Physicians Who Agreed to Treat Medicare/Medicaid Patients Physicians Licensed Between June 2015 - June 2020

Important: This list is updated after each board meeting, which is now five times per year. You should always refer to the board's profile information for the most recent data and for more details about a physician. The link is below. You will need the physician's license number for easiest access to profile information. http://www.tmb.state.tx.us/page/look-up-a-license

This list is sorted alphabetically by name.

Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date DELINQUEN T-NON R3982 ABBAS, AAMIR , MD 8/1/2017 8/1/2022 CARDIOLOGY INTERNAL MEDICINE PAYMENT 12/20/2017 None N/A Q7307 ABBAS, MALIHA , DO 3/4/2016 3/4/2021 INTERNAL MEDICINE FORT WORTH TX ACTIVE 5/26/2016 None N/A INFECTIOUS Q5311 ABBAS, UME LUBNA, MD 8/3/2015 8/3/2020 DISEASES INTERNAL MEDICINE HOUSTON TX ACTIVE 8/5/2015 None N/A S6103 ABBOOD, HAYDER ALI, MD 4/17/2020 4/17/2025 INTERNAL MEDICINE HOSPITALIST WACONIA MN ACTIVE 5/4/2020 None N/A PLASTIC SURGERY OPHTHALMOLOGY - WITHIN THE HEAD R3781 ABBOUD, JEAN-PAUL, MD 7/17/2017 7/17/2022 RECONST SURGERY AND NECK ACTIVE 11/29/2017 None N/A JACKSONVILL Q5133 ABBURI, TRIVENI, MD 7/15/2015 7/15/2020 INTERNAL MEDICINE E FL ACTIVE 9/11/2015 None N/A R2258 ABDALLA, KHUZAM, MD 4/4/2017 4/4/2022 PEDIATRICS ACTIVE 4/5/2017 None N/A INTERVENTIONAL S6340 ABDEL AAL, AHMED KAMEL, MD 5/1/2020 5/1/2025 RADIOLOGY RADIOLOGY HOUSTON TX ACTIVE 5/28/2020 None N/A ORTHOPEDIC R3782 ABDELFATTAH, ADHAM , MD 7/17/2017 7/17/2022 SURGERY OTHER SPECIALTY SAN ANTONIO TX ACTIVE 8/2/2017 None N/A ABDEL-NABY, RAMY MOHAMED, SURGICAL CRITICAL S4426 MD 12/20/2019 12/20/2024 TRAUMATIC SURGERY CARE ACTIVE 1/27/2020 None N/A R6139 ABDELSALAM, AHMED, MD 3/2/2018 3/2/2023 INTERNAL MEDICINE OPHTHALMOLOGY CHICAGO IL ACTIVE 3/9/2018 None N/A S5304 ABDERRAHMAN, YEZAN , MD 3/6/2020 3/6/2025 PEDIATRICS ACTIVE 4/30/2020 None N/A R5344 ABDULAZIZ, MOHAMMED I, MD 12/8/2017 12/8/2022 NEPHROLOGY INTERNAL MEDICINE HOUSTON TX ACTIVE 12/11/2017 None N/A

Q5743 ABDULLAH, FARHAN SALMAN, DO 8/28/2015 8/28/2020 INTERNAL MEDICINE HOUSTON TX ACTIVE 9/1/2015 None N/A R3783 ABEBE, ERMIAS SHAWEL , MD 7/17/2017 7/17/2022 ORTHOPEDICS DALLAS TX ACTIVE 9/25/2017 None N/A LICENSE Q5611 ABEBE, EYOEL, MD 8/14/2015 8/14/2020 INTERNAL MEDICINE TX ISSUED 8/14/2015 None N/A EMERGENCY LICENSE Q4552 ABERCROMBIE, JOHN F, MD 6/1/2015 6/1/2020 MEDICINE ISSUED 6/1/2015 None N/A

Page 1 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date GASTROENTEROLOG Q9930 ABIDI, WASIF M, MD 9/15/2016 9/15/2021 Y ACTIVE 10/25/2016 None N/A ORTHOPEDIC SPORTS MEDICINE - VIRGINIA S6341 ABOKA, ALEXANDER, MD 5/1/2020 5/1/2025 SURGERY ORTHOPEDICS BEACH VA ACTIVE 5/4/2020 None N/A ABOU EL-EZZ, KHALED MOHAMED BLOOMINGTO R1157 FAHMY, MD 1/6/2017 1/6/2022 INTERNAL MEDICINE INTERNAL MEDICINE N IN ACTIVE 4/3/2017 None N/A ABOUELSEOUD, TANSEEM HAMAD R0171 MOHAMED AHMED, MD 9/30/2016 9/30/2021 FAMILY MEDICINE BAYTOWN TX ACTIVE 10/6/2016 None N/A GASTROENTEROLOG EAST Q6996 ABRAHAM, ALBIN, MD 2/1/2016 2/1/2021 INTERNAL MEDICINE Y MEADOW NY ACTIVE 2/3/2016 None N/A Q7621 ABRAHAM, ASHLEY, MD 4/1/2016 4/1/2021 OPHTHALMOLOGY KANSAS CITY MO ACTIVE 4/20/2016 None N/A R1680 ABRAHAM, JAEON , MD 2/22/2017 2/22/2022 PEDIATRICS PLANO TX ACTIVE 3/6/2017 None N/A

TM00646 ABRAHAM, RALPH LEE III, MD 9/30/2016 9/30/2021 RADIOLOGY ACTIVE 1/30/2017 None N/A ENDOCRINOLOGY, DIABETES AND Q5315 ABRAMOWITZ, JESSICA, MD 8/3/2015 8/3/2020 METABOLISM INTERNAL MEDICINE DALLAS TX ACTIVE 8/5/2015 None N/A PULMONARY ABRENCILLO, RODEO APURADO, CRITICAL CARE R3626 MD 6/30/2017 6/30/2022 MEDICINE HOUSTON TX ACTIVE 7/3/2017 None N/A Q7125 ABU SULB, AHMAD, MD 2/16/2016 2/16/2021 PEDIATRICS ACTIVE 2/19/2016 None N/A

R6140 ABUHANTESH, ALYA HAKAM, MD 3/2/2018 3/2/2023 PEDIATRICS AMARILLO TX ACTIVE 3/13/2018 None N/A PEDIATRIC EMERGENCY EMERGENCY K7129 ABUJAMRA, LINA MAY, MD 2/1/2016 2/1/2021 MEDICINE (PEDS) MEDICINE NAPERVILLE IL ACTIVE 4/13/2016 None N/A PLASTIC & RECONSTRUCTIVE R3627 ABURTO, JAIME , MD 6/30/2017 6/30/2022 SURGERY GENERAL SURGERY EL PASO TX ACTIVE 7/12/2017 None N/A ABU-SPEITAN, MOHANAD Q7622 HAMDAN, MD 4/1/2016 4/1/2021 INTERNAL MEDICINE TUSCALOOSA AL ACTIVE 4/21/2016 None N/A SPORTS MEDICINE - FOOT AND ANKLE, S5818 ABYAR, EILDAR, MD 4/3/2020 4/3/2025 ORTHOPEDICS ORTHOPEDICS LAREDO TX ACTIVE 4/6/2020 None N/A Q8688 ACEVEDO, ABNER JORGE, MD 6/10/2016 6/10/2021 INTERNAL MEDICINE SAN ANGELO TX ACTIVE 6/20/2016 None N/A S6778 ACHARYA, SAMPADA, MD 5/29/2020 5/29/2025 RHEUMATOLOGY INTERNAL MEDICINE HARTFORD CT ACTIVE 6/8/2020 None N/A Q9272 ACHILEFU, ALLISON JOY, MD 8/1/2016 8/1/2021 FAMILY MEDICINE WACO TX ACTIVE 8/2/2016 None N/A PEDIATRIC CRITICAL Q5316 ACHUFF, BARBARA-JO, MD 8/3/2015 8/3/2020 PEDIATRICS CARE MEDICINE HOUSTON TX ACTIVE 8/7/2015 None N/A LICENSE Q8652 ACORD, STEPHANIE NOELLE, MD 6/1/2016 6/1/2021 CHILD NEUROLOGY ISSUED 6/1/2016 None N/A

Page 2 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date GERIATRIC MEDICINE (FAMILY G8776 ACOSTA, RODRIGO, MD 9/15/2016 9/15/2021 FAMILY MEDICINE PRACTICE) STAMFORD CT ACTIVE 10/17/2016 None N/A OBSTETRICS AND Q8404 ACOSTA-TORRES, STEFANY , MD 6/1/2016 6/1/2021 GYNECOLOGY DALLAS TX ACTIVE 6/7/2016 None N/A ORTHOPEDIC R4654 ACREE, JOSHUA SCOTT, DO 9/22/2017 9/22/2022 SURGERY GREENVILLE TX ACTIVE 9/25/2017 None N/A CARDIOVASCULAR R0983 ADACHI, IKI , MD 12/16/2016 12/16/2021 SURGERY HOUSTON TX ACTIVE 12/23/2016 None N/A PULMONARY CRITICAL CARE R0820 ADAMS, ALLEN, MD 12/2/2016 12/2/2021 MEDICINE COSTA MESA CA ACTIVE 2/21/2017 None N/A Q7822 ADAMS, BARBARA JEANNE, MD 4/15/2016 4/15/2021 GENERAL SURGERY ACTIVE 4/25/2016 None N/A ORTHOPEDIC SPORTS MEDICINE - Q4879 ADAMS, BROOK ANDREW, MD 7/1/2015 7/1/2020 SURGERY ORTHOPEDICS GRANBURY TX ACTIVE 7/13/2015 None N/A ANESTHESIOLOGY - Q7519 ADAMS, CLAYTON , MD 3/15/2016 3/15/2021 PAIN MANAGEMENT LUBBOCK TX ACTIVE 3/25/2016 None N/A EMERGENCY R0821 ADAMS, DAWN, MD 12/2/2016 12/2/2021 MEDICINE ACTIVE 1/23/2017 None N/A Q9100 ADAMS, OLA , MD 7/15/2016 7/15/2021 INTERNAL MEDICINE HOUSTON TX ACTIVE 8/22/2016 None N/A PULMONARY CRITICAL CARE R5061 ADAMS, TRACI NICOLE, MD 11/3/2017 11/3/2022 MEDICINE INTERNAL MEDICINE DALLAS TX ACTIVE 12/5/2017 None N/A ADAMS-KRUEGER, ANDREA Q6386 JANENE, MD 11/2/2015 11/2/2020 INTERNAL MEDICINE AUSTIN TX ACTIVE 11/17/2015 None N/A EMERGENCY CORPUS R0984 ADAMSON, AARON KENNETH, DO 12/16/2016 12/16/2021 MEDICINE CHRISTI TX ACTIVE 1/20/2017 None N/A R4173 ADANE, TIRSIT, MD 8/15/2017 8/15/2022 FAMILY MEDICINE ACTIVE 11/16/2017 None N/A Q7309 ADAPA, PAVANI, MD 3/4/2016 3/4/2021 RADIOLOGY NEURO-RADIOLOGY BOSTON MA ACTIVE 4/1/2016 None N/A SAN R4352 ADDUCI, ALEXANDER JUDE, MD 8/25/2017 8/25/2022 RADIOLOGY FRANCISCO CA ACTIVE 9/20/2017 None N/A R5062 ADEBAYO, AISHAT , MD 11/3/2017 11/3/2022 OPHTHALMOLOGY GALVESTON TX ACTIVE 11/9/2017 None N/A BRECKENRID Q5745 ADEGBESAN, SUSAN, MD 8/28/2015 8/28/2020 FAMILY MEDICINE GE TX ACTIVE 8/31/2015 None N/A ADOLESCENT LICENSE S6779 ADEGITE, ENITAN, MD 5/29/2020 5/29/2025 MEDICINE - PD PEDIATRICS ISSUED 5/29/2020 None N/A

R1922 ADEJORIN, OLUWASEYI DAVID, MD 3/3/2017 3/3/2022 INTERNAL MEDICINE MEMPHIS TN ACTIVE 3/13/2017 None N/A

S5109 ADELEKE, ADEGOKE OLAOLU, MD 2/21/2020 2/21/2025 FAMILY MEDICINE FRISCO TX ACTIVE 2/28/2020 None N/A

Page 3 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date GASTROENTEROLOG R1332 ADENIJI, OLAITAN ABIDEMI, MD 1/20/2017 1/20/2022 Y INTERNAL MEDICINE ACTIVE 1/30/2017 None N/A

