Ciudad de Humble

Minute Clinic, Located Inside

CVS

8000 N Sam Houston Pkwy EHumble, TX 77396(855) 417-2486

Carla Maddox, MSW

Yolanda Owens, MSW

12102 Guadalupe Trail LnHumble, TX 77346(346) 345-9696

Yolanda Owens, MSW

City of Katy

Ciudad de Katy

Deer Oaks Consultation

Services PC

1222 Park West Green DrKaty, TX 77493(210) 569-8605

April Micheau, MSW

Minute Clinic, Located Inside

CVS

602 W Grand Pkwy SKaty, TX 77494(855) 417-2486

Julie J Strunk, MSW

Spring Branch Community

Health Center

19333 Clay RdKaty, TX 77449(713) 462-6555

Emiliano Herrera, MSW

City of Pasadena

Ciudad de Pasadena

Texas Behavioral Health

4102 Woodlawn Ave Ste 210Pasadena, TX 77504(281) 819-1438

Kathleen Lanini, MSW

City of Spring

Ciudad de Spring

Minute Clinic, Located Inside

CVS

24802 Aldine Westfield RdSpring, TX 77373(855) 417-2486

Kenethia Morgan, MSW

Minute Clinic, Located Inside

CVS

3850 FM 2920 RdSpring, TX 77388(855) 417-2486

Sereathia Kesee, MSW

City of The Woodlands

Ciudad de The Woodlands

Creating Connections Counseling

Services PLLC

26400 Kuykendahl Rd Ste C180278The Woodlands, TX 77375(832) 639-8080

Doretha Pengel, MSW

City of Tomball

Ciudad de Tomball

Minute Clinic, Located Inside

CVS

24048 Kuykendahl RdTomball, TX 77375(855) 417-2486

Kenethia Morgan, MSW

Liberty County / Condado

City of Cleveland

Ciudad de Cleveland

Tri County Behavioral Healthcare

2004 Truman StCleveland, TX 77327(281) 432-3000

Shalynn M McFadden, MSW

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales53

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Additions to Mental Health Providers

Adiciones a los Proveedores de Salud Mental

City of Liberty

Ciudad de Liberty

Tri County Behavioral

Healthcare

2000 Panther LnLiberty, TX 77575(936) 334-3299

Shalynn M McFadden, MSW

Montgomery County

Montgomery Condado

City of Conroe

Ciudad de Conroe

Tri County Behavioral

Healthcare

233 Sgt Ed Holcomb Blvd SConroe, TX 77304(936) 521-6100

Shalynn M McFadden, MSW

Tri County Behavioral

Healthcare

706 Old Montgomery RdConroe, TX 77301(936) 538-1102

Shalynn M McFadden, MSW

City of Porter

Ciudad de Porter

Minute Clinic, Located Inside

CVS

23865 FM 1314 RdPorter, TX 77365(855) 417-2486

Carla Maddox, MSW

City of Spring

Ciudad de Spring

Happier Living

24624 Interstate 45 N Ste 200Spring, TX 77386(888) 684-2779

Jacquelyn Hafford, MSW

Malinda P Bickham Logan, MSW

Mark W Chapman, MSW

Tonya Norman, MSW

Paula McDonald-Neely, LCSW,

PLLC

26411 Oak Ridge DrSpring, TX 77380(281) 610-8412

Paula McDonald Neely, MSW

City of The Woodlands

Ciudad de The Woodlands

Happier Living

1790 Hughes Landing Blvd Ste 400The Woodlands, TX 77380(888) 684-2779

Jacquelyn Hafford, MSW

Malinda P Bickham Logan, MSW

Mark W Chapman, MSW

Tonya Norman, MSW

Walker County / Condado

City of Huntsville

Ciudad de Huntsville

Tri County Behavioral

Healthcare

7045 Hwy 75 SHuntsville, TX 77340(936) 291-5800

Shalynn M McFadden, MSW

Psychiatry / Psiquiatría

Brazoria County / Condado

City of Pearland

Ciudad de Pearland

Pearland Psychiatric Associates

PLLC

2743 Smith Ranch Rd Unit 101Pearland, TX 77584(281) 778-9530

Darko Zdilar, MD

Prashant Gajwani, MD

Fort Bend County

Fort Bend Condado

City of Missouri City

Ciudad de Missouri City

Sanjay G. Adhia, MD

22 Foggy Heights LnMissouri City, TX 77459(832) 778-8887

Sanjay G Adhia, MD

UT Physicians

8810 Hwy 6 Ste 100Missouri City, TX 77459(713) 486-1200

Nubia G Lluberes, MD

City of Rosenberg

Ciudad de Rosenberg

The Harris Center for Mental

Health and IDD

4910 Airport AveRosenberg, TX 77471(281) 342-6384

Dominic M Joseph, MD

City of Sugar Land

Ciudad de Sugar Land

St Hope Foundation Inc

14815 Southwest FwySugar Land, TX 77478(281) 277-8571

Carlin D Barnes, MD

Texas Behavioral Health

800 Bonaventure Way Ste 137Sugar Land, TX 77479(281) 819-1438

Raees Ahmed, MD

Galveston County

Galveston Condado

City of Dickinson

Ciudad de Dickinson

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Additions to Mental Health Providers

