Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through...

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Provider Directory Addendum 2017 Through 6/30/2017

Transcript of Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through...

Page 1: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Provider

Directory

Addendum 2017

Through 6/30/2017

Page 2: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

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KelseyCare Advantage

HMO and HMO-POS Plan

Provider Directory Addendum

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

This addendum includes updates as of 06/30/17. 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 February

14, hours are 8:00 a.m. to 8:00 p.m., seven days a week. During this period on Thanksgiving Day and

Christmas Day, calls are handled by our voicemail system. From February 15 through September 30, hours

are 8:00 a.m. to 8:00 p.m., Monday through Friday. During this period on Saturdays, Sundays and holidays,

calls are handled by our voicemail system. (TTY users should call 1-866-302-9336).

KelseyCare Advantage is a Medicare Advantage organization with a Medicare contract.

This information is available for free in other languages. Please contact our Member Services department at

1-866-535-8343 for additional information.

Esta información está disponible gratis en otros idiomas. Contacte por favor a nuestro departamento de

Servicios de Miembro a 1-866-535-8343 para la información adicional.

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

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

tiene un contrato con Medicare.

KelseyCare Advantage puede brindarle información en braille, en tamaño de letra grande o en otros formatos

alternativos, si lo solicita.

Discrimination is Against the Law

KelseyCare Advantage complies with applicable Federal civil rights laws and does not discriminate on the

basis of race, color, national origin, age, disability, or sex. 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: 1-

866-302-9936).

KelseyCare Advantage cumple con las leyes federales de derechos civiles aplicables y no discrimina por

motivos de raza, color, nacionalidad, edad, discapacidad o sexo. ATENCIÓN: si habla español, tiene a su

disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-535-8343 (TTY: 1-866-302-9936).

KelseyCare Advantage tuân thủ luật dân quyền hiện hành của Liên bang và không phân biệt đối xử dựa trên

chủng tộc, màu da, nguồn gốc quốc gia, độ tuổi, khuyết tật, hoặc giới tính. CHÚ Ý: Nếu bạn nói Tiếng Việt,

có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-866-535-8343 (TTY: 1-866-302-9936).

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Table of Contents

Additions to KelseyCare Advantage Provider Network....................................................................................2 Terminations to KelseyCare Advantage Provider Network ............................................................................17 Other Changes to KelseyCare Advantage Provider Network .........................................................................32 Facility Additions to KelseyCare Advantage Provider Network ....................................................................52 Facility Terminations to KelseyCare Advantage Provider Network ...............................................................53 Additions to Mental Health Providers .............................................................................................................54 Terminations to Mental Health Providers .......................................................................................................59 Other Changes to Mental Health Providers .....................................................................................................61 Additions to Vision Service Providers ............................................................................................................63 Terminations to Vision Service Providers .......................................................................................................67 Other Changes to Vision Service Providers ....................................................................................................69 Additions/Reinstatements of Retail Pharmacies - Part B Drugs .....................................................................73 Terminations of Retail Pharmacies - Part B Drugs .........................................................................................74 Terminations of Long-Term Care Facility Pharmacies - Part B Drugs ...........................................................76

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Additions to KelseyCare Advantage Provider Network Through 6/30/2017

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Cardiology

Fort Bend County

City of Katy

UT Physicians23923 Cinco Ranch Blvd Katy, TX 77494(713) 486-5300

Enrique D Garcia-Sayan Rivas, MD

Harris County

City of Houston

Kelsey-Seybold Clinic-Main Campus2727 West Holcombe Blvd Houston, TX 77025 (713) 442-0000

Chung Han Yoon, MDMehran Massumi, MD

Baylor College of Medicine6620 Main Ste 1225 Houston, TX 77030 (713) 798-2545

Srikanth Koneru, MD

Cardiology Specialists of Houston6624 Fannin St Ste 2480 Houston, TX 77030 (713) 529-5530

Gerado Kalife, MD

UT Physicians6400 Fannin Ste 2550 Houston, TX 77030 (713) 486-1631

Ijeoma A Ekeruo, MD

BSLMG Woodlands North Houston Heart Center 1140A Cypress Station Ste 300Houston, TX 77090 (281) 444-3278

Brenda Peabody, MDChacko Alexander, MDGary Coleman, MDVincent Aquino, MD

City of Kingwood

Texas Cardiology Associates of Houston2627 Chestnut Ridge Rd Ste 100Kingwood, TX 77339(281) 358-1950

Xianfeng Wen, MD

City of La Porte

Cardiology Specialists of Houston401 W Fairmont Pkwy Ste DLa Porte, TX 77571 (713) 797-1620

Carlos R Jessurun, MD Robert J Card, MD

City of Pasadena

Cardiology Specialists of Houston3801 Vista Ste 380 Pasadena, TX 77504 (713) 797-1620

Juan Carlos Rozo, MD

Montgomery County

City of Conroe

BSLMG Woodlands North Houston Heart Center 3251 Ih 45 North Ste 110 Conroe, TX 77304 (281) 444-3278

Kedarnath A Vaidya, MD

Current Patients Only Spanish SpeakingMedicaid Provider

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Additions to KelseyCare Advantage Provider Network Through 6/30/2017

Southern Texas Physicians Network500 Medical Center Blvd Ste 300 Conroe, TX 77304 (936) 539-5027

Connie C Hutton, MD

City of Shenandoah

Kelsey-Seybold Clinic-the Woodlands106 Vision Park Blvd Shenandoah, TX 77384 (713) 442-1800

Rahul Trikha, MD

City of The Woodlands

Baylor St Luke's Woodlands North HoustonHeart Center 17350 St Luke's Way Ste 400The Woodlands, TX 77384 (281) 444-3278

Margit Nemeth, MD

BSLMG Woodlands North Houston Heart Center 17350 St Luke's Way Ste 400The Woodlands, TX 77384 (281) 444-3278

Bernardo De La Guardia, MD Bruce Lachterman, MDChristopher Lavergne, MDChristopher V Nguyen, MDGeorge Kantis, MDJessica L Brown, MDMargit Nemeth, MDScott Greenberg, MD

Cardiothoracic Surgery

Harris County

City of Baytown

TMHPO Surgery Department4201 Garth Road Ste 211 Baytown, TX 77251(832) 556-6046

Shawn L Tittle, MD

City of Cypress

KDS Cardiovascular Surgery21212 Northwest Fwy Ste 305Cypress, TX 77429(281) 583-4000

Clifford Kitten, MDDaniel Stroud, MDLucas Duvall, MD

City of Houston

Baylor College of Medicine6620 Main Ste 1225 Houston, TX 77030 (832) 355-9910

Ernesto Jimenez, MDGabriel Loor, MDJoseph Lamelas, MDKimberly Shay Lamelas, MDRavi Kiran Ghanta, MD

Baylor College of Medicine6770 Bertner Ave Ste C-350 Houston, TX 77030 (832) 355-2285

William E Cohn, MD

Baylor St Luke's Medical Group6620 Main Ste 1450 Houston, TX 77030 (713) 798-8100

Subhasis Chatterjee, MD

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Current Patients Only Spanish Speaking Medicaid Provider 3

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

Thomas E Macgillivray, MD

Montgomery County

City of Shenandoah

KDS Cardiovascular Surgery118 Shenandoah Dr Ste A Shenandoah, TX 77381 (281) 583-4000

Clifford Kitten, MDDaniel Stroud, MDLucas Duvall, MD

Endocrinology

Fort Bend County

City of Katy

UT Physicians Health Center-Cinco Ranch23923 Cinco Ranch Boulevard Katy, TX 77494(713) 486-5300

Hongjie Zhang, MD

Harris County

City of Houston

Baylor College of Medicine6620 Main Ste 1290 Houston, TX 77030 (713) 798-0180

Ashok Balasubramanyam, MD

ENT/Otolaryngology

Harris County

City of Houston

UT Physicians6400 Fannin Ste 2700 Houston, TX 77030 (713) 486-5000

Zhen Huang, MD

Montgomery County

City of The Woodlands

Baylor St Luke's Medical Group17450 St Luke's Way Ste 320The Woodlands, TX 77384 (936) 266-2630

Michael Briscoe, MD

Family Medicine

Fort Bend County

City of Missouri City

Kelsey-Seybold Clinic-Sienna Plantation7010 Hwy 6Missouri City, TX 77459(713) 442-6700

Mehreen Fatima, MD

City of Sugar Land

Kelsey-Seybold Fort Bend Medical and Diagnostic Center11555 University BoulevardSugar Land, TX 77478(713) 442-9100

Elmira I Rakhmatulina, MD

Current Patients Only Spanish SpeakingMedicaid Provider 4

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Gastroenterology

Harris County

City of Houston

Baylor College of Medicine7200 Cambridge St Ste 10 CHouston, TX 77030 (713) 798-2500

Wasif F Abidi, MD

Ertan Digestive Disease Center6400 Fannin Street Ste 1400 Houston, TX 77030 (713) 704-3450

Julie C Guider, MD

UT Physicians6400 Fannin Street 14th Floor Houston, TX 77030 (713) 704-3450

Preethi M Reddy, MD

Gastroenterology Consultants Pa444 Fm 1959 Rd Ste A Houston, TX 77034 (281) 481-9400

Shahid Ali, MD

General Surgery

Fort Bend County

City of Sugar Land

Southwest Surgical Associates23920 Katy Frwy Ste 410Sugar Land, TX 77479(713) 772-1200

Robert M Shirley, MD

TMHPO Surgery Department16605 Southwest Fwy Ste 220Sugar Land, TX 77479(281) 494-3000

Sandra Templeton, MD

Harris County

City of Baytown

TMHPO Surgery Department4201 Garth Rd Ste 211 Baytown, TX 77521(832) 556-6046

Laura H Choi, MD

TMHPO Surgery Department4201 Garth Road Ste 307 Baytown, TX 77521(832) 556-6046

Boutros Peter Kahla, MD

TMHPO Surgery Department4401 Garth Road Baytown, TX 77521(832) 556-6046

Klaus J Thaler, MD

City of Cypress

General & Minimally Invasive Surgery21216 Northwest Fwy Ste 230Cypress, TX 77429(281) 290-6300

Harvinderpal Singh, MD

City of Houston

Southwest Surgical Associates 1315 St. Joseph Pkwy Ste 1708Houston, TX 77002 (713) 772-1200

Adrienne P Floyd, MD

Current Patients Only Spanish Speaking Medicaid Provider 5

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Southwest Surgical Associates920 Frostwood Ste 620 Houston, TX 77024 (713) 772-1200

Robert M Shirley, MD

Baylor St Luke's Medical Group6620 Main Ste 1350 Houston, TX 77030 (713) 798-2262

Marcus Keith Hoffman, MD

Baylor St Luke's Medical Group6620 Main Ste 1450 Houston, TX 77030 (713) 798-8100

Millard A Davis, MD

TMHPO Surgery Department6550 Fannin Ste 2435 Houston, TX 77030 (713) 441-5141

Jihad Kudsi, MD

TMHPO Surgery Department6560 Fannin St Ste 1404 Houston, TX 77030 (713) 790-0600

Joshua C Coursey, MD

Southwest Surgical Associates 7777 Southwest Frwy Ste 810Houston, TX 77074 (713) 772-1200

Amanda Garza, MD Elegy Etter, MD

UT Physicians11920 Astoria Boulevard Ste 460 Houston, TX 77086 (713) 486-7650

Obonouma I Ekhaese, MD

Through 6/30/2017

Memorial Hermann Medical Group11920 Astoria Blvd St 350 Houston, TX 77089 (281) 929-4222

Joshua Hamilton, MD

City of Tomball

General & Minimally Invasive Surgery11609 Spring Cypress Rd Ste CTomball, TX 77377 (281) 290-6300

Harvinderpal Singh, MD

Gyencology, OB/GYN

Fort Bend County

City of Sugar Land

Baylor St Luke's Medical Group1327 Lake Pointe Parkway Ste 500Sugar Land, TX 77478(281) 637-9095

Brooke Elaine Jemelka, MD

Gynecology, OB/GYN

Fort Bend County

City of Sugar Land

Baylor St Luke's Medical Group1327 Lake Pointe Parkway Ste 500Sugar Land, TX 77478(281) 637-9095

Jamie Gautreau Hernandez, MD Kathryn A Karges, MD

Current Patients Only Spanish SpeakingMedicaid Provider 6

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Additions to KelseyCare Advantage Provider Network Through 6/30/2017

Harris County

City of Houston

UT Physicians6410 Fannin Ste 250 Houston, TX 77030 (832) 352-7131

Asha P Bhalwal, MD Ghulam MD Murtaza, MD

UT Physicians6410 Fannin Street Ste 350 Houston, TX 77030 (832) 325-7200

Jenifer Dinis Ballestas, MD

UT Physicians Women's Center-Texas Medical Center 6410 Fannin Street Ste 250 Houston, TX 77030 (832) 324-7131

Tessa Kincade, MD

Infectious Disease

Harris County

City of Houston

Methodist Academic Medicine Associates 6560 Fannin Ste 1540 Houston, TX 77030 (713) 799-9997

Tobias C Samo, MD

Baylor College of Medicine6620 Main Ste 1375 Houston, TX 77030 (713) 798-2500

Mayar Al Mohajer, MD

Methodist Academic Medicine Associates 6550 Fannin Ste 1101 Houston, TX 77030 (713) 441-0006

Ashley L Drews, MDMadiha Ashraf, MD Siraya Jaijakul, MD

Methodist Academic Medicine Associates 6560 Fannin Ste 1540 Houston, TX 77030 (713) 799-9997

Jiejian Lin, MDKevin Grimes, MD Victor Fainstein, MD

UT Physicians2015 Thomas Street Houston, TX 77030 (713) 236-7125

Jordan E Lake, MD

Montgomery County

City of Shenandoah

Charles R. Sims, MD 101 Vision Park Blvd Shenandoah, TX 77384 (936) 273-5214

Charles Sims, MD

Internal Medicine

Harris County

City of Houston

Kelsey-Seybold Clinic-Main Campus2727 West Holcombe Blvd Houston, TX 77025 (713) 442-0000

Michelle Udayamurthy, MD

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Additions to KelseyCare Advantage Provider Network Through 6/30/2017

Nephrology

Harris County

Neurology

Harris County

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City of Houston

Baylor College of Medicine6620 Main Ste 1225 Houston, TX 77030 (713) 798-2500

Jyotsana Thakkar, MD

UT Physicians6400 Fannin Ste 600 Houston, TX 77030 (832) 325-6545

Aisha Khattak, MD

UT Physicians6410 Fannin Street Ste 600 Houston, TX 77030 (832) 325-6545

Aleksandra M De Golovine, MDJohn R Foringer, MD

Southwest Nephrology Associates7777 Southwest Fwy Ste 304Houston, TX 77074 (713) 270-4545

Jonathan M Smith, MD

Nephrology - Dialysis Only

Harris County

City of Katy

Renal Clinic of Houston, PA 21720 Kingsland Blvd Ste 308Katy, TX 77450(281) 579-5799

Sheetal P Golla, MD

City of Baytown

Houston Methodist Neurology Associates4201 Garth Rd Ste 208 Baytown, TX 77521(832) 556-6660

Ruby Jamal Parveen, MD

City of Houston

Baylor College of Medicine7200 CambridgeHouston, TX 77030 (713) 798-8259

Edward Cooper, MD

Baylor College of Medicine7200 CambridgeHouston, TX 77030 (713) 798-8259

Everton Anthony Edmondson, MDGreg S McLauchlin, MD

Baylor College of Medicine7200 CambridgeHouston, TX 77030 (713) 798-7416

Hichi Doris Kung, DORachelle S Doody, MD, PhDThomas A Kent, MD

TMHPO Neruology Department6560 Fannin Suite 802 Houston, TX 77030 (713) 441-3780

Mohammad Obadah Nakawah, MD

Current Patients Only Spanish SpeakingMedicaid Provider 8

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TMHPO Neurology Department6560 Fannin Ste 802 Houston, TX 77030 (713) 441-3780

Jason R Thonhoff, MD Vivek Misra, MD

TMHPO Neurology Department13300 Hargrave Dr Ste 505Houston, TX 77070 (281) 737-1167

Aarthi Ram, MD

Montgomery County

City of The Woodlands

BSLMG Woodlands Neurology17450 St. Luke's Way Ste 320The Woodlands, TX 77384 (936) 266-2450

Lorenzo Gustavo Blas, MD

Neurosurgery

Harris County

City of Houston

Baylor College of Medicine7200 Cambridge St Ste 9BHouston, TX 77030 (713) 798-4696

Jeremiah N Johnson, MD

Mischer Neuroscience Associates 6400 Fannin St Ste 2072 Houston, TX 77030 (713) 704-6772

Yoshua Esquenazi Levy, MD

Through 6/30/2017

Mischer Neuroscience Associates 6400 Fannin Ste 2070 Houston, TX 77030 (713) 704-6772

