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1997 DIRECTORY OF MANAGED CARE PROVIDERS ( TEXAS)

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Prudential HealthCare POS-Amarillo/
Lubbock
4100 Alpha Road, Suite 400, Dallas, Texas 75244; 800-882-2734; fax: 972-448-3875
Staff/Facilities
Primary practitioners105
Board-certified69%
Specialists155
Hospitals6
Primary care locations6
Users
Single coverage697
Family coverage1,083
Employees & dependents4,120
Total4,120Operational date: January 1989.
Licensed in: Texas.
NCQA fully accredited.
Model type: IPA.
Service area: Texas: Armstrong, Carson, Crosby, Floyd, Garza, Gray, Hale, Hockley, Hutchinson, Lamb, Lubbock, Lynn, Moore, Potter, Randall, Swisher and Terry counties.
Services: General medical, dental, prescription drug, mental health. Services available unbundled.
See Prudential HealthCare POS consolidated listing under New Jersey.
Prudential HealthCare POS-Austin
7700 Chevy Chase Drive, Suite 200, Austin, Texas 78752; 512-323-0440; fax: 512-323-5908
Staff/Facilities
Primary practitioners1,177
Board-certified68%
Specialists1,078
Hospitals11
Pharmacies39
Primary care locations16
Users
Single coverage9,634
Family coverage9,900
Employees & dependents41,153
Total41,153Licensed in: Texas.
NCQA fully accredited.
Model type: IPA.
Service area: Texas: Austin, Bastrop, Bell, Burnet, Caldwell, Colorado, Coryell, Falls, Fayette, Gonzales, Hays, Lee, Limstone, Llano, McLennan, Milam, Travis and Williamson counties.
Services: General medical, dental, vision, prescription drug, mental health. Services available unbundled.
Officers: Ken Janda, executive director; Jeff Reagan, marketing director; Gloria Robichaud, provider relations; Dr. William J. Taylor, medical director; Mary Cris Crawford, case management.
Contact: Jeff Reagan, 512-323-0440.
See Prudential HealthCare POS consolidated listing under New Jersey.
Prudential HealthCare POS-Beaumont
1 Prudential Circle, Mail Stop 300-H, Sugar Land, Texas 77478; 281-276-3856; fax: 281-276-8803
Staff/Facilities
Primary practitioners107
Board-certified66%
Specialists147
Hospitals5
Pharmacies8
Primary care locations5
Users
Single coverage932
Family coverage1,198
Employees & dependents4,605
Total4,605Operational date: September 1995.
Licensed in: Texas.
NCQA fully accredited.
Model type: IPA.
Service area: Texas: Hardin, Jefferson and Orange counties.
Services: General medical, dental, vision, prescription drug, mental health, laboratory, durable medical equipment, home infusion. Services available unbundled*.
Officers: Vic Lazzaro, executive director.
**Dental and vision only.
See Prudential HealthCare POS consolidated listing under New Jersey.
Prudential HealthCare POS-Corpus Christi
1 Prudential Circle, Mail Stop 300-H, Sugar Land, Texas 77478; 281-276-3856; fax: 281-276-8803
Staff/Facilities
Primary practitioners122
Board-certified66%
Specialists2
Hospitals8
Pharmacies16
Primary care locations10
Users
Single coverage2,119
Family coverage2,076
Employees & dependents8,902
Total8,902Operational date: January 1988.
Licensed in: Texas.
NCQA fully accredited.
Model type: IPA.
Service area: Texas: Aransas, Calhoun, Duval, Goliad, Jim Wells, Kleberg, Nueces and Rufugio counties.
Services: General medical, dental, vision, prescription drug, mental health. Services available unbundled.
Officers: Cynthia Patella, executive director; Cindy Mille, marketing director; Catherine Harper, provider relations; Dr. Richard Armstrong, medical director; Connie Evans, case management.
Contact: Cindy Miller, 210-366-1921.
See Prudential HealthCare POS consolidated listing under New Jersey.
Prudential HealthCare POS-El Paso
100 N. Staten, Suite 130, El Paso, Texas 79801; 915-532-0700; fax: 915-532-0342
Staff/Facilities
Primary practitioners121
Board-certified78%
Specialists270
Hospitals2
Pharmacies15
Primary care locations4
Users
Single coverage2,404
Family coverage3,143
Employees & dependents12,628
Total12,628Operational date: January 1988.
Licensed in: Texas.
NCQA fully accredited.
Model type: IPA.
Service area: Texas: El Paso County.
Services: General medical, dental, vision, prescription drug, mental health. Services available unbundled.
Officers: Russell Hill, executive director; John Jackson, marketing director; Waynette Detter, provider relations; Dr. William M. Crutcher, medical director; Margaret Aldano, case management.
Contact: John Jackson, 915-532-0700.
See Prudential HealthCare POS consolidated listing under New Jersey.