Adiciones a los Proveedores de Salud Mental

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St Hope Foundation Inc

3750 Medical Park Blvd Ste 150Dickinson, TX 77539(832) 738-1305

Carlin D Barnes, MD

City of Friendswood

Ciudad de Friendswood

LifeStance Health PBH

308 S Friendswood Dr Ste 110Friendswood, TX 77546(281) 993-3733

Darren Fred, MD

Texas Behavioral Health

104 Whispering Pines AveFriendswood, TX 77546(281) 819-1438

Khwaja K Tariq, MD

UTMB Faculty Group Practice

1505 E Winding Way Dr Ste 210Friendswood, TX 77546(835) 505-5050

Stephen A Baughn, MD

City of Galveston

Ciudad de Galveston

The Gulf Coast Center

123 Rosenberg St Ste 4Galveston, TX 77550(800) 643-0967

Kelly A Campbell, MD

City of League City

Ciudad de League City

UTMB Faculty Group Practice

2660 Gulf Fwy SLeague City, TX 77573(409) 762-2328

Stephen A Baughn, MD

Harris County / Condado

City of Bellaire

Ciudad de Bellaire

St Hope Foundation Inc

6800 West Loop S Ste 560Bellaire, TX 77401(713) 839-7111

Carlin D Barnes, MD

City of Houston

Ciudad de Houston

Asian American Health

Coalition

7001 Corporate Dr Ste 120Houston, TX 77036(713) 773-0803

Endra R Sookoor, MD

Baylor College of Medicine

1502 Taub Loop Fl 2Houston, TX 77030(713) 873-4900

Kristen L Guilford, MD

Bharath G Raj

5751 Blythewood St Ste 800Houston, TX 77021(281) 532-5462

Bharath G Raj, MD

Compass Psychiatry Solutions

2026 Wirt Rd Fl 2Houston, TX 77055(409) 420-4430

Arianne Suarez Lago, MD

Fulshear Family Health

Consultants

19255 Park Row Ste 105Houston, TX 77084(346) 251-5901

Madiha Ghayas, MD

Kinghaven Counseling Group

6315 Gulfton St Ste 100Houston, TX 77081(713) 457-4372

Shahid Hussain, MD

Legacy Community Health

Services

12667 Bissonnet StHouston, TX 77099(713) 351-7360

Claire Friedman, MD

Legacy Community Health

Services

6500 Rookin St Ste 200Houston, TX 77074(713) 351-7360

Marguerite Patel, MD

LifeStance Health PBH

3355 W Alabama St Ste 195Houston, TX 77098(281) 993-3733

Sarah Gatumu, MD

Medcare Clinics PLLC

10130 Louetta Rd Ste EHouston, TX 77070(281) 893-3656

Ifeoma N Arene, MD

Medcare Clinics PLLC

12828 Willow Centre Dr Ste EHouston, TX 77066(281) 893-3656

Ifeoma N Arene, MD

Progressive Behavioral Health

PLLC

3355 W Alabama St Ste 195Houston, TX 77098(281) 993-3733

Claire Friedman, MD

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales55

Page 57: Provider Directory Addendum

Additions to Mental Health Providers

Adiciones a los Proveedores de Salud Mental

Psych Matters PLLC

9894 Bissonnet St Ste 175Houston, TX 77036(832) 225-3345

Gerard A Scardino, MD

Spring Branch Community

Health Center

1615 Hillendahl Blvd Ste 100Houston, TX 77055(713) 462-6565

Darice M Rodriguez, MD

St Hope Foundation Inc

255 Northpoint Dr Ste 200Houston, TX 77060(832) 300-8040

Carlin D Barnes, MD

Texas Behavioral Health

50 Briar Hollow Ln Ste 290WHouston, TX 77027(281) 810-7781

Lauren Wilson, MD

The Harris Center for Mental

Health and IDD

1502 Taub LoopHouston, TX 77030(713) 970-7000

Dominic M Joseph, MD

Sandy Y Lee, MD

Shakeel Raza, MD

The Harris Center for Mental

Health and IDD

2627 Caroline StHouston, TX 77004(713) 970-7000

Dominic M Joseph, MD

Sandy Y Lee, MD

Shakeel Raza, MD

The Harris Center for Mental

Health and IDD

3737 Dacoma StHouston, TX 77092(713) 970-7000

Dominic M Joseph, MD

Sandy Y Lee, MD

Shakeel Raza, MD

The Harris Center for Mental

Health and IDD

5901 Long DrHouston, TX 77087(713) 970-7000

Sandy Y Lee, MD

Shakeel Raza, MD

The Harris Center for Mental

Health and IDD

6032 Airline DrHouston, TX 77076(713) 970-7000

Dominic M Joseph, MD

Sandy Y Lee, MD

Shakeel Raza, MD

The Harris Center for Mental

Health and IDD

7011 Southwest FwyHouston, TX 77074(713) 970-7000

Dominic M Joseph, MD

The Harris Center for Mental

Health and IDD

7200 North Loop EHouston, TX 77028(713) 970-7000

Dominic M Joseph, MD

Sandy Y Lee, MD

Shakeel Raza, MD

The Harris Center for Mental

Health and IDD

9401 Southwest FwyHouston, TX 77074(713) 970-7000

Dominic M Joseph, MD

Sandy Y Lee, MD

Shakeel Raza, MD

UT Physicians

4755 Aldine Mail RteHouston, TX 77039(281) 985-7600

Maria J Orejarena, MD

UT Physicians

1941 East RdHouston, TX 77054(713) 486-2700

Michael F Weaver, MD

Vineeth P John, MD

UT Physicians

1941 East Rd Ste 2100Houston, TX 77054(713) 486-2700

Michael F Weaver, MD

Vineeth P John, MD

UT Physicians

2620 E Crosstimbers St Ste 100Houston, TX 77093(713) 486-8550

Mohammed W Ahmed, MD

UT Physicians

2800 S MacGregor WayHouston, TX 77021(713) 741-5000

Alexandra N Duran, MD

Lokesh R Shahani, MD

Nubia G Lluberes, MD

Zeshen Wu, MD

UT Physicians

5656 Kelley StHouston, TX 77026(713) 873-2309

Kawal Bir, MD

City of Kingwood

Ciudad de Kingwood

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● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales

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Page 58: Provider Directory Addendum

Additions to Mental Health Providers

Adiciones a los Proveedores de Salud Mental

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Bharath G Raj

3411 Cedar Knolls Dr Ste BKingwood, TX 77339(281) 532-5462

Bharath G Raj, MD

City of Pasadena

Ciudad de Pasadena

Med Management Associates

5020 Space Ctr BlvdPasadena, TX 77505(888) 365-6271

Yahya Saeed, MD

Liberty County / Condado

City of Cleveland

Ciudad de Cleveland

Tri County Behavioral

Healthcare

2004 Truman StCleveland, TX 77327(281) 432-3000

Arjun G Karkhanis, MD

Daniel R Lavin, MD

Jamon Blood, MD

Kelly A Campbell, MD

Natalia Kazakevich, MD

Samuel D Scott, MD

Susan F Zink, MD

City of Liberty

Ciudad de Liberty

Tri County Behavioral

Healthcare

2000 Panther LnLiberty, TX 77575(936) 334-3299

Arjun G Karkhanis, MD

Daniel R Lavin, MD

Jamon Blood, MD

Kelly A Campbell, MD

Natalia Kazakevich, MD

Samuel D Scott, MD

Susan F Zink, MD

Montgomery County

Montgomery Condado

City of Conroe

Ciudad de Conroe

St Hope Foundation Inc

1414 S Frazier St Ste 105Conroe, TX 77301(936) 441-2440

Carlin D Barnes, MD

St Hope Foundation Inc

1414 S Frazier St Ste 106Conroe, TX 77301(936) 441-2440

Carlin D Barnes, MD

Tri County Behavioral

Healthcare

233 Sgt Ed Holcomb Blvd SConroe, TX 77304(936) 521-6100

Arjun G Karkhanis, MD

Daniel R Lavin, MD

Deana Abdel Reheim, MD

Jamon Blood, MD

Kelly A Campbell, MD

Natalia Kazakevich, MD

Samuel D Scott, MD

Susan F Zink, MD

Victor Stiebel, MD

Zachary Drennan, MD

Tri County Behavioral

Healthcare

706 Old Montgomery RdConroe, TX 77301(936) 538-1102

Arjun G Karkhanis, MD

Daniel R Lavin, MD

Jamon Blood, MD

Kelly A Campbell, MD

Natalia Kazakevich, MD

Samuel D Scott, MD

Susan F Zink, MD

City of The Woodlands

Ciudad de The Woodlands

Progressive Behavioral Health

PLLC

2103 Research Forest Dr Ste 175The Woodlands, TX 77380(281) 993-3733

Sheila M Sasieta, MD

Walker County / Condado

City of Huntsville

Ciudad de Huntsville

Tri County Behavioral Healthcare

7045 Hwy 75 SHuntsville, TX 77340(936) 291-5800

Arjun G Karkhanis, MD

Daniel R Lavin, MD

Jamon Blood, MD

Kelly A Campbell, MD

Natalia Kazakevich, MD

Samuel D Scott, MD

Susan F Zink, MD

Psychology / Psicología

Fort Bend County

Fort Bend Condado

City of Missouri City

Ciudad de Missouri City

Amazing Healthcare Inc.

8511 Rockmont CtMissouri City, TX 77489(713) 259-2250

Eboni T Butler, PHD

Neurocognitive Specailty Group

4501 Cartwright Rd Ste 705Missouri City, TX 77459(281) 954-6828

Jane Booth, PHD

Nicholas Wisdom, PHD

Harris County / Condado

City of Houston

Ciudad de Houston

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales57

Page 59: Provider Directory Addendum

Additions to Mental Health Providers

Adiciones a los Proveedores de Salud Mental

Gulf Coast Neuropsychology

PLLC

1110 Nasa Pkwy Ste 108CHouston, TX 77058(409) 789-1339

Dennis Zgaljardic, PHD

Houston Neuropsychology

Associates, PLLC

11211 Katy Fwy Ste 505Houston, TX 77079(713) 893-7105

Jesse Passler, PHD

Houston Neuropsychology

Associates, PLLC

3100 Timmons Ln Ste 565Houston, TX 77027(713) 893-7105

Jesse Passler, PHD

Jacqueline K Jones, PhD

9525 Katy Fwy Ste 312Houston, TX 77024(713) 463-9449

Jacqueline K Jones, PHD

Kinghaven Counseling Group

6315 Gulfton St Ste 100Houston, TX 77081(713) 457-4372

Yolanda Crosby, PHD

Lone Star Circle of Care

4849 Calhoun Rd Ste 1001AHouston, TX 77204(877) 800-5722

William B Elder, PHD

Moore Mental Health &

Behavioral Services PLLC

17030 Nanes Dr Ste 201Houston, TX 77090(281) 415-1280

Amanda Richter, PhD

Neurocognitive Specailty Group

1300 Bay Area Blvd Ste B15015Houston, TX 77058(281) 954-6828

Jane Booth, PHD

Nicholas Wisdom, PHD

Neurocognitive Specailty Group

10333 Harwin Dr Ste 435Houston, TX 77036(888) 606-0086

Jane Booth, PHD

Psy Med Inc

10125 Katy Fwy Ste 106Houston, TX 77024(214) 348-5557

Rosslyn Douglas, PHD

Psy Med Inc

7505 Fannin St Ste 310Houston, TX 77054(214) 348-5557

Ericka Brothers, PHD

Rosslyn Douglas, PHD

Senior Psychological Care

Dallas I LLC

4635 Southwest Fwy Ste 635Houston, TX 77027(713) 850-0049

David R Egerton, PHD

Senior Psychological Care SA I

LLC

4635 Southwest Fwy Ste 635Houston, TX 77027(713) 850-0049

Roberto Montes, PHD

UT Physicians

6410 Fannin St Ste 130Houston, TX 77030(713) 500-5171

Marion P Zahn, PHD

City of Spring

Ciudad de Spring

Jacqueline K Jones, PhD

3407 Spring Creek DrSpring, TX 77373(713) 859-8240

Jacqueline K Jones, PHD

Montgomery County

Montgomery Condado

City of Shenandoah

Ciudad de Shenandoah

Psy Med Inc

9200 Pinecroft Dr Ste 250Shenandoah, TX 77380(214) 348-5557

Rosslyn Douglas, PHD

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Terminations to Mental Health Providers

Terminaciones a Proveedores de Salud Mental

Through 11/1/2021The following providers are no longer part of the KelseyCare Advantage provider network. If you need help

finding a network provider, please call 713-442-CARE(2273) option 2 or toll-free 1-866-535-8343 (TTY users

should dial 1-866-302-9336), or visit www.kelseycareadvantage.com to access our online searchable directory.