Q7624 ADENWALA, YUSUF EBRAHIM, MD 4/1/2016 4/1/2021 INTERNAL MEDICINE HOUSTON TX ACTIVE 4/20/2016 None N/A CEDAR Q6804 ADEPOJU, OLUWAROTIMI , MD 1/6/2016 1/6/2021 PEDIATRICS RAPIDS IA ACTIVE 3/3/2016 None N/A EMERGENCY Q9561 ADESINA, ADEDOYIN, MD 8/15/2016 8/15/2021 MEDICINE HOUSTON TX ACTIVE 8/17/2016 None N/A Q8813 ADESINA, JOYCE, MD 7/1/2016 7/1/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 7/6/2016 None N/A S4907 ADESOYE, TAIWO , MD 2/7/2020 2/7/2025 GENERAL SURGERY HOUSTON TX ACTIVE 2/17/2020 None N/A ADHYARU, HARSH OBSTETRICS AND OBSTETRICS AND Q9101 YOGESHKUMAR, MD 7/15/2016 7/15/2021 GYNECOLOGY GYNECOLOGY KINGSVILLE TX ACTIVE 7/22/2016 None N/A ADJETEY, ADIKUOR OHENEWA, CORPUS Q9562 MD 8/15/2016 8/15/2021 PEDIATRICS CHRISTI TX ACTIVE 9/23/2016 None N/A Q9773 ADLER, LAURA ELAINE, MD 8/26/2016 8/26/2021 PSYCHIATRY EL PASO TX ACTIVE 10/31/2016 None N/A OBSTETRICS AND R4353 ADOMAKO, ANGELA ASIEDUA, MD 8/25/2017 8/25/2022 GYNECOLOGY ACTIVE 9/7/2017 None N/A Q8195 ADONIS, MICHEL JOHN, MD 5/16/2016 5/16/2021 PEDIATRICS FORT WORTH TX ACTIVE 5/20/2016 None N/A ADRAKTAS, DIONESIA DEMETRA, DIAGNOSTIC ABDOMINAL R3461 MD 6/16/2017 6/16/2022 RADIOLOGY RADIOLOGY FORT WORTH TX ACTIVE 6/22/2017 None N/A PULMONARY CRITICAL CARE R2037 ADRISH, MUHAMMAD, MD 3/20/2017 3/20/2022 MEDICINE BRONX NY ACTIVE 3/21/2017 None N/A R2516 ADUBA, IFEOMA , MD 4/20/2017 4/20/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 5/8/2017 None N/A ADYA, SHWETA NARESHKUMAR, R4354 MD 8/25/2017 8/25/2022 INTERNAL MEDICINE AURORA IN ACTIVE 11/22/2017 None N/A PEDIATRIC CRITICAL PEDIATRICS, M7810 AFFOLTER, JEREMY TODD, MD 5/29/2020 5/29/2025 CARE MEDICINE CARDIOLOGY AUSTIN TX ACTIVE 6/3/2020 None N/A R2260 AFFUM, KEVIN, MD 4/4/2017 4/4/2022 INTERNAL MEDICINE HOSPITALIST DALLAS TX ACTIVE 5/26/2017 None N/A R5235 AFZAL, ZEESHAN , MD 11/17/2017 11/17/2022 FAMILY MEDICINE MCALLEN TX ACTIVE 12/21/2017 None N/A Q9931 AGAN, ASHLEY DYAN, MD 9/15/2016 9/15/2021 OTOLARYNGOLOGY DALLAS TX ACTIVE 9/23/2016 None N/A R3630 AGAPITO, ADRIAN PAOLO, MD 6/30/2017 6/30/2022 PSYCHIATRY SAN ANTONIO TX ACTIVE 7/4/2017 None N/A

R1923 AGARWAL, RAJENDER KUMAR, MD 3/3/2017 3/3/2022 HOSPITALIST ROUND ROCK TX ACTIVE 3/7/2017 None N/A

Q8196 AGARWAL, SHIVUM K, MD 5/16/2016 5/16/2021 FAMILY MEDICINE GENERAL PRACTICE FORT WORTH TX ACTIVE 6/6/2016 None N/A

Q7996 AGBOOLA, SUNDAY ABIODUN, MD 5/2/2016 5/2/2021 INTERNAL MEDICINE CRANBERRY PA ACTIVE 5/4/2016 None N/A PEDIATRICS, S5305 AGGARWAL, AVICHAL, MD 3/6/2020 3/6/2025 CARDIOLOGY HOUSTON TX ACTIVE 3/24/2020 None N/A

Page 4 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date INTERVENTIONAL R1924 AGGARWAL, BHUVNESH, MD 3/3/2017 3/3/2022 CARDIOLOGY CARDIOLOGY CLEVELAND OH ACTIVE 3/15/2017 None N/A

R5346 AGGARWAL, MANIK NARAYAN, MD 12/8/2017 12/8/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 12/11/2017 None N/A PEDIATRICS, R5347 AGGARWAL, NIMISHA, MD 12/8/2017 12/8/2022 PEDIATRICS CARDIOLOGY WASHINGTON DC ACTIVE 12/12/2017 None N/A Q5318 AGHAROKH, LADAN, MD 8/3/2015 8/3/2020 HOSPITALIST PEDIATRICS DALLAS TX ACTIVE 8/4/2015 None N/A

R4174 AGNANT, PIERRE MONVERDY, MD 8/15/2017 8/15/2022 INTERNAL MEDICINE OTHER SPECIALTY HARLINGEN TX ACTIVE 11/7/2017 None N/A CORPUS R5494 AGNEW, JOSEPH WILLIAM, MD 1/5/2018 1/5/2023 INTERNAL MEDICINE HOSPITALIST CHRISTI TX ACTIVE 1/15/2018 None N/A ENDOCRINOLOGY, AGOSTO SALGADO, SARIMAR DIABETES AND Q8690 NAHOMIS, MD 6/10/2016 6/10/2021 METABOLISM INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 6/21/2016 None N/A CARDIOVASCULAR R0350 AGRAWAL, HARSH , MD 10/14/2016 10/14/2021 DISEASES INTERNAL MEDICINE EL PASO TX ACTIVE 10/21/2016 None N/A Q5135 AGRAWAL, MEGHA , MD 7/15/2015 7/15/2020 OPHTHALMOLOGY GARLAND TX ACTIVE 7/17/2015 None N/A UNDER BOARD Q9932 AGRAWAL, VANITA , MD 9/15/2016 9/15/2021 FAMILY MEDICINE HOUSTON TX ACTIVE 11/21/2016 ORDER 8/26/2016 PULMONARY CRITICAL CARE R1335 AGU, CHIDOZIE CHARLES, MD 1/20/2017 1/20/2022 INTERNAL MEDICINE MEDICINE GREENVILLE NC ACTIVE 4/3/2017 None N/A PEDIATRIC AGUAYO-HIRALDO, PAIBEL IXIA, HEMATOLOGY/ONCOL HEMATOLOGY/ONCO Q9774 MD 8/26/2016 8/26/2021 OGY LOGY HOUSTON TX ACTIVE 8/29/2016 None N/A Q6387 AGUIAR, RUDXANDRA, MD 11/2/2015 11/2/2020 INTERNAL MEDICINE AUSTIN TX ACTIVE 11/10/2015 None N/A S6559 AGUILAR, RICHARD BURT, MD 5/15/2020 5/15/2025 INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 5/18/2020 None N/A RADIATION R0986 AGUILERA, TODD ANTHONY, MD 12/16/2016 12/16/2021 ONCOLOGY DALLAS TX ACTIVE 3/7/2017 None N/A CARDIOVASCULAR R3462 AHIABLE, LILIAN ENYONAM, MD 6/16/2017 6/16/2022 DISEASES HOSPITALIST PHILADELPHIA PA ACTIVE 7/3/2017 None N/A HEMATOLOGY/ONCO R3985 AHLERS, SHANE ALVIN , MD 8/1/2017 8/1/2022 INTERNAL MEDICINE LOGY DALLAS TX ACTIVE 10/16/2017 None N/A HEMATOLOGY/ONCOL R4175 AHMAD, ASIM, MD 8/15/2017 8/15/2022 OGY INTERNAL MEDICINE FORT WORTH TX ACTIVE 8/16/2017 None N/A EMERGENCY S4254 AHMAD, HAMAD, MD 12/6/2019 12/6/2024 FAMILY MEDICINE MEDICINE MILLINGTON TN ACTIVE 12/20/2019 None N/A EMERGENCY S4254 AHMAD, HAMAD, MD 12/6/2019 12/6/2024 FAMILY MEDICINE MEDICINE MILLINGTON TN ACTIVE 12/20/2019 None N/A

Page 5 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date LICENSE Q6596 AHMAD, JAZBEEN HENNA, MD 12/4/2015 12/4/2020 INTERNAL MEDICINE ISSUED 12/4/2015 None N/A Q6596 AHMAD, JAZBEEN HENNA, MD 12/4/2015 12/4/2020 INTERNAL MEDICINE WACO TX ACTIVE 1/13/2016 None N/A Q6596 AHMAD, JAZBEEN HENNA, MD 12/4/2015 12/4/2020 INTERNAL MEDICINE WACO TX ACTIVE 1/13/2016 None N/A CRITICAL CARE R1683 AHMAD, MUDASSAR , MD 2/22/2017 2/22/2022 INTERNAL MEDICINE MEDICINE (IM) HOUSTON TX ACTIVE 2/23/2017 None N/A HEMATOLOGY/ONCOL N4887 AHMAD, NISAR, MD 8/15/2017 8/15/2022 OGY INTERNAL MEDICINE HARLINGEN TX ACTIVE 9/6/2017 None N/A PHYSICAL MED. & R4798 AHMAD, OMAIR, MD 10/6/2017 10/6/2022 REHABILITATION KATY TX ACTIVE 10/10/2017 None N/A CARDIOVASCULAR R3463 AHMAD, RASHID MOBIN, MD 6/16/2017 6/16/2022 SURGERY WEBSTER TX ACTIVE 11/3/2017 None N/A CARDIO- INTERVENTIONAL R0527 AHMAD, SAAD SAIFUDDIN, MD 10/31/2016 10/31/2021 RADIOLOGY CARDIOLOGY CINCINNATI OH ACTIVE 11/21/2016 None N/A ENDOCRINOLOGY, DIABETES AND R2517 AHMAD, SHEMA RIAZ, MD 4/20/2017 4/20/2022 INTERNAL MEDICINE METABOLISM ROUND ROCK TX ACTIVE 5/31/2017 None N/A AHMED TAHA, RIHAB ELAMEEN , Q4882 MD 7/1/2015 7/1/2020 INTERNAL MEDICINE NEPHROLOGY DALLAS TX ACTIVE 8/5/2015 None N/A EMERGENCY SPORTS MEDICINE - Q5959 AHMED, ABDUL-AZIZ R, MD 9/15/2015 9/15/2020 MEDICINE EMERGENCY MED EDINBURG TX ACTIVE 9/21/2015 None N/A Q4880 AHMED, ALI, MD 7/1/2015 7/1/2020 INTERNAL MEDICINE HOSPITALIST LONDON KY ACTIVE 7/9/2015 None N/A R0823 AHMED, ANDALEEB ABRAR, MD 12/2/2016 12/2/2021 ANESTHESIOLOGY INTERNAL MEDICINE SALISBURY MD ACTIVE 12/26/2016 None N/A PULMONARY CRITICAL CARE Q5320 AHMED, FARHAN, MD 8/3/2015 8/3/2020 MEDICINE HOSPITALIST HOUSTON TX ACTIVE 8/17/2015 None N/A R3464 AHMED, IBRAHIM M, MD 6/16/2017 6/16/2022 PEDIATRICS DALLAS TX ACTIVE 9/13/2017 None N/A PEDIATRIC ANESTHESIOLOGY Q6725 AHMED, MOHAMMED IQBAL, MD 12/15/2015 12/15/2020 ANESTHESIOLOGY (PEDS) DALLAS TX ACTIVE 12/16/2015 None N/A AHMED, MOHAMMED SAIFUDDIN, Q5321 MD 8/3/2015 8/3/2020 ANESTHESIOLOGY DALLAS TX ACTIVE 8/4/2015 None N/A