Prudential HealthCare POS-Houston
1 Prudential Circle, Sugar Land, Texas 77478; 281-494-5000; fax: 281-276-8254
Staff/Facilities
Primary practitioners968
Board-certified43%
Specialists2,004
Hospitals26
Pharmacies22
Primary care locations93
Users
Single coverage20,398
Family coverage25,897
Employees & dependents102,057
Total102,057Operational date: January 1987.
Licensed in: Texas.
NCQA fully accredited.
Model type: IPA.
Service area: Texas: Bandera, Bastrop, Brazoria, Chambers, Comal, Fort Bend, Jefferson, Kendall, Galveston, Gillespie, Gonzales, Harris, Lavaca, Liberty, Montgomery, Waller, Wharton and Williamson counties.
Services: General medical, dental, vision, prescription drug, mental health, laboratory. Services available unbundled*.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries.
Officers: Vic Lazarro, executive director; Dennis McDowell, marketing director; Becky Monroe, provider relations; Dr. Greg Cortez, medical director; Connie Evans, case management.
*General medical and dental only.
See Prudential HealthCare POS consolidated listing under New Jersey.
Prudential HealthCare POS-North Texas
4100 Alpha Road, Suite 400, Dallas, Texas 75244; 972-991-0014; fax: 972-448-3898
Staff/Facilities
Primary practitioners1,253
Board-certified75%
Specialists2,851
Hospitals68
Pharmacies204
Primary care locations91
Users
Single coverage36,649
Family coverage58,969
Employees & dependents220,584
Total220,584Operational date: January 1986.
Licensed in: Texas.
NCQA fully accredited.
Model type: PA.
Service area: Texas: 36 counties.
Services: General medical, dental, prescription drug, mental health. Services available unbundled*. May be customized to meet employer specifications.
Officers: C. Carleton King, executive director; John Jackson, marketing director; Ellen McCully, provider relations; Dr. William Hauser, medical director; Pamela Lewis, case management.
Contact: John Jackson, 972-991-0014.
**Dental only.
See Prudential HealthCare POS consolidated listing under New Jersey.
Prudential HealthCare POS-Northeast Texas
4100 Alpha Road, Suite 400, Dallas, Texas 75701; 903-592-0600; fax: 903-592-8166
Staff/Facilities
Primary practitioners377
Board-certified68%
Specialists336
Hospitals23Operational date: January 1994.
Licensed in: Texas.
NCQA fully accredited.
Model type: IPA.
Service area: Texas: 30 counties.
Services: General medical, dental, prescription drug, mental health. Services available unbundled. Services available unbundled*. May be customized to meet employer specifications.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries. Individual enrollment is allowed.
Officers: C. Carleton King, executive director; John Jackson, marketing director; Ellen McCully, provider relations; Dr. William Hauser, medical director; Pamela Lewis, case management.
**Dental only.
See Prudential HealthCare POS consolidated listing under New Jersey.
Prudential HealthCare POS-Rio Grande Valley
1 Prudential Circle, Mail Stop 300-H, Sugar Land, Texas 77478; 281-276-3856; fax: 281-276-8803
Staff/Facilities
Primary practitioners123
Board-certified74%
Specialists219
Hospitals8
Pharmacies13
Primary care locations8
Users
Single coverage1,855
Family coverage1,958
Employees & dependents8,455
Total8,455Operational date: January 1993.
Licensed in: Texas.
NCQA fully accredited.
Model type: IPA.
Service area: Texas: Cameron, Hidalgo, Starr and Willacy counties.
Services: General medical, dental, vision, prescription drug, mental health.
Officers: Cynthia A. Patella, executive director; Art Dickerson, marketing director; Cathy Harper, director-provider relations, Dr. Richard Armstrong, medical director; Elaine Whaley, case management director.
See Prudential HealthCare POS consolidated listing under New Jersey.
Prudential HealthCare POS-San Antonio
40 N.E. Loop 410, Suite 600, San Antonio, Texas 78216; 210-366-1921; fax: 210-366-1209
Staff/Facilities
Primary practitioners271
Board-certified78%
Specialists807
Hospitals10
Pharmacies33
Primary care locations23
Users
Single coverage18,336
Family coverage18,046
Employees & dependents74,570
Total74,570Operational date: January 1987.
Licensed in: Texas.
NCQA fully accredited.
Model type: IPA.
Service area: Texas: Atascosa, Bexar, Caldwell, Chambers, Colorado, Fayette, Fort Bend, Galveston, Jackson and Zavala counties.
Services: General medical, dental, vision, prescription drug, mental health. Services available unbundled.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries.
Officers: Robert L. Smith, executive director; Cindy Miller, marketing director; Alice Tejeda, provider relations; Dr. Charlene Kaiser, medical director; Cyndi Linkes, case management.
Contact: Cindy Miller, 210-366-1927.
See Prudential HealthCare POS consolidated listing under New Jersey.
Prudential HealthCare PPO-Austin
7700 Chevy Chase Drive, Suite 200, Austin, Texas 78752; 512-323-0440; fax: 512-323-5908
Staff/Facilities
Primary practitioners6
Board-certified66%
Specialists82
Hospitals2
Pharmacies39
Operational date: May 1991.