Joseph Lionel Martinez, MDOmar A Choudhri, MD

Mischer Neuroscience Associates 6400 Fannin Ste 2800 Houston, TX 77030 (713) 704-7262

Joseph Cochran, MD

TMHPO Neurosurgery Department6560 Fannin Ste 900 Houston, TX 77030 (713) 441-3800

Brian D Dalm, MD Robert Cullen Rostomily, MD

Oncology - Medical, Surgical

Fort Bend County

City of Sugar Land

Texas Oncology1350 First Colony BlvdSugar Land, TX 77479(281) 277-5200

Kristy K Ward, MD

Harris County

City of Houston

Texas Oncology925 Gessner Road Ste 550 Houston, TX 77024 (713) 467-1722

Monica D Desai, MD

Current Patients Only Spanish Speaking Medicaid Provider 9

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Kelsey-Seybold Clinic-Main Campus2727 West Holcombe Blvd Houston, TX 77025 (713) 442-0000

Kanza S Abbas, MD

Kelsey-Seybold Spring Medical and DiagnosticCenter 15655 Cypress Woods Medical Drive Ste 100Houston, TX 77025 (713) 442-0000

Kanza S Abbas, MD

Baylor College of Medicine6565 Fannin Ste 800 Houston, TX 77030 (713) 441-1450

Caroline Eva Arber Barth, MD

Baylor College of Medicine6620 Main Ste 1350 Houston, TX 77030 (713) 798-1999

Angela Coscio, MDSamer Srour, MD

TMHPO Surgery Department13300 Hargrave Ste 450Houston, TX 77070 (281) 737-4861

Liza Opper Thalheimer, MD

Oncology - Radiation/Radiation Oncology

Harris County

City of Houston

Northwest Radiotherapy Association1631 North Loop West Ste 150Houston, TX 77008 (713) 876-4668

Aparna Surapaneni, MD

Methodist Radiation Oncology Group18400 Katy Fwy Ste 120Houston, TX 77094 (281) 737-4425

Peter B Morgan, MD

Montgomery County

City of The Woodlands

Greater Houston Radiaition Oncology25511 Budde Rd Ste 1201 The Woodlands, TX 77380 (281) 364-1707

Guangquan Zhao, MD

Texas Oncology9323 Pine Croft Ste 110 The Woodlands, TX 77380 (281) 943-2440

Umang H Patel, MD

Texas Oncology9323 Pinecroft Dr Ste 110 The Woodlands, TX 77380 (281) 943-2440

Jason E Berilgen, MD

Ophthalmology

Fort Bend County

City of Katy

Retina Consultants of Houston 23501 Cinco Ranch Blvd Ste G205 Katy, TX 77494(713) 524-3434

Christopher Henry, MD

Current Patients Only Spanish SpeakingMedicaid Provider 10

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Additions to KelseyCare Advantage Provider Network Through 6/30/2017

Harris County

City of Cypress

Retina Consultants of Houston 21216 Northwest Fwy Ste 630Cypress, TX 77429(713) 524-3434

Christopher Henry, MD

City of Houston

Retina Consultants of Houston 902 Frostwood Ste 280 Houston, TX 77024 (713) 524-3434

Christopher Henry, MD

Retina & Vitreous of Texas 2727 GramercyHouston, TX 77025 (713) 799-9975

Jonathan M Perkins, MD

Baylor College of Medicine1977 Butler Blvd Ste E3 100 Houston, TX 77030 (713) 798-6100

Ella Leung, MDLauren S Blieden, MD

Macula Vitreous Retina Physicians & Surgeons,Pa 6655 Travis Ste 560 Houston, TX 77030 (281) 605-5000

Petros E Carvounis, MD

Retina Consultants of Houston 11460 Space Center Blvd Ste 2Houston, TX 77059 (713) 524-3434

Christopher Henry, MD

Retina Consultants of Houston 17030 Nanes Dr. Ste 214 Houston, TX 77090 (713) 524-3434

Christopher Henry, MD

Montgomery County

City of Kingwood

Retina Consultants of Houston 350 Kingwood Medical Dr Ste 200Kingwood, TX 77339(713) 524-3434

Christopher Henry, MD

City of Shenandoah

Kelsey-Seybold Clinic-the Woodlands106 Vision Park Blvd Shenandoah, TX 77384 (713) 442-1800

Neema Nayeb-Hashemi, MD

Optometry

Harris County

City of Houston

Kelsey-Seybold Spring Medical and DiagnosticCenter 15655 Cypress Woods Medical Drive Ste 100Houston, TX 77014 (713) 442-1700

Kelly Santesteban, OD

Diagnostic Eye Center3405 Edloe St Ste 300 Houston, TX 77027 (713) 797-1500

Aric Welton, OD

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Current Patients Only Spanish Speaking Medicaid Provider 11

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Oral & Maxillofacial Surgery

Harris County

City of Houston

UT Physicians7500 Cambridge Ste 5371Houston, TX 77054 (713) 486-4410

Nadarajah Vigneswaran, DMD

Orthopedic Surgery

Brazoria County

City of Pearland

UT Physicians10905 Memorial Hermann Dr Ste 130 Pearland, TX 77584 (713) 486-6000

Taggart T Gauvain, MD

Harris County

City of Baytown

TMHPO Orthopedics Department4201 Garth Rd Ste 107 Baytown, TX 77521(281) 427-7400

Venkata Karthik Jonna, MD

City of Cypress

UT Physicians27700 Northwest FreewayCypress, TX 77433(713) 489-5750

Darin D Tessier, MD

City of Houston

East Houston Orthopedics & Sports Medicine12930 East FreewayHouston, TX 77015 (713) 453-6909

David Randall, MD Edward B Roberts, MD

Kelsey-Seybold Clinic-Main Campus2727 West Holcombe Blvd Houston, TX 77025 (713) 442-0000

Catherine W Palisch, MD Eileen Wan-Ying Wu, MD

Baylor College of Medicine7200 Cambridge 10th FlHouston, TX 77030 (713) 986-6016

James Bruce Moseley, Jr, MD

UT Physicians6400 Fannin Ste 1700 Houston, TX 77030 (713) 786-4500

Phillip N Williams, MD

TMHPO Orthopedics Department2020 Nasa Pkwy Ste 230Houston, TX 77058 (713) 363-9090

Jaime J Alexander, MD

Montgomery County

City of Conroe

Surgical Specialists of Conroe500 Medical Center Blvd Ste 218 Conroe, TX 77575 (713) 852-1538

James Westmoreland, MD

Current Patients Only Spanish SpeakingMedicaid Provider 12

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Otolaryngology

Harris County

Podiatry

Harris County

City of Houston

UT Physicians6655 Travis Ste 900 Houston, TX 77030 (713) 526-5665

Vivek-Sagar M Patel, MD

Plastic Surgery

Harris County

City of Houston

Edward I Lee, MD Plastic Surgery2606 Grant Houston, TX 77006 (281) 974-2566

Edward I Lee, MD

Downey Plastic Surgery2500 West Loop S Ste 150Houston, TX 77027 (713) 496-2427

Cara R Downey, MD

Baylor College of Medicine1977 Butler Blvd Ste E6 100 Houston, TX 77030 (713) 798-6141

Edward Reece, MD

Montgomery County

City of The Woodlands

Correa Plastic Surgery4850 W Panther Creed Dr Ste 105 The Woodlands, TX 77381 (832) 779-2778

Bryan J Correa, MD

City of Houston

Baylor College of Medicine6620 Main Ste 1325 Houston, TX 77030 (713) 798-5700

Brian D Lepow, DPM

City of Houston

Baylor College of Medicine6620 Main St Ste 1225 Houston, TX 77030 (713) 798-2500

Gloria Wai-Chung Li, MDSarah K Medrek, MD

Pulmonology

Harris County

City of Baytown

Methodist Academic Medicine Associates 4201 Garth Road Ste 211 Baytown, TX 77521(832) 556-6046

Kalil Ibrahim Al-Nassir, MD

City of Houston

Baylor College of Medicine6620 Main Ste 1225 Houston, TX 77030 (713) 798-2505

Ali Zul Jiwani, MD

Pulmonary Medicine

Harris County

Current Patients Only Spanish Speaking Medicaid Provider 13

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Additions to KelseyCare Advantage Provider Network Through 6/30/2017

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Baylor St Luke's Medical Group6620 Main Ste 1225 Houston, TX 77030 (713) 798-2500

Andrea B Braun, MDAsim Muhammad Sissique, MDChristopher M Howard, MDDereddi Raja S Reddy, MDDipaben D Modi, MDJairo Hernando Barrantes Perez, MDJames Patrick Herlihy, MDJigna Zatikia, DOPrasad Manian, MDRitwick Agrawal, MD

Coselli & Lemaire Surgery6620 Main Ste 1225 Houston, TX 77030 (832) 355-9910

Jose G Casar, MD

UT Physicians6410 Fannin Street Ste 600 Houston, TX 77030 (832) 325-7396

Rosa M Estrada-Y-Martin, MD

Houston Pulmonary Medicine Associates11920 Astoria Ste 320 Houston, TX 77089 (281) 484-9369

Charles G Hebenstreit, MD Enash S Moodley, DO

Radiology

Harris County

City of Houston

UT Physicians6431 Fannin St Houston, TX 77030 (713) 704-4680

Pritish Bawa, MD

Rehabilitation Medicine

Harris County

City of Houston

Kelsey-Seybold Spring Medical and DiagnosticCenter 15655 Cypress Woods Medical Drive Ste 100Houston, TX 77014 (713) 442-1700

Siddharth Vijay Aranke, MD

Kelsey-Seybold Clinic-Main Campus2727 West Holcombe Blvd Houston, TX 77025 (713) 442-0000

Siddharth Vijay Aranke, MD

Baylor College of Medicine6550 Fannin Ste 1421 Houston, TX 77030 (713) 798-6198

Uvieoghene O Ughwanogho, MD

UT Physicians1333 Moursund St Houston, TX 77030 (713) 799-5000

Isaac Hernandez-Jimenez, MDStacy L Hall, MD

UT Physicians6411 Fannin Street Houston, TX 77030 (713) 704-3961

Ajai Sambasivan, MD

UT Physicians9250 Pinecroft Houston, TX 77038 (713) 897-2864

Kendall Kessler, MD

Current Patients Only Spanish SpeakingMedicaid Provider 14

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Additions to KelseyCare Advantage Provider Network

Kelsey-Seybold Clinic-the Vintage10701 Vintage Preserve PkwyHouston, TX 77070 (713) 442-1500

Siddharth Vijay Aranke, MD

City of Houston

TMHPO Orthopedics Department13802 Centerfield Dr Ste 300 Houston, TX 77070 (281) 737-0999

Olusanjo Olaoluwa Adeoye, MD

Montgomery County

City of The Woodlands

TMHPO Orthopedics Department3115 College Park Dr Ste 112The Woodlands, TX 77384 (936) 539-2663

Alysia N Robichau, MD

Thoracic Surgery

Harris County

City of Webster

Surgical Specialist of Clear Lake, Pllc450 Medical Center Blvd Ste 600 Webster, TX 77598 (281) 332-4596

Christos Katsigiannis, MD

Through 6/30/2017

City of Houston

Baylor College of Medicine7200 Cambridge St 10th FlrHouston, TX 77030 (713) 798-4001

Victor M Lizarraga, MD

UT Physicians6410 Fannin Street Ste 950 Houston, TX 77030 (832) 325-7234

Lawrence J Cisek, MD

Methodist Urology Associates2060 Space Park Drive, Suite 410Houston, TX 77058 (713) 441-6455

Gabriel Rodriguez, MD

Methodist Urology Associates18220 State Hwy 249 Ste 400Houston, TX 77070 (281) 737-0390

Xishi J Tan, MD

Montgomery County

City of Shenandoah

Northwoods Urology Associates135 Vision Park Blvd Shenandoah, TX 77384 (281) 364-7300

Zeeshan Danawala, MD

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Urology

Harris County

Sports Medicine

Harris County

Current Patients Only Spanish Speaking Medicaid Provider 15

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Additions to KelseyCare Advantage Provider Network Through 6/30/2017

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Vascular Surgery

Harris County

City of Houston

Methodist Cardiovascular Surgery Assocaites6550 Fannin Ste 1401 Houston, TX 77030 (713) 441-5200

Ulises Baltazar, MD

Current Patients Only Spanish SpeakingMedicaid Provider 16

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directory.

Allergy and Immunology

Harris County

City of Houston

UT Physicians925 N ShepherdHouston, TX 77008 (713) 486-1200

Dimple V Shah, MD

Baylor College of Medicine7200 Cambridge Ste 10th FloorHouston, TX 77030 (713) 798-3390

Adrian M Casillas, MD

Audiology

Harris County

City of Houston

UT Physicians11914 Astoria Blvd Ste 670 Houston, TX 77089 (713) 486-1120

Allison S Boggess, AuD

Cardiology

Brazoria County

City of Pearland

Methodist Debakey Cardiology Associates2950 Bullen Pkwy Ste 111Pearland, TX 77584 (713) 441-9909

Alpesh R Shah, MD

Terminations to KelseyCare Advantage Provider NetworkThrough 6/30/2017

The 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

Harris County

City of Houston

Baylor College of Medicine6620 Main St Ste 1225 Houston, TX 77030 (713) 798-2545

Deborah Ellen Meyers, MDRoberta Camden Bogaev, MD

Methodist DeBakey Cardiology Associates6550 Fannin Ste 1901 Houston, TX 77030 (713) 441-1100

Myung Hee Park, MD

Methodist Debakey Cardiology Associates18220 Tomball Pkwy Ste 400Houston, TX 77070 (713) 441-9909

Anton Peter Nielsen, MD

Texas Cardiology Associates of Houston7333 North Fwy Ste 100Houston, TX 77076 (832) 707-8858

Charles H Moore, MD

Woodlands North Houston Heart Center 411 Lantern Bend Dr Ste 100 Houston, TX 77090 (281) 444-3278

Bernardo De La Guardia, MD Brenda Peabody, MDBruce Lachterman, MDChacko Alexander, MDChristopher Lavergne, MDChristopher V Nguyen, MDGary Coleman, MDGeorge Kantis, MD

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Page 20: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Terminations to KelseyCare Advantage Provider NetworkThrough 6/30/2017

The 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.

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Margit Nemeth, MDVincent Aquino, MD

Montgomery County

City of Conroe

Healing Hearts Clinic100 Medical Center Blvd Ste 200 Conroe, TX 77304 (936) 441-9680

Paul Y Cunningham, MD

Woodlands North Houston Heart Center 17350 St Luke's Way Ste 400Conroe, TX 77384 (281) 444-2378

Bernardo De La Guardia, MD Bruce Lachterman, MDChacko Alexander, MDChristopher La Vergne, MDChristopher Lavergne, MDChristopher V Nguyen, MDGary Coleman, MDGeorge Kantis, MDKedarnath A Vaidya, MDMargit Nemeth, MDVincent Aquino, MD

Cardiothoracic Surgery

Harris County

City of Cypress

KDS Cardiovascular Surgery21212 Northwest Fwy Ste 305Cypress, TX 77429(281) 583-4000

Lucas Duvall, MD

City of Houston

Baylor College of Medicine6770 Bertner Ave Ste C-350 Houston, TX 77030 (832) 355-9696

Steve K Singh, MD

Surgical Associates of Texas, Pa1101 Bates Ste P514 Houston, TX 77030 (832) 355-4900

Denton A Cooley, MD

TMHPO Surgery Department6550 Fannin St Ste 1601 Houston, TX 77030 (713) 441-5151

Puja G Khaitan, MD

Montgomery County

City of Shenandoah

KDS Cardiovascular Surgery118 Shenandoah Dr Ste A Shenandoah, TX 77381 (281) 583-4000

Lucas Duvall, MD

Dermatology

Fort Bend County

City of Sugar Land

Fort Bend Skin Cancer Center 15400 Southwest Frwy Ste 150Sugar Land, TX 77478(281) 980-6647

Keith Schulze, MD

Current Patients Only Spanish Speaking Medicaid Provider 18

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directory.

Harris County

City of Houston

Baylor College of Medicine1977 Butler Blvd Ste E6 200 Houston, TX 77030 (713) 798-6131

Sylvia Hsu, MD

City of Pasadena

Kelsey-Seybold Clinic-Pasadena5001 E Sam Houston Pkwy SPasadena, TX 77505 (713) 442-7100

Jia-Yen Chi, MD

City of Webster

Kelsey-Seybold Clinic-Pasadena1010 South Ponds Dr Webster, TX 77598 (713) 442-4300

Jia-Yen Chi, MD

Endocrinology

Harris County

City of Houston

UT Physicians6410 Fannin St Ste 600 Houston, TX 77030 (832) 325-7161

Jeena M Varghese, MD

Terminations to KelseyCare Advantage Provider NetworkThrough 6/30/2017

The 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

ENT/Otolaryngology

Harris County

City of Houston

Baylor College of Medicine1977 Butler Blvd E5 100 Houston, TX 77030 (713) 798-3200

Robert A Williamson, MD

UT Physicians11452 Space Center BlvdHouston, TX 77059 (713) 486-6200

Terryl W Owens, MD

Montgomery County

City of Spring

UT Physicians1120 Medical Plaza Dr Med Plaza 1 Ste 150 Spring, TX 77380(713) 486-5000

James A Owusu, MD

Family Medicine

Brazoria County

City of Pearland

Kelsey-Seybold Clinic-Pearland2515 Business Center Dr Pearland, TX 77584 (713) 442-7200

Lecresha A Peters, MDYong F Li, MD

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Page 22: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Terminations to KelseyCare Advantage Provider NetworkThrough 6/30/2017

The 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

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directory.