Los siguientes proveedores ya no forman parte de la red de proveedores KelseyCare Advantage. Si necesita

ayuda la búsqueda de un proveedor de la red, por favor llame al 713-442-CARE(2273) opción 2 o al

númerogratuito 1-866-535-8343 (los usuarios de TTY deben marcar 1-866-302-9336) o visite

www.kelseycareadvantage.com para acceder a nuestra búsqueda directorio.

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Counselor / Consejero

Brazoria County / Condado

City of Pearland

Ciudad de Pearland

Jacquelyn Hafford, MSW

11200 Broadway St Ste 2743Pearland, TX 77584(888) 684-2779

Jacquelyn Hafford, MSW

Malinda Bickham Logan, MSW

11200 Broadway St Ste 2743Pearland, TX 77584(888) 684-2779

Malinda P Bickham Logan, MSW

Galveston County

Galveston Condado

City of League City

Ciudad de League City

Mark T Middlebrooks, MSW

614 W Main St Ste 102League City, TX 77573(281) 332-4396

Mark T Middlebrooks, MSW

Harris County / Condado

City of Bellaire

Ciudad de Bellaire

Kenneth R McLeod, MSW

5900 Memorial DR STE 218Bellaire, TX 77401(713) 628-1776

Kenneth R McLeod, MSW

City of Cypress

Ciudad de Cypress

Deundra Johnson, MSW

26265 Northwest FwyCypress, TX 77429(855) 417-2486

Deundra Johnson, MSW

City of Houston

Ciudad de Houston

Amy Friendt, MSW

6110 Pinemont Dr Ste 106Houston, TX 77092(713) 686-9194

Amy C Friend, MSW

Amy Huber, MSW

1502 Taub LoopHouston, TX 77030(713) 970-7000

Amy C Huber, MSW

Destiny Green, MSW

8588 Katy Fwy Ste 350Houston, TX 77024(281) 993-3733

Destiny Green, MSW

Erica Govind Feist, MSW

1111 North Loop W Ste 935Houston, TX 77008(832) 233-3086

Erica Govind Feist, MSW

Erica Madloct, MSW

6110 Pinemont Dr Ste 106Houston, TX 77092(713) 686-9194

Erica N Madlock, MSW

Erin Dow, MSW

4635 Southwest Fwy Ste 635Houston, TX 77027(713) 850-0049

Erin Dow, MSW

Ethel Richard Peterson, MSW

3355 W Alabama St Ste 195Houston, TX 77098(281) 993-3733

Ethel M Richard Peterson, MSW

George Devejian, MSW

4635 Southwest Fwy Ste 635Houston, TX 77027(713) 850-0049

George Devejian, MSW

Jacqueline Garza, MSW

6701 Fannin St Fl 16Houston, TX 77030(832) 822-1900

Jacqueline V Garza, MSW

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales59

Page 61: Provider Directory Addendum

Terminations to Mental Health Providers

Terminaciones a Proveedores de Salud Mental

Through 11/1/2021The following providers are no longer part of the KelseyCare Advantage provider network. If you need help

finding a network provider, please call 713-442-CARE(2273) option 2 or toll-free 1-866-535-8343 (TTY users

should dial 1-866-302-9336), or visit www.kelseycareadvantage.com to access our online searchable directory.

Los siguientes proveedores ya no forman parte de la red de proveedores KelseyCare Advantage. Si necesita

ayuda la búsqueda de un proveedor de la red, por favor llame al 713-442-CARE(2273) opción 2 o al

númerogratuito 1-866-535-8343 (los usuarios de TTY deben marcar 1-866-302-9336) o visite

www.kelseycareadvantage.com para acceder a nuestra búsqueda directorio.

James Fox, MSW

4635 Southwest Fwy Ste 635Houston, TX 77027(713) 850-0049

James Fox, MSW

Jennifer Hanson, MSW

1111 North Loop W Ste 935Houston, TX 77008(832) 233-3086

Jennifer Hanson, MSW

Jessica Medrano Villafana,

MSW

6701 Fannin St Fl 16Houston, TX 77030(832) 822-1900

Jessica E Medrano Villafana, MSW

Joseph Robertt, MSW

401 Branard St Fl 2Houston, TX 77006(713) 529-0037

Joseph E Roberts, MSW

Kimberly Clough, MSW

4635 Southwest Fwy Ste 635Houston, TX 77027(713) 850-0049

Kimberly Clough, MSW

Madeline Vaughn, MSW

303 Jackson Hill StHouston, TX 77007(281) 200-9285

Madeline M Vaughn, MSW

Maria Pasco, MSW

1502 Taub LoopHouston, TX 77030(713) 970-7000

Maria S Pasco, MSW

Maria R Webb, MSW

1415 California StHouston, TX 77006(713) 351-7360

Maria R Webb, MSW

Maria R Webb, MSW

5598 North Fwy Ste A1Houston, TX 77076(713) 351-7360

Maria R Webb, MSW

Mary Locke, MSW

1502 Taub LoopHouston, TX 77030(713) 970-7000

Mary K Locke, MSW

MegAnne Duke, MSW

10777 Westheimer Rd Ste 1100Houston, TX 77042(888) 684-2779

MegAnne R Duke, MSW

Megan Keyser, MSW

1502 Taub LoopHouston, TX 77030(713) 970-7000

Megan E Keyser, MSW

Nancy Hernandez, MSW

4635 Southwest Fwy Ste 635Houston, TX 77027(713) 850-0049

Nancy H Hernandez, MSW

Nieesha Princet, MSW

2222 Greenhouse Rd Ste 200BHouston, TX 77084(281) 993-3733

Nieesha Prince, MSW

Sara D Lewis, MSW

340 N Sam Houston Pkwy E Ste A232Houston, TX 77060(877) 306-4600

Sara D Lewis, MSW

Smithosh Mathew, MSW

6110 Pinemont Dr Ste 106Houston, TX 77092(713) 686-9194

Smithosh Mathew, MSW

Sophie Gluzkater, MSW

50 Briar Hollow Ln Ste 290WHouston, TX 77027(281) 816-5930

Sophie Gluzkater, MSW

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● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales

60

Page 62: Provider Directory Addendum

Terminations to Mental Health Providers

Terminaciones a Proveedores de Salud Mental

Through 11/1/2021The following providers are no longer part of the KelseyCare Advantage provider network. If you need help

finding a network provider, please call 713-442-CARE(2273) option 2 or toll-free 1-866-535-8343 (TTY users

should dial 1-866-302-9336), or visit www.kelseycareadvantage.com to access our online searchable directory.

Los siguientes proveedores ya no forman parte de la red de proveedores KelseyCare Advantage. Si necesita

ayuda la búsqueda de un proveedor de la red, por favor llame al 713-442-CARE(2273) opción 2 o al

númerogratuito 1-866-535-8343 (los usuarios de TTY deben marcar 1-866-302-9336) o visite

www.kelseycareadvantage.com para acceder a nuestra búsqueda directorio.