S4255 AHMED, MOHAMMED WAQAR, MD 12/6/2019 12/6/2024 PSYCHIATRY HOUSTON TX ACTIVE 12/25/2019 None N/A

S4255 AHMED, MOHAMMED WAQAR, MD 12/6/2019 12/6/2024 PSYCHIATRY HOUSTON TX ACTIVE 12/25/2019 None N/A ANESTHESIOLOGY - R3016 AHMED, MOUSTAFA, MD 5/22/2017 5/22/2022 ANESTHESIOLOGY PAIN MANAGEMENT HOUSTON TX ACTIVE 5/29/2017 None N/A LICENSE S5539 AHMED, MUSHTAQUE, MD 3/20/2020 3/20/2025 INTERNAL MEDICINE ISSUED 3/20/2020 None N/A Page 6 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date R3254 AHMED, NAFISA, MD 6/2/2017 6/2/2022 PEDIATRICS SAN ANTONIO TX ACTIVE 6/23/2017 None N/A R5348 AHMED, NUSRAT, MD 12/8/2017 12/8/2022 FAMILY PRACTICE ACTIVE 12/14/2017 None N/A INTERNAL MED - PREV Q9103 AHMED, OSAF, MD 7/15/2016 7/15/2021 MED SHOW LOW AZ ACTIVE 8/17/2016 None N/A NEUROLOGICAL R0681 AHMED, OSAMA IQBAL, MD 11/15/2016 11/15/2021 SURGERY SAN ANTONIO TX ACTIVE 11/16/2016 None N/A OBSTETRICS AND Q8816 AHMED, RABIA , DO 7/1/2016 7/1/2021 GYNECOLOGY LEAGUE CITY TX ACTIVE 7/13/2016 None N/A R5065 AHMED, SAAMIA MUSHTAQ, MD 11/3/2017 11/3/2022 FAMILY MEDICINE DALLAS TX ACTIVE 12/11/2017 None N/A P7602 AHMED, SALMAN , MD 2/7/2020 2/7/2025 NEPHROLOGY INTERNAL MEDICINE HOUSTON TX ACTIVE 4/3/2020 None N/A PULMONARY CRITICAL CARE R4799 AHMED, SAMAN, MD 10/6/2017 10/6/2022 INTERNAL MEDICINE MEDICINE ACTIVE 10/16/2017 None N/A R4800 AHMED, SAYED SHAYAN, MD 10/6/2017 10/6/2022 NEPHROLOGY INTERNAL MEDICINE HOUSTON TX ACTIVE 11/10/2017 None N/A Q5746 AHMED, UMER, MD 8/28/2015 8/28/2020 FAMILY MEDICINE HOSPITALIST BRYAN TX ACTIVE 9/11/2015 None N/A CRITICAL CARE - LICENSE Q4881 AHMED, WAMDA OSMAN, MD 7/1/2015 7/1/2020 NEUROLOGY NEUROSURGERY HOUSTON TX ISSUED 7/1/2015 None N/A Q6137 AHMED, YASIR, MD 10/1/2015 10/1/2020 INTERNAL MEDICINE FAMILY MEDICINE VICTORIA TX ACTIVE 10/14/2015 None N/A INTERVENTIONAL Q6805 AHN, JIYONG, MD 1/6/2016 1/6/2021 RADIOLOGY RADIOLOGY WILTON CT ACTIVE 1/28/2016 None N/A DIAGNOSTIC CARDIOTHORACIC R4506 AHUJA, JITESH, MD 9/8/2017 9/8/2022 RADIOLOGY RADIOLOGY TACOMA WA ACTIVE 12/29/2017 None N/A R3988 AHUJA, SHONA, MD 8/1/2017 8/1/2022 INTERNAL MEDICINE BELTON TX ACTIVE 8/9/2017 None N/A Q5747 AIBANA, OMOWUNMI, MD 8/28/2015 8/28/2020 INTERNAL MEDICINE HOUSTON TX ACTIVE 8/31/2015 None N/A PEDIATRIC EMERGENCY R3256 AIDEN, AVIVA PRESSER, MD 6/2/2017 6/2/2022 PEDIATRICS MEDICINE (EM) HOUSTON TX ACTIVE 6/16/2017 None N/A COLON AND RECTAL R1684 AILABOUNI, LUAY D, MD 2/22/2017 2/22/2022 SURGERY GENERAL SURGERY RICHLAND WA ACTIVE 3/2/2017 None N/A AIYEJORUN, AYODEJI EMERGENCY Q4883 OLUKAYODE, MD 7/1/2015 7/1/2020 MEDICINE HOUSTON TX ACTIVE 7/3/2015 None N/A R0825 AIYER, RAVI K, MD 12/2/2016 12/2/2021 INTERNAL MEDICINE NEPHROLOGY SPOKANE WA ACTIVE 12/13/2016 None N/A R0351 AJAO, OLUWATOSIN LISA, MD 10/14/2016 10/14/2021 INTERNAL MEDICINE HOSPITALIST HOUSTON TX ACTIVE 12/27/2016 None N/A ADULT R5828 AJAY, DIVYA, MD 2/2/2018 2/2/2023 UROLOGY RECONSTRUCTION HOUSTON TX ACTIVE 2/12/2018 None N/A NEUROLOGICAL R2262 AJAYI, OLAIDE, MD 4/4/2017 4/4/2022 SURGERY FORT WORTH TX ACTIVE 4/20/2017 None N/A AJIBOYE, ONAOPEMIPO R4930 BENJAMIN, MD 10/20/2017 10/20/2022 FAMILY MEDICINE SPRINGFIELD MO ACTIVE 11/30/2017 None N/A

Page 7 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date ADULT RECONSTRUCTIVE Q4884 AJMAL, MUHAMMAD , MD 7/1/2015 7/1/2020 ORTHOPEDICS ORTHOPEDICS NASHVILLE TN ACTIVE 7/3/2015 None N/A AJUFO, EZIMAMAKA S4590 CHUKWUDUMEBI, MD 1/10/2020 1/10/2025 INTERNAL MEDICINE DALLAS TX ACTIVE 1/15/2020 None N/A OBSTETRICS AND LICENSE Q4885 AKAJAGBOR, EDESIRI, MD 7/1/2015 7/1/2020 GYNECOLOGY ISSUED 7/1/2015 None N/A EMERGENCY R5959 AKALA, OLABIYI, MD 2/16/2018 2/16/2023 MEDICINE EDINBURG TX ACTIVE 3/2/2018 None N/A AKANDE, AMINATU ANASTASIA, OBSTETRICS AND R1158 MD 1/6/2017 1/6/2022 GYNECOLOGY SAN MARCOS TX ACTIVE 3/6/2017 None N/A INTERVENTIONAL S4257 AKHIGBE, KELVIN , DO 12/6/2019 12/6/2024 CARDIOLOGY CARDIOLOGY PAMPA TX ACTIVE 12/12/2019 None N/A INTERVENTIONAL S4257 AKHIGBE, KELVIN , DO 12/6/2019 12/6/2024 CARDIOLOGY CARDIOLOGY PAMPA TX ACTIVE 12/12/2019 None N/A R5496 AKHTAR, RABIA SALMAN, MD 1/5/2018 1/5/2023 INTERNAL MEDICINE THORNTON CO ACTIVE 1/30/2018 None N/A OBSTETRICS AND Q5322 AKINSANYA, ADEKEMI O, MD 8/3/2015 8/3/2020 GYNECOLOGY LAREDO TX ACTIVE 8/10/2015 None N/A

R2799 AKINSEYE-AFFUM, NOVLETTE, MD 5/5/2017 5/5/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 5/26/2017 None N/A EMERGENCY Q7997 AKINTOLA, MORAKINYO O, MD 5/2/2016 5/2/2021 MEDICINE KATY TX ACTIVE 5/6/2016 None N/A R3631 AKINTUNDE, OLUYEMISI, MD 6/30/2017 6/30/2022 PEDIATRICS PALESTINE TX ACTIVE 7/13/2017 None N/A AKINWALE, ABUMERE OPHTHALMOLOGY - R4507 FOLASHADE, MD 9/8/2017 9/8/2022 VITREOUS SURGERY HATTIESBURG MS ACTIVE 9/18/2017 None N/A GASTROENTEROLOG Q7311 AKPAN, IMO MURRAY, MD 3/4/2016 3/4/2021 Y ACTIVE 3/14/2016 None N/A

Q9564 AKTER, SHARIAR MOHAMMED, MD 8/15/2016 8/15/2021 PEDIATRICS HOUSTON TX ACTIVE 8/22/2016 None N/A EMERGENCY R3257 AKULY, HASEEB, DO 6/2/2017 6/2/2022 MEDICINE WACO TX ACTIVE 7/3/2017 None N/A PULMONARY CRITICAL CARE LICENSE S6345 AL AQTASH, TAMEEM, MD 5/1/2020 5/1/2025 MEDICINE ISSUED 5/1/2020 None N/A GASTROENTEROLOG S4908 AL BAYATI, IHSAN , MD 2/7/2020 2/7/2025 Y INTERNAL MEDICINE EL PASO TX ACTIVE 2/17/2020 None N/A R0175 AL BITAR, SADO, MD 9/30/2016 9/30/2021 INTERNAL MEDICINE HOSPITALIST MANSFIELD TX ACTIVE 10/10/2016 None N/A R0176 AL HAIDER, MOHAMMED, MD 9/30/2016 9/30/2021 FAMILY MEDICINE TULSA OK ACTIVE 11/15/2016 None N/A R1486 AL HALLAK, ANAS AHMAD, MD 2/6/2017 2/6/2022 INTERNAL MEDICINE FORT WORTH TX ACTIVE 2/7/2017 None N/A

Page 8 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date

PEDIATRIC Q5323 AL HAMMOUD, ROUKAYA , MD 8/3/2015 8/3/2020 INFECTIOUS DISEASE PEDIATRICS ACTIVE 9/1/2015 None N/A Q8198 AL ISLAM ASHRAF, MUFEED, MD 5/16/2016 5/16/2021 NEONATOLOGY HOUSTON TX ACTIVE 6/13/2016 None N/A INFECTIOUS R0177 AL MOHAJER, MAYAR , MD 9/30/2016 9/30/2021 DISEASES INTERNAL MEDICINE HOUSTON TX ACTIVE 10/3/2016 None N/A S6105 AL MUTAR, SALWAN , MD 4/17/2020 4/17/2025 ONCOLOGY INTERNAL MEDICINE DALLAS TX ACTIVE 5/12/2020 None N/A AL QAYSI, MUSTAFA S4591 DHEYAULDEEN KASHKOOL, MD 1/10/2020 1/10/2025 INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 1/21/2020 None N/A AL RAWAS, NAWAR NAZAR CARDIOTHORACIC CRITICAL CARE R2263 YOUSIF, MD 4/4/2017 4/4/2022 ANESTHESIOLOGY ANESTHESIOLOGY DALLAS TX ACTIVE 4/27/2017 None N/A Q7521 AL RIFAI, ANAS, MD 3/15/2016 3/15/2021 NEPHROLOGY DALLAS TX ACTIVE 4/7/2016 None N/A ENDOCRINOLOGY, DIABETES AND S6994 AL WARD, RUAA YOUSUF, MD 6/12/2020 6/12/2025 METABOLISM INTERNAL MEDICINE HOUSTON TX ACTIVE 6/16/2020 None N/A R4932 ALAKSHAR, HASSAN, MD 10/20/2017 10/20/2022 FAMILY MEDICINE FAMILY MEDICINE CONWAY AR ACTIVE 10/27/2017 None N/A CARDIOVASCULAR LICENSE S6780 ALAM, AMIT , MD 5/29/2020 5/29/2025 DISEASES OTHER SPECIALTY ISSUED 5/29/2020 None N/A LICENSE Q4712 ALAM, HILMI, MD 6/12/2015 6/12/2020 FAMILY MEDICINE ISSUED 6/12/2015 None N/A LICENSE S6781 ALAM, SYED, MD 5/29/2020 5/29/2025 RHEUMATOLOGY INTERNAL MEDICINE ISSUED 5/29/2020 None N/A Q9106 ALAMO, JORGE GUILLERMO, MD 7/15/2016 7/15/2021 FAMILY MEDICINE ACTIVE 8/2/2016 None N/A OKLAHOMA R5066 ALAPATI, SINDHURA, MD 11/3/2017 11/3/2022 RADIOLOGY CITY OK ACTIVE 11/17/2017 None N/A OBSTETRICS & GYNECOLOGICAL Q9107 ALAS, ALEXANDRIAH NICOLE, MD 7/15/2016 7/15/2021 SURGERY UROGYNECOLOGY SAN ANTONIO TX ACTIVE 9/9/2016 None N/A ALBUQUERQU M4695 ALAS, EDUARDO ARTURO, MD 8/15/2017 8/15/2022 NEPHROLOGY INTERNAL MEDICINE E NM ACTIVE 8/22/2017 None N/A GERIATRIC ALASE, JOYCE ONYINYECHUKWU, MEDICINE (INTERNAL R5686 MD 1/19/2018 1/19/2023 INTERNAL MEDICINE MED) ACTIVE 1/22/2018 None N/A ALAWIN, ISSAM ABDELKARIM LICENSE Q5138 HUSSEIN, MD 7/15/2015 7/15/2020 ONCOLOGY INTERNAL MEDICINE GALVESTON TX ISSUED 7/15/2015 None N/A Q9273 ALBAALBAKI, FYSAL , MD 8/1/2016 8/1/2021 INTERNAL MEDICINE NEPHROLOGY FORTWORTH TX ACTIVE 8/9/2016 None N/A DERMATOPATHOLO R1926 ALBAHRANI, YASSER A, MD 3/3/2017 3/3/2022 DERMATOLOGY GY ACTIVE 3/10/2017 None N/A LICENSE Q7824 ALBINI, PAUL THOMAS, MD 4/15/2016 4/15/2021 GENERAL SURGERY ISSUED 4/15/2016 None N/A