Harris County

City of Houston

Kelsey-Seybold Clinic-Tanglewood1111 Augusta DriveHouston, TX 77057 (713) 442-2400

Julie K Toll, MDKelly C Castro, MD

Kelsey-Seybold Clinic-the Vintage 10701 Vintage Preserve PkwyHouston, TX 77070 (713) 442-1500

Nicizaki Guzman, MD

Kelsey-Seybold Clinic-Meyerland Plaza560 Meyerland Plaza MallHouston, TX 77096 (713) 442-3222

Dino Nguyen, MD

Montgomery County

City of Shenandoah

Kelsey-Seybold Clinic-the Woodlands106 Vision Park Blvd Shenandoah, TX 77384 (713) 442-1800

Hugh R Poindexter, MDKent Erickson, MD

Gastroenterology

Harris County

City of Houston

Baylor College of Medicine7200 Cambridge St 10th FloorHouston, TX 77030 (713) 798-2500

Joseph Henry Sellin, MDYasser Hani Shaib, MD, MPH

UT Physicians6400 Fannin St Ste 1400 Houston, TX 77030 (713) 704-3450

Michael B Fallon, MD

Montgomery County

City of Conroe

Baylor College of Medicine17200 St. Luke's WayConroe, TX 77384 (936) 266-2000

Paul McNeely, MD

General Surgery

Harris County

City of Bellaire

UT Physicians6700 West Loop S Ste 500Bellaire, TX 77401 (713) 892-5500

Mustafa H Alibhai, MD

Current Patients Only Spanish Speaking Medicaid Provider 20

Page 23: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Terminations to KelseyCare Advantage Provider NetworkThrough 6/30/2017

The 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.

UT Physicians6700 West Loop South Ste 500Bellaire, TX 77401 (713) 892-5500

Aarthy Kannappan, MD

City of Houston

Baylor College of Medicine6620 Main St Ste 1350 Houston, TX 77030 (713) 798-2262

Lillian Liao, MD

TMHPO Surgery Department6550 Fannin St Ste 2435 Houston, TX 77030 (713) 441-5141

Carter Todd Smith, MD Shin-Chern Wang, MD

Transplantation and General SurgeryAssociates, Pa 6624 Fannin St Ste 1200 Houston, TX 77030 (713) 795-8994

R Patrick Wood, MD

UT Physicians6410 Fannin St Ste 250 Houston, TX 77030 (832) 325-7181

Christian A Perez, MD

UT Physicians6700 West Loop S Ste 500Houston, TX 77030 (713) 892-5500

Tanyaradzwa M Kajese, MD

UT Physicians6700 West Loop S Ste 500Houston, TX 77041 (713) 892-5500

Donald P Lesslie, DO

TMHPO Surgery Department18220 Tomball Pkwy Ste 400Houston, TX 77070 (713) 441-5151

Rafael Angel Lugo, MD

Gynecology, OB/GYN

Harris County

City of Houston

Kelsey-Seybold Clinic-The Woodlands Ob/Gyn15655 Cypress Woods Medical Drive Ste 100Houston, TX 77014 (713) 442-1700

Anh-Van H Mai, MD

UT Physicians6410 Fannin St Ste 250 Houston, TX 77030 (832) 325-7131

Ziad A Haidar, MD

Kelsey-Seybold Clinic-Tanglewood1111 Augusta DriveHouston, TX 77057 (713) 442-2400

J Andrew Pollard, MDMark A Turrentine, MD

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Page 24: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Terminations to KelseyCare Advantage Provider NetworkThrough 6/30/2017

The 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.

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UT Physicians245 West Greens Rd Houston, TX 77067 (832) 325-7131

Milinda M Morris, MD

Kelsey-Seybold Clinic-The Vintage10701 Vintage Preserve PkwyHouston, TX 77070 (713) 442-1500

Aeneid L Chen, MD

Kelsey-Seybold Clinic-Tanglewood560 Meyerland Plaza MallHouston, TX 77096 (713) 442-3222

J Andrew Pollard, MD

Montgomery County

City of The Woodlands

Kelsey-Seybold Clinic-The Woodlands Ob/Gyn17198 St. Luke's Way Ste 540The Woodlands, TX 77385 (713) 442-1900

Anh-Van H Mai, MD

Infectious Disease

Harris County

City of Houston

Baylor College of Medicine6620 Main St Ste 1375 Houston, TX 77030 (713) 798-2500

Cezarina Mindru, MD Hoonmo L Koo, MDLaila E Woc-Colburn, MD

Infectious Disease Associates of Houston, Pa 6560 Fannin St Ste 1540 Houston, TX 77030 (713) 799-9997

Kevin Grimes, MDTobias C Samo, MDVictor Fainstein, MD

Internal Medicine

Brazoria County

City of Pearland

Kelsey-Seybold Clinic-Pearland Clinic2515 Business Center Dr Pearland, TX 77584 (713) 442-7200

Satish S Naik, MD

Fort Bend County

City of Sugar Land

Kelsey-Seybold Clinic-Fort Bend Medical andDiagnostic Center11555 University BoulevardSugar Land, TX 77478(713) 442-9100

Spencer R Berthelsen, MD

Harris County

City of Houston

Kelsey-Seybold Clinic-Main Campus2727 West Holcombe Blvd Houston, TX 77025 (713) 442-0000

Eve N Bowers, MD

Current Patients Only Spanish Speaking Medicaid Provider 22

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Terminations to KelseyCare Advantage Provider NetworkThrough 6/30/2017

The 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

Internal Medicine - Wound Care

Harris County

directory.

Kelsey-Seybold Clinic-Tanglewood1111 Augusta DriveHouston, TX 77057 (713) 442-2400

Nasreen J Notta, MD

Kelsey-Seybold Clinic-Meyerland560 Meyerland Plaza MallHouston, TX 77096 (713) 442-3222

Kimberly A Vernon, MD

City of Humble

Kelsey-Seybold Clinic-Humble8233 N Sam Houston Parkway EHumble, TX 77396 (713) 442-2000

Keith D Vassallo, MD

City of Houston

St. Luke's Center of Wound Care 2457 S Braeswood Blvd Houston, TX 77030 (832) 355-7163

Paul A Remmers, MD

Nephrology

Harris County

City of Houston

Renal Specialists of Houston, Pa6624 Fannin St Ste 2200 Houston, TX 77030 (713) 791-2648

Humaria Chaudhary, MD

UT Physicians6410 Fannin St Ste 600 Houston, TX 77030 (832) 325-6545

Carl P Walther, MD

City of Webster

Renal Specialists of Houston, Pa250 Blossom Ste 275 Webster, TX 77598 (281) 332-2059

Humaria Chaudhary, MD

Neurology

Harris County

City of Houston

Baylor College of Medicine7200 CambridgeHouston, TX 77030 (713) 798-8259

Stelios M Smirnakis, MD, PhD

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Page 26: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Terminations to KelseyCare Advantage Provider NetworkThrough 6/30/2017

The 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.

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Pinky S. Tiwari, MD PA6624 Fannin Ste 2190 Houston, TX 77030 (713) 790-1775

Pinky S Tiwari, MD

The Neurology Center7505 S Main Ste 290 Houston, TX 77030 (713) 795-0074

Greg S McLauchlin, MDJulia Jones, MD

TMHPO Neurology Department6560 Fannin Ste 802 Houston, TX 77030 (713) 441-3780

Abraham Palamootil Thomas, MD Bryan Michael-Paul Spann, DOMilvia Yadira Pleitez, MDStanley Fisher, MD

UT Physicians6410 Fannin St Ste 1014 Houston, TX 77030 (832) 325-7080

Jerry S Wolinsky, MD

TMHPO Neurology Department2060 Space Park Dr Ste 104Houston, TX 77052 (832) 783-1999

Akhila Vijayakumar, MD

Neurosurgery

Harris County

City of Houston

Mischer Neurosurgical Associates6400 Fannin Ste 2800 Houston, TX 77030 (713) 242-4410

Baraa Al-Hafez, MD

Thomas J. Mims, MD 6624 Fannin St Ste 2340 Houston, TX 77030 (713) 799-8993

T Jefferson Mims, Jr, MD

TMHPO Neurosurgery Department6560 Fannin St Ste 900 Houston, TX 77030 (713) 441-3800

Richard Kendall Simpson, MD

Montgomery County

City of Conroe

Evergreen Neurosurgery Center, Pllc17350 St Luke's Way Ste 370Conroe, TX 77384 (281) 719-9681

Cyril T Sebastian, MD

Current Patients Only Spanish Speaking Medicaid Provider 24

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Terminations to KelseyCare Advantage Provider NetworkThrough 6/30/2017

The 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.

Oncology - Medical, Surgical

Fort Bend County

City of Sugar Land

Texas Oncology1350 First Colony BlvdSugar Land, TX 77479(281) 277-5200

Robert A Furse, MD

Harris County

City of Baytown

Texas Oncology4021 Garth Rd Ste 101 Baytown, TX 77521(281) 427-7298

Deepa R Sashital, MDPamela L Medellin, MD

City of Houston

Kelsey-Seybold Clinic-Spring Medical andDiagnostic Center15655 Cypress Woods Medical Drive Ste 100Houston, TX 77014 (713) 442-1700

Priya Ramshesh, MD

Texas Oncology909 Frostwood Dr Ste 152 Houston, TX 77024 (713) 242-3500

Rosalyn Morrell, MD

Kelsey-Seybold Clinic-Spring Medical andDiagnostic Center2727 West Holcombe Blvd Houston, TX 77025 (713) 442-0000

Priya Ramshesh, MD

Baylor College of Medicine6620 Main St Ste 1350 Houston, TX 77030 (713) 798-1999

Polly Ann Niravath, MDSao Jiralerspong, MD

Texas Oncology7515 S Main Ste 740 Houston, TX 77030 (713) 795-0202

Gilchrist L Jackson, MD

Houston Methodist Obstetrics & Gynecology Associates 7580 Fannin Ste 335D Houston, TX 77054 (713) 394-6308

Geri-Lynn Fromm, MD

City of Webster

Texas Oncology17099 Texas Ave Ste 400 Webster, TX 77598 (281) 332-1668

Joseph Nicholas Sreshta, MD

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Terminations to KelseyCare Advantage Provider NetworkThrough 6/30/2017

The 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.

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Oncology - Radiation/Radiation Oncology

Fort Bend County

City of Sugar Land

West Houston Radiation Oncology15500 Southwest FrwySugar Land, TX 77478(281) 274-8200

Julia L Oh, MD

Harris County

City of Houston

Radiotherapy Physicians1313 Hermann Houston, TX 77004 (713) 527-5038

Howard C Moench, MD

Northwest Radiotherapy Association1631 N Loop West Ste 150Houston, TX 77008 (713) 864-3350

Neelofur R Ahmad, MD

MH Radiation Oncology Associates, PA2457 S Braeswood Blvd Houston, TX 77030 (713) 520-8860

Larry Steven Carpenter, MD

MH Radiation Oncology Associates, PA2491 S Braeswood Blvd Houston, TX 77030 (832) 355-7118

Hsin Lu, MD

Golden Triangle Radiation Oncology, Pa10650 Steepletop DrHouston, TX 77065 (281) 890-8885

Peter B Morgan, MD

Mark A D'Andrea, MD PA 12811 Beamer Rd Houston, TX 77089 (713) 474-1414

Mark D'Andrea, MD

Oncology-Medical,Surgical

Harris County

City of Houston

Texas Oncology925 Gessner Road Ste 310 Houston, TX 77024 (713) 467-1630

Joel W Abramowitz, MD

Ophthalmology

Fort Bend County

City of Katy

UT Physicians23923 Cinco Ranch Blvd Katy, TX 77494(713) 486-5300

Kartik S Kumar, MD

Current Patients Only Spanish Speaking Medicaid Provider 26

Page 29: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Terminations to KelseyCare Advantage Provider NetworkThrough 6/30/2017

The 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.

Harris County

City of Houston

Retina & Vitreous of Texas 12393 KingsrideHouston, TX 77024 (713) 973-7834

Arthur Willis, MD

Houston Eye Associates PA2855 GramercyHouston, TX 77025 (713) 668-6828

Jeffrey D Lanier, MD

Kelsey-Seybold Clinic-Main Campus2727 West Holcombe Blvd Houston, TX 77025 (713) 442-0000

Madhuri Chilakapati, MD

Retina & Vitreous of Texas 2727 Gramercy St Ste 200Houston, TX 77025 (713) 799-9975

Jessica D Randolph, MD

Baylor College of Medicine1977 Butler Blvd Ste E3 100 Houston, TX 77030 (713) 798-6100

Shaheen Kavoussi, MD

University Eye Associates6400 Fannin St Ste 1800 Houston, TX 77030 (713) 704-1777

Robert W Butner, MD

UT Physicians6400 Fannin Ste 1800 Houston, TX 77030 (713) 559-5200

Lauren S Blieden, MD

City of Tomball

Houston Eye Associates PA13414 Medical Complex Dr Ste 4Tomball, TX 77375 (281) 351-5468

Hayne Sheffield, MD

Optometry

Harris County

City of Houston

Kelsey-Seybold Spring Medical and DiagnosticCenter 15655 Cypress Woods Medical Drive Ste 100Houston, TX 77014 (713) 442-1700

Ling B Hong, OD

Kelsey-Seybold Clinic-Main Campus2727 West Holcombe Blvd Houston, TX 77025 (713) 442-0000

Martha B Stern, OD

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Page 30: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Terminations to KelseyCare Advantage Provider NetworkThrough 6/30/2017

The 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.

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Oral Surgery

Harris County

City of Houston

Houston Oral Surgery and Dental Implant Center 6560 Fannin St Ste 1522 Houston, TX 77030 (713) 790-6477

Christopher D Dauterive, DDS

UT Physicians6550 Fannin St Ste 2237 Houston, TX 77030 (713) 790-4600

James E Bertz, DDS

Orthopedic Surgery

Fort Bend County

City of Sugar Land

UT Physicians15035 Southwest Frwy Ste 1100Sugar Land, TX 77478(713) 486-7000

Henry N Small, MD

Harris County

City of Houston

Baylor College of Medicine12930 East FreewayHouston, TX 77015 (713) 453-6909

David C Randall, MD Edward B Roberts, MD

Bone and Joint Clinic of Houston Pa 6624 Fannin St Ste 2600 Houston, TX 77030 (713) 791-1818

Robert S Neff, II, MD

UT Physicians6400 Fannin St Ste 1700 Houston, TX 77030 (713) 486-7500

Mark S Adickes, MD

TMHPO Orthopedics Department13802 Centerfield Dr Ste 300 Houston, TX 77070 (281) 737-0999

James Bruce Moseley, MD

TMHPO Orthopedics Department18220 State Hwy 249 Ste 400Houston, TX 77070 (713) 737-0999

James Bruce Moseley, MD

KSF Orthopaedic Center, PA17270 Red Oak Dr Ste 200 Houston, TX 77090 (281) 440-6960

Alan Rosen, MDRay M Fitzgerald, MD

Orthopedic Surgeon, PLLC845 Fm 1960 W Ste 104 Houston, TX 77090 (281) 444-9898

Eileen Wan-Ying Wu, MD

Current Patients Only Spanish Speaking Medicaid Provider 28

Page 31: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Terminations to KelseyCare Advantage Provider NetworkThrough 6/30/2017

The 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.

Pain Management

Harris County

Pulmonology

Harris County

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City of Houston

TMHPO Neurosurgery Department6550 Fannin Ste 489 Houston, TX 77030 (713) 441-3800

Michelle Nguyen Dang, MD

Plastic Surgery

Harris County

City of Houston

Baylor College of Medicine1977 Butler Blvd Ste E6 100 Houston, TX 77030 (713) 798-6141

Anh Hung Nguyen, MD

Plastic Surgery Specialists6624 Fannin St Ste 1600 Houston, TX 77030 (713) 799-8330

Craig S Rock, MD

City of Houston

Baylor College of Medicine6620 Main St Ste 1225 Houston, TX 77030 (713) 798-2500

Diana M Guerra, MD Jairo Hernando Barrantes Perez, MDMarcia F Katz, MD

Pulmonary Critical Care and Sleep MedicineConsultants 6624 Fannin St Ste 1730 Houston, TX 77030 (713) 255-4000

Prasad Manian, MD

UT Physicians6410 Fannin St Ste 600 Houston, TX 77030 (832) 325-7222

Philip P Foster, MD

Millennium Physicians Association1125 Cypress Station Dr Ste EHouston, TX 77090 (281) 537-6300

Salah Ghobrial, MD

Current Patients Only Spanish Speaking Medicaid Provider

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Page 32: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Terminations to KelseyCare Advantage Provider NetworkThrough 6/30/2017

The 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

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directory.