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Steven Parks, MSW

4131 S Braeswood BlvdHouston, TX 77025(713) 667-9336

Steven L Parks, MSW

Valencia Robinson, MSW

4635 Southwest Fwy Ste 635Houston, TX 77027(713) 850-0049

Valencia D Robinson, MSW

Victor Reyes, MSW

4635 Southwest Fwy Ste 635Houston, TX 77027(713) 850-0049

Victor M Reyes, MSW

Xiaocan Zhang, MSW

1415 California StHouston, TX 77006(713) 351-7360

Xiaocan S Zhang, MSW

City of Humble

Ciudad de Humble

Jennifer Hanson, MSW

20031 W Lake Houston Pkwy Ste 400Humble, TX 77346(832) 233-3086

Jennifer Hanson, MSW

City of Kingwood

Ciudad de Kingwood

Jennifer Hanson, MSW

2323 Timber Shadows Dr Ste BKingwood, TX 77339(832) 233-3086

Jennifer Hanson, MSW

City of Spring

Ciudad de Spring

Jack Swanson, MSW

6823 Cypresswood DrSpring, TX 77379(281) 376-8006

Jack P Swanson, MSW

Montgomery County

Montgomery Condado

City of Conroe

Ciudad de Conroe

Diana Adelekt, MSW

17600 Interstate 45 SConroe, TX 77384(832) 822-1900

Diana A Adeleke, MSW

City of The Woodlands

Ciudad de The Woodlands

Jo Ann W Vick, MSW

2441 High Timbers Dr Ste 100The Woodlands, TX 77380(281) 367-2337

Jo Ann W Vick, MSW

Psychiatry / Psiquiatría

Brazoria County / Condado

City of Pearland

Ciudad de Pearland

Selma Raheemt, MD

2225 County Rd 90 Ste 115Pearland, TX 77584(832) 947-3562

Selma Raheem, MD

Fort Bend County

Fort Bend Condado

City of Missouri City

Ciudad de Missouri City

Prashant Gajwant, MD

4502 Riverstone Blvd Ste 601Missouri City, TX 77459(281) 778-9549

Prashant Gajwani, MD

Ramaswamy Lakshmanan,

MD

4502 Riverstone Blvd Ste 601Missouri City, TX 77459(281) 778-9530

Ramaswamy Lakshmanan, MD

Galveston County

Galveston Condado

City of Friendswood

Ciudad de Friendswood

Caleb Jordan, MD

308 S Friendswood Dr Ste 110Friendswood, TX 77546(281) 993-3733

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales61

Page 63: Provider Directory Addendum

Terminations to Mental Health Providers

Terminaciones a Proveedores de Salud Mental

Through 11/1/2021The following providers are no longer part of the KelseyCare Advantage provider network. If you need help

finding a network provider, please call 713-442-CARE(2273) option 2 or toll-free 1-866-535-8343 (TTY users

should dial 1-866-302-9336), or visit www.kelseycareadvantage.com to access our online searchable directory.

Los siguientes proveedores ya no forman parte de la red de proveedores KelseyCare Advantage. Si necesita

ayuda la búsqueda de un proveedor de la red, por favor llame al 713-442-CARE(2273) opción 2 o al

númerogratuito 1-866-535-8343 (los usuarios de TTY deben marcar 1-866-302-9336) o visite

www.kelseycareadvantage.com para acceder a nuestra búsqueda directorio.

Caleb L Jordan, MD

Manuel Guillet, MD

308 S Friendswood Dr Ste 110Friendswood, TX 77546(281) 993-3733

Manuel A Guillen, MD

Harris County / Condado

City of Houston

Ciudad de Houston

Amina Abdulla, MD

1502 Taub LoopHouston, TX 77030(713) 970-7000

Amina Abdulla, MD

Bengi B. Melton, MD

1415 California StHouston, TX 77006(832) 548-5000

Bengi B Melton, MD

Bengi B. Melton, MD

3811 Lyons AveHouston, TX 77020(832) 548-5000

Bengi B Melton, MD

Claire Friedman, MD

3355 W Alabama St Ste 195Houston, TX 77098(281) 993-3733

Claire Friedman, MD

David Hunter, MD

1941 East Rd Ste 4358Houston, TX 77054(713) 486-0500

David Hunter, MD

Don M. Mrone, MD

2246 Bissonnet StHouston, TX 77005(713) 630-0930

Don M LaGrone, MD

Elizabeth Ohiku, MD

1502 Taub LoopHouston, TX 77030(713) 970-7000

Elizabeth E Ohiku, MD

Ernest Kendrick, MD

1502 Taub LoopHouston, TX 77030(713) 970-7000

Ernest A Kendrick, MD

Felecia Garner, MD

1502 Taub LoopHouston, TX 77030(713) 970-7000

Felecia I Garner, MD

Gerald Busch, MD

6550 Mapleridge St Ste 210Houston, TX 77081(713) 665-9000

Gerald I Busch, MD

Janis Smeal, MD

1502 Taub LoopHouston, TX 77030(713) 970-7000

Janis L Smeal, MD

Michael McGinnis, MD

1502 Taub LoopHouston, TX 77030(713) 970-7000

Michael R McGinnis, MD

Nathalie A. Farie, MD

1415 California StHouston, TX 77006(832) 548-5000

Nathalie A Marie, MD

Taylor Hise, MD

1502 Taub LoopHouston, TX 77030(713) 970-7000

Taylor L Hise, MD

Zia Uddin, MD

9401 Southwest FwyHouston, TX 77074(713) 970-7000

Zia Uddin, MD

Liberty County / Condado

City of Liberty

Ciudad de Liberty

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● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales

62

Page 64: Provider Directory Addendum

Terminations to Mental Health Providers

Terminaciones a Proveedores de Salud Mental

Through 11/1/2021The following providers are no longer part of the KelseyCare Advantage provider network. If you need help

finding a network provider, please call 713-442-CARE(2273) option 2 or toll-free 1-866-535-8343 (TTY users

should dial 1-866-302-9336), or visit www.kelseycareadvantage.com to access our online searchable directory.

Los siguientes proveedores ya no forman parte de la red de proveedores KelseyCare Advantage. Si necesita

ayuda la búsqueda de un proveedor de la red, por favor llame al 713-442-CARE(2273) opción 2 o al

númerogratuito 1-866-535-8343 (los usuarios de TTY deben marcar 1-866-302-9336) o visite

www.kelseycareadvantage.com para acceder a nuestra búsqueda directorio.

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Angelica Harrelt, MD

2000 Panther LnLiberty, TX 77575(936) 334-3299

Angelica L Harrell, MD

Montgomery County

Montgomery Condado

City of Conroe

Ciudad de Conroe

Humera Danwar, MD

17600 Interstate 45 SConroe, TX 77384(832) 822-1900

Humera N Danwar, MD

Psychology / Psicología

Brazoria County / Condado

City of Pearland

Ciudad de Pearland

Lydia Sagar, PHD

11200 Broadway St Ste 2743Pearland, TX 77584(888) 684-2779

Lydia Sagar, PHD

Fort Bend County

Fort Bend Condado

City of Rosenberg

Ciudad de Rosenberg

Maria R Fragioudakis, PHD

4706 Airport Ave Bldg ARosenberg, TX 77471(281) 238-1750

Maria Fragioudakis, PHD

Harris County / Condado

City of Houston

Ciudad de Houston

David Latini, PHD

401 Branard St Fl 2Houston, TX 77006(713) 529-0037

David M Latini, PHD

Delbert B Price, PHD

8702 S Course DrHouston, TX 77099(210) 615-3428

Delbert B Price, PHD

Erika Loehmke Phelan, PHD

617 Janisch RdHouston, TX 77018(210) 615-3428

Erika Loehmke Phelan, PHD

Jacinda Tucker, PHD

2180 North Loop W Ste 300Houston, TX 77018(346) 204-4632

Jacinda C Tucker, PHD

Jerome Caroselli, PhD

3100 Timmons Ln Ste 565Houston, TX 77027(713) 893-7105

Jerome S Caroselli, PHD

Marsha Gragert, PhD

6701 Fannin St Fl 16Houston, TX 77030(832) 822-1900

Marsha N Gragert, PHD

City of Seabrook

Ciudad de Seabrook

Lisa Bowles, PhD

2600 Nasa Pkwy Ste 101Seabrook, TX 77586(832) 580-7038

Lisa Bowles, PHD

Liberty County / Condado

City of Cleveland

Ciudad de Cleveland

Lisa Bowles, PHD

807 E Hanson StCleveland, TX 77327(281) 592-9222

Lisa Bowles, PHD

Montgomery County

Montgomery Condado

City of The Woodlands

Ciudad de The Woodlands

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales63

Page 65: Provider Directory Addendum

Terminations to Mental Health Providers

Terminaciones a Proveedores de Salud Mental

Through 11/1/2021The following providers are no longer part of the KelseyCare Advantage provider network. If you need help

finding a network provider, please call 713-442-CARE(2273) option 2 or toll-free 1-866-535-8343 (TTY users

should dial 1-866-302-9336), or visit www.kelseycareadvantage.com to access our online searchable directory.

Los siguientes proveedores ya no forman parte de la red de proveedores KelseyCare Advantage. Si necesita

ayuda la búsqueda de un proveedor de la red, por favor llame al 713-442-CARE(2273) opción 2 o al

númerogratuito 1-866-535-8343 (los usuarios de TTY deben marcar 1-866-302-9336) o visite

www.kelseycareadvantage.com para acceder a nuestra búsqueda directorio.