Page 9 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date HEMATOLOGY/ONCOL Q7825 ALBINO, MIGUEL, MD 4/15/2016 4/15/2021 OGY EL PASO TX ACTIVE 4/21/2016 None N/A WICHITA R4803 ALBREJAWI ALHOMSI, ANAS , MD 10/6/2017 10/6/2022 FAMILY MEDICINE FALLS TX ACTIVE 10/11/2017 None N/A COLON AND RECTAL R3786 ALBRIGHT, JEFFREY BURTON, MD 7/17/2017 7/17/2022 SURGERY GENERAL SURGERY BIRMINGHAM AL ACTIVE 7/26/2017 None N/A

Q5325 ALCALAN, PAULINA MARTINEZ, DO 8/3/2015 8/3/2020 INTERNAL MEDICINE MANSFIELD TX ACTIVE 8/5/2015 None N/A EMERGENCY R2264 ALCANTER, WENDY BROOKS, MD 4/4/2017 4/4/2022 MEDICINE HOUSTON TX ACTIVE 4/5/2017 None N/A R5830 ALDAPE, CLARISSA NICOLE, MD 2/2/2018 2/2/2023 PEDIATRICS HOUSTON TX ACTIVE 2/8/2018 None N/A EMERGENCY Q9108 ALDAZ, SEBASTIAN, MD 7/15/2016 7/15/2021 MEDICINE AUSTIN TX ACTIVE 10/4/2016 None N/A UNDER BOARD K7967 ALDER, LAWRENCE ALLEN, MD 8/3/2015 8/3/2020 INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 8/10/2015 ORDER 7/20/2015 ALDINGER, JARRETT DESMOND, Q7004 MD 2/1/2016 2/1/2021 ANESTHESIOLOGY SAN ANGELO TX ACTIVE 3/16/2016 None N/A HAND SURGERY - ORTHOPEDIC ORTHOPEDIC WALLINGFOR S6106 ALDRICH, KEITH PATRICK JR, MD 4/17/2020 4/17/2025 SURGERY SURGERY D CT ACTIVE 4/20/2020 None N/A R2265 ALEAGHA, JAFFAR KYLE, DO 4/4/2017 4/4/2022 HOSPITALIST INTERNAL MEDICINE DALLAS TX ACTIVE 4/24/2017 None N/A Q9275 ALEX, ASHA, MD 8/1/2016 8/1/2021 INTERNAL MEDICINE AUSTIN TX ACTIVE 8/10/2016 None N/A ORTHOPEDIC Q7312 ALEXANDER, JAMIE JACOB , MD 3/4/2016 3/4/2021 SURGERY HOUSTON TX ACTIVE 5/2/2016 None N/A ALEXANDER, JAMIE KADUKUNNEL, Q8199 MD 5/16/2016 5/16/2021 PEDIATRICS HOUSTON TX ACTIVE 5/23/2016 None N/A

PEDIATRIC CRITICAL ST S4593 ALEXANDER, PLATO JOHN, MD 1/10/2020 1/10/2025 CARE MEDICINE PEDIATRICS PETERSBURG FL ACTIVE 1/29/2020 None N/A ALGENDY, ABDALRAHMAN AHMED, ANESTHESIOLOGY - LICENSE Q4556 MD 6/1/2015 6/1/2020 ANESTHESIOLOGY PAIN MANAGEMENT ISSUED 6/1/2015 None N/A SOUTH R1159 AL-HAJJ, GABRIEL EMILE, MD 1/6/2017 1/6/2022 GENERAL SURGERY CHARLESTON WV ACTIVE 1/10/2017 None N/A PULMONARY ALHAKEEM, MOUHSEN HASSAN, CRITICAL CARE R4804 MD 10/6/2017 10/6/2022 MEDICINE INTERNAL MEDICINE MESA AZ ACTIVE 10/18/2017 None N/A DELINQUEN VASCULAR T-NON Q7523 ALHALBOUNI, SAADI, MD 3/15/2016 3/15/2021 GENERAL SURGERY SURGERY PAYMENT 6/13/2016 None N/A

Page 10 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date NEUROLOGICAL R0352 AL-HOLOU, WAJD , MD 10/14/2016 10/14/2021 SURGERY HOUSTON TX ACTIVE 10/25/2016 None N/A INTERVENTIONAL R3633 ALI, ARSHAD, MD 6/30/2017 6/30/2022 CARDIOLOGY CARDIOLOGY EL PASO TX ACTIVE 7/10/2017 None N/A Q7127 ALI, EMAD S, MD 2/16/2016 2/16/2021 INTERNAL MEDICINE HOSPITALIST LUBBOCK TX ACTIVE 2/18/2016 None N/A CORNEA REFRACTIVE R4655 ALI, FATIMA HADI, MD 9/22/2017 9/22/2022 OPHTHALMOLOGY SURGERY ACTIVE 10/12/2017 None N/A S6107 ALI, HIBA , MD 4/17/2020 4/17/2025 INTERNAL MEDICINE HOUSTON TX ACTIVE 5/4/2020 None N/A

PEDIATRIC NEURO-PHYSIOLOGY Q6138 ALI, IRFAN , MD 10/1/2015 10/1/2020 NEUROLOGY (NEUROLOGY) HOUSTON TX ACTIVE 10/5/2015 None N/A ABDOMINAL Q6139 ALI, JAWAD TAHIR, MD 10/1/2015 10/1/2020 GENERAL SURGERY SURGERY AUSTIN TX ACTIVE 11/4/2015 None N/A R2802 ALI, MARRIAM S, MD 5/5/2017 5/5/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 6/14/2017 None N/A LAKE R1490 ALI, MAYADA , MD 2/6/2017 2/6/2022 FAMILY MEDICINE JACKSON TX ACTIVE 2/13/2017 None N/A DELINQUEN PALLIATIVE T-NON R1336 ALI, MIR MAHAMED, MD 1/20/2017 1/20/2022 INTERNAL MEDICINE MEDICINE PAYMENT 4/20/2017 None N/A Q6929 ALI, MIR MAJID, MD 1/15/2016 1/15/2021 FAMILY MEDICINE WINDOM MN ACTIVE 2/1/2016 None N/A S4431 ALI, MONSUR , DO 12/20/2019 12/20/2024 INTERNAL MEDICINE HOSPITALIST ARLINGTON TX ACTIVE 2/6/2020 None N/A

Q5326 ALI, MUJTABA MOHAMMED, MD 8/3/2015 8/3/2020 VASCULAR SURGERY DALLAS TX ACTIVE 8/5/2015 None N/A GERIATRIC MEDICINE (INTERNAL R5351 ALI, MUJTABA, MD 12/8/2017 12/8/2022 INTERNAL MEDICINE MED) HONOLULU HI ACTIVE 3/2/2018 None N/A GERIATRIC MEDICINE (INTERNAL Q9565 ALI, NAFEA, MD 8/15/2016 8/15/2021 INTERNAL MEDICINE MED) SAN ANTONIO TX ACTIVE 10/4/2017 None N/A S5308 ALI, NISHA NIZAR, MD 3/6/2020 3/6/2025 INTERNAL MEDICINE BRONX NY ACTIVE 3/18/2020 None N/A LICENSE R6142 ALI, OMAIR MOHAMMAD, MD 3/2/2018 3/2/2023 CARDIOLOGY ISSUED 3/2/2018 None N/A FAMILY PRACTICE - LICENSE Q6599 ALI, RAMI, MD 12/4/2015 12/4/2020 EMERGENCY MED ISSUED 12/4/2015 None N/A FAMILY PRACTICE - QUEBEC H1L Q6599 ALI, RAMI, MD 12/4/2015 12/4/2020 EMERGENCY MED 2N9 CA ACTIVE 12/9/2015 None N/A FAMILY PRACTICE - QUEBEC H1L Q6599 ALI, RAMI, MD 12/4/2015 12/4/2020 EMERGENCY MED 2N9 CA ACTIVE 12/9/2015 None N/A PHYSICAL MED. & ANESTHESIOLOGY - R2266 ALI, RAO KAMRAN, MD 4/4/2017 4/4/2022 REHABILITATION PAIN MANAGEMENT FRISCO TX ACTIVE 4/6/2017 None N/A Page 11 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date R4355 ALI, REZA ABBAS, MD 8/25/2017 8/25/2022 NEPHROLOGY INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 9/1/2017 None N/A Q7128 ALI, SADIQ, MD 2/16/2016 2/16/2021 RHEUMATOLOGY INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 3/29/2016 None N/A R0989 ALI, SHAH RUKH, MD 12/16/2016 12/16/2021 INTERNAL MEDICINE CARDIOLOGY DALLAS TX ACTIVE 12/20/2016 None N/A R2519 ALI, SHAZIA FARHEEN, MD 4/20/2017 4/20/2022 OPHTHALMOLOGY HOUSTON TX ACTIVE 5/4/2017 None N/A EMERGENCY S4432 ALI, SHIHAB, MD 12/20/2019 12/20/2024 MEDICINE HOUSTON TX ACTIVE 12/24/2019 None N/A Q6140 ALI, SYED IRFAN QASIM, MD 10/1/2015 10/1/2020 ANESTHESIOLOGY FAMILY MEDICINE BROCKTON MA ACTIVE 10/5/2015 None N/A R0682 ALI, YASER, MD 11/15/2016 11/15/2021 INTERNAL MEDICINE CONROE TX ACTIVE 11/16/2016 None N/A CARDIO- INTERVENTIONAL LICENSE S6108 ALI, ZIAD ANWAR, MD 4/17/2020 4/17/2025 RADIOLOGY CARDIOLOGY ISSUED 4/17/2020 None N/A

R3788 ALI, ZULFIQAR, MD 7/17/2017 7/17/2022 PEDIATRICS FAYETTEVILLE NC ACTIVE 8/22/2017 None N/A Q6004 ALIAN, ALI, MD 9/15/2015 9/15/2020 RADIOLOGY INTERNAL MEDICINE ACTIVE 9/17/2015 None N/A OBSTETRICS AND Q4886 ALIFONSO-AMADOR, YAMINÉS, MD 7/1/2015 7/1/2020 GYNECOLOGY ACTIVE 7/27/2015 None N/A Q5750 ALIKAH, MAUREEN, MD 8/28/2015 8/28/2020 ANESTHESIOLOGY ACTIVE 9/2/2015 None N/A Q9935 ALKHAIAT, DHUHA MAJEED, MD 9/15/2016 9/15/2021 INTERNAL MEDICINE ANESTHESIOLOGY TOMBALL TX ACTIVE 11/18/2016 None N/A CARDIOVASCULAR R5831 ALKHATEEB, HAIDER , MD 2/2/2018 2/2/2023 DISEASES INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 3/19/2018 None N/A ORTHOPEDIC S6561 ALLA, SREENIVASA REDDY, MD 5/15/2020 5/15/2025 SURGERY GREENVILLE AL ACTIVE 5/25/2020 None N/A R0827 AL-LAHAM, AMMAR, MD 12/2/2016 12/2/2021 INTERNAL MEDICINE NEPHROLOGY BEDFORD TX ACTIVE 12/5/2016 None N/A