Rehabilitation Medicine

Harris County

City of Houston

Kelsey-Seybold Spring Medical and DiagnosticCenter 15655 Cypress Woods Medical Drive Ste 100Houston, TX 77014 (713) 442-1700

Gwenevere E Williams, MD

Sleep Medicine

Harris County

City of Houston

TMHPO Neurology Department6560 Fannin Ste 802 Houston, TX 77030 (713) 441-3970

Amit Verma, MD

Urology

Brazoria County

City of Pearland

Houston Metro Urology, PA10970 Shadow Creek Pkwy Ste 255Pearland, TX 77584 (713) 634-4470

Darren M Chapman, MD

Galveston County

City of Texas City

Texas Urology Specialists-Clear Lake6807 Emmett F Lowry ExpwyTexas City, TX 77591(409) 935-2863

James Edouard Morneau, MD

Harris County

City of Houston

Kelsey-Seybold Clinic-Main Campus2727 West Holcombe Blvd Houston, TX 77025 (713) 442-0000

Robert A Renner, MD

Methodist Urology Associates6560 Fannin St Ste 2100 Houston, TX 77030 (713) 441-5866

Alvin Chun Chin Goh, MDTerry R Williams, MD

Texas Oncology13215 Dotson Rd Ste 170 Houston, TX 77070 (281) 517-0808

Penner T Schraudenbach, MD

Texas Oncology1140 Cypress Station Dr Ste 303Houston, TX 77090 (281) 537-6211

E C "Chip" Winkel, III, MD

Current Patients Only Spanish Speaking Medicaid Provider 30

Page 33: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Terminations to KelseyCare Advantage Provider NetworkThrough 6/30/2017

The 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.

Texas Oncology17070 Red Oak Dr Ste 200 Houston, TX 77090 (281) 537-6211

Don L Berardinucci, MDStuart Zykorie, MD

City of Pasadena

Urology Associates of Houston, Pa3315 Burke Rd Ste 201 Pasadena, TX 77504 (713) 910-9428

Thanh A Nguyen, MD

City of Webster

Texas Oncology450 Blossom St Ste C Webster, TX 77598 (281) 338-1668

Gabriel Rodriguez, MD

Montgomery County

City of Conroe

Texas Oncology17198 St Luke's Way Ste 410Conroe, TX 77384 (281) 444-7077

Howard R Lippman, MD

City of Kingwood

Texas Oncology22751 Professional Dr Ste 270 Kingwood, TX 77339(281) 358-0171

Cordel O Nwokeji, MDJustin Robert Gyorfi, MD

Vascular Surgery

Harris County

City of Houston

Baylor College of Medicine6620 Main St Ste 1325 Houston, TX 77030 (713) 798-5700

Charles A West, Jr, MD

Methodist Cardiovascular Surgery Associates6550 Fannin St Ste 1401 Houston, TX 77030 (713) 441-5200

Carlos Fares Bechara, MD

UT Physicians6400 Fannin St Ste 2850 Houston, TX 77030 (713) 486-5100

Christopher A Durham, MD

Methodist Cardiovascular Surgery Associates18400 Katy Frwy Ste 690Houston, TX 77094 (832) 522-8600

Houssam Khaled Younes, MD

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Page 34: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Other Changes to KelseyCare Advantage Provider NetworkThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies to the provider(s) listed under the location information.

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City of Crosby

Cardiology Specialists of Houston Location Termed14700 N FM 2100Crosby, TX 77532(281) 462-2635

Gerardo Kalife, MD

City of Houston

Baylor College of Medicine Location Termed1200 Binz StHouston, TX 77004(713) 798-2759

Alam Mahboob, MDMahboob Alam, MD

Hall Garcia Cardiology At Baylor College of Medicine Location Termed1631 North Loop West Ste 250Houston, TX 77008(713) 529-5530

Abdi Rasekh, MDJoseph P Navarijo, MDMehdi Razavi, MDMohammad Saeed, MDNeil E Strickman, MDRaymond F Stainback, III, MDShelia K Heinle, MDVirendra S Mathur, MD

Memorial Cardiology Associates Location Added1631 N Loop West Ste 520Houston, TX 77008(713) 861-2424

Omar Awar, MD

UT Physicians Location Added225 W 19th StHouston, TX 77008(713) 242-2980

Philip C Haas, DO

UTP- Center for Advanced Cardiology Location Added1631 North Loop West Ste 250Houston, TX 77008(281) 864-2710

Rajiv Goswami, MD

UTP- Center for Advanced Cardiology Location Termed225 West 19th StreetHouston, TX 77008(713) 242-2980

Rajiv Goswami, MD

Cardiology Specialists of Houston Location Added1140 Westmont Ste 460Houston, TX 77015(713) 797-1620

Gerardo Kalife, MD

Baylor Heart Clinic Phone Number Changed6550 Fannin St. Ste B-160Houston, TX 77030(713) 798-5800

Peter Jones, MD

Cardiology Specialists of Houston Location Termed6620 Main Ste 1520Houston, TX 77030(713) 797-1620

Gerardo Kalife, MD

Cardiology Specialists of Houston Location Termed6624 Fannin Ste 1420Houston, TX 77030(713) 797-1620

Gerardo Kalife, MD

Cardiology

Harris County

Page 35: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Other Changes to KelseyCare Advantage Provider NetworkThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies tothe provider(s) listed under the location information.

Cardiology Specialists of Houston Location Termed 6624 Fannin Ste 2480 Houston, TX 77030 (713) 529-5530

Gerardo Kalife, MD

Hall Garcia Cardiology At Baylor College ofMedicine Location Added 6624 Fannin Ste 2480 Houston, TX 77030 (713) 529-5530

Mehdi Razavi, MD Neil E Strickman, MD

UT Physicians Location Termed 6400 Fannin Ste 2500 Houston, TX 77030 (713) 704-7300

Rajiv Goswami, MD

UT Physicians Location Termed 6400 Fannin Ste 2550 Houston, TX 77030 (713) 486-1631

Justin T Sauders, MD

UT Physicians- Cardiology Location Termed 6410 Fannin St Ste 600 Houston, TX 77030 (832) 325-7211

Simbo M Chiadika, MD

UT Physicians-General Medicine Location Termed 6410 Fannin Ste 600 Houston, TX 77030 (832) 325-7211

Ali Marian, MD

UT-Physicians Location Termed 1740 West 27th Street Houston, TX 77030 (713) 704-4300

Imran A Dar, MD

UT-Physicians Location Termed 6400 Fannin Ste 2500 Houston, TX 77030 (713) 704-4300

Imran A Dar, MD

Texas Cardiology Associates of HoustonLocation Added 7333 North Fwy Ste 100Houston, TX 77076 (832) 707-8828

Ira H Lieber, MD Shakeel Uddin, MD Syed A Raza, MD

UT Physicians-Cardiology Location Added 5420 Dashwood Drive Ste 210 Houston, TX 77084 (713) 486-1075

Prakash Balan, MD

Rajan Kadakia, MD PA Phone Number Changed 11920 Astoria Ste 370 Houston, TX 77089 (281) 506-8720

Nisheeth K Goel, MD

Texas Cardiology Associates of HoustonLocation Added 837 Cypress Creek Pkwy Ste 105Houston, TX 77090 (281) 358-1950

Ira H Lieber, MD Shakeel Uddin, MD Syed A Raza, MD

Texas Cardiology Associates of HoustonLocation Added 511 West Tidwell Rd Houston, TX 77091 (281) 358-1950

Ira H Lieber, MD Shakeel Uddin, MD Syed A Raza, MD

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Page 36: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Other Changes to KelseyCare Advantage Provider NetworkThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies tothe provider(s) listed under the location information.

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Memorial Cardiology Associates Location Added 18400 Katy Frwy Ste 620Houston, TX 77094 (281) 398-4944

Omar Awar, MD

City of Humble

Baylor College of Medicine Location Termed 18648 McKay Dr Ste 100Humble, TX 77338 (281) 446-0148

David Aguilar, MDIhab R Hamzeh, MD

City of Katy

Memorial Cardiology Associates Location Termed 777 S Fry Rd Ste 104Katy, TX 77450(281) 398-4944

Michael M Mitschke, MD Philip Berman, MDRandall E Morris, MD Stuart Jacobson, MD

UT Physicians Location Termed 23920 Katy FwyKaty, TX 77494(713) 486-6714

Justin T Sauders, MD

UT Physicians Location Added 23960 Katy Freeway Ste 200Katy, TX 77494(713) 704-5352

Rajiv Goswami, MD

UT-Physicians Katy Location Added 23960 Katy Freeway Ste 200Katy, TX 77494(281) 644-8920

Imran A Dar, MD

City of La Porte

Cardiology Specialists of Houston Location Termed 401 W Fairmont PkwyLa Porte, TX 77571 (713) 797-1620

Gerardo Kalife, MD

City of Pasadena

Cardiology Specialists of Houston Location Added 3801 Vista Ste 380 Pasadena, TX 77504 (713) 797-1620

Gerardo Kalife, MD

City of Webster

Hall Garcia Cardiology At Baylor College ofMedicine Location Termed 450 Medical Center Blvd Ste 510 Webster, TX 77598 (713) 529-5530

Abdi Rasekh, MD Joseph P Navarijo, MDMehdi Razavi, MD Mohammad Saeed, MD Raymond F Stainback, III, MDShelia K Heinle, MD Virendra S Mathur, MD

Hall Garcia Cardiology At Baylor College ofMedicine Location Termed 450 Medical Center Boulevard Ste 510 Webster, TX 77598 (713) 529-5530

Neil E Strickman, MD

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Other Changes to KelseyCare Advantage Provider NetworkThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies tothe provider(s) listed under the location information.

Cardiothoracic Surgery

Fort Bend County

City of Richmond

Uttam Tripathy MD Pa Phone Number Changed1601 Main St Ste 202 Richmond, TX 77469 (281) 232-1908

Uttam Tripathy, MD

Harris County

City of Baytown

TMHPO Surgery Department Phone Number Changed4201 Garth Road Ste 107 Baytown, TX 77521(281) 428-4510

Shawn L Tittle, MD

City of Cypress

KPS Cardiovascular Surgery Location Termed 21212 Northwest Fwy Ste 305Cypress, TX 77429(281) 583-4000

Clifford Kitten, MD Daniel Stroud, MD Lucas Duvall, MD

City of Houston

Surgical Associates of Texas, Pa Location Termed 1101 Bates Ste P514 Houston, TX 77030 (832) 355-4900

Ross M Reul, MD

Texas Surgical Associates, LLP Location Termed 6560 Fannin Ste 1512 Houston, TX 77030 (713) 790-5227

Robert T Baldwin, MD

Methodist Cardiovascular Surgery AssociatesLocation Termed 13300 Hargrave Rd Ste 390Houston, TX 77070 (281) 737-2918

Walter Waldo O'Hara, MD

Methodist Cardiovascular Surgery AssociatesLocation Termed 18220 Tomball Pkwy Ste 400Houston, TX 77070 (713) 441-9909

Walter Waldo O'Hara, MD

Montgomery County

City of Shenandoah

KPS Cardiovascular Surgery Location Termed 118 Shenandoah Dr Ste A Shenandoah, TX 77381 (281) 583-4000

Clifford Kitten, MD Daniel Stroud, MD Lucas Duvall, MD

ENT/Otolaryngology

Harris County

City of Houston

Baylor College of Medicine Location Termed 7200 Cambridge Ste 9BHouston, TX 77030 (713) 798-5465

Nelson Eddie Liou, MD

TMHPO Neurosurgery Department Location Added 6550 Fannin Ste 1703 Houston, TX 77030 (713) 441-3223

Anthony E Brissett, MD

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Other Changes to KelseyCare Advantage Provider NetworkThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies to

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the provider(s) listed under the location information.

TMHPO Neurosurgery Department Location Termed 6560 Fannin Ste 900 Houston, TX 77030 (713) 441-3800

Anthony E Brissett, MD

Gastroenterology

Harris County

City of Houston

Gastroenterology Consultants Pa Phone Number Changed2060 Space Park Dr Ste 409Houston, TX 77058 (281) 481-9400

Jignesh P Shah, MD

Northside Gastroenterology Associates, PALocation Added 18400 Katy Freeway Ste 430Houston, TX 77094 (281) 477-9305

Ayub Hussain, MD

General Surgery

Fort Bend County

City of Sugar Land

Memorial Hermann Medical Group Location Added 17510 W Grand Pkwy S Ste 210Sugar Land, TX 77479(281) 725-5970

Glen B Garner, MD Theodoros Voloyiannis, MD

Southwest Surgical Associates Location Termed 16651 Southwest Frwy Ste 360Sugar Land, TX 77479(281) 491-6200

Arlene Ricardo, MD Charles Aramburo, MD Dieu R Ngo, MDJoey M Bluhm, MDJohn D Fisher, MD Kelly Dempsey, MDMichael T Wood, MD

Southwest Surgical Associates Location Termed 17510 W Grand Pkwy S Ste 490Sugar Land, TX 77479(281) 342-8932

Arlene Ricardo, MD Charles Aramburo, MD Joey M Bluhm, MDJohn D Fisher, MD Michael T Wood, MD Robert Hillery, MDThomas W Moore, MD

Harris County

City of Houston

Southwest Surgical Associates Location Added 920 Frostwood Ste 620 Houston, TX 77024 (713) 772-1200

Thu Ha Lee, MD

Baylor College of Medicine Phone Number Changed6620 Main St Ste 1350 Houston, TX 77030 (713) 798-5700

James W Suliburk, MD

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Page 39: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Other Changes to KelseyCare Advantage Provider NetworkThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies tothe provider(s) listed under the location information.

TMHPO Surgery Department Location Termed 6550 Fannin St Ste 1601 Houston, TX 77030 (713) 441-5141

Ashish Saharia, MD Timothy Edward Oppermann, MD

TMHPO Surgery Department Phone Number Changed6550 Fannin St Ste 2435 Houston, TX 77030 (713) 441-5141

Lee Mathew Morris, MD

Southwest Surgical Associates Location Termed 15015 Kirby Dr SteHouston, TX 77047 (713) 772-1200

Lucrecia T Staana, MD

Southwest Surgical Associates Location Added 7777 Southwest Frwy Ste 810Houston, TX 77074 (713) 772-1200

Dieu R Ngo, MDGuillermo P Ponce De Leon, MD

Timothy J. Sehorn, MD PA Location Added 6560 Fannin St Ste 1160 Houston, TX 77090 (713) 790-9151

Timothy J Sehorn, MD

Memorial and Katy Surgical Specialists Phone Number Changed18400 Katy Frwy Ste 420Houston, TX 77094 (281) 492-1612

Cameron R Ruttman, MD Kevin D Wheeler, MD

City of Katy

Southwest Surgical Associates Location Added 23920 Katy Frwy Ste 560AKaty, TX 77494(713) 772-1200

Buckminster Farrow, MD Dieu R Ngo, MDThomas W Moore, MD

Gynecology, OB/GYN

Fort Bend County

City of Missouri City

Kelsey-Seybold Clinic Sienna PlantationLocation Added 7010 Hwy 6Missouri City, TX 77459(713) 442-6700

Adrienne L Legendre, MD

Harris County

City of Houston

UT Physicians Phone Number Changed6410 Fannin St Ste 350 Houston, TX 77030 (832) 325-7131

Shahla Nader-Eftekhari, MD

Southwest Women's Health Alliance Location Termed 7900 Fannin St Ste 4000 Houston, TX 77054 (713) 512-7000

Kimberly R Miller-Miles, MDNichole F Cole, MD

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Page 40: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Other Changes to KelseyCare Advantage Provider NetworkThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies tothe provider(s) listed under the location information.