Needhi Bhaga, PHD

5055 W Panther Creek DrThe Woodlands, TX 77381(765) 860-7198

Needhi R Bhaga, PHD

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● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales

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Additions to Vision Service Providers

Adiciones a Proveedores de servicios visión

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Optometry / Optometría

Brazoria County / Condado

City of Pearland

Ciudad de Pearland

Berkeley Eye Center

1535 Cullen Blvd Ste 200Pearland, TX 77581(713) 436-1551

Jeffrey Jeong, OD

Joe Nguyen, OD

Mary Jane Cuevas, OD

Bruce W Cline OD

2005 Broadway StPearland, TX 77581(281) 485-0388

Shannon Lebus, OD

Mann Eye Center

10223 Broadway St Ste JPearland, TX 77584(281) 971-9337

David Riojas, OD

Memorial Eye Center

2705 Broadway St Ste 115Pearland, TX 77581(281) 485-2020

Monica L Gonzales-Deliganis, OD

Phuong Dung Nguyen, OD

Sarah R Zaver, OD

Vinh Nguyen, OD

Fort Bend County

Fort Bend Condado

City of Houston

Ciudad de Houston

Vision Comfort

8751 Hwy 6 S Ste AHouston, TX 77083(281) 498-1381

Sandra Alvarado, OD

City of Katy

Ciudad de Katy

Ifocus Vision

23541 Westheimer Pkwy Ste 100Katy, TX 77494(281) 672-0202

Jennifer Nguyen, OD

Trang T Nguyen, OD

Memorial Eyecare

23701 Cinco Ranch Blvd Ste 170Katy, TX 77494(281) 347-3937

Manvi Madhok, OD

Michael J Everson, OD

Monica L Gonzales-Deliganis, OD

Phuong Dung Nguyen, OD

Sarah R Zaver, OD

Sophia Nooruddin, OD

Vinh Nguyen, OD

Myeyedr

9550 Spring Green Blvd Ste 434Katy, TX 77494(281) 394-7773

Brett W Donaldson, OD

Deepak N Kotecha, OD

Ryann M Donaldson, OD

Tran Michael, OD

Troy C Becker, OD

Myeyedr

1534 W Grand Pkwy SKaty, TX 77494(281) 693-3937

Brett W Donaldson, OD

Bryan E McDaniel, OD

Dan Lam, OD

Deepak N Kotecha, OD

Kent B Wise, OD

Ryann M Donaldson, OD

Tran Michael, OD

Troy C Becker, OD

Wishnow - Sugar Katy

22132 Westheimer PkwyKaty, TX 77450(281) 828-1010

Monica L Gonzales-Deliganis, OD

Phuong Dung Nguyen, OD

Sarah R Zaver, OD

Vinh Nguyen, OD

City of Missouri City

Ciudad de Missouri City

Myeyedr-Missouri City

6026 Hwy 6Missouri City, TX 77459(281) 499-2600

Deepak N Kotecha, OD

City of Richmond

Ciudad de Richmond

Lumi re Eyes & Vision

7101 W Grand Pkwy S Ste 170Richmond, TX 77407(281) 609-2121

Tien K Lu, OD

Tso Richmond Aliana

10177 W Grand Pkwy S Ste 101Richmond, TX 77407(832) 781-2020

Natalia Aksamentov, OD

Sarah Byrnes, OD

City of Rosenberg

Ciudad de Rosenberg

For Eyes Inc

24200 Southwest Fwy Ste 102Rosenberg, TX 77471(000) 000-0000

Beatriz Villegas, OD

City of Sugar Land

Ciudad de Sugar Land

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales65

Page 67: Provider Directory Addendum

Additions to Vision Service Providers

Adiciones a Proveedores de servicios visión

Aeg Texas Professional PLLC

1437 Hwy 6 Ste 400Sugar Land, TX 77478(281) 265-9090

Monica L Gonzales-Deliganis, OD

Phuong Dung Nguyen, OD

Sarah R Zaver, OD

Vinh Nguyen, OD

Berkeley Eye Institute PA

1435 Hwy 6 Ste 202Sugar Land, TX 77478(281) 478-9889

Adam D Miller, OD

Anthony Kruger, OD

Audrey Graham, OD

Chandler Mann, OD

Charles W Hollas, OD

Chase R Hilton, OD

David B Beeler, OD

David A Garza, OD

Dorothy Chou, OD

Flor De Azalea Arenales, OD

Holli A Groff, OD

Jeffrey Jeong, OD

Joe Nguyen, OD

Karl M Ermis, OD

Kayci A Ermis, OD

Keith J Ermis, OD

Macon Newcomer, OD

Marsha Thomas, OD

Mary Jane Cuevas, OD

Nikki S Kokel, OD

Paul M Palumbo, OD

Pontea A Momeni, OD

Preston Davis, OD

Robert E Brumbelow, OD

Robert L Reid, OD

Roosevelt Gloyd, OD

Sarah Weeks, OD

Whitney J Barker, OD

Eye Trends-Sugarland

16200 City WalkSugar Land, TX 77479(000) 000-0000

Roxana T Hemmati, OD

Eyecare Experts

12930 Dairy Ashford Rd Ste 701Sugar Land, TX 77478(713) 340-0000

Zubin Jiwani, OD

Mann Eye Center

15999 City Walk Ste 270Sugar Land, TX 77479(000) 000-0000

Simeen Jhaver, OD

Memorial Eyecare

15337 Southwest FwySugar Land, TX 77478(281) 242-2020

Manvi Madhok, OD

Michael J Everson, OD

Monica L Gonzales-Deliganis, OD

Phuong Dung Nguyen, OD

Sarah R Zaver, OD

Sophia Nooruddin, OD

Vinh Nguyen, OD

Tso Riverstone

18851 University Blvd Ste 220Sugar Land, TX 77479(713) 714-2320

Natalia Aksamentov, OD

Sarah Byrnes, OD

Galveston County

Galveston Condado

City of Friendswood

Ciudad de Friendswood

Parkwood Vision Center

1102 S Friendswood Dr Ste AFriendswood, TX 77546(281) 482-0066

William K Pope, OD

City of League City

Ciudad de League City

Elite Vision Care LLC

1615 W League City Pkwy Ste 100League City, TX 77573(281) 554-7080

Annalisa Erder, OD

Harris County / Condado

City of Baytown

Ciudad de Baytown

Vision Source

6956 Garth RdBaytown, TX 77521(281) 421-1243

Kelsea Skidmore, OD

City of Cypress

Ciudad de Cypress

Cy Fair Eyecare

9740 Barker Cypress Rd Ste 112Cypress, TX 77433(281) 550-7900

Jose Payan, OD

Loraine R Payan, OD

Iluvicare PLLC

7710 Fry Rd Ste 600Cypress, TX 77433(832) 974-2021

Tajal Patel-Darne, OD

Memorial Eye Center

12320 Bark Cypres Rd Ste 400Cypress, TX 77429(281) 373-1020

Dana C Ziskrout, OD

Huy A Nguyen, OD

Katie Pham, OD

Memorial Eye Center

12320 Barker Cypress Rd # 400Cypress, TX 77429(281) 373-1020

Monica L Gonzales-Deliganis, OD

Phuong Dung Nguyen, OD

Sarah R Zaver, OD

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● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales

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Additions to Vision Service Providers

