NPI age
8 years
Enumerated 2018-02-21
● Active Type 2 · Organization
Crockett Medical Center, Llc
Crockett Medical Center, Llc is 1 of 15966 family medicine organizations in Texas.
Primary specialty
Family Medicine
Plus 5 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Tjelmeland
Ceo
Last NPPES update
2018-08-28
Source: monthly bulk 2026-05
How this organization compares
Across 15966 active family medicine providers in Texas.
NPI age
8 years
↓ 9 yr below median
Practice locations
1
0 secondary on file
Subspecialties
5
In the 26% of peers with subspecialties
NPI lifetime · 2018 → 2026
2018-02Enumerated in NPPES
2018
2026
Where they practice
Primary practice location
1050 E Loop 304
Crockett, TX 75835
Mailing address
4220 Bull Creek Rd
Austin, TX 787316026
Authorized official
Kelly Eugene Tjelmeland
Ceo
📞 5126177500
Individual providers at this organization
5 individual providers on file at this primary practice address.
- Christopher Haeckler, MD Family Medicine NPI 1134111263
- Joseph Holcomb, DDS Dentist NPI 1942318035
- Richard Kelly, MD Family Medicine NPI 1376535419
- Ravi Konidala, MD Family Medicine NPI 1124013552
- Bryan Shaver, PA Physician Assistant NPI 1659826626
Specialties
-
Family Medicine PrimaryFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of...
-
Internal MedicineA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer,...
-
Internal MedicineAn internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
-
Internal MedicineAn area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical...
-
Orthopaedic SurgeryAn orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is...
-
UrologyA urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 385139603 | |
| 05 (TX) | 385139602 | |
| 05 (TX) | 385139601 |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Crockett Medical Center Clinic
Practice context
Multi-provider organization. 5 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.