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Infectious Disease

Harris County

City of Houston

Baylor College of Medicine Phone Number Changed6620 Main St Ste 1375 Houston, TX 77030 (713) 798-2500

Alejandro Restrepo, MD

Infectious Disease Associates of Houston, Pa Location Termed 6560 Fannin St Ste 1540 Houston, TX 77030 (713) 799-9997

Mary F Weinert, MD

Internal Medicine

Harris County

City of Houston

Kelsey-Seybold Clinic-Cypress Location Termed 13114 Fm 1960 West Ste 200 Houston, TX 77065 (713) 442-4000

Wilber A Estrada Santiago, MD

Nephrology

Harris County

City of Houston

Baylor College of Medicine Location Termed 6624 Fannin Ste 1610 Houston, TX 77030 (832) 355-7220

Bhamidipati Venkata R Murthy, MD

Montgomery County

City of Spring

Renal Specialists of Houston, Pa Phone Number Changed9449 Grogans Mill RdSpring, TX 77380(713) 791-2648

Billy Gilbert, MDJune Yao, MD

Nephrology - Dialysis Only

Fort Bend County

City of Sugar Land

Southwest Nephrology Associates Location Added 1429 Hwy 6 Ste 103Sugar Land, TX 77478(281) 242-1166

Caleb Chen, MD Marializa V Bernardo, MD

Harris County

City of Cypress

Houston Nephrology Group Location Added 21216 Northwest Frwy Ste 410Cypress, TX 77429(281) 571-8090

Anil U Sheth, MD Ariel M Velasco, MD Redentor Antonio Anton Roy, MDRupinder K Chatha, MDVijayaprakash Sreenarasimhaiah, MD

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Page 41: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Other Changes to KelseyCare Advantage Provider NetworkThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies tothe provider(s) listed under the location information.

City of Houston

Renal Clinic of Houston, PA Location Added 909 Frostwood Ste 164 Houston, TX 77024 (713) 464-9100

Alicia Romero, MD Rahul Prakash, MD Shalin Patel, MD

The Kidney Institute Nephrology Dialysis and Transplantation Associates Location Termed 915 Gessner Rd Ste 360 Houston, TX 77024 (713) 468-5440

Devaraj Munikrishnappa, MD

The Kidney Institute Nephrology Dialysis andTransplantation Associates Phone Number Changed1700 Romano Park Ln Houston, TX 77090 (281) 866-9995

Ulka Desai, MD

Neurology

Harris County

City of Houston

Houston MD's PA Location Termed 6624 Fannin Ste 2190 Houston, TX 77030 (713) 790-1775

Pinky S Tiwari, MD

TMHPO Neurology Department Phone Number Changed6560 Fannin Ste 802 Houston, TX 77030 (713) 441-3780

Eugene Chi-Ho Lai, MDJulia Jones, MD

TMHPO Neurology Department Location Termed 13300 Hargrave Rd Ste 505Houston, TX 77070 (832) 237-1000

Amy Lynette Naquin-Chappel, MD

TMHPO Neurology Department Location Termed 18400 Katy Fwy Ste 520Houston, TX 77094 (832) 522-8520

Mohammad Al-Baeer, MD

City of Spring

TMHPO Neurology Department Phone Number Changed7105 Fm 2920 Spring, TX 77379(936) 270-3900

Laura B Bonds, MD

Montgomery County

City of Shenandoah

TMHPO Neurology Department Location Added 17183 I-45 South Ste 690 Shenandoah, TX 77385 (936) 270-3900

Laura B Bonds, MD

Neurosurgery

Fort Bend County

City of Sugar Land

Baylor College of Medicine Phone Number Changed1327 Lake Point Pkwy Ste 305Sugar Land, TX 77478(713) 798-4696

Shashikant Patil, MD

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Page 42: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Other Changes to KelseyCare Advantage Provider NetworkThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies tothe provider(s) listed under the location information.

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Harris County

City of Houston

Mischer Neurosurgical Associates Location Added 929 Gessner Ste 2410 Houston, TX 77024 (713) 242-4410

Albert F Fenoy, MD

Mischer Neuroscience Associates Location Termed 6400 Fannin St Ste 2510 Houston, TX 77030 (713) 704-6772

Joseph Chia-Yu Hsieh, MD

Mischer Neurosurgical Associates Location Termed 6400 Fannin Ste 2800 Houston, TX 77030 (713) 704-6772

Joseph Chia-Yu Hsieh, MDPaul D Boone, MD

TMHPO Neurosurgery Department Location Added 6445 Main St Opc P24-CO26Houston, TX 77030 (713) 441-3803

David Stuart Baskin, MD

TMHPO Neurosurgery Department Location Termed 6560 Fannin Ste 900 Houston, TX 77030 (713) 441-3800

David Stuart Baskin, MD

Montgomery County

City of Shenandoah

Mischer Neurosurgical Associates Location Added 9200 Pinecroft Ste 130 Shenandoah, TX 77380 (713) 897-5900

Albert F Fenoy, MD

Oncology - Medical, Surgical

Harris County

City of Houston

Texas Oncology Location Added 925 Gessner Rd Ste 550 Houston, TX 77024 (713) 467-1722

Michelina M Cairo, MD

UT Physicians Gynecologic Oncology -Memorial City Location Added 915 Gessner Road Ste 400 Houston, TX 77024 (713) 486-6400

Barry S Siller, MD

Baylor College of Medicine Location Termed 6620 Main St Ste 1225 Houston, TX 77030 (713) 798-2500

Mark M Udden, MD

Baylor College of Medicine Location Added 6620 Main St Ste 1350 Houston, TX 77030 (713) 798-3750

Anita Lyn Sabichi, MDBenjamin Musher, MDJulie R Nangia, MDMartha P Mims, MD, PhD Steven A Curley, MD

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Other Changes to KelseyCare Advantage Provider NetworkThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies tothe provider(s) listed under the location information.

Baylor College of Medicine Location Termed 6620 Main St Ste 1375 Houston, TX 77030 (713) 798-2500

Jun Zhang, MDYvonne Hsiao-Fan Sada, MD

Center for Cell and Gene Therapy Location Added 6565 Fannin Ste M800 Houston, TX 77030 (713) 441-1450

Carlos Ramos, MD Premal Lulla, MD

Dan L Duncan Cancer Center - Hematology/Oncology Location Added 6620 Main St Ste 1350 Houston, TX 77030 (713) 798-3750

Carlos Ramos, MD Gustavo A Rivero, MD Jun Zhang, MDMark M Udden, MD Yvonne Hsiao-Fan Sada, MD

Dan L Duncan Cancer Center - Hematology/Oncology Location Termed 6620 Main St Ste 1375 Houston, TX 77030 (713) 798-2500

Carlos Ramos, MD Gustavo A Rivero, MD

Dan L. Duncan Cancer Center - Hematology/Oncology Location Added 6620 Main St Ste 1350 Houston, TX 77030 (713) 798-3750

Premal Lulla, MD

Methodist Academic Medicine Associates Location Termed 6445 Main St Ste Opc 21Houston, TX 77030 (713) 441-9948

Angel Augusto Rodriguez, MDDaniel Edward Lehane, MD Eric Howard Bernicker, MD Jenny Chee Ning Chang, MDKirk Edward Heyne, MDMonisha Singh, MDSwaminathan Padmanabhan Iyer, MDTejal Amar Patel, MD

Methodist Academic Medicine Associates Location Added 6445 Main St Ste Opc 24Houston, TX 77030 (713) 441-9948

Angel Augusto Rodriguez, MDDaniel Edward Lehane, MD Eric Howard Bernicker, MD Jenny Chee Ning Chang, MDKirk Edward Heyne, MDMonisha Singh, MDSwaminathan Padmanabhan Iyer, MDTejal Amar Patel, MD

Methodist Academic Medicine Associates Location Termed 6445 Main St Ste Opc 21Houston, TX 77030 (713) 441-9948

Polly Ann Niravath, MD

Methodist Academic Medicine Associates Location Added 6445 Main Street Opc 24Houston, TX 77030 (713) 441-9948

Polly Ann Niravath, MD

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Page 44: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Other Changes to KelseyCare Advantage Provider NetworkThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies tothe provider(s) listed under the location information.

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Methodist Academic Medicine Associates Phone Number Changed18220 State Hwy 249 Ste 130Houston, TX 77070 (281) 737-0435

Asha Murthy, MD

Texas Oncology Location added 13215 Dotson Rd Ste 300 Houston, TX 77070 (281) 894-8822

Henna M Maik, MD

Texas Oncology Location added 13300 Hargrave Rd Ste 190Houston, TX 77070 (281) 894-8822

Henna M Maik, MD

TMHPO Surgery Department Phone Number Changed13300 Hargrave Rd Ste 450Houston, TX 77070 (281) 737-4861

Loren Lynn Rourke, MD

Texas Oncology Location Added 17070 Red Oak Dr Ste 406 Houston, TX 77090 (713) 830-9100

Gurjyot K Doshi, MD

Montgomery County

City of The Woodlands

MD Anderson Regional Care Center in TheWoodlands Location Termed 17198 St Luke's WayThe Woodlands, TX 77384 (713) 745-9940

Angela Coscio, MD

Oncology - Radiation/Radiation Oncology

Harris County

City of Houston

Texas Oncology Location Termed 921 N Gessner Rd Houston, TX 77024 (713) 467-1722

David P Walker, MD

Texas Oncology Phone Number Changed 13215 Dotson Rd Houston, TX 77070 (281) 517-0809

Howard Lewis, MD

Northwest Radiotherapy Association Location Termed 7600 Beechnut St Houston, TX 77074 (713) 456-6522

Mi Kyung Ko, MDNeelofur R Ahmad, MD

City of Tomball

Northwest Radiotherapy Association Location Termed 13700 Medical Complex DrTomball, TX 77375 (281) 401-5900

M Elizabeth Sands, MD Mi Kyung Ko, MDNeelofur R Ahmad, MD

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Page 45: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Other Changes to KelseyCare Advantage Provider NetworkThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies tothe provider(s) listed under the location information.

Ophthalmology

Fort Bend County

City of Katy

Retina Consultants of Houston Location Added 23501 Cinco Ranch Blvd Ste G205 Katy, TX 77494(713) 524-3434

Tien Wong, MD

UT Physicians Location Termed 23923 Cinco Ranch Blvd Katy, TX 77494(713) 486-5300

Stella Kim, MD

City of Sugar Land

Houston Eye Associates PA Location Termed 1429 Hwy 6 South Ste 102Sugar Land, TX 77478(281) 565-2020

Prajay Dhir, MDTimmy A Kovoor, MD

Galveston County

City of Texas City

Houston Eye Associates PA Location Termed 7111 Medical Center Dr Ste 110 Texas City, TX 77591(409) 938-8437

Allan H Fradkin, MD

Harris County

City of Cypress

Retina Consultants of Houston Location Added 21216 Northwest Frwy Ste 630Cypress, TX 77429(713) 524-3434

Charles C Wykoff, MD,Ph.D

Retina Consultants of Houston Location Added 21216 Northwest Fwy Ste 630Cypress, TX 77429(713) 524-3434

Amy C Schefler, MD

Houston Eye Associates PA Location Added 27700 Hwy 290 Ste 300Cypress, TX 77433(832) 280-3600

Victor Y Chang, MD

City of Houston

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

Mitchell Porias, DO

Houston Eye Associates PA Location Added 915 Gessner Road Ste 250 Houston, TX 77024 (713) 467-6474

Timmy A Kovoor, MD

Retina Consultants of Houston Location Termed 902 Frostwood Dr Ste 280 Houston, TX 77024 (832) 358-9306

James Major, MD

Retina Consultants of Houston Location Added 902 Frostwood Ste 280 Houston, TX 77024 (713) 524-3434

Charles C Wykoff, MD,Ph.DDavid Mark Brown, MD

Houston Eye Associates Location Termed 2855 GramercyHouston, TX 77025 (713) 668-6828

Justus W Thomas, MD Mitchell Porias, DO

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Page 46: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Other Changes to KelseyCare Advantage Provider NetworkThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies tothe provider(s) listed under the location information.

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Houston Eye Associates PA Location Termed 2855 GramercyHouston, TX 77025 (713) 668-6828

Sapa Pham, MD

Houston Eye Associates PA Location Termed 6560 Fannin Ste 450 Houston, TX 77030 (281) 351-5468

Aaron M Miller, MD Richard J Ou, MD

Houston Oculoplastic Associates Location Termed 1913 Canterbury StHouston, TX 77030 (832) 868-3938

Imtiaz A Chaudhry, MD

Retina Consultants Location Added 6560 Fannin Ste 750 Houston, TX 77030 (713) 524-3434

Matthew Benz, MD

Robert Cizik Eye Clinic Location Added 6400 Fannin Street Ste 1800 Houston, TX 77030 (713) 559-5200

Stella Kim, MD

Retina Consultants of Houston Location Added 9600 Bellaire Blvd Ste 211 Houston, TX 77036 (713) 524-3434

Eric Chen, MD

Houston Eye Associates Location Termed 1229 Campbell RoadHouston, TX 77055 (713) 467-6600

Victor Chang, MD

Houston Eye Associates PA Location Added 590 Chimney RockHouston, TX 77056 (713) 782-4406

Andrew Kopel, MDCarlos A Gonzales, MD Malcolm L Mazow, MD

Retina Consultants of Houston Location Added 11460 Space Center Blvd Ste 2Houston, TX 77059 (713) 524-3434

Eric Chen, MD

Retina Consultants of Houston Location Added 17030 Nanes Dr Ste 214 Houston, TX 77090 (713) 524-3434

Rosa Kim, MD

City of Humble

Houston Eye Associates PA Location Added 9810 FM 1960 Rd West Ste 250 Humble, TX 77338 (281) 446-9333

Lindsey Harris, MD

City of Katy

Houston Eye Associates Location Added 1331 W Grand Pkwy North Ste 250Katy, TX 77493(281) 347-0176

Victor Chang, MD

City of Tomball

Houston Eye Associates PA Location Added 13414 Medical Complex Dr Ste 4Tomball, TX 77375 (281) 351-5468

Susan Fish, MD Tom H Sun, MD

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Page 47: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Other Changes to KelseyCare Advantage Provider NetworkThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies tothe provider(s) listed under the location information.

Montgomery County

City of Kingwood

Houston Eye Associates Location Added 22659 Hwy 59 North Ste 100Kingwood, TX 77339(281) 858-3937

Justus W Thomas, MD

Houston Eye Associates PA Location Added 22659 Hwy 59 North Ste 100Kingwood, TX 77339(281) 858-3937

Andrew Kopel, MD

Retina Consultants of Houston Location Termed 350 Kingwood Medical Dr Ste 200Kingwood, TX 77339(713) 524-3434

Charles C Wykoff, MDMatthew Benz, MD

City of Shenandoah

Houston Eye Associates Location Termed 1699 Research Forest Dr Ste 150 Shenandoah, TX 77380 (281) 363-2155

Fiaz Zaman, MD

Houston Eye Associates PA Location Added 1699 Research Forest Dr Ste 150 Shenandoah, TX 77380 (281) 363-2155

Andrew Kopel, MDLindsey Harris, MD

Plastic Eye Surgery Associates, Pllc Location Added 920 Medical Plaza Dr Ste 490 Shenandoah, TX 77380 (713) 795-0705

Charles S Soparkar, MD

City of The Woodlands

Retina Consultants of Houston Location Added 17350 St. Luke's Way Ste 120The Woodlands, TX 77385 (713) 524-3434

Ankoor Shah, MD

Orthopedic Surgery

Fort Bend County

City of Sugar Land

Baylor College of Medicine Location Termed 15200 Southwest Frwy Ste 175Sugar Land, TX 77478(281) 494-0550

Thomas R Hunt, III, MD

TMHPO Orthopedics Department Location Termed 16811 Southwest FwySugar Land, TX 77479(281) 690-4678

Kevin Eugene Varner, M.D.

TMHPO Orthopedics Department Location Termed 16651 Southwest Frwy Ste 400Sugar Land, TX 77479(713) 441-3535

Stephen Joseph Incavo, MD

Harris County

City of Baytown

TMHPO Orthopedics Department Location Termed 4000 Garth Rd Ste 200 Baytown, TX 77521(832) 556-0880

David Mark Lintner, MD

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Page 48: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Other Changes to KelseyCare Advantage Provider NetworkThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies tothe provider(s) listed under the location information.

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City of Houston

Kelsey-Seybold Clinic-Tanglewood Location Termed 15655 Cypress Woods Medical Drive Ste 100Houston, TX 77014 (713) 442-1700

David W Edelstein, MD

TMHPO Department of Orthopedics Location Added 9090 Katy Fwt Ste 200Houston, TX 77024 (713) 353-5770

William C Watters, MD

TMHPO Department of Orthopedics Location Added 9090 Katy Fwy Ste 200Houston, TX 77024 (713) 353-5770

Robert S Neff, MD

TMHPO Orthopedics Department Location Added 9090 Katy Freeway, Suite 200Houston, TX 77024 (713) 353-5770

Hosun Hwang, MD

TMHPO Orthopedics Department Location Added 9090 Katy Fwy Ste 200Houston, TX 77024 (713) 353-5770

David L Dice, Jr, MD

TMHPO Orthopedics Department Location Termed 915 Gessner Rd Ste 560 Houston, TX 77024 (713) 790-1818

David L Dice, Jr, MD

TMHPO Orthopedics Department Location Termed 6550 Fannin St Ste 2601 Houston, TX 77030 (713) 790-1818

David L Dice, Jr, MD Marc Labbe, MD

TMHPO Orthopedics Department Location Added 14903 El Camino Real Houston, TX 77058 (713) 363-9090

Edward Won Lee, MD

Montgomery County

City of Conroe

TMHPO Orthopedics Department Phone Number Changed3115 College Park Dr Ste 112Conroe, TX 77384 (281) 737-2630

John Martin Fackler, MD

City of Shenandoah

Kelsey-Seybold Clinic-Tanglewood Location Termed 106 Vision Park Blvd Shenandoah, TX 77384 (713) 442-1800

David W Edelstein, MD

City of The Woodlands

TMHPO Orthopedics Department Phone Number Changed17198 St Luke's Way Ste 600The Woodlands, TX 77384 (713) 790-1818

David L Dice, Jr, MD Marc Labbe, MD

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Page 49: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Other Changes to KelseyCare Advantage Provider NetworkThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies tothe provider(s) listed under the location information.