Adiciones a Proveedores de servicios visión

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Vinh Nguyen, OD

Wink Optometry

14119 Grant Rd Ste 200Cypress, TX 77429(949) 933-8279

Joanne Kim, OD

City of Friendswood

Ciudad de Friendswood

Texas State Optical Baybrook

19052 Gulf FwyFriendswood, TX 77546(281) 486-5043

Joe M Salazar, OD

Lori M Gonzales, OD

City of Houston

Ciudad de Houston

Berkeley Eye Center

11110 East Fwy Ste 100CHouston, TX 77029(000) 000-0000

Anthony Kruger, OD

Berkeley Eye Center

18040 Saturn LnHouston, TX 77058(281) 333-8600

Joe Nguyen, OD

Mary Jane Cuevas, OD

Berkeley Eye Center

3100 Weslayan St Ste 400Houston, TX 77027(713) 526-1600

Chandler Mann, OD

Joe Nguyen, OD

Mary Jane Cuevas, OD

Berkeley Eye Center

7438 Harrisburg BlvdHouston, TX 77011(713) 928-3375

Flor De Azalea Arenales, OD

Joe Nguyen, OD

Mary Jane Cuevas, OD

Berkeley Eye Center

902 Frostwood Dr Ste 256Houston, TX 77024(713) 935-9485

Joe Nguyen, OD

Mary Jane Cuevas, OD

Berkeley Eye Center

11110 East Fwy Ste 100CHouston, TX 77029(832) 995-2613

Joe Nguyen, OD

Mary Jane Cuevas, OD

Berkeley Eye Institute

1200 McKinney St Ste 411Houston, TX 77010(000) 000-0000

Anthony Kruger, OD

Berkeley Eye Institute

1200 McKinney St Ste 411Houston, TX 77010(713) 759-9449

Joe Nguyen, OD

Mary Jane Cuevas, OD

Berkeley Eye Institute PA

5419 FM 1960 Rd W Ste CHouston, TX 77069(281) 894-2020

Joe Nguyen, OD

Mary Jane Cuevas, OD

Berkeley Eye Institute PA

8800 Katy Fwy Ste 107Houston, TX 77024(713) 827-8311

Joe Nguyen, OD

Mary Jane Cuevas, OD

Bimal Patel LLC

600 N Shepherd Dr Ste 134Houston, TX 77007(713) 485-6033

Bimal J Patel, OD

Bird's Eye View Optometry

Tanglewood

5706 San Felipe St Ste B400Houston, TX 77057(000) 000-0000

Betty C Cuchilla Hannah, OD

Braeswood Vision

4004 S Braeswood Blvd Ste 200Houston, TX 77025(713) 667-2010

Lon D Cartwright, OD

Corinthian Pointe Tso

5505 W Orem Dr Ste 400Houston, TX 77085(713) 257-8612

Bereket H Tsegai, OD

Maxwell A Olumba, OD

Monica L Gonzales-Deliganis, OD

Rokeisha L Joseph, OD

Ruby Philip, OD

Eye Site at Town and Country

700 TWN N Cntry Blvd Ste 2460Houston, TX 77024(713) 984-9144

Delina Patel, OD

Eyecare Central

1202 Elgin StHouston, TX 77004(713) 739-9008

Ryan N Vo, OD

Eyes on The Heights

2401 N Shepherd DrSte A Ste 110Houston, TX 77008(512) 887-4378

Jennifer Law, OD

Kim Vu, OD

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales67

Page 69: Provider Directory Addendum

Additions to Vision Service Providers

Adiciones a Proveedores de servicios visión

Family Eye Center

17282 State Hwy 249Houston, TX 77064(281) 955-9999

Jantz Chappel, OD

Family Vision Solutions

5177 Richmond Ave Ste 780Houston, TX 77056(713) 349-0224

Sara J Brown, OD

Greater Sights PLLC

3004 Yale St Ste 600Houston, TX 77018(713) 766-6650

Tiffanie R Gorman, OD

Hawk Eye Center

10304 Blackhawk Blvd Ste CHouston, TX 77089(713) 987-5555

David V Nguyen, OD

Hong Bui OD PA

13709 State Hwy 249Houston, TX 77086(281) 893-8027

Rose Hong Bui, OD

Hope Clinic

7001 Corporate Dr Ste 120Houston, TX 77036(713) 773-0803

Amita Patel, OD

Houston Eye Associates Optical

Center

1250 Cypress Station Dr Ste AHouston, TX 77090(281) 444-1677

Mary M Morales, OD

Houston Eye Associates Optical

Center

915 Gessner Rd Ste 250Houston, TX 77024(713) 467-5660

Haleh Ebrahimi, OD

Memorial Eyecare

15080 Memorial DrHouston, TX 77079(281) 531-0300

Manvi Madhok, OD

Michael J Everson, OD

Monica L Gonzales-Deliganis, OD

Phuong Dung Nguyen, OD

Sarah R Zaver, OD

Sophia Nooruddin, OD

Vinh Nguyen, OD

Memorial Eyecare

9620 Westheimer RdHouston, TX 77063(713) 975-9393

Christina S Abuata, OD

Manvi Madhok, OD

Michael J Everson, OD

Monica L Gonzales-Deliganis, OD

Phuong Dung Nguyen, OD

Sarah R Zaver, OD

Sophia Nooruddin, OD

Vinh Nguyen, OD

Memorial Eyecare

2677 Wilcrest DrHouston, TX 77042(713) 977-1170

Christina S Abuata, OD

Manvi Madhok, OD

Michael J Everson, OD

Monica L Gonzales-Deliganis, OD

Phuong Dung Nguyen, OD

Sarah R Zaver, OD

Sophia Nooruddin, OD

Vinh Nguyen, OD

Memorial Oak Forest

1229 W 43rd StHouston, TX 77018(713) 686-3221

Michael J Everson, OD

Monica L Gonzales-Deliganis, OD

Phuong Dung Nguyen, OD

Sarah R Zaver, OD

Sophia Nooruddin, OD

Vinh Nguyen, OD

Memorial West Chase

11805 Westheimer Rd Ste 300Houston, TX 77077(281) 496-3937

Linda T Enciso, OD

Michael J Everson, OD

Monica L Gonzales-Deliganis, OD

Phuong Dung Nguyen, OD

Sarah R Zaver, OD

Sophia Nooruddin, OD

Vinh Nguyen, OD

Montrose Eye Care

520 Waugh DrHouston, TX 77019(713) 300-1477

Nancy K Lo, OD

Myeyedr

6127 FM 1960 Rd WHouston, TX 77069(281) 469-2020

Phuong Loan S Dong, OD

Myeyedr

1635A S Voss RdHouston, TX 77057(713) 954-2020

Deepak N Kotecha, OD

Ivan O Velazquez, OD

Myeyedr

11159 Westheimer RdHouston, TX 77042(713) 978-7504

Anjana Bhakta, OD

Deepak N Kotecha, OD

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● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales

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Additions to Vision Service Providers

Adiciones a Proveedores de servicios visión

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Lin H Tou, OD

Northline Vision

7610 Fulton St Ste AHouston, TX 77022(713) 699-8443

Matthew Pham, OD

Pearle Vision

16929 El Camino RealHouston, TX 77058(346) 230-7273

Zelmira Farmer, OD

Penn Eye Care

17395 State Hwy 249 Ste 312Houston, TX 77064(281) 894-0011

Jeffrey M Penn, OD

Queenston Eye Care

12238 Queenston Blvd Ste KHouston, TX 77095(281) 357-9220

Ashley Hemmati, OD

Scarsdale Eye Care

12507 Scarsdale Blvd Ste BHouston, TX 77089(281) 464-0885

Michael Pham, OD

Texas State Optical

14637 Memorial Dr Ste DHouston, TX 77079(000) 000-0000

Beatriz Villegas, OD

Texas State Optical Museum

District

4850 Main StHouston, TX 77002(000) 000-0000

Sabah Hasan, OD

Todays Vision Rice Village

2366 Rice Blvd Ste AHouston, TX 77005(713) 521-2020

Monica L Gonzales-Deliganis, OD

Phuong Dung Nguyen, OD

Sarah R Zaver, OD

Vinh Nguyen, OD

Twenty 20 Vision Center-Egret

Bay

18333 Egret Bay Blvd Ste 101Houston, TX 77058(281) 488-5169

Megan M Matocha, OD

Reagan M Ratcliff, OD

Unnati Chotai, OD

Uh Eye Center at Heights

190 Heights BlvdHouston, TX 77007(713) 527-8480

Eng Ann Sung, OD

Justin Simbulan, OD

Mary Sain, OD

Miriam Almanza, OD

University of Houston College

of Optometry

4901 Calhoun Rd Ste 1228Houston, TX 77204(713) 743-2020

Eng Ann Sung, OD

Justin Simbulan, OD

Mary Sain, OD

Miriam Almanza, OD

Vision Source

13615 Bellaire BlvdHouston, TX 77083(281) 933-3446

Nicole Pham, OD

Valeri Le, OD

City of Huffman

Ciudad de Huffman

Vista Eye Center

11747 FM 1960 Ste 102Huffman, TX 77336(281) 764-5915

Katy R Owens, OD

City of Humble

Ciudad de Humble

Berkeley Eye Institute

18545 W Lake Houston PkwyHumble, TX 77346(281) 812-4000

Joe Nguyen, OD

Mary Jane Cuevas, OD

Mann Eye Center

9802 FM 1960 Byp Rd W Ste 110Humble, TX 77338(832) 412-1233

Carmen Mosqueda, OD

Texas State Optical Aldine

Westfield PA

3103 FM 1960 Rd W Ste VHumble, TX 77338(281) 443-0340

Waqar Akhtar, OD

City of Katy

Ciudad de Katy

Berkeley Eye Center

21502 Merchants WayKaty, TX 77449(281) 579-6777

Joe Nguyen, OD

Mary Jane Cuevas, OD

Eye Site Dr John O'neil OD

24217 Kingsland BlvdKaty, TX 77494(281) 644-2010

Delina Patel, OD

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales69

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Additions to Vision Service Providers