Service area: Texas: Austin, Bastrop, Bell, Burnet, Caldwell, Colorado, Coryell, Falls, Fayette, Gonzales, Hays, Lee, Limestone, Llano, McLennan, Milam, Travis and Williamson counties.
Officers: Ken Janda, executive director; Jeff Reagan, marketing director; Gloria Robichaud, provider relations; Dr. William J. Taylor, medical director.
Contact: Jeff Reagan, 512-323-0440.
See Prudential HealthCare PPO consolidated listing under New Jersey.
Prudential HealthCare PPO-Beaumont
1 Prudential Circle, Mail Stop 300-H, Sugar Land, Texas 77478; 281-276-3856; fax: 281-276-8803
Staff/Facilities
Primary practitioners107
Board-certified66%
Specialists147
Operational date: September 1995.
Service area: Texas: Hardin, Jefferson and Orange counties.
Services: General medical, prescription drug, mental health. Services available unbundled. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by per diem; is compensated by employers/payers; charges flat fee per employee.
UR: Precertification, concurrent review, discharge planning, case management. UR provided by the PPO.
Officers: Vic Lazzaro, executive director.
See Prudential HealthCare PPO consolidated listing under New Jersey.
Prudential HealthCare PPO-Corpus Christi
1 Prudential Circle, Mail Stop 300-H, Sugar Land, Texas 77478; 281-276-3856; fax: 281-276-8803
Staff/Facilities
Primary practitioners67
Board-certified68%
Specialists194
Hospitals8
Pharmacies16
Operational date: January 1991.
Service area: Texas: Aransas, Calhoun, Duval, Goliad, Jim Wells, Kleberg, Nueces and Refugio counties.
Services: General medical, dental, vision, prescription drug, mental health. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by per diem, discount off customary rates, DRGs; is compensated by employers/payers.
UR: Standard procedures, excluding outpatient service predetermination. UR provided by the PPO.
Officers: Cynthia Patella, executive director; Cindy Miller, marketing director; Catherine Harper, provider relations; Dr. Richard Armstrong, medical director.
Contact: Cindy Miller, 210-366-1921.
See Prudential HealthCare PPO consolidated listing under New Jersey.
Prudential HealthCare PPO-Houston
3 Greenway Plaza, Houston, Texas 77046; 281-494-5000; fax 281-276-8254
Staff/Facilities
Primary practitioners67
Board-certified68%
Specialists194
Hospitals8
Pharmacies22
Operational date: January 1991.
Service area: Texas: Bandera, Bastrop, Brazoria, Chambers, Comal, Fort Bend, Jefferson, Kendall, Galveston, Gillespie, Gonzales, Harris, Lavaca, Liberty, Montgomery, Waller, Wharton and Williamson counties.
Services: General medical, dental, vision, prescription drug, mental health, laboratory. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by per diem; is compensated by employers/payers; charges flat fee per employee.
UR: Precertification, concurrent review, discharge planning, case management. UR provided by the PPO.
Officers: Vic Lazarro, executive director; Dennis McDowell, marketing director; Becky Monroe, provider relations; Dr. Greg Cortez, medical director.
Contact: Dennis McDowell.
See Prudential HealthCare PPO consolidated listing under New Jersey.
Prudential HealthCare PPO-North Texas
4100 Alpha Road, Suite 400, Dallas, Texas 75244; 972-991-0014; fax: 972-448-3898
Staff/Facilities
Primary practitioners343
Board-certified67%
Specialists688
Hospitals39
Pharmacies204
Operational date: January 1991.
Service area: Texas: 38 counties.
Officers: C. Carleton King, executive director; John Jackson, marketing director; Ellen McCully, provider relations; Dr. William Hauser, medical director.
Contact: John Jackson.
See Prudential HealthCare PPO consolidated listing under New Jersey.
Prudential HealthCare PPO-San Antonio
40 N.E. Loop 410, Suite 600, San Antonio, Texas 78216; 800-373-4070; fax: 210-366-1209
Staff/Facilities
Primary practitioners17
Board-certified70%
Patients/practitioner100
Specialists457
Hospitals4
Pharmacies33
Operational date: January 1991.
Service area: Texas: Atascosa, Bexar, Caldwell, Chambers, Colorado, Fayette, Fort Bend, Galveston, Jackson and Zavala counties.
Services: General medical, dental, vision, prescription drug, mental health. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by per diem, DRGs; is compensated by employers/payers; charges flat fee per employee.
UR: Precertification, concurrent review, discharge planning, case management. UR provided by the PPO.
Officers: Robert L. Smith, executive director; Cindy Miller, marketing director; Alice Tejeda, provider relations; Dr. Charlene Kaiser, medical director.
Contact: Cindy Miller, 210-366-1927.
See Prudential HealthCare PPO consolidated listing under New Jersey.