Orthopedics - Sports Medicine

Harris County

City of Houston

Kelsey-Seybold Clinic-Meyerland Plaza Clinic Location Termed 560 Meyerland Plaza MallHouston, TX 77096 (713) 442-3222

Randal R Stavinoha, MD

Plastic Surgery

Harris County

City of Houston

Baylor College of Medicine Location Termed 1977 Butler Blvd Ste E6 100 Houston, TX 77030 (713) 798-6141

Edward P Buchanan, MD

Pulmonology

Fort Bend County

City of Richmond

Kelsey- Seybold Clinic Katy Location Added 22121 Fm 1093 Richmond, TX 77407 (713) 442-4100

Bashar I Farjo, MD

Harris County

City of Houston

UT Physicians Phone Number Changed6410 Fannin St Ste 600 Houston, TX 77030 (832) 325-7222

Bindu Akkanti, MD

City of Katy

Kelsey- Seybold Clinic Cinco Ranch Location Termed 23000 Highland Knolls DrKaty, TX 77494(713) 442-4200

Bashar I Farjo, MD

Rehabilitation Medicine

Harris County

City of Houston

UT Physicians- Physical Medicine &Rehabilitation Location Added 1635 North Loop WestHouston, TX 77008 (713) 867-2000

Prathap J Joseph, MD

UT Physicians- Physical Medicine &Rehabilitation Location Added 1635 North Loop West Unit 4 NorthHouston, TX 77008 (713) 867-2000

Richard A Huang, MD

TIRR Memorial Hermann OutpatientRehabilitation - West University Location Added 2909 West Holcombe Boulevard Houston, TX 77025 (800) 447-3422

Carolina Gutierrez, MD

Baylor College of Medicine Location Added 7200 Cambridge St. 10th Floor, Suite 10 CHouston, TX 77030 (713) 798-7246

Batool M Mirabi, MD Donna M Bloodworth, MD Faye C Tan, MDJocelyn John, MD

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Page 50: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Other Changes to KelseyCare Advantage Provider NetworkThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies tothe provider(s) listed under the location information.

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Baylor College of Medicine Location Termed 7200 Cambridge Ste 10CHouston, TX 77030 (713) 798-7246

Cindy B Ivanhoe, MD

Memorial Hermann Hospital-TMC Location Added 6411 Fannin Street Houston, TX 77030 (713) 704-4000

Argyrios Stampas, MDChristopher M Falco, MDGerard E Francisco, MD Joel E Frontera, MD Judy L Thomas, MDMatthew E Davis, MD Prathap J Joseph, MDRadha Korupolu, MDStacy L Hall, MD

Memorial Hermann Hospital-TMC Location Added 6411 Fannin Street Jones Ste 400 Houston, TX 77030 (713) 704-4000

Jose E Arias-Berrios, MD

UT Physicians Location Termed 1300 Moursund Houston, TX 77030 (713) 799-5000

Jason W Chen, DO

UT Physicians Location Termed 6411 Fannin Street Houston, TX 77030 (713) 704-3961

Ajai Sambasivan, MD

UT Physicians at Texas Medical Center Location Added 6410 Fannin Street Houston, TX 77030 (713) 704-4000

Carolina Gutierrez, MD

UT Physicians Otorhinolaryngology - TexasMedical Center Location Added 6400 Fannin Street Ste 2700 Houston, TX 77030 (713) 486-5000

Carolina Gutierrez, MD

UT Physicians Physical Medicine and Rehabilitation - TIRR Memorial Hermann Location Added 1333 Moursund Houston, TX 77030 (713) 500-5874

Judy L Thomas, MDRichard A Huang, MD

UT Physicians Physical Medicine and Rehabilitation - TIRR Memorial Hermann Location Added 1333 Moursund Ste 129 Houston, TX 77030 (713) 799-7024

Prathap J Joseph, MD

UT Physicians Physical Medicine and Rehabilitation - TIRR Memorial Hermann Location Added 1333 Moursund Street Houston, TX 77030 (713) 799-5000

Carolina Gutierrez, MD Joel E Frontera, MD

UT Physicians Physical Medicine and Rehabilitation - TIRR Memorial Hermann Location Added 1333 Moursund Street Ste 128B Houston, TX 77030 (713) 799-7024

Monica Verduzco-Gutierrez, MD

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Other Changes to KelseyCare Advantage Provider NetworkThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies tothe provider(s) listed under the location information.

UT Physicians Physical Medicine and Rehabilitation - TIRR Memorial Hermann Location Added 1333 Moursund Street Ste 144.2 Houston, TX 77030 (713) 797-7634

Gerard E Francisco, MD

UT Physicians Physical Medicine and Rehabilitation - TIRR Memorial Hermann Location Added 1333 Moursund Street Ste 145 Houston, TX 77030 (713) 799-7024

Radha Korupolu, MD

UT Physicians Physical Medicine and Rehabilitation - TIRR Memorial Hermann Location Added 1333 Moursund Street Ste 164 Houston, TX 77030 (713) 799-5007

Elaine M Magat, MD

UT Physicians Physical Medicine and Rehabilitation - TIRR Memorial Hermann Location Added 1333 Moursund Street Ste 165.4A Houston, TX 77030 (713) 797-5912

Christopher M Falco, MD

UT Physicians Physical Medicine and Rehabilitation - TIRR Memorial Hermann Location Added 1333 Moursund Street Ste 165.5 Houston, TX 77030 (713) 797-5912

Matthew E Davis, MD

UT Physicians Physical Medicine and Rehabilitation - TIRR Memorial Hermann Location Added 1333 Moursund Street Ste 165.D6 Houston, TX 77030 (713) 797-5938

Argyrios Stampas, MD

UT Physicians Physical Medicine and Rehabilitation - TIRR Memorial Hermann Location Added 1333 Moursund Street Ste RB 224 Houston, TX 77030 (713) 799-5007

Sheng Li, MD

UT Physicians Physical Medicine and Rehabilitation- TIRR Memorial Hermann Location Added 1333 Moursund 1st Floor Houston, TX 77030 (713) 799-5007

Juan C Galloza-Otero, MD

UT Physicians- Physical Medicine &Rehabilitation Location Added 7600 Beechnut Street Houston, TX 77074 (713) 456-3000

Prathap J Joseph, MDRichard A Huang, MD

UT Physicians- Physical Medicine &Rehabilitation Location Added 7333 North FreewayHouston, TX 77076 (713) 807-8686

Richard A Huang, MD

UT Physicians- Physical Medicine &Rehabilitation Location Added 11800 Astoria Blvd Houston, TX 77089 (281) 929-6100

Prathap J Joseph, MD

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Page 52: Provider 2017 Directory Addendum - KelseyCare AdvantageProvider Directory Addendum 2017 Through 6/30/2017. 1 KelseyCare Advantage HMO and HMO-POS Plan ... Ashok Balasubramanyam, MD

Other Changes to KelseyCare Advantage Provider NetworkThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies tothe provider(s) listed under the location information.

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UT Physicians- Physical Medicine &Rehabilitation Location Added 11800 Astoria Boulevard Houston, TX 77089 (281) 929-6100

Richard A Huang, MD

City of Humble

UT Physicians- Physical Medicine &Rehabilitation Location Added 18951 North Memorial Drive Humble, TX 77338 (281) 540-7700

Richard A Huang, MD

City of Katy

Hemorial Hermann - Katy Location Added 21720 Kingsland BlvdKaty, TX 77450(281) 579-5555

Joel E Frontera, MD

City of Pasadena

Kelsey-Seybold Clinic-Pasadena Location Termed 5001 E Sam Houston Pkwy SPasadena, TX 77505 (713) 442-7100

Huiqing Yang, MD

City of Webster

Kelsey-Seybold Clinic-Clear Lake Location Termed 1010 South Ponds Dr Webster, TX 77598 (713) 442-4300

Huiqing Yang, MD

Montgomery County

City of Shenandoah

The Institution for Rehabilitation and Research Location Added 9250 Pinecroft Drive Shenandoah, TX 77380 (713) 897-2864

Monica E Crump, MD

Rheumatology

Harris County

City of Houston

Baylor College of Medicine Location Termed 6620 Main St Ste 1375 Houston, TX 77030 (713) 798-3390

Sandeep K Agarwal, MD

Baylor College of Medicine Location Termed 7200 Cambridge 10th FloorHouston, TX 77030 (713) 798-3390

Marissa Nicole Meissner, MD

Baylor College of Medicine Location Termed 7200 Cambridge St 10th FloorHouston, TX 77030 (713) 798-3390

Rashmi M Maganti, MD

Sports Medicine

Fort Bend County

City of Sugar Land

Baylor College of Medicine Location Termed 15200 Southwest Frwy Ste 175Sugar Land, TX 77478(281) 494-0550

Theodore Benjamin Shybut, MD

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Other Changes to KelseyCare Advantage Provider NetworkThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies tothe provider(s) listed under the location information.

Harris County

City of Houston

TMHPO Orthopedics Department Location Termed 18400 Katy Frwy Ste 520Houston, TX 77094 (832) 522-8280

Winfield M. Campbell, MD

Thoracic Surgery

Harris County

City of Houston

Texas Surgical Associates, LLP Phone Number Changed7737 Southwest Frwy Ste 201Houston, TX 77074 (713) 776-0655

Timothy T Hamilton, MD

City of Webster

Surgical Specialist of Clear Lake, Pllc Location Termed 450 Medical Center Blvd Ste 600 Webster, TX 77598 (281) 332-4596

Christos Katsigiannis, MD

Urology

Harris County

City of Houston

Houston Metro Urology PA Location Termed 915 Gessner Rd Ste 370 Houston, TX 77024 (713) 634-4441

Francisco J Gelpi-Hammerschmidt, MDGregory D Hester, MD

Methodist Urology Associates Phone Number Changed18220 State Hwy 249 Ste 400Houston, TX 77070 (281) 737-0309

David Joonbeom Lim, MD

Vascular Surgery

Fort Bend County

City of Sugar Land

Baylor College of Medicine Location Termed 1327 Lake Pointe Parkway Ste 305Sugar Land, TX 77498(713) 798-8412

Jayer Chung, MDJoseph L Mills, MD

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Facility Additions to KelseyCare Advantage Provider Network Through 6/30/2017

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City of Sugar Land

Cure & Co 2584 Town Center Blvd N Ste A Sugar Land, TX 77479(281) 265-0533

City of Pearland

St. Luke's Community Emergency Center-Pearland 11713 Shadow Creek ParkwayPearland, TX 77584 (713) 793-4600

City of Houston

St. Luke's Community Emergency Center-Holcombe 2727 W. Holcombe Houston, TX 77025 (832) 355-7525

St. Luke's Community Emergency Center-SanFelipe6363 San Felipe Ste 100Houston, TX 77057 (832) 355-3081

City of Houston

Plaza Specialty Hospital1300 Binz Houston, TX 77004 (713) 285-1028

City of Houston

CHI St. Luke's Health Baylor College ofMedicine Medical Center-McNair Campus7200 Cambridge StHouston, TX 77030 (713) 785-8537

City of Conroe

Memorial Hermann Surgery Center Conroe1501 River Pointe Dr Ste 200 Conroe, TX 77304 (936) 523-5501

Durable Medical Equipment

Fort Bend County

Free Standing Emergency Center

Brazoria County

Harris County

Long Term Acute Care

Harris County

Surgical Services

Harris County

Montgomery County

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Facility Terminations to KelseyCare Advantage Provider Network Through 6/30/2017

The following facilities are no longer part of the KelseyCare Advantage facility network. If you need help finding a network facility, 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

Home Health

Fort Bend County

City of Richmond

JD Homecare 19003 Spring MeadowRichmond, TX 77407 (281) 344-1091

Pulmonary Lab

Harris County

City of Houston

Gulf Coast Lung Center, Inc364B Fm 1959 Rd Houston, TX 77034 (281) 974-5095

Skilled Nursing Facility

Harris County

City of Pasadena

The Medical Resort at Bay Area4900 East Sam Houston Pkwy SPasadena, TX 77505 (972) 442-2900

Facility T

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elseyCare A

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53

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Additions to Mental Health Providers Through 6/30/2017

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Fort Bend County

City of Missouri City

Christine Kiss LCSW 4501 Cartwright Rd Ste 103Missouri City, TX 77459(281) 552-7087

Christine W Kiss, MSW

Clansy, Carolyn D.4501 Cartwright Rd Ste 705Missouri City, TX 77459(281) 969-8235

Carolyn D Clansy, PHD

City of Richmond

Freeman, William J. 2116 Thompson Rd Ste 101Richmond, TX 77469 (281) 239-6700

William J Freeman, MSW

City of Sugar Land

Halverson and Bevan 101 Southwestern Blvd Ste 109 Sugar Land, TX 77478(281) 242-1970

Jay P Bevan, PHD

Texana Center 2535 Cordes Dr Sugar Land, TX 77479(281) 276-4400

Yahya Saeed, MD

Galveston County

City of Dickinson

Utmb Faculty Group Practice2401 Fm 646 Rd W Ste C Dickinson, TX 77539 (281) 614-1256

Lisa Falls, MD

City of Friendswood

Insights150 W Shadowbend Ave Ste 100 Friendswood, TX 77546 (281) 576-9343

Venette C Westhoven, PHD

City of Galveston

The Gulf Coast Center 123 Rosenberg St Ste 6Galveston, TX 77550 (800) 643-0967

Holly C Dubois, MDHoward L Wong, MDHumberto B Quintana, MD Joshua Niclas, MD Neysa L Johnson, MDNga A Nguyen, MDNicolas D Brown, MD Robin E Hostetter, MD Ronald L Rogers, MDStuart D Crane, MD Suellen M Brown, MSW Swati Ellendula, MD Taghi Shafie, MDTerry A Rustin, MD

City of League City

Devereux Texas Treatment Network 1150 Devereux Dr League City, TX 77573(281) 335-1000

Carolyn T Villarrubia, MD

54

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Additions to Mental Health Providers Through 6/30/2017

The Gulf Coast Center 305 E Main St League City, TX 77573(800) 643-0967

Angelica F Torres, MSWAnnette H Martinez, MSW Clara Pena, MSW

Utmb Faculty Group Practice2240 Gulf Fwy SLeague City, TX 77573(832) 505-1800

Jeffrey M Baker, PHD

Utmb Faculty Group Practice2785 Gulf Fwy S Ste 200League City, TX 77573(409) 772-3695

Amanda M Dunn, MSW

Harris County

City of Galena Park

Baylor College of Medicine1721 16th St Galena Park, TX 77547 (713) 921-7361

Elyssa M Fink, MSW

City of Houston

Altaf Loya11920 Astoria Blvd Ste 110 Houston, TX 77089 (281) 481-4646

Amanda Barrett, RN

Baylor College of Medicine1502 Taub Loop Fl 2Houston, TX 77030 (713) 873-4900

Xiaofan Li, MD

Baylor College of Medicine1502 Taub Loop Fl 4Houston, TX 77030 (713) 873-4901

Britta Ostermeyer, MDSarah E Ramos, MD Sharadamani Anandan, MD

Baylor College of Medicine6620 Main St Ste 1225 Houston, TX 77030 (713) 798-2500

Angela Caughlin, MSW

Bharath G Raj2020 North Loop W Ste 150Houston, TX 77018 (832) 410-4602

Bharath R Raj, MD

Butler Psychological Group PLLC6260 Westpark Dr Ste 310Houston, TX 77057 (832) 386-9449

Eboni T Butler, PhD

Carole A Busick 804 W Main St Houston, TX 77006 (713) 942-9747

Carole A Busick, PHD

Cynthia K Otter3880 Greenhouse Rd Ste 201 Houston, TX 77084 (281) 636-6753

Cynthia K Otter, MSW

Deblin Health Concepts and Associates13201 Northwest Fwy Ste 800Houston, TX 77040 (713) 686-9194

Beth Kobb, MSW Hanna K Del Toro, MSW

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Additions to Mental Health Providers Through 6/30/2017

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Jamila Woods, MSW Maria C Davila, MSW Scott Helm, MSW

Deer Oaks Consultation Services Inc 1737 North Loop WHouston, TX 77008 (210) 615-3428