Adiciones a Proveedores de servicios visión

Houston Eye Associates Optical

Center

1331 W Grand Pkwy N Ste 120Katy, TX 77493(281) 347-0177

Amna Majeed, OD

Michaela Anukwuem, OD

Mann Eye Institute

750 Westgreen BlvdKaty, TX 77450(713) 580-2500

David Riojas, OD

City of La Porte

Ciudad de La Porte

Frazier Eye Center PLLC

9500 Spencer HwyLa Porte, TX 77571(281) 476-5107

Ashley Olivarez, OD

Susana C Moreno, OD

City of Spring

Ciudad de Spring

Aeg Texas Professional PLLC

21195 Kuykendahl RdSpring, TX 77379(832) 843-6369

Monica L Gonzales-Deliganis, OD

Phuong Dung Nguyen, OD

Sarah R Zaver, OD

Vinh Nguyen, OD

Myeyedr

6603 FM 2920 RdSpring, TX 77379(281) 370-4444

David M Way, OD

Deepak N Kotecha, OD

Lauren R Nelson, OD

Urban Eyes Inc

8765 Spring Cypress Rd Ste NSpring, TX 77379(281) 655-9595

Deanna L Gates, OD

City of Tomball

Ciudad de Tomball

Berkeley Eye Institute

14030 FM 2920 Rd Ste ETomball, TX 77377(000) 000-0000

Anthony Kruger, OD

Berkeley Eye Institute

14030 FM 2920 Rd Ste ETomball, TX 77377(281) 351-0744

Joe Nguyen, OD

Mary Jane Cuevas, OD

Glimpse Eye Care

26435 Kuykendahl Rd Ste 800Tomball, TX 77375(000) 000-0000

Khanh Pham, OD

Warren Chen, OD

Houston Eye Associates Optical

Center

13414 Medical Complex Dr Ste 4Tomball, TX 77375(281) 351-5468

Michaela Anukwuem, OD

Mann Eye Center

14079 FM 2920 RdTomball, TX 77377(346) 701-4035

Carmen Mosqueda, OD

Liberty County / Condado

City of Cleveland

Ciudad de Cleveland

Berkeley Eye Center

901 E Houston St Ste BCleveland, TX 77327(281) 659-2020

Mary Jane Cuevas, OD

Montgomery County

Montgomery Condado

City of Kingwood

Ciudad de Kingwood

Berkeley Eye Center

22741 Professional DrKingwood, TX 77339(281) 319-4334

Joe Nguyen, OD

Mary Jane Cuevas, OD

Houston Optic PLLC

22659 Hwy 59 N Ste 100Kingwood, TX 77339(281) 858-3937

Clint Gonzales, OD

Tso Kingwood Northpark PA

25639 Hwy 59 N Ste 109Kingwood, TX 77339(832) 810-2020

Natalia Aksamentov, OD

Sarah Byrnes, OD

City of Shenandoah

Ciudad de Shenandoah

Houston Eye Associates Optical

Center

1699 Research Forest DrSte 150Shenandoah, TX 77380(281) 363-2155

Clint Gonzales, OD

City of Spring

Ciudad de Spring

Mann Eye Institute

1501 Lake Robbins Dr Ste 130Spring, TX 77380(713) 580-2500

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● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales

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Additions to Vision Service Providers

Adiciones a Proveedores de servicios visión

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Carmen Mosqueda, OD

Memorial Eyecare

2319 Rayford Rd Ste 200Spring, TX 77386(281) 601-1001

Linda T Enciso, OD

Manvi Madhok, OD

Michael J Everson, OD

Monica L Gonzales-Deliganis, OD

Phuong Dung Nguyen, OD

Sarah R Zaver, OD

Shelby D Gross, OD

Sophia Nooruddin, OD

Vinh Nguyen, OD

Today's Vision Rayford

2833 Riley Fuzzel Rd Ste 300Spring, TX 77386(000) 000-0000

Manvi Madhok, OD

Today's Vision Rayford

2833 Riley Fuzzel Rd Ste 300Spring, TX 77386(281) 719-9926

Monica L Gonzales-Deliganis, OD

Phuong Dung Nguyen, OD

Sarah R Zaver, OD

Vinh Nguyen, OD

Tso Rayford PA

3535 Rayford Rd Ste 500Spring, TX 77386(832) 791-2020

Natalia Aksamentov, OD

Sarah Byrnes, OD

City of The Woodlands

Ciudad de The Woodlands

Berkeley Eye Center

17450 St Lukes Way Ste 100The Woodlands, TX 77384(000) 000-0000

Joe Nguyen, OD

Berkeley Eye Center

17450 St Lukes Way Ste 100The Woodlands, TX 77384(281) 363-3443

Mary Jane Cuevas, OD

Walker County / Condado

City of Huntsville

Ciudad de Huntsville

Berkeley Eye Institute

2 Financial Plaza Ste 801Huntsville, TX 77340(936) 295-2020

Mary Jane Cuevas, OD

Wharton County / Condado

City of El Campo

Ciudad de El Campo

Berkeley Eye Center

2012 West LoopEl Campo, TX 77437(979) 543-6821

Joe Nguyen, OD

Mary Jane Cuevas, OD

City of Wharton

Ciudad de Wharton

Berkeley Eye Center

1120 N Fulton StWharton, TX 77488(000) 000-0000

Anthony Kruger, OD

Berkeley Eye Center

1120 N Fulton StWharton, TX 77488(979) 532-0805

Joe Nguyen, OD

Mary Jane Cuevas, OD

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales71

Page 73: Provider Directory Addendum

Terminations to Vision Service Providers

Terminaciones a Proveedores de servicios visión

Through 11/1/2021The following providers are no longer part of the KelseyCare Advantage provider network. If you need help

finding a network provider, please call 713-442-CARE(2273) option 2 or toll-free 1-866-535-8343 (TTY users

should dial 1-866-302-9336), or visit www.kelseycareadvantage.com to access our online searchable directory.

Los siguientes proveedores ya no forman parte de la red de proveedores KelseyCare Advantage. Si necesita

ayuda la búsqueda de un proveedor de la red, por favor llame al 713-442-CARE(2273) opción 2 o al

númerogratuito 1-866-535-8343 (los usuarios de TTY deben marcar 1-866-302-9336) o visite

www.kelseycareadvantage.com para acceder a nuestra búsqueda directorio.

Optometry / Optometría

Brazoria County / Condado

City of Pearland

Ciudad de Pearland

Todays Vision

2705 Broadway St Ste 115Pearland, TX 77581(000) 000-0000

Dianne B Dao, OD

Todays Vision

2705 Broadway St Ste 115Pearland, TX 77581(281) 485-2020

Dianne B Dao, OD

Fort Bend County

Fort Bend Condado

City of Katy

Ciudad de Katy

Corporate Eye Care 2 PC

9550 Spring Green Blvd Ste 434Katy, TX 77494(281) 394-7773

Brett W Donaldson, OD

Ryann M Donaldson, OD

Corporate Eye Care PC

1534 W Grand Pkwy SKaty, TX 77494(281) 693-3937

Brett W Donaldson, OD

Ryann M Donaldson, OD

Myeyedr

9550 Spring Green Blvd Ste 434Katy, TX 77494(281) 394-7773

Jorge E Garrett, OD

Myeyedr

1534 W Grand Pkwy SKaty, TX 77494(281) 693-3937

Jorge E Garrett, OD

City of Missouri City

Ciudad de Missouri City

Myeyedr-Missouri City

6026 Hwy 6Missouri City, TX 77459(281) 499-2600

Elissa R Wedemeyer, OD

Jorge E Garrett, OD

City of Rosenberg

Ciudad de Rosenberg

For Eyes Inc

24200 Southwest Fwy Ste 102Rosenberg, TX 77471(281) 342-3554

Shumaila A Haji, OD

Galveston County

Galveston Condado

City of Friendswood

Ciudad de Friendswood

Parkwood Vision Center

1102 S Friendswood Dr Ste AFriendswood, TX 77546(281) 482-0066

William K Pope, OD

City of Galveston

Ciudad de Galveston

DRS Matocha and Ullman

Optometrists

2115 Broadway StGalveston, TX 77550(409) 762-2020

Duane J Ullman, OD

City of League City

Ciudad de League City

Houston Eye Associates

Optical Center

1100 Gulf Fwy S Ste 114League City, TX 77573(281) 332-3937

Thao H Nguyen, OD

City of Texas City

Ciudad de Texas City

Houston Eye Associates

Optical Center

7111 Medical Ctr Dr Ste 110Texas City, TX 77591(000) 000-0000

Thao H Nguyen, OD

Grimes County / Condado

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● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales

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Page 74: Provider Directory Addendum

Terminations to Vision Service Providers

Terminaciones a Proveedores de servicios visión

Through 11/1/2021The following providers are no longer part of the KelseyCare Advantage provider network. If you need help

finding a network provider, please call 713-442-CARE(2273) option 2 or toll-free 1-866-535-8343 (TTY users

should dial 1-866-302-9336), or visit www.kelseycareadvantage.com to access our online searchable directory.

Los siguientes proveedores ya no forman parte de la red de proveedores KelseyCare Advantage. Si necesita

ayuda la búsqueda de un proveedor de la red, por favor llame al 713-442-CARE(2273) opción 2 o al

númerogratuito 1-866-535-8343 (los usuarios de TTY deben marcar 1-866-302-9336) o visite

www.kelseycareadvantage.com para acceder a nuestra búsqueda directorio.

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City of Navasota

Ciudad de Navasota

Navasota Eye Care Center

501 E Washington Ave Ste 5Navasota, TX 77868(936) 825-2273

Belinda S Dobson, OD

Harris County / Condado

City of Cypress

Ciudad de Cypress

Cy Fair Eyecare

9740 Barker Cypress Rd Ste 112Cypress, TX 77433(281) 550-7900

Jose Payan, OD

Loraine R Payan, OD

Eye Trends Barker Cypress

12320 Bark Cypres Rd Ste 400Cypress, TX 77429(000) 000-0000

Huy A Nguyen, OD

Katie Pham, OD

Eye Trends Barker Cypress

12320 Bark Cypres Rd Ste 400Cypress, TX 77429(281) 373-1020

Huy A Nguyen, OD

Katie Pham, OD

City of Friendswood

Ciudad de Friendswood

Texas State Optical of

Baybrook Inc

19052 Gulf FwyFriendswood, TX 77546(281) 486-5043

Douglas R Fingold, OD

Mercy Garcia, OD

Sheril Cherian, OD

City of Houston

Ciudad de Houston

Braeswood Vision

4009 S Braeswood BlvdHouston, TX 77025(713) 667-2010

Lon D Cartwright, OD

Corinthian Pointe Tso

5505 W Orem Dr Ste 400Houston, TX 77085(713) 487-2020

Bereket H Tsegai, OD

Maxwell A Olumba, OD

Rokeisha L Joseph, OD

Ruby Philip, OD

Donald Glenz OD & Associates

6970 FM 1960 Rd W Ste AHouston, TX 77069(281) 469-2020

Donald R Glenz, OD

Phuong Loan S Dong, OD

Eye Doctor Houston PC

4899 Griggs RdHouston, TX 77021(713) 748-5000

Chike R Mordi, OD

Eye Trends- Meyerland Plaza

238 Meyerland Plaza MallHouston, TX 77096(713) 771-2020

Casey Johnston, OD

Eyecare Central

1202 Elgin StHouston, TX 77004(713) 739-9008

Ryan N Vo, OD

Family Eye Center

17282 State Hwy 249Houston, TX 77064(281) 955-9999

Jitesh K Patel, OD

Moes R Nasser, OD

Sarah E Godward, OD

Wendy V Conde, OD

Family Vision Solutions

5177 Richmond Ave Ste 780Houston, TX 77056(713) 349-0224

Kelsea Skidmore, OD

● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales73

Page 75: Provider Directory Addendum

Terminations to Vision Service Providers

Terminaciones a Proveedores de servicios visión

Through 11/1/2021The following providers are no longer part of the KelseyCare Advantage provider network. If you need help

finding a network provider, please call 713-442-CARE(2273) option 2 or toll-free 1-866-535-8343 (TTY users

should dial 1-866-302-9336), or visit www.kelseycareadvantage.com to access our online searchable directory.

Los siguientes proveedores ya no forman parte de la red de proveedores KelseyCare Advantage. Si necesita

ayuda la búsqueda de un proveedor de la red, por favor llame al 713-442-CARE(2273) opción 2 o al

númerogratuito 1-866-535-8343 (los usuarios de TTY deben marcar 1-866-302-9336) o visite

www.kelseycareadvantage.com para acceder a nuestra búsqueda directorio.

Hong Bui OD PA

1412 Cypress Creek Pkwy Ste BHouston, TX 77090(281) 893-8027

Rose Hong Bui, OD

Houston Eye Associates Optical

Center

1415 North Loop W Ste 400Houston, TX 77008(713) 869-6400

Thao H Nguyen, OD

Jeffrey M Penn OD PC

17395 State Hwy 249 Ste 312Houston, TX 77064(281) 894-0011

Jeffrey M Penn, OD

Myeyedr

1635A S Voss RdHouston, TX 77057(713) 954-2020

Jorge E Garrett, OD

Myeyedr

11159 Westheimer RdHouston, TX 77042(713) 978-7504

Jorge E Garrett, OD

Northwest Eye Optical

1740 W 27th St Ste 180Houston, TX 77008(713) 864-8652

Shoshana Nock, OD

SEE-N-FOCUS Optical

1171 Edgebrook DrHouston, TX 77034(713) 941-7190

Lisa G Crouch, OD

Texas State Optical

14637 Memorial Dr Ste DHouston, TX 77079(832) 770-4926

Shumaila A Haji, OD

Texas State Optical Downtown

805 Walker StHouston, TX 77002(713) 654-0042

Danielle Richardson, OD

Today's Vision Tanglewood

5771 San Felipe StHouston, TX 77057(713) 782-3937

Maha Tufail, OD

University of Houston College

of Optometry

4901 Calhoun Rd Ste 1228Houston, TX 77204(713) 743-2020

Kim Anh N Jow, OD

Vision Source Greenway

Galleria PA

3800 Southwest Fwy Ste 112Houston, TX 77027(713) 627-3937

Mary I Shatleh, OD

Moes R Nasser, OD

Vision Source Premier

Optometry PLLC

11159 Westheimer RdHouston, TX 77042(713) 978-7504

Anjana Bhakta, OD

Dixie Yee, OD

Li-Fang Hung, OD

Lin H Tou, OD

Supriya Krishnan, OD

Wishnow Vision Associates

5649 Beechnut StHouston, TX 77096(713) 771-1206

Irving C Wishnow, OD

City of Humble

Ciudad de Humble

Mann Eye Center

9745 FM 1960 Bypass WHumble, TX 77338(832) 412-4658

Brian S Tan, OD

Chau N VI, OD

Christina Guerrero, OD

Martha Gallia, OD

Mylan Nguyen, OD

Paul M Mann, MD

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● Medicaid Provider/Proveedor de Medicaid ■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales

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Page 76: Provider Directory Addendum

Terminations to Vision Service Providers

Terminaciones a Proveedores de servicios visión

Through 11/1/2021The following providers are no longer part of the KelseyCare Advantage provider network. If you need help

finding a network provider, please call 713-442-CARE(2273) option 2 or toll-free 1-866-535-8343 (TTY users

should dial 1-866-302-9336), or visit www.kelseycareadvantage.com to access our online searchable directory.

Los siguientes proveedores ya no forman parte de la red de proveedores KelseyCare Advantage. Si necesita

ayuda la búsqueda de un proveedor de la red, por favor llame al 713-442-CARE(2273) opción 2 o al

númerogratuito 1-866-535-8343 (los usuarios de TTY deben marcar 1-866-302-9336) o visite

www.kelseycareadvantage.com para acceder a nuestra búsqueda directorio.

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Tracy T Kwan, OD

The Vision Source

20119A Hwy 59 NHumble, TX 77338(281) 446-5800

Moes R Nasser, OD

City of Katy

Ciudad de Katy

Dorsey C Blair OD

830 S Mason Rd Ste A2Katy, TX 77450(281) 392-9020

Dorsey C Blair, OD

City of Spring

Ciudad de Spring

Myeyedr

6603 FM 2920 RdSpring, TX 77379(281) 370-4444

Jorge E Garrett, OD

Spring Klein Vision Center

6603 FM 2920 RdSpring, TX 77379(281) 370-4444

David M Way, OD

Lauren R Nelson, OD

Montgomery County

Montgomery Condado

City of The Woodlands

Ciudad de The Woodlands

Texas State Optical Woodlands

1570 Lake Woodlands DrThe Woodlands, TX 77380(281) 681-3937

Kathryn K Clair, OD

● Medicaid Provider/Proveedor de Medicaid■ Spanish Speaking/Se Habla Español◆ Current Patients Only/Solo Pacientes Actuales75