R3258 AL-LAMI, MUSTAFA S KHODER, MD 6/2/2017 6/2/2022 INTERNAL MEDICINE BROOKLYN NY ACTIVE 6/26/2017 None N/A

R2520 ALLEN, FORREST PENDLETON, DO 4/20/2017 4/20/2022 FAMILY MEDICINE VESTAVIA AL ACTIVE 7/24/2017 None N/A S5309 ALLEN, JAMES, DO 3/6/2020 3/6/2025 HOSPITALIST MACON GA ACTIVE 3/18/2020 None N/A OTORHINOLARYNGOL Q5328 ALLEN, SHAWN MICHAEL, MD 8/3/2015 8/3/2020 OGY RHINOLOGY HOUSTON TX ACTIVE 8/4/2015 None N/A ORTHOPEDIC R1161 ALLEN, VALERIE NICOLE, MD 1/6/2017 1/6/2022 RADIOLOGY SURGERY MESQUITE TX ACTIVE 3/24/2017 None N/A EMERGENCY Q6727 ALLEN, ZOEL GLEN III, MD 12/15/2015 12/15/2020 MEDICINE SAN MARCOS TX ACTIVE 12/22/2015 None N/A PEDIATRIC CRITICAL Q9566 ALLEYNE, TRICIA SHINELLE, MD 8/15/2016 8/15/2021 CARE MEDICINE EDINBURG TX ACTIVE 8/16/2016 None N/A ALLGOWER, LANCE FREDERICK, EMERGENCY R1927 DO 3/3/2017 3/3/2022 MEDICINE LAS VEGAS NV ACTIVE 3/14/2017 None N/A CHILD AND ADOLESCENT S6562 ALLISON, CLAYTON LEE, MD 5/15/2020 5/15/2025 PSYCHIATRY PSYCHIATRY DALLAS TX ACTIVE 5/19/2020 None N/A Page 12 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date DIAGNOSTIC R1162 ALLISON, KENNETH S JR, MD 1/6/2017 1/6/2022 RADIOLOGY NEURO-RADIOLOGY ENGLEWOOD CO ACTIVE 1/10/2017 None N/A RADIATION R2267 ALLURI, PRASANNA G, MD 4/4/2017 4/4/2022 ONCOLOGY DALLAS TX ACTIVE 4/10/2017 None N/A ALMAHMOUD, MOHAMED FAHER , R2804 MD 5/5/2017 5/5/2022 INTERNAL MEDICINE GALVESTON TX ACTIVE 6/5/2017 None N/A R4178 ALMEIDA, JORGE, MD 8/15/2017 8/15/2022 PSYCHIATRY AUSTIN TX ACTIVE 8/17/2017 None N/A VASCULAR AND DIAGNOSTIC INTERVENTIONAL CORPUS Q9568 ALMONTE, CASEY, MD 8/15/2016 8/15/2021 RADIOLOGY RADIOLOGY CHRISTI TX ACTIVE 8/22/2016 None N/A R3790 ALNAJJAR, WAEL, MD 7/17/2017 7/17/2022 FAMILY MEDICINE KERRVILLE TX ACTIVE 7/19/2017 None N/A ALNAZEER, MOEZ MOHAMED R0828 SALEH, MD 12/2/2016 12/2/2021 INTERNAL MEDICINE HOSPITALIST TEXARKANA TX ACTIVE 12/20/2016 None N/A R4511 ALNOOR, MOHAMMAD , MD 9/8/2017 9/8/2022 PEDIATRICS HOUSTON TX ACTIVE 9/12/2017 None N/A Q7522 AL-NUAIMI, AHMED, MD 3/15/2016 3/15/2021 INTERNAL MEDICINE JAMAICA NY ACTIVE 4/7/2016 None N/A UROLOGIC R2521 ALONZO, DAVID GABRIEL, MD 4/20/2017 4/20/2022 ONCOLOGY UROLOGIC SURGERY EDINBURG TX ACTIVE 4/24/2017 None N/A Q7525 ALOUD, ABDRAHIM, MD 3/15/2016 3/15/2021 INTERNAL MEDICINE ACTIVE 3/24/2016 None N/A ALQAISI, FADI THABIT ABDALLAH, INTERVENTIONAL R5068 MD 11/3/2017 11/3/2022 CARDIOLOGY CARDIOLOGY RICHLAND WA ACTIVE 1/31/2018 None N/A ALQUICIRA-MACEDO, FERNANDO , R5069 MD 11/3/2017 11/3/2022 ANESTHESIOLOGY GALVESTON TX ACTIVE 1/22/2018 None N/A OBSTETRICS AND S5112 ALQULALI, MONA ELSAYED, MD 2/21/2020 2/21/2025 GYNECOLOGY COSMETIC SURGERY CLINTON IA ACTIVE 3/10/2020 None N/A INTERVENTIONAL LAKE HAVASU Q9938 ALRABADI, ODAY, MD 9/15/2016 9/15/2021 CARDIOLOGY CARDIOLOGY CITY AZ ACTIVE 10/6/2016 None N/A PEDIATRIC ANESTHESIOLOGY R2038 ALRAYASHI, WALID, MD 3/20/2017 3/20/2022 ANESTHESIOLOGY (PEDS) BOSTON MA ACTIVE 4/17/2017 None N/A

S6563 ALSADEK, CAMLI IMAN ADNAN, MD 5/15/2020 5/15/2025 INTERNAL MEDICINE DALLAS TX ACTIVE 6/2/2020 None N/A

Q7133 ALTAKI, MUHAMMAD SOUBHI , MD 2/16/2016 2/16/2021 INTERNAL MEDICINE ACTIVE 3/1/2016 None N/A HEMATOLOGY - R0529 ALTAN, MEHMET, MD 10/31/2016 10/31/2021 ONCOLOGY INTERNAL MEDICINE HOUSTON TX ACTIVE 11/14/2016 None N/A NEONATAL- NEONATAL- PERINATAL Q8821 ALTHOUSE, MELISSA HELENE , MD 7/1/2016 7/1/2021 PERINATAL MEDICINE MEDICINE HOUSTON TX ACTIVE 7/4/2016 None N/A

Page 13 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date

LIC. ISSUED DUE TO ADMIN Q5330 ALTMAN, KENNETH WAYNE, MD 8/3/2015 8/3/2020 OTOLARYNGOLOGY HOUSTON TX ERROR 8/3/2015 None N/A Q5330 ALTMAN, KENNETH WAYNE, MD 8/26/2016 8/26/2021 OTOLARYNGOLOGY HOUSTON TX ACTIVE 9/9/2016 None N/A Q6303 ALTMAN, KIRSTIN , MD 10/15/2015 10/15/2020 DERMATOLOGY TEMPLE TX ACTIVE 10/16/2015 None N/A OCCUPATIONAL OCCUPATIONAL ENVIRONMENTAL ENVIRONMENTAL Q7526 ALTMAN, MATTHEW , MD 3/15/2016 3/15/2021 MEDICINE MEDICINE KILLEEN TX ACTIVE 6/2/2016 None N/A NEUROLOGY & R4934 ALVA, GUSTAVO, MD 10/20/2017 10/20/2022 NEURO-PSYCHIATRY PSYCHIATRY COSTA MESA CA ACTIVE 11/1/2017 None N/A CHILD AND ADOLESCENT R1337 ALVARADO, CARLA IVONNE, MD 1/20/2017 1/20/2022 PSYCHIATRY PSYCHIATRY EL PASO TX ACTIVE 1/30/2017 None N/A R5960 ALVARADO, DAVID EARL, MD 2/16/2018 2/16/2023 ANESTHESIOLOGY PAIN MEDICINE AUSTIN TX ACTIVE 2/22/2018 None N/A OSTEO MANIPULATIVE Q9110 ALVARADO, MAUREEN, DO 7/15/2016 7/15/2021 FAMILY MEDICINE MEDICINE SAN ANTONIO TX ACTIVE 7/22/2016 None N/A Q9112 ALVAREZ, ADAN , MD 7/15/2016 7/15/2021 FAMILY PRACTICE HOUSTON TX ACTIVE 7/21/2016 None N/A OBSTETRICS AND LICENSE Q5140 ALVAREZ, CRYSTAL ALEX, MD 7/15/2015 7/15/2020 GYNECOLOGY ISSUED 7/15/2015 None N/A OBSTETRICS AND S5310 ALVAREZ, JIMENA BEATRIZ, MD 3/6/2020 3/6/2025 GYNECOLOGY CHICAGO IL ACTIVE 3/9/2020 None N/A Q5331 ALVAREZ, NAIARA , MD 8/3/2015 8/3/2020 RHEUMATOLOGY INTERNAL MEDICINE EDINBURG TX ACTIVE 8/17/2015 None N/A Q9113 ALVAREZ, PAOLA IVETTE, MD 7/15/2016 7/15/2021 INTERNAL MEDICINE EL PASO TX ACTIVE 7/18/2016 None N/A R4656 ALVAREZ, REFUGIO , MD 9/22/2017 9/22/2022 FAMILY MEDICINE FAMILY PRACTICE AMARILLO TX ACTIVE 9/25/2017 None N/A CORPUS Q5332 ALVAREZ, YVETTE VALERIO, DO 8/3/2015 8/3/2020 FAMILY MEDICINE CHRISTI TX ACTIVE 8/5/2015 None N/A ALVAREZ-BRECKENRIDGE, NEUROLOGICAL S5543 CHRISTOPHER ALLEN, MD 3/20/2020 3/20/2025 SURGERY HOUSTON TX ACTIVE 3/24/2020 None N/A CRITICAL CARE EMERGENCY Q7828 ALVEY, HEIDI LYNN, MD 4/15/2016 4/15/2021 MEDICINE MEDICINE TEMPLE TX ACTIVE 4/18/2016 None N/A ALWAZEER, MOUHAMMAD RATEB , PEDIATRIC LICENSE Q6487 MD 11/16/2015 11/16/2020 PEDIATRICS ENDOCRINOLOGY ISSUED 11/16/2015 None N/A ALWAZNI, MONTADHER EMERGENCY R4935 MOHAMMED ABED , MD 10/20/2017 10/20/2022 FAMILY MEDICINE MEDICINE ODESSA TX ACTIVE 11/20/2017 None N/A R2522 ALY, MUHAMMAD, MD 4/20/2017 4/20/2022 FAMILY MEDICINE HOSPITALIST HUNTSVILLE AL ACTIVE 5/17/2017 None N/A

Q7829 ALY, MUSTAFA GHALEB M R, MD 4/15/2016 4/15/2021 INTERNAL MEDICINE NEPHROLOGY LUBBOCK TX ACTIVE 5/9/2016 None N/A

Page 14 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date EMERGENCY R1689 ALZAHRI, MOHAMMAD , MD 2/22/2017 2/22/2022 MEDICINE HOUSTON TX ACTIVE 3/6/2017 None N/A NEURO- Q6486 AL-ZUBIDI, NAGHAM , MD 11/16/2015 11/16/2020 NEUROLOGY OPHTHALMOLOGY SAN ANTONIO TX ACTIVE 11/23/2015 None N/A OCCUPATIONAL R4512 AMA, IFEOMA MARGARET, MD 9/8/2017 9/8/2022 FAMILY MEDICINE MEDICINE HOUSTON TX ACTIVE 9/13/2017 None N/A NEUROLOGICAL R5689 AMADIO, JORDAN PAUL, MD 1/19/2018 1/19/2023 SURGERY AUSTIN TX ACTIVE 2/16/2018 None N/A PULMONARY CRITICAL CARE R1338 AMALAKUHAN, BRAVEIN , MD 1/20/2017 1/20/2022 MEDICINE INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 2/9/2017 None N/A EMERGENCY LICENSE Q5334 AMAN, MUAZZUM, MD 8/3/2015 8/3/2020 MEDICINE FAMILY MEDICINE ISSUED 8/3/2015 None N/A INTERVENTIONAL S6996 AMAN, WAHAJ , MD 6/12/2020 6/12/2025 CARDIOLOGY CARDIOLOGY KATY TX ACTIVE 6/16/2020 None N/A MATERNAL AND LICENSE S5198 AMARA, SUSHMA, MD 2/21/2020 2/21/2025 FETAL MEDICINE OBSTETRICS ISSUED 2/21/2020 None N/A AMARAM-DAVILA, JAYA SHEELA, Q7313 MD 3/4/2016 3/4/2021 INTERNAL MEDICINE HOSPITALIST HOUSTON TX ACTIVE 3/8/2016 None N/A AMBALONG, MARIA PHARAH Q9277 PAGUSARA, MD 8/1/2016 8/1/2021 FAMILY MEDICINE GERIATRICS DALLAS TX ACTIVE 8/9/2016 None N/A R0180 AMBATI, BALAMURALI K, MD 9/30/2016 9/30/2021 OPHTHALMOLOGY ACTIVE 10/10/2016 None N/A LICENSE S6997 AMBATI, MEGHA, MD 6/12/2020 6/12/2025 HOSPITALIST INTERNAL MEDICINE ISSUED 6/12/2020 None N/A LICENSE R5690 AMBERKER, DEEPA, MD 1/19/2018 1/19/2023 INTERNAL MEDICINE NEPHROLOGY ISSUED 1/19/2018 None N/A S6564 AMEEN, NAUREEN WASIF, MD 5/15/2020 5/15/2025 PEDIATRICS ACTIVE 5/18/2020 None N/A DEERFIELD R4657 AMEND, JAMES A, MD 9/22/2017 9/22/2022 RADIOLOGY NEURO-RADIOLOGY BEACH FL ACTIVE 9/26/2017 None N/A S4258 AMIN, CHIRAG, DO 12/6/2019 12/6/2024 ANESTHESIOLOGY ACTIVE 2/14/2020 None N/A S4258 AMIN, CHIRAG, DO 12/6/2019 12/6/2024 ANESTHESIOLOGY ACTIVE 2/14/2020 None N/A PHYSICAL MED. & SPINE AND SPORTS S5311 AMIN, KUNJ BHARAT, MD 3/6/2020 3/6/2025 REHABILITATION MEDICINE AUSTIN TX ACTIVE 3/17/2020 None N/A UNDERSEA AND PHYSICAL MED. & HYPERBARIC MED R1492 AMIN, MAYUR JAYANT, MD 2/6/2017 2/6/2022 REHABILITATION (PREV MED) ACTIVE 4/14/2017 None N/A R3018 AMIN, RAKA, MD 5/22/2017 5/22/2022 INTERNAL MEDICINE WASHINGTON DC ACTIVE 5/29/2017 None N/A LICENSE R5692 AMIN, RANJANI DAVALATH, DO 1/19/2018 1/19/2023 FAMILY MEDICINE ISSUED 1/19/2018 None N/A S6111 AMIN, RUPEN SURESH, MD 4/17/2020 4/17/2025 FAMILY MEDICINE DALLAS TX ACTIVE 4/21/2020 None N/A

Page 15 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date AMINI-VAUGHAN, ZHALEH R4356 JACQUELINE, MD 8/25/2017 8/25/2022 FAMILY MEDICINE CONROE TX ACTIVE 9/18/2017 None N/A R3259 AMIT, MEGHANA, MD 6/2/2017 6/2/2022 INTERNAL MEDICINE PITTSBURGH PA ACTIVE 8/16/2017 None N/A PLASTIC & RECONSTRUCTIVE LICENSE Q6488 AMJAD, IBRAHIM H, MD 11/16/2015 11/16/2020 SURGERY ISSUED 11/16/2015 None N/A R0990 AMSBAUGH, ASHLEY KAY, MD 12/16/2016 12/16/2021 PAIN MANAGEMENT ANESTHESIOLOGY HOUSTON TX ACTIVE 12/20/2016 None N/A Q8005 AMUDIPE, OLUBUKOLA T, MD 5/2/2016 5/2/2021 FAMILY MEDICINE FORT WORTH TX ACTIVE 5/25/2016 None N/A

Q8006 AN, RUOSU, MD 5/2/2016 5/2/2021 VASCULAR SURGERY ROWLETT TX ACTIVE 5/9/2016 None N/A Q5964 ANABOR, OMEGIE LINDA, MD 9/15/2015 9/15/2020 FAMILY MEDICINE BAYTOWN TX ACTIVE 11/2/2015 None N/A S5544 ANAND, DEEPA , MD 3/20/2020 3/20/2025 PSYCHIATRY HOUSTON TX ACTIVE 4/16/2020 None N/A EMERGENCY Q9569 ANAND, NISHANT, MD 8/15/2016 8/15/2021 MEDICINE HOUSTON TX ACTIVE 8/17/2016 None N/A REPRODUCTIVE OBSTETRICS AND ENDOCRINOLOGY Q9940 ANAYA, YANETT , MD 9/15/2016 9/15/2021 GYNECOLOGY AND INFERTILITY HOUSTON TX ACTIVE 10/24/2016 None N/A R2806 ANCY, KAYLEY, MD 5/5/2017 5/5/2022 INTERNAL MEDICINE ACTIVE 5/18/2017 None N/A R1690 ANDAYA, MARO STEPHANIE, MD 2/22/2017 2/22/2022 FAMILY MEDICINE AUSTIN TX ACTIVE 3/7/2017 None N/A EMERGENCY R1691 ANDERS, JOEL WILLIAM, DO 2/22/2017 2/22/2022 MEDICINE HOUSTON TX ACTIVE 3/9/2017 None N/A DIAGNOSTIC TM00620 ANDERSON, ANTHONY SHANE, MD 2/1/2016 2/1/2021 RHEUMATOLOGY RADIOLOGY GREENSBORO NC ACTIVE 2/22/2016 None N/A PULMONARY CRITICAL CARE CORPUS Q8007 ANDERSON, BRYAN, DO 5/2/2016 5/2/2021 MEDICINE INTERNAL MEDICINE CHRISTI TX ACTIVE 5/9/2016 None N/A OBSTETRICS AND LICENSE Q6142 ANDERSON, CHARMAINE, MD 10/1/2015 10/1/2020 GYNECOLOGY ISSUED 10/1/2015 None N/A

R4658 ANDERSON, DANIELLE AW, MD 9/22/2017 9/22/2022 FAMILY MEDICINE WHEAT RIDGE CO ACTIVE 9/28/2017 None N/A ANDERSON, DANIELLE NICOLE, OBSTETRICS AND SALT LAKE Q9941 MD 9/15/2016 9/15/2021 GYNECOLOGY CITY UT ACTIVE 11/28/2016 None N/A ANDERSON, KATHRYN TINSLEY, LICENSE Q5614 MD 8/14/2015 8/14/2020 GENERAL SURGERY ISSUED 8/14/2015 None N/A INACTIVE- PRELIM TO PEDIATRIC CRITICAL BECOMING R0686 ANDERSON, MALCOLM, DO 11/15/2016 11/15/2021 CARE MEDICINE PEDIATRICS CN/CR 1/10/2018 None N/A Q6806 ANDERSON, MARK ROBERT, MD 1/6/2016 1/6/2021 UROLOGIC SURGERY FORT HOOD TX ACTIVE 2/11/2016 None N/A ANDERSON, NICOLAAS NEUROMUSCULAR Q8201 CORNELIUS, DO 5/16/2016 5/16/2021 NEUROLOGY DISEASE HOUSTON TX ACTIVE 5/23/2016 None N/A Page 16 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date Q7831 ANDERSON, RACHEL MAY, MD 4/15/2016 4/15/2021 PEDIATRICS AMARILLO TX ACTIVE 4/21/2016 None N/A Q8008 ANDERSON, SEAN DANIEL, MD 5/2/2016 5/2/2021 FAMILY MEDICINE AMARILLO TX ACTIVE 5/24/2016 None N/A Q9570 ANDERSON, SHARON, MD 8/15/2016 8/15/2021 FAMILY MEDICINE HOUSTON TX ACTIVE 8/19/2016 None N/A ANDERSON, TERRENCE DAMON, PEDIATRIC SPORTS MEDICINE - Q5965 MD 9/15/2015 9/15/2020 ORTHOPEDICS ORTHOPEDICS BETHESDA MD ACTIVE 10/5/2015 None N/A Q4889 ANDRADE, ALONSO , MD 7/1/2015 7/1/2020 GENERAL SURGERY EL PASO TX ACTIVE 7/3/2015 None N/A OBSTETRICS AND S6784 ANDRADE, AMANDA IRENE, MD 5/29/2020 5/29/2025 GYNECOLOGY HOUSTON TX ACTIVE 6/4/2020 None N/A ANDRADE, NICHOLAS STEPHEN, NEUROLOGICAL Q5142 MD 7/15/2015 7/15/2020 SURGERY TYLER TX ACTIVE 7/17/2015 None N/A

S7000 ANDRAOUS, WESAM FAROUK, MD 6/12/2020 6/12/2025 ANESTHESIOLOGY SYOSSET NY ACTIVE 6/15/2020 None N/A ORTHOPEDIC R1692 ANDRAWIS, JOHN PHILIP, MD 2/22/2017 2/22/2022 SURGERY AUSTIN TX ACTIVE 2/28/2017 None N/A

NEURO-PHYSIOLOGY R1163 ANDREWS, WEGDAN, MD 1/6/2017 1/6/2022 NEUROLOGY (NEUROLOGY) ACTIVE 3/30/2017 None N/A OSTEO MANIPULATIVE Q9942 ANGADICHERIL, TRACEY , DO 9/15/2016 9/15/2021 FAMILY MEDICINE MEDICINE FORT WORTH TX ACTIVE 11/29/2016 None N/A ORTHOPEDIC S5313 ANIGHORO, KENOMA, MD 3/6/2020 3/6/2025 SURGERY ACTIVE 3/19/2020 None N/A Q9943 ANNAKULA, MADHAVI, MD 9/15/2016 9/15/2021 INTERNAL MEDICINE LONGVIEW TX ACTIVE 9/16/2016 None N/A S6350 ANNOR, STEPHANIE YAA, MD 5/1/2020 5/1/2025 PEDIATRICS ACTIVE 5/18/2020 None N/A GERIATRIC R5071 ANSARI, ADEEL, MD 11/3/2017 11/3/2022 PSYCHIATRY PSYCHIATRY SAN ANTONIO TX ACTIVE 1/22/2018 None N/A EMERGENCY S4910 ANSARI, FAISAL , MD 2/7/2020 2/7/2025 MEDICINE TEMPLE TX ACTIVE 2/10/2020 None N/A R0530 ANSARI, SAEMA, MD 10/31/2016 10/31/2021 PEDIATRICS ACTIVE 6/23/2017 None N/A RADIATION S4594 ANSARI, SOBIYA, MD 1/10/2020 1/10/2025 ONCOLOGY BROOKLYN NY ACTIVE 1/22/2020 None N/A RADIATION R5237 ANSCHER, MITCHELL STEVEN, MD 11/17/2017 11/17/2022 ONCOLOGY HOUSTON TX ACTIVE 11/27/2017 None N/A R3792 ANSHASI, AHMAD, MD 7/17/2017 7/17/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 7/19/2017 None N/A INTERVENTIONAL Q8414 ANSINELLI, RICHARD ALLEN, MD 6/1/2016 6/1/2021 CARDIOLOGY CARDIOLOGY ACTIVE 6/3/2016 None N/A DELINQUEN HEMATOLOGY/ONCOL T-NON R5492 ANTHONY, STEPHEN PATRICK, DO 12/8/2017 12/8/2022 OGY INTERNAL MEDICINE PAYMENT 3/8/2018 None N/A ORTHOPEDIC R4660 ANTHONY, TRAVIS LEE, MD 9/22/2017 9/22/2022 SURGERY TEMPLE TX ACTIVE 11/16/2017 None N/A Page 17 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date DELINQUEN T-NON R1164 ANTOINE, STEVE MARC, MD 1/6/2017 1/6/2022 INTERNAL MEDICINE PAYMENT 4/6/2017 None N/A ORTHOPEDIC PEDIATRIC THE S6565 ANTONY, ANTONY KALLUR, MD 5/15/2020 5/15/2025 SURGERY ORTHOPEDICS WOODLANDS TX ACTIVE 5/25/2020 None N/A S4716 ANUGOM, CHIDI EUGENE, MD 1/24/2020 1/24/2025 HOSPITALIST INTERNAL MEDICINE GASTONIA NC ACTIVE 1/27/2020 None N/A OBSTETRICS AND R0531 ANUMUDU, UCHECHI B, MD 10/31/2016 10/31/2021 GYNECOLOGY DALLAS TX ACTIVE 1/13/2017 None N/A

R4360 ANUSIONWU, OBIORA FRANK, MD 8/25/2017 8/25/2022 INTERNAL MEDICINE CARDIOLOGY ACTIVE 10/31/2017 None N/A PHYSICAL MED. & Q9571 ANUVAT, KEVIN JUKARIN, MD 8/15/2016 8/15/2021 REHABILITATION PAIN MEDICINE HOUSTON TX ACTIVE 8/19/2016 None N/A

Q7316 ANVAR, BARDIA AARON, MD 3/4/2016 3/4/2021 GENERAL SURGERY LOS ANGELES CA ACTIVE 3/22/2016 None N/A ALBUQUERQU Q5143 ANWAR, FAISAL, MD 7/15/2015 7/15/2020 INTERNAL MEDICINE E NM ACTIVE 8/3/2015 None N/A ANESTHESIOLOGY - R2808 ANWAR, SAEED, MD 5/5/2017 5/5/2022 PAIN MANAGEMENT PAIN & SPINE HORSEHEADS NY ACTIVE 5/15/2017 None N/A MATERNAL AND OBSTETRICS AND THE Q8824 ANYIKAM, ADANNA LINDA, MD 7/1/2016 7/1/2021 FETAL MEDICINE GYNECOLOGY WOODLANDS TX ACTIVE 9/15/2016 None N/A S4260 AOSHIMA, ANDREW M, MD 12/6/2019 12/6/2024 HOSPITALIST ACTIVE 12/10/2019 None N/A S4260 AOSHIMA, ANDREW M, MD 12/6/2019 12/6/2024 HOSPITALIST ACTIVE 12/10/2019 None N/A

AOUTHMANY, MOUSTAFA NEONATAL- Q6304 MOUHAMAD, MD 10/15/2015 10/15/2020 PERINATAL MEDICINE PEDIATRICS MISHAWAKA IN ACTIVE 10/21/2015 None N/A APAKAMA, CHUKWUMA TONNA, ABDOMINAL R4180 MD 8/15/2017 8/15/2022 GENERAL SURGERY SURGERY DENTON TX ACTIVE 8/17/2017 None N/A APPALANENI, SRI RAMA MURTHY, Q6490 MD 11/16/2015 11/16/2020 INTERNAL MEDICINE HOSPITALIST LITTLE ROCK AR ACTIVE 12/3/2015 None N/A APPLEBAUM, MATTHEW LOUIS, NEW S6786 MD 5/29/2020 5/29/2025 INTERNAL MEDICINE BRAUNFELS TX ACTIVE 6/8/2020 None N/A PHYSICAL MED. & Q8692 APPLEBURY, JAMES EDWARD, MD 6/10/2016 6/10/2021 REHABILITATION SAN LEANDRO CA ACTIVE 6/14/2016 None N/A APPLETON, CHARLOTTE CHASE, NACOGDOCH R4806 MD 10/6/2017 10/6/2022 INTERNAL MEDICINE ES TX ACTIVE 10/9/2017 None N/A Q8415 APPLETON, JEWEL N, MD 6/1/2016 6/1/2021 RADIOLOGY BODY IMAGING HOUSTON TX ACTIVE 6/6/2016 None N/A EMERGENCY Q7136 APRILE, LOUIS DANTON, MD 2/16/2016 2/16/2021 MEDICINE AUSTIN TX ACTIVE 2/29/2016 None N/A THE R1693 ARAIN, GHULAM MUSTAFA, MD 2/22/2017 2/22/2022 INTERNAL MED - PEDS HOSPITALIST WOODLANDS TX ACTIVE 2/23/2017 None N/A

Page 18 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PHYSICAL MED. & Q7631 ARANKE, SIDDHARTH VIJAY, MD 4/1/2016 4/1/2021 REHABILITATION ACTIVE 4/7/2016 None N/A PEDIATRICS, R2270 ARAR, YOUSEF MAZEN, MD 4/4/2017 4/4/2022 CARDIOLOGY SAN ANTONIO TX ACTIVE 4/11/2017 None N/A HEMATOLOGY M5029 ARBINI, ARNALDO AUGUSTO, MD 4/3/2020 4/3/2025 PATHOLOGY (PATHOLOGY) NEW YORK NY ACTIVE 4/6/2020 None N/A ARBOLEDA MOREJON, ANDRES S4912 ESTEBAN, MD 2/7/2020 2/7/2025 INTERNAL MEDICINE WESLACO TX ACTIVE 2/13/2020 None N/A

R5072 ARBOLEDA, MEGAN ABIGAIL, MD 11/3/2017 11/3/2022 FAMILY MEDICINE WACO TX ACTIVE 11/20/2017 None N/A EMERGENCY EMERGENCY R3793 ARBULU, MIGUEL, MD 7/17/2017 7/17/2022 MEDICINE MEDICINE MIAMI FL ACTIVE 8/2/2017 None N/A ANESTHESIOLOGY - Q7138 ARCOS, GEORGE JOHN, DO 2/16/2016 2/16/2021 PAIN MANAGEMENT PAIN MANAGEMENT PENSACOLA FL ACTIVE 2/26/2016 None N/A S4913 ARCOT-JOSHI, PRIYA, DO 2/7/2020 2/7/2025 FAMILY PRACTICE LUMBERTON NJ ACTIVE 3/16/2020 None N/A

SPORTS MEDICINE - PHYSICAL MED. & PHYSICAL MEDICINE Q8009 ARCURE, JESS JOSEPH, MD 5/2/2016 5/2/2021 REHABILITATION & REHABILITATION ANNAPOLIS MD ACTIVE 5/19/2016 None N/A PHYSICAL MED. & S5546 ARCURE, JOHN DAVID, MD 3/20/2020 3/20/2025 REHABILITATION ACTIVE 4/3/2020 None N/A R0832 ARDESHNA, RISHI , MD 12/2/2016 12/2/2021 ANESTHESIOLOGY GALVESTON TX ACTIVE 12/12/2016 None N/A R2271 AREITER, ERIC, MD 4/4/2017 4/4/2022 OPHTHALMOLOGY ABILENE TX ACTIVE 6/6/2017 None N/A Q7317 ARENAS, CARLITO GAVIOLA, MD 3/4/2016 3/4/2021 INTERNAL MEDICINE HOSPITALIST ACTIVE 3/14/2016 None N/A Q9279 ARFFA, RACHEL ELIZABETH, MD 8/1/2016 8/1/2021 OTOLARYNGOLOGY RHINOLOGY ROUND ROCK TX ACTIVE 8/3/2016 None N/A S5114 ARGUELLES, ARMANDO , MD 2/21/2020 2/21/2025 FAMILY MEDICINE MCALLEN TX ACTIVE 4/1/2020 None N/A LICENSE Q4558 ARGUELLO, VANESSA , MD 6/1/2015 6/1/2020 INTERNAL MEDICINE ISSUED 6/1/2015 None N/A REPRODUCTIVE ARIAN MEHR, SARA ELIZABETH , OBSTETRICS AND ENDOCRINOLOGY Q9280 MD 8/1/2016 8/1/2021 GYNECOLOGY AND INFERTILITY HOUSTON TX ACTIVE 8/3/2016 None N/A ARIAS MENDOZA, PAOLA EMERGENCY S5314 ALEXANDRA, MD 3/6/2020 3/6/2025 MEDICINE GENERAL PRACTICE EL PASO TX ACTIVE 4/30/2020 None N/A ARIAS-BERRIOS, JOSE EDUARDO, PHYSICAL MED. & NEUROMUSCULAR Q9115 MD 7/15/2016 7/15/2021 REHABILITATION DISEASE HOUSTON TX ACTIVE 7/28/2016 None N/A OBSTETRICS AND R5238 ARIAS-FRANKLIN, SONIA L, MD 11/17/2017 11/17/2022 GYNECOLOGY DALLAS TX ACTIVE 11/20/2017 None N/A Q5144 ARIF, SAHAR, MD 7/15/2015 7/15/2020 INTERNAL MEDICINE HOSPITALIST ACTIVE 7/22/2015 None N/A ARIYAMUTHU, VENKATESH Q5340 KUMAR, MD 8/3/2015 8/3/2020 NEPHROLOGY NEPHROLOGY DALLAS TX ACTIVE 8/4/2015 None N/A

Page 19 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date OBSTETRICS AND Q8416 ARMS, RICHARD GRAVES III, MD 6/1/2016 6/1/2021 GYNECOLOGY EL PASO TX ACTIVE 6/13/2016 None N/A LICENSE Q5145 ARMSTRONG, MIA, MD 7/15/2015 7/15/2020 PEDIATRICS ISSUED 7/15/2015 None N/A PEDIATRIC EMERGENCY LICENSE Q4559 ARNOLD, ALANA JACQUELINE , MD 6/1/2015 6/1/2020 MEDICINE (EM) ISSUED 6/1/2015 None N/A ARNOLD, DANIELLE Q9283 PLATTENBURG, MD 8/1/2016 8/1/2021 PEDIATRICS ROUND ROCK TX ACTIVE 8/3/2016 None N/A

NEONATAL- R3022 ARON, CHAIM , DO 5/22/2017 5/22/2022 PERINATAL MEDICINE PEDIATRICS HOUSTON TX ACTIVE 5/24/2017 None N/A EMERGENCY FORT R3262 ARONOVICH, DANIEL MICHAEL, DO 6/2/2017 6/2/2022 MEDICINE LAUDERDALE FL ACTIVE 6/12/2017 None N/A

R2272 ARREDONDO, ANTHONY RAY, DO 4/4/2017 4/4/2022 PEDIATRICS AUSTIN TX ACTIVE 6/23/2017 None N/A Q5616 ARRIETA, SOLEIL , MD 8/14/2015 8/14/2020 FAMILY MEDICINE ACTIVE 8/31/2015 None N/A EMERGENCY R3263 ARRINGTON, MICHAEL, MD 6/2/2017 6/2/2022 MEDICINE TYLER TX ACTIVE 6/5/2017 None N/A PEDIATRIC EMERGENCY R2523 ARROYO, MIGUEL ANGEL JR, MD 4/20/2017 4/20/2022 PEDIATRICS MEDICINE (PEDS) HOUSTON TX ACTIVE 6/5/2017 None N/A EMERGENCY R4808 ARSHAD, MARYAM, MD 10/6/2017 10/6/2022 MEDICINE PEARLAND TX ACTIVE 10/30/2017 None N/A R3265 ARSHAD, SAAIMA, MD 6/2/2017 6/2/2022 INTERNAL MEDICINE CORONA CA ACTIVE 9/11/2017 None N/A DERMATOLOGIC S6116 ARSHANAPALLI, ASHISH, MD 4/17/2020 4/17/2025 DERMATOLOGY SURGERY MANSFIELD TX ACTIVE 4/20/2020 None N/A CARDIOVASCULAR INTERVENTIONAL NEW R2273 ARTHAM, SURYA M, MD 4/4/2017 4/4/2022 DISEASES CARDIOLOGY BRAUNFELS TX ACTIVE 4/10/2017 None N/A Q8693 ARYAIE, AMIR HOSSEIN, MD 6/10/2016 6/10/2021 GENERAL SURGERY LUBBOCK TX ACTIVE 6/20/2016 None N/A S4915 ASAD, ROMANA, MD 2/7/2020 2/7/2025 INTERNAL MEDICINE FORT WORTH TX ACTIVE 2/17/2020 None N/A R4363 ASAITHAMBI, RATHI, MD 8/25/2017 8/25/2022 PEDIATRICS HOUSTON TX ACTIVE 9/4/2017 None N/A ASAPU, ESWARA VENKATA LICENSE Q6601 ANJANI PRATHAP, MD 12/4/2015 12/4/2020 OTHER SPECIALTY ISSUED 12/4/2015 None N/A ASAPU, ESWARA VENKATA Q6601 ANJANI PRATHAP, MD 12/4/2015 12/4/2020 INTERNAL MEDICINE HOSPITALIST URBANA IL ACTIVE 1/25/2016 None N/A ASAPU, ESWARA VENKATA Q6601 ANJANI PRATHAP, MD 12/4/2015 12/4/2020 INTERNAL MEDICINE HOSPITALIST URBANA IL ACTIVE 1/25/2016 None N/A Q8011 ASARE, ANGELA, MD 5/2/2016 5/2/2021 HOSPITALIST SPRINGFIELD IL ACTIVE 5/9/2016 None N/A SURGICAL R1167 ASARE, ELLIOT AMPONSAH, MD 1/6/2017 1/6/2022 ONCOLOGY GENERAL SURGERY HOUSTON TX ACTIVE 2/10/2017 None N/A Page 20 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date R3995 ASGHAR, SARAH, MD 8/1/2017 8/1/2022 INTERNAL MEDICINE ACTIVE 9/19/2017 None N/A EMERGENCY Q9572 ASHAR, TOM, MD 8/15/2016 8/15/2021 MEDICINE PEARLAND TX ACTIVE 8/19/2016 None N/A EMERGENCY S6118 ASHBY, GEORGE EDWARD, MD 4/17/2020 4/17/2025 MEDICINE STATESVILLE NC ACTIVE 4/30/2020 None N/A R1340 ASHBY, LYNN STUART, MD 1/20/2017 1/20/2022 NEUROLOGY NEURO-ONCOLOGY TEXARKANA TX ACTIVE 1/23/2017 None N/A ASHE-LAMBERT, ELTON MELVILLE, PEDIATRIC LICENSE Q4715 MD 6/12/2015 6/12/2020 OTOLARYNGOLOGY OTOLARYNGOLOGY ISSUED 6/12/2015 None N/A

Q8012 ASHFAQ, MUHAMMAD ZUBAIR, MD 5/2/2016 5/2/2021 INTERNAL MEDICINE INTERNAL MEDICINE ACTIVE 5/23/2016 None N/A EMERGENCY R2044 ASHFAQ, SHAH MUHAMMAD, MD 3/20/2017 3/20/2022 MEDICINE ACTIVE 3/23/2017 None N/A OBSTETRICS & ASHIMI BALOGUN, OLAIDE AZIZAT, GYNECOLOGICAL MATERNAL AND Q5970 MD 9/15/2015 9/15/2020 SURGERY FETAL MEDICINE HOUSTON TX ACTIVE 10/14/2015 None N/A ENDOVASCULAR NEUROLOGICAL SURGICAL R0532 ASHOUR, RAMSEY RAFEEK, MD 10/31/2016 10/31/2021 SURGERY NEURORADIOLOGY AUSTIN TX ACTIVE 11/1/2016 None N/A R0688 ASHRAF, MOHAMMED A, MD 11/15/2016 11/15/2021 FAMILY MEDICINE KILLEEN TX ACTIVE 12/5/2016 None N/A

R1695 ASHTON, GREGORY WILLIAM, MD 2/22/2017 2/22/2022 ANESTHESIOLOGY WORCESTER MA ACTIVE 2/27/2017 None N/A LICENSE S6567 ASIF, MUHAMMAD, MD 5/15/2020 5/15/2025 INTERNAL MEDICINE NEPHROLOGY ISSUED 5/15/2020 None N/A OKLAHOMA Q6390 ASIF, SHAHIDA, MD 11/2/2015 11/2/2020 INTERNAL MEDICINE CITY OK ACTIVE 11/9/2015 None N/A

Q6807 ASIKAIWE, CHIMA NATHANIEL, MD 1/6/2016 1/6/2021 PSYCHIATRY BINGHAMTON NY ACTIVE 1/18/2016 None N/A Q6728 ASIM, AMNA, MD 12/15/2015 12/15/2020 INTERNAL MEDICINE SUGAR LAND TX ACTIVE 3/7/2016 None N/A CRITICAL CARE Q5146 ASIMI, NTESI ANASTASIOS, MD 7/15/2015 7/15/2020 ANESTHESIOLOGY ANESTHESIOLOGY DALLAS TX ACTIVE 7/16/2015 None N/A S4718 ASIRVATHAM, JAYA RUTH, MD 1/24/2020 1/24/2025 PATHOLOGY GAINESVILLE FL ACTIVE 2/11/2020 None N/A LICENSE Q6492 ASKARI, NASSER DEAN, DO 11/16/2015 11/16/2020 INTERNAL MED - PEDS ISSUED 11/16/2015 None N/A CARDIOVASCULAR S5116 ASKARI, RAZA, MD 2/21/2020 2/21/2025 CARDIOLOGY DISEASES MEMPHIS TN ACTIVE 2/24/2020 None N/A R0833 ASLAM, SAMAR, MD 12/2/2016 12/2/2021 FAMILY MEDICINE LEWISVILLE TX ACTIVE 12/13/2016 None N/A R1168 ASSALITA, STEVEN , MD 1/6/2017 1/6/2022 CARDIOLOGY INTERNAL MEDICINE HOUSTON TX ACTIVE 3/2/2017 None N/A

NEONATAL- R5353 ASWANI, ROHIT, MD 12/8/2017 12/8/2022 PERINATAL MEDICINE PEDIATRICS TOPEKA KS ACTIVE 12/22/2017 None N/A R4662 ATHER, SYED, MD 9/22/2017 9/22/2022 FAMILY MEDICINE ACTIVE 10/2/2017 None N/A Page 21 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date ATHREYA, KHANNAN Q9573 KAMESHVARAN, MD 8/15/2016 8/15/2021 INTERNAL MEDICINE HOUSTON TX ACTIVE 8/16/2016 None N/A Q9116 ATIF, MUZNA, MD 7/15/2016 7/15/2021 PEDIATRICS ACTIVE 9/29/2016 None N/A LICENSE Q4560 ATLA, RAMA MOHAN REDDY, MD 6/1/2015 6/1/2020 FAMILY MEDICINE ISSUED 6/1/2015 None N/A Q9117 ATORE, CARLOS , MD 7/15/2016 7/15/2021 FAMILY MEDICINE AUSTIN TX ACTIVE 7/18/2016 None N/A GRAND R0835 ATTAL, HOUSSAM, MD 12/2/2016 12/2/2021 PATHOLOGY CYTOPATHOLOGY RAPIDS MI ACTIVE 12/12/2016 None N/A INTERVENTIONAL DIAGNOSTIC R3266 ATTAYA, HOSAM N, MD 6/2/2017 6/2/2022 RADIOLOGY RADIOLOGY SAN ANTONIO TX ACTIVE 6/14/2017 None N/A OPHTHALMOLOGY - S6120 ATTIA, HOSAM, MD 4/17/2020 4/17/2025 VITREOUS SURGERY OPHTHALMOLOGY ACTIVE 5/21/2020 None N/A PEDIATRIC GASTROENTEROLOG Q8694 ATTIA, SUZANNA LABIB, MD 6/10/2016 6/10/2021 Y PEDIATRICS BOGOTÁ ACTIVE 6/16/2016 None N/A PEDIATRIC Q7633 ATTRA, JAMES JOHNATHAN, MD 4/1/2016 4/1/2021 OTOLARYNGOLOGY OTOLARYNGOLOGY AUSTIN TX ACTIVE 4/14/2016 None N/A Q7833 AU, JASON , MD 4/15/2016 4/15/2021 PEDIATRIC UROLOGY HOUSTON TX ACTIVE 4/25/2016 None N/A EMERGENCY LICENSE Q6603 AUBIN, DEAN JR, MD 12/4/2015 12/4/2020 MEDICINE ISSUED 12/4/2015 None N/A EMERGENCY Q6603 AUBIN, DEAN JR, MD 12/4/2015 12/4/2020 MEDICINE ALLEN TX ACTIVE 12/9/2015 None N/A EMERGENCY Q6603 AUBIN, DEAN JR, MD 12/4/2015 12/4/2020 MEDICINE ALLEN TX ACTIVE 12/9/2015 None N/A EMERGENCY S6568 AUGILLARD, ALLAN, MD 5/15/2020 5/15/2025 MEDICINE BEAUMONT TX ACTIVE 5/18/2020 None N/A LAWRENCEVIL S6121 AUGUSTINE, ROSE C, MD 4/17/2020 4/17/2025 PEDIATRICS LE GA ACTIVE 4/20/2020 None N/A LICENSE S5117 AUSTIN, FELICIA MONIQUE, MD 2/21/2020 2/21/2025 INTERNAL MEDICINE ISSUED 2/21/2020 None N/A K7982 AUSTIN, PAUL FARMER, MD 2/6/2017 2/6/2022 PEDIATRIC UROLOGY UROLOGY HOUSTON TX ACTIVE 2/10/2017 None N/A

R1169 AUSTIN-GLASS, ANTOINETTE, MD 1/6/2017 1/6/2022 ANESTHESIOLOGY ACTIVE 1/9/2017 None N/A PEDIATRIC Q4892 AVERILL, KELLY ANNE, MD 7/1/2015 7/1/2020 NEUROLOGY SAN ANTONIO TX ACTIVE 7/6/2015 None N/A ADDICTION Q7008 AVILA, JORGE N, MD 2/1/2016 2/1/2021 PSYCHIATRY MEDICINE ACTIVE 4/21/2016 None N/A GYNECOLOGIC S4720 AVILA, MONICA , MD 1/24/2020 1/24/2025 ONCOLOGY HOUSTON TX ACTIVE 2/19/2020 None N/A

R3267 AWA, UGO, MD 6/2/2017 6/2/2022 INTERNAL MED - PEDS RHEUMATOLOGY HOUSTON TX ACTIVE 6/9/2017 None N/A Page 22 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date AWAN, AHMED ARSLAN YOUSUF, R2045 MD 3/20/2017 3/20/2022 INTERNAL MEDICINE NEPHROLOGY ACTIVE 4/3/2017 None N/A R4810 AWAN, LEAH LAEEKA, MD 10/6/2017 10/6/2022 FAMILY MEDICINE SAN ANTONIO TX ACTIVE 10/9/2017 None N/A Q7009 AWE, OPEYEMI ABIODUN, MD 2/1/2016 2/1/2021 HOSPITALIST INTERNAL MEDICINE ACTIVE 4/25/2016 None N/A Q9118 AWWAD, MAHDI MANSOUR, MD 7/15/2016 7/15/2021 FAMILY MEDICINE OBSTETRICS ACTIVE 8/5/2016 None N/A PEDIATRIC PHYSICAL MED. & REHABILITATION CANC NON- Q9285 AYALA, AMANDA CECILIA, MD 8/1/2016 8/1/2021 REHABILITATION MEDICINE PAYMENT 12/11/2017 None N/A S6123 AYALA, PAMELA MICHELLE, MD 4/17/2020 4/17/2025 FAMILY MEDICINE SUGAR LAND TX ACTIVE 4/20/2020 None N/A PALLIATIVE Q8015 AYERS, GREGORY WAYNE, MD 5/2/2016 5/2/2021 INTERNAL MEDICINE MEDICINE BIRMINGHAM AL ACTIVE 5/10/2016 None N/A INFECTIOUS R3268 AYI, BERTHA SERWA, MD 6/2/2017 6/2/2022 DISEASES INTERNAL MEDICINE SIOUX CITY IA ACTIVE 6/9/2017 None N/A S4596 AYMUT, HAGOS ZEFERU, MD 1/10/2020 1/10/2025 INTERNAL MEDICINE ACTIVE 1/31/2020 None N/A Q4893 AYOUB, SURA , MD 7/1/2015 7/1/2020 INTERNAL MEDICINE ACTIVE 7/28/2015 None N/A ELECTROPHYSIOLOG Q9119 AYUB, BILAL, MD 7/15/2016 7/15/2021 Y CARDIOLOGY PLANO TX ACTIVE 7/27/2016 None N/A CRITICAL CARE R4185 AYYAGARI, KRISHNA SUDHIR, MD 8/15/2017 8/15/2022 MEDICINE INTERNAL MEDICINE ODESSA TX ACTIVE 9/4/2017 None N/A EMERGENCY MARBLE Q9945 AZAM, HUMZA S, DO 9/15/2016 9/15/2021 MEDICINE FALLS TX ACTIVE 9/29/2016 None N/A R1495 AZAM, MUHAMMAD OMAR, MD 2/6/2017 2/6/2022 NEPHROLOGY INTERNAL MEDICINE FORT WORTH TX ACTIVE 4/5/2017 None N/A

NEUROLOGY & CLINICAL R0355 AZAR, NABIL JOHN, MD 10/14/2016 10/14/2021 PSYCHIATRY NEUROPHYSIOLOGY NASHVILLE TN ACTIVE 12/13/2016 None N/A CARDIAC CARDIOVASCULAR ELECTROPHYSIOLO R3996 AZEEM, AMIR, MD 8/1/2017 8/1/2022 DISEASES GY SUGAR LAND TX ACTIVE 8/3/2017 None N/A EMERGENCY Q7319 AZEEZ, FARHAN ABDUL, DO 3/4/2016 3/4/2021 MEDICINE IRVING TX ACTIVE 3/10/2016 None N/A R0533 AZHAR, ASHAUR, MD 10/31/2016 10/31/2021 INTERNAL MEDICINE HUMBLE TX ACTIVE 11/15/2016 None N/A CARDIOTHORACIC LICENSE R5962 AZIMI-BOLOURIAN, JIAN PAUL, MD 2/16/2018 2/16/2023 ANESTHESIOLOGY ANESTHESIOLOGY ISSUED 2/16/2018 None N/A R6145 AZIZ, HAMZA , MD 3/2/2018 3/2/2023 INTERNAL MEDICINE HOUSTON TX ACTIVE 3/5/2018 None N/A ORTHOPEDIC FOOT AND ANKLE, S4597 AZIZ, HIBBA , MD 1/10/2020 1/10/2025 SURGERY ORTHOPEDICS ACTIVE 2/26/2020 None N/A DIAGNOSTIC S4438 AZIZ, MUHAMMAD USMAN, MD 12/20/2019 12/20/2024 RADIOLOGY BIRMINGHAM AL ACTIVE 1/21/2020 None N/A Q4562 AZIZAD, OMAIRA , MD 6/1/2015 6/1/2020 ANESTHESIOLOGY DALLAS TX ACTIVE 6/15/2015 None N/A AZNAUROVA-ANDERSON, LILIYA , EMERGENCY Q4894 MD 7/1/2015 7/1/2020 MEDICINE INTERNAL MEDICINE ACTIVE 7/24/2015 None N/A Page 23 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date MISSOURI Q9574 AZUOGU, KELECHI , MD 8/15/2016 8/15/2021 GENERAL PRACTICE CITY TX ACTIVE 8/18/2016 None N/A Q7634 AZZAM, MOHAMAD ALI, MD 4/1/2016 4/1/2021 ANESTHESIOLOGY PAIN MANAGEMENT ACTIVE 6/21/2016 None N/A S4917 AZZAWE