Janet M Peterson, PHD

Deer Oaks Consultation Services Inc 6150 South Loop EHouston, TX 77087 (210) 615-3428

Lisa Bowles, PhD

Depelchin Psychiatric Services4950 Memorial Dr Houston, TX 77007 (713) 730-2335

Oscar G Bukstein, MD

Innovative Cousneling Options of Houston Pllc14441 Memorial Dr Ste 12 Houston, TX 77079 (281) 946-9567

Jeanie Low, MSW

Innovative Cousneling Options of Houston Pllc5900 Memorial Dr Ste 218 Houston, TX 77007 (281) 946-9567

Jeanie Low, MSW

Lea, Melinda J. 17045 El Camino Real Ste 210 Houston, TX 77058 (281) 488-0615

Melinda J Lea, PHD

On Site Counseling Inc3007 Caroline St Houston, TX 77004 (713) 942-8100

Curtis Willis, PhD

Ursula Rice, MSW

Pham, George G.1570 S Dairy Ashford Rd Ste 120Houston, TX 77077 (713) 981-4081

George G Pham, MD

Psychiatric Services of Houston and Assoiates I Pllc 4314 Yoakum Blvd Houston, TX 77006 (713) 850-0049

Karimot A Pedro, NP

Senior Psychcare of Dallas I, Pllc4314 Yoakum Blvd Houston, TX 77006 (713) 850-0049

Chima N Asikaiwe, MD

Senior Psychological Care Dallas I, Llc4314 Yoakum Blvd Houston, TX 77006 (713) 850-0049

Kenneth P Adams, PHD

Senior Psychological Care I4515 Yoakum Blvd Houston, TX 77006 (713) 850-0049

Arthemease Bloxson Melancon, MSW

Sherry Shallow LCSW PLLC701 N Post Oak Rd Ste 7 Houston, TX 77024 (713) 416-2907

Sherry L Shrallow, MSW

The Adolescent Center and Mental Health Services Pllc 4500 Montrose Blvd Ste E Houston, TX 77006 (832) 484-2635

Akalita Ross, PhD

56

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Additions to Mental Health Providers Through 6/30/2017

The Anxiety Center of Houston9950 Cypresswood Dr Ste 207Houston, TX 77070 (346) 206-3992

Bianca N Asteris, MSW

The Harris Center For Mental Health and Idd 1502 Taub LoopHouston, TX 77030 (713) 970-4600

An H Dinh, MD Cordia Y Anderson Hopkins, MSWDiane G Bliven, MSW Elizabeth Nguyen, MDFasiha Haq, MDJennifer T Dague, MSWJoseph E Newman, MSWMatthew Hinthorn, MD Ronald C Moomaw, MD Shama Rasheed, MD

The Harris Center For Mental Health and Idd 3630 W Dallas St Houston, TX 77019 (713) 970-7000

Carmen Deneen, MSW Paula A Moore, PhD

UT Physicians11452 Space Center BlvdHouston, TX 77059 (713) 741-5000

Seema R Basnett, MD

UT Physicians1941 East Rd Houston, TX 77054 (713) 486-2642

Megan Mooney, PHD

UT Physicians2800 S Macgregor WayHouston, TX 77021 (713) 741-7829

David S Bobb, MD Salih Selek, MD

UT Physicians6410 Fannin St Ste 1014 Houston, TX 77030 (832) 325-7080

Bethany R Williams, PHDChristina Burrows, PHD Rony Ninan, MD

UT Physicians6410 Fannin St Ste 500 Houston, TX 77030 (832) 325-7477

Allison G Dempsey, PHD

City of Kingwood

Krishna V R Sunkureddi MD Pa 1406 Stonehollow Dr Kingwood, TX 77339(281) 358-0502

Chidinma E Isinguzo, MD

City of Pasadena

Deer Oaks Consultation Services Inc 811 Garner Rd Pasadena, TX 77502 (210) 615-3428

Stephanie Zeid, PhD

City of Seabrook

Jacqueline Lanier1201 Hardesty AveSeabrook, TX 77586 (281) 474-1488

Jacqueline W Lanier, PHD

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Provid

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Additions to Mental Health Providers Through 6/30/2017

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City of Spring

Behavioral Services of Houston 17207 Kuykendahl Rd Ste 100Spring, TX 77379(281) 374-8555

Javier Ruiz Nazario, MD

City of Tomball

Everhealth PLLC 14011 Park Dr Ste 205 Tomball, TX 77377 (281) 290-8188

Mehboob A Nazarani, MD

Montgomery County

City of Kingwood

Athi P Venkatesh 19701 Kingwood Dr Bldg 3Kingwood, TX 77339(281) 358-5701

Ayanna J Brown, MD

Clamp Network700 Rockmead Dr Ste 213 Kingwood, TX 77339(281) 433-8210

Carola Sepulveda, MSW

City of The Woodlands

Innovative Cousneling Options of Houston Pllc25301 Borough Park Dr Ste 201The Woodlands, TX 77380 (281) 946-9567

Jeanie Low, MSW

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Terminations to Mental Health Providers Through 6/30/2017

The following providers are no longer part of the KelseyCare Advantage provider network. If you needhelp 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.

Fort Bend County

City of Sugar Land

Houston Center For Christian Counseli 402 Julie Rivers Dr Sugar Land, TX 77478(281) 277-8811

Judith A Morris, MSW

Galveston County

City of Galveston

Broadway Medical Clinic2217 Broadway St Ste RGalveston, TX 77550 (409) 762-6252

J Felipe Nieto, MD

The Gulf Coast Center 123 Rosenberg St Ste 6Galveston, TX 77550 (800) 643-0967

Gonzalo J Perez Garcia, MD Wanda K Terry, MD

Harris County

City of Baytown

Little, Karley Y.1770 Hillcrest St Baytown, TX 77520(734) 355-0946

Karley Y Little, MD

City of Bellaire

Hauser Clinic and Associates 5959 West Loop S Ste 660Bellaire, TX 77401 (713) 669-0303

Bernard M Gerber, MD

City of Houston

Baylor College of Medicine1977 Butler Blvd Ste E4400 Houston, TX 77030 (713) 798-4857

Kristin A Kassaw, MD

BCM Physicians1502 Taub Loop Fl 4Houston, TX 77030 (713) 873-4901

Mihaela C Ivan, MD

Broadway Medical Clinic3208 Broadway StHouston, TX 77017 (713) 641-5656

J Felipe Nieto, MD

Depelchin Psychiatric Services4950 Memorial Dr Houston, TX 77007 (713) 730-2335

Adrienne Tinder, PHD Janet Zoch, MD Sadaf Javaid, MD

James R Wright14340 Torrey Chase Blvd Ste 325Houston, TX 77014 (281) 586-0747

James R Wright III, MD

Term

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Terminations to Mental Health Providers Through 6/30/2017

The following providers are no longer part of the KelseyCare Advantage provider network. If you needhelp 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.

Ter

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Lindsay and Susana Rosin3730 Kirby Dr Ste 825Houston, TX 77098 (713) 523-0000

Lindsay Z Rosin, PHD

Liz Steele Llc 12337 Jones Rd Ste 310 Houston, TX 77070 (281) 796-6049

Elizabeth L Steele, MSW

Markowitz, Michael L. 11721 Fuqua StHouston, TX 77034 (281) 217-7761

Michael L Markowitz, PHD

Memorial Hermann Medical Group3033 Gessner Rd Ste 2221 Houston, TX 77080 (713) 329-7524

Donna T Rocha, MD

Memorial Hermann Medical Group3033 Gessner Road Ste 2221 Houston, TX 77080 (713) 329-7524

Donna T Rocha, MD

Memorial Neurological Association7777 Southwest Fwy Ste 900Houston, TX 77074 (713) 772-4600

Barbara P Uzzell, PHD

Miekka, Jacqueline A.950 Echo Ln Ste 335 Houston, TX 77024 (281) 394-8876

Jacqueline A Miekka, PHD

Silverlake Behavioral Associates 3314 Mercer St Houston, TX 77027 (281) 489-1290

Luis A Valdes, PHD

The Harris Center For Mental Health and Idd 9401 Southwest FwyHouston, TX 77074 (713) 970-7000

Sriya De Silva, MD

UT Physicians1941 East Rd Houston, TX 77054 (713) 486-2700

Vineeth P John, MD

UT Physicians2800 S Macgregor WayHouston, TX 77021 (713) 741-5000

Jonathan Findley, MD

Montgomery County

City of The Woodlands

Cross Mountain Clinicians Network 26022 Oak Ridge DrThe Woodlands, TX 77380 (281) 236-3989

Beth C Boone, PHD

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Other Changes to Mental Health ProvidersThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies tothe provider(s) listed under the location information.

Counselor

Fort Bend County

City of Rosenberg

Texana Center Phone Number Changed4910 Airport Ave Ste ARosenberg, TX 77471(281) 342-6384

Ginette Reedy, MSWKara Janecek, MSW Kimberly K Pore, MSWLinda Bracey, MSWPhaetra K Raney Semien, MSW

Harris County

City of Houston

The Harris Center For Mental Health and Idd Phone Number Changed1502 Taub LoopHouston, TX 77030 (713) 970-4600

Lisa M Guillory, MSW

Psychaitry

Fort Bend County

City of Rosenberg

Texana Center Phone Number Changed4910 Airport Ave Ste ARosenberg, TX 77471(281) 342-6384

Bahadur P Sarkari, MD Claire Friedman, MD Olajide H Masha, MDOri S Ogebe, MDOwen O Osagie, MDRuth E Netscher, MD Sriya De Silva, MD

Harris County

City of Houston

The Harris Center For Mental Health and Idd Phone Number Changed1502 Taub LoopHouston, TX 77030 (713) 970-4600

Mollie R Gordon, MD

Psychiatry

Fort Bend County

City of Rosenberg

Texana Center Phone Number Changed4910 Airport Ave Ste ARosenberg, TX 77471(281) 342-6384

Shama Rasheed, MD

Galveston County

City of Galveston

The Gulf Coast Center Location Termed 123 Rosenberg St Ste 6Galveston, TX 77550 (800) 643-0967

Manizeh Mirza Gruber, MD

City of League City

The Gulf Coast Center Location Termed 305 E Main St League City, TX 77573(800) 643-0967

Manizeh Mirza Gruber, MD

Oth

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Other Changes to Mental Health ProvidersThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies to

Oth

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the provider(s) listed under the location information.

City of Texas City

The Gulf Coast Center Location Termed 3201 Fm 2004 Rd Texas City, TX 77591(800) 643-0967

Manizeh Mirza Gruber, MD

The Gulf Coast Center Location Termed 7510 Fm 1765 Texas City, TX 77591(800) 643-0967

Manizeh Mirza Gruber, MD

Harris County

City of Houston

Tony A Pham Location Termed 7707 Fannin St Ste 205 Houston, TX 77054 (713) 790-0745

Tony A Pham, MD

City of Pasadena

Matthew Brams MD and Alice Mao MD Location Termed 825 Fairmont PkwyPasadena, TX 77504 (713) 943-2267

Alice R Mao, MD Matthew N Brams, MD

Psych Management Solutions Location Termed 825 Fairmont PkwyPasadena, TX 77504 (713) 943-2267

Matthew N Brams, MD

Psychology

Fort Bend County

City of Rosenberg

Texana Center Phone Number Changed4910 Airport Ave Ste ARosenberg, TX 77471(281) 342-6384

Maria Fragioudakis, PHDRoger Worthen, PHD

Harris County

City of Houston

Casazza, Ralph E. Location Termed 6614 Hornwood Dr Houston, TX 77074 (713) 271-0000

Ralph E Casazza, PHD

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Additions to Vision Service Providers

Ophthalmology

Fort Bend County

City of Sugar Land

Lone Star Eye Care3515 Town Center Blvd S Sugar Land, TX 77479(281) 277-8400

Theresa Leung, MD

Harris County

City of Katy

Berkeley Eye Center21502 Merchants WayKaty, TX 77449(281) 579-6777

Rachel Cook, MD

Optometry

Fort Bend County

City of Katy

Maxton Vision Group24502 Kingsland BlvdKaty, TX 77494(281) 394-5006

Julie Ly, OD

Vision Source 1721 Spring Green Blvd Ste 300Katy, TX 77494(832) 774-5834

Rick D Dinh, OD

Through 6/30/2017

City of Richmond

Pearle Vision 7101 W Grand Pkwy S Ste 170Richmond, TX 77407 (832) 222-9185

Imrana Momin, OD

City of Sugar Land

Colony Eye Care Center LLP4511 Sweetwater Blvd Sugar Land, TX 77479(281) 265-2020

Matthew Rosner, OD

Galveston County

City of League City

Eye Definition3831 E League City Pkwy Ste DLeague City, TX 77573(832) 376-8688

Paul D Driggers, OD

City of Texas City

Texas State Optical of Texas City2702 Palmer HwyTexas City, TX 77590(409) 948-1311

Joshua Devera, OD

Harris County

City of Cypress

Strong Vision Center17445 Spring Cypress Rd Ste GCypress, TX 77429(281) 373-3063

Lindsay S Owen, ODLisa Kakade, OD

Ad

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Service P

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Additions to Vision Service Providers Through 6/30/2017

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City of Houston

20 15 Vision Center 3271 Southwest Fwy Ste AHouston, TX 77027 (713) 664-2015

Jason Idiculla, OD

Alpha Eyecare Associates PLLC12401 S Post Oak Rd Ste D Houston, TX 77045 (713) 721-9000

Janis N Hamsa, OD

Bellaire Eye Care Inc1701 Sunset Blvd Ste 6207 Houston, TX 77005 (713) 592-6550

Elba D Fernandez, OD

Berkeley Eye Center3100 Weslayan St Ste 400Houston, TX 77027 (713) 526-1600

Alyce Alven, OD

Berkeley Eye Center8800 Katy Fwy Ste 107Houston, TX 77024 (713) 827-8311

Preston Davis, OD

Charles A Garcia MD PA 1315 St Joseph Pkwy Ste 1205Houston, TX 77002 (713) 659-3937

Saina Esfandiari, OD

Diagnostic Eye Center3405 Edloe St Ste 300 Houston, TX 77027 (713) 797-1500

Andrew K Salem, OD

Eye Contact2055 Westheimer Rd Ste 135 Houston, TX 77098 (713) 520-6600

Cindy E Pouw, OD

Eye Excellence PA6624 Fannin St Ste 2105 Houston, TX 77030 (713) 791-9494

Jia Lee, OD Louis Binder, OD

Eye Site Katy Dr John Oneil700 Town & Country Blvd Ste 2460 Houston, TX 77024 (713) 984-9144

Supriya Krishnan, OD

Good Neighbor Eye Clinic190 Heights BlvdHouston, TX 77007 (713) 527-8480

Marsha Thomas, OD

Gulf Coast Vision Center 2636 S Loop W Ste 500Houston, TX 77054 (713) 790-0513

Jelita Green Dathorne, OD

Memorial Eye425 W Oaks Mall Houston, TX 77082 (281) 558-2000

Jena T Nguyen, OD

Quality Eye Care PLLC12822 Willow Centre Ste C Houston, TX 77066 (281) 893-7394

Sharon Mathukutty, OD

64

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Additions to Vision Service Providers Through 6/30/2017

River Oaks Vision 1426 W Gray StHouston, TX 77019 (713) 640-2020

Michelle M Hung, OD

Texas State Optical Champions5774 Cypress Creek PkwyHouston, TX 77069 (281) 440-5887

Deanna L Gates, OD Nicole D West, OD

Todays Vision Sawyer Heights1909 Taylor St Ste BHouston, TX 77007 (713) 862-3937

Neda Esmaeili, OD

University of Houston College of Optometry4901 Calhoun Rd Houston, TX 77004 (713) 743-2020

Dieu Hong Ho, ODKimble Slonaker, OD Mary Delino, ODNapoleon C Lovero II, ODSheila D Morrison, OD Tiffany Chen, OD

City of Humble

The Vision Source 20119A Highway 59 NHumble, TX 77338 (281) 446-5800

Amy C Munroe, ODTihomira Petkova, OD

City of Katy

Eye Site Katy Dr John Oneil24217 Kingsland BlvdKaty, TX 77494(281) 644-2010

Supriya Krishnan, OD

City of Spring

20/20 Eye Associates8403 Louetta Rd Ste 100 Spring, TX 77379(832) 717-7140

Betty Vinh, ODTroy C Becker, OD

Spring Klein Texas State Optical21195 Kuykendahl RdSpring, TX 77379(832) 843-6369

Jennifer Nguyen, OD

City of The Woodlands

Creekside Family Eyecare26400 Kuykendahl Rd Ste A190The Woodlands, TX 77375 (832) 559-3861

Andrew K To, OD

Montgomery County

City of Conroe

Vision Trends Conroe Pa 1329 W Davis St Conroe, TX 77304 (936) 441-3939

Ellen Fandry, ODJenna Cedillo, OD

City of Spring

Focus Optical1925 Hughes Landing Blv STE600Spring, TX 77380(832) 225-1150

Thy Nguyen, OD

Ad

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Service P

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Additions to Vision Service Providers Through 6/30/2017

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Texas State Optical Spring Ray3535 Rayford Rd Ste 500Spring, TX 77386(832) 791-2020

Joanne Kim, OD

Todays Vision Rayford2319 Rayford Rd Ste 200Spring, TX 77386(281) 601-1001

Hiral Mehta, OD

City of The Woodlands

Lifetime Eyecare Associates6704 Sterling Ridge Dr Ste DThe Woodlands, TX 77382 (281) 465-8300

Robyn Kralich, OD

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Terminations to Vision Service Providers Through 6/30/2017

The following providers are no longer part of your provider network. If you need help finding a network provider, please call 713-442-CARE(2273) 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.

Ophthalmology Opotemtry

Fort Bend County Harris County

City of Sugar Land City of Houston

Lone Star Eye Care Charles A Garcia MD PA 3515 Town Center Blvd S 4704 Montrose Sugar Land, TX 77479 Houston, TX 77006

Asad S Abbas, MD John A McCrary III, OD

Optometry Harris County

City of Houston

Charles A Garcia MD PA 1315 St Joseph Pkwy Ste 1205Houston, TX 77002

Asad S Abbas, MD Jon M Lampkin, MD

Charles A Garcia MD PA 4704 Montrose Houston, TX 77006

Jon M Lampkin, MD

Garcia and Associates East Houston Pa 12970 East FwyHouston, TX 77015

Jon M Lampkin, MD

City of Tomball

Houston Optic PLLC13414 Medical Complex Dr Ste 4Tomball, TX 77375 (281) 351-5468

Hayne J Sheffield, MD

Galveston County

City of League City

Elite Vision Care LLC 192 Gulf Fwy S Ste C2League City, TX 77573

Emmeline C Peng, ODRayan A Abilmouna, OD

Harris County

City of Bellaire

Stacy M Sonik Od4710 Bellaire Blvd Ste 160 Bellaire, TX 77401

Stacy M Sonik, OD

City of Deer Park

Deer Park Vision Center 2009 Center St Deer Park, TX 77536

Merlyn L Harger, OD

Term

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Terminations to Vision Service Providers Through 6/30/2017

The following providers are no longer part of your provider network. If you need help finding a network provider, please call 713-442-CARE(2273) 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.

City of Houston

Berkeley Eye Institute PA18040 Saturn Ln Houston, TX 77058

Thomas W Muecke, OD

Berkeley Eye Institute PA3100 Weslayan St Ste 400Houston, TX 77027 (713) 526-1600

David A Garza, OD Thomas W Muecke, OD

Bruce Wick OD PhD PA 13615 Bellaire Blvd Houston, TX 77083 (281) 933-3446

Christine L Shuchart, OD

Christine A Tyler OD PA2055 Westheimer Rd Ste 135 Houston, TX 77098

Rubin V Urban, OD

Gilbert B Cohen OD 909 Dairy Ashford St Ste 112Houston, TX 77079

Gilbert B Cohen, OD

Karl E Hormann III Od 1171 Edgebrook DrHouston, TX 77034 (713) 941-7190

Jessica A Baxter, OD

Todays Vision Sawyer Heights1909 Taylor St Ste BHouston, TX 77007

Jared Chen, OD

University of Houston College of Optometry4901 Calhoun Rd Houston, TX 77004

Anastas F Pass, OD Maria Magana, ODRayan A Abilmouna, ODSarah R Zaver, OD Shama Essa, OD Thien T Tran, OD

University of Houston College of Optometry505 J Davis Armistead BldgHouston, TX 77204

Anastas F Pass, OD

Vision Source Greenway Galleria Pa3800 Southwest Fwy Ste 112Houston, TX 77027 (713) 627-3937

Caroline K Freeman, OD

Vision Trends Greenspoint Pa127 Greens Rd Houston, TX 77060 (281) 876-2021

Cindy H Truong, ODKim M Nguyen, OD

City of Tomball

Icare Clinic 23110 Kuykendahl Rd Ste 100Tomball, TX 77375

Ikechi Ikechi, OD

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Other Changes to Vision Service ProvidersThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies tothe provider(s) listed under the location information.

Opthamology

Harris County

City of Houston

University of Houston College of OptometryLocation Termed 505 J Davis Armistead BldgHouston, TX 77204 (713) 743-2020

Charles A Garcia, MD Marlene E Morales, MD

City of Katy

Berkeley Eye Institute PA Location Termed 707 S Fry Rd Ste 480Katy, TX 77450(281) 579-6777

Erin A Doe, MD

Optometry

Fort Bend County

City of Katy

LTW Vision Empire PA Location Termed 22762 Westheimer Pkwy Ste 405Katy, TX 77450(281) 395-2010

Laurence C Won, OD

City of Sugar Land

Rd Le Inc Location Termed 13879 Southwest FwySugar Land, TX 77478(281) 277-3100

Robert D Le, OD

Sairah I Malik OD PA Location Termed 16103 Lexington Blvd Ste ISugar Land, TX 77479(281) 242-1331

Sairah I Malik, OD

Galveston County

City of Texas City

Nelson Juarez OD PA Location Termed 2702 Palmer HwyTexas City, TX 77590(409) 948-1311

Cindy E Pouw, OD

Coastal Eye Associates Location Termed 6807 Emmett F Lowry Expy # 102Texas City, TX 77591(409) 945-2269

David M Johnson, OD

Harris County

City of Houston

PNZ Place Texas State Optical PC Location Termed 711 Louisiana St Houston, TX 77002 (713) 224-2020

Tony N Tran, OD

PNZ Place TSO PC Location Termed 711 Louisiana St Houston, TX 77002 (713) 224-2020

Eric K Underwood, OD Hong Vinh Van Le, ODMichael A Reade, OD Michael J Moulder, OD Phong Q Pham, OD

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Other Changes to Vision Service ProvidersThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies tothe provider(s) listed under the location information.

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Texas State Optical Northshore Location Termed 1250 Ulvalde Houston, TX 77015 (713) 453-2972

Brent A Woolverton Jr, OD Van K Nguyen, OD

Dr Esther Kovacs PLLC Location Termed 1337 W 43rd St Ste B Houston, TX 77018 (713) 686-3221

Esther M Kovacs, OD

Coastal Eye Associates Location Termed 11550 Fugua St Ste 205Houston, TX 77034 (281) 669-3600

David M Johnson, OD

Insight Eyecare Phone Number Changed13147 Nw Fwy Ste 100Houston, TX 77040 (713) 462-2010

Victoria V Glickman Pham, OD

Houston Eye Associates Optical Center Location Termed 1220 Augusta Dr Ste 100Houston, TX 77057 (713) 782-4409

Chloe F Butts, OD

Bruce Wick OD PhD PA Location Termed 13615 Bellaire Blvd Houston, TX 77083 (281) 933-3446

Diem Phuong N Tran, OD

University of Houston College of OptometryLocation Termed 505 J Davis Armistead BldgHouston, TX 77204 (713) 743-2020

Amador Sanchez Jr, OD Amber G Giannoni, OD

Amie Gisbert, OD Ana M Perez, OD Anastas F Pass, OD Angela S Chu, ODAnita Ticak, OD Anna F Ablamowicz, OD Ashley D Wallace Tucker, ODBindi A Desai, OD Brent L Mixon, OD Brooke C Vegas, ODBruce Onofrey, ODCarolyn R Carman, ODCasey Johnston, ODChristine A Tyler, ODChristy Jew, ODD Rudolph Black, ODDanica J Marrelli, OD David A Berntsen, OD David M Way, ODDeborah S Bernay, ODDebra Currie, OD Diane E Gregory, ODElizabeth M Peguese, ODGavin G Gerondale, OD Hamida Hemani, OD Han Cheng, ODHeather A Anderson, OD Jacqueline S Brending, ODJames W Walters, OD Jan Bergmanson, ODJanet Garza, OD Janice Wensveen, OD Jennifer Tasca, OD Jerrad S Mills, OD Jessica R Mathew, OD Jill W Liu, OD Juan M Prati, OD Judith A Perrigin, ODJulianne R Knowles, OD Justin C Ward, OD Karen Fern, OD Kassaundra L Johnston, OD Katherine M Bickle, OD Kathryn T Keyzer, ODKatrina E Parker, OD Katy R Owens, OD

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Other Changes to Vision Service ProvidersThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies tothe provider(s) listed under the location information.

University of Houston College of Optometry(continued)505 J Davis Armistead Bldg

Kerolus R Mikhail, OD Kevin L Gee, OD Kia B Eldred, OD Kim Anh N Jow, OD Kimberly C Bertrand, ODKimberly Lambreghts, ODKristen Bowles, OD Krystal L Schulle, ODLanny Shulman, ODLaura P Pardon, OD Leah A Johnson, OD Lisa B Kamino, OD Lisa M Maxwell Malik, OD Lloyd D Pate, ODLorena De La Garza, OD Lucy E Kehinde, ODMarcus G Piccolo, OD Maria E Magana, ODMaria K Walker, OD Mark K Davis, OD Mary M Morales, ODMatt S Valdes, OD Matthew J Kauffman, OD Michele Quintero, OD Michelle L Cunningham, ODMona A Younes, OD Muriel M Ferreira, OD Nancy C George, ODNicole C Hooper, ODNikki S Kokel, OD Nimesh B Patel, OD Norman E Leach, OD Pat Segu, ODRachel A Cruz, OD Rachel L Rump, ODRalph J Herring, ODRandy W Charrier, ODReed A Hopping, ODRhonda J Manuel Saldivar, OD Robert D Le, OD Roger L Boltz, ODRussell J Malik, OD Ruth E Manny, OD

Sabrina E Charrier, OD Sam Quintero, OD Samuel A Adeseye, ODSara J Brown, OD Sarah R Zaver, OD Seema Nanda, OD Shama Essa, OD Shawn Muldoon, OD Stephanie A Cox, ODSusana C Moreno, OD Suzanne M Wickum, OD Swati C Modi, OD Tammi H Graham, OD Teresa Ramirez, OD Thien T Tran, OD Thomas G Iszard, OD Tiffanie R Childs, OD Tonya G Ketcham, ODTracy A Eickhoff, ODVu K Nguyen, ODWilliam L Miller, OD

City of Humble

Vision Source Atascocita Pa Location Termed 5514 Atascocita Rd Ste 100 Humble, TX 77346 (281) 548-2020

Ka Yee Mak, OD

City of Katy

Berkeley Eye Institute PA Location Termed 707 S Fry Rd Ste 480Katy, TX 77450(281) 579-6777

Holli A Groff, OD Jorge E Garrett, ODKimberly C Bertrand, ODPontea A Momeni, OD Sriyuta Thota, OD

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Other Changes to Vision Service ProvidersThrough 6/30/2017

Please note that items are labeled with "Location Termed" or "Location Added". This change only applies tothe provider(s) listed under the location information.

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City of Kingwood

The Vision Source Kingwood Location Termed 1714 Kingwood DrKingwood, TX 77339(281) 359-2020

Jared S Kenyan, OD

City of Pasadena

Coastal Eye Associates Location Termed 3333 Bayshore Blvd Ste 280Pasadena, TX 77504 (713) 943-8671

David M Johnson, OD

City of Tomball

Texas State Optical Aldine Westfield Pa Location Termed 23110 Kuykendahl Rd Ste 100Tomball, TX 77375 (832) 717-3937

Mark R Richardson, OD

City of Webster

Coastal Eye Associates Location Termed 555 E Medical Center Blvd #101 Webster, TX 77598 (281) 488-7213

David M Johnson, OD

Montgomery County

City of Kingwood

Vision Source North Park Phone Number Changed23822 Highway 59 N Ste 100Kingwood, TX 77339(832) 777-1920

Christine E Acosta, OD Hans M Kell, OD

City of Magnolia

Ravindra Kankaria OD PC Location Termed 18230 Fm 1488 Rd Ste 104 Magnolia, TX 77354(281) 252-6060

Dorothy M Win Hall, OD

City of Spring

Texas State Optical Spring Ray Phone Number Changed3535 Rayford Rd Ste 500Spring, TX 77386(832) 791-2020

Katy R Owens, ODPhong Q Pham, OD

City of The Woodlands

George C Kaufman III OD PC Location Termed 1001 Medical Plz Dr Ste 100 The Woodlands, TX 77380 (281) 367-2020

Tammi H Graham, OD

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Additions/Reinstatements of Retail Pharmacies - Part B Drugs Through 6/30/2017

Harris County

City of Houston

Pharmserv Rx 6828 Ranchester Dr Houston, TX 77036 (713) 988-0883

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Terminations of Retail Pharmacies - Part B DrugsThrough 6/30/2017

The following pharmacies are no longer part of the KelseyCare Advantage pharmacy network. If you need help finding a network pharmacy, 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.

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Fort Bend County

City of Missouri City

Fort Bend Rx Pharmacy1100 FM 1092 Rd Ste D Missouri City, TX 77459(281) 969-7611

City of Richmond

Lifechek Drug1100 Jackson St Richmond, TX 77469 (281) 232-3529

City of Sugar Land

Healthscripts Specialty Pharmacy LLC13020 Dairy Ashford Ste 301Sugar Land, TX 77478(855) 777-1772

Pro Med Rx 13134 Dairy Ashford Rd Ste # 900Sugar Land, TX 77478(281) 313-0730

Accu-Care Pharmacy4645 Highway 6 Ste JSugar Land, TX 77478(832) 939-9052

Omni-One-Med Pharmacy Services LLC17310 W Grand Pkwy S Ste ESugar Land, TX 77479(832) 554-5008

Harris County

City of Bellaire

Medley Compounding Pharmacy5711 Bissonnet St Ste F Bellaire, TX 77401 (713) 838-1500

City of Cypress

BGC Pharmacy LLC12101 Grant Rd Cypress, TX 77429(281) 257-4299

City of Houston

Walgreens1315 St Joseph PkwyHouston, TX 77002 (713) 658-0022

Hope Pharmacy1919 N Loop WHouston, TX 77008 (713) 864-0100

J & J Pharmacy13415 Woodforest Blvd Houston, TX 77015 (713) 330-4400

Altus Pharmacy1535 W Loop S BuildingHouston, TX 77027 (972) 432-6550

Altus Pharmacy1535 West Loop South BuildingHouston, TX 77027 (972) 432-6550

Madonna Pharmacy Inc10333 Harwin Dr Ste 450 Houston, TX 77036 (832) 831-8114

Pharmserv Inc 6828 Ranchester Dr Houston, TX 77036 (713) 988-0883

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Terminations of Retail Pharmacies - Part B Drugs Through 6/30/2017

The following pharmacies are no longer part of the KelseyCare Advantage pharmacy network. If you need help finding a network pharmacy, 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.

Xpress Pharmacy7555 Bellaire Blvd Ste B Houston, TX 77036 (713) 541-3300

Kings Rx Pharmacy9501 Long Point Rd Ste JHouston, TX 77055 (713) 465-6007

Walgreens3833 FM 1960 W Houston, TX 77068 (281) 866-9674

Precious Place's Pharmacy11336 Beechnut St Ste A8 Houston, TX 77072 (281) 760-3660

Primary Care Pharmacy LLC6612 Hornwood Ste C H Houston, TX 77074 (832) 433-7346

United Rx Inc 6121 Hillcroft Houston, TX 77081 (713) 496-1328

Express Family Pharmacy LLC10101 Fondren Rd Ste 106 Houston, TX 77096 (713) 636-9177

City of Humble

Kroger Pharmacy19611 Eastex FwyHumble, TX 77338 (281) 446-2620

Prize Pharmacy9761 FM 1960 Bypass Rd WHumble, TX 77338 (281) 973-8683

Montgomery County

City of Shenandoah

Village Pharmacy1490 Research Forest Dr Shenandoah, TX 77381 (832) 948-1012

City of Spring

The Woodlands Apothecary9303 Pinecroft Dr Ste 300 Spring, TX 77380(281) 962-7006

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Terminations of Long-Term Care Facility Pharmacies - Part B Drugs

Through 6/30/2017 Residents of a long-term care facility may access their prescription drugs covered under KelseyCare Advantage through the facility's long-term care pharmacy or another network long-term pharmacy. The following pharmacies are no longer part of the KelseyCare Advantage pharmacy network. If you needhelp finding a network pharmacy, 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

Fort Bend County

Fort Bend Rx Pharmacy1100 FM 1092 Rd Ste D Missouri City, TX 77459(281) 969-7611

Lifechek Drug1100 Jackson St Richmond, TX 77469 (281) 232-3529

Healthscripts Specialty Pharmacy LLC13020 Dairy Ashford Ste 301Sugar Land, TX 77478(855) 777-1772

Harris County

Precious Place's Pharmacy11336 Beechnut St Ste A8 Houston, TX 77072 (281) 760-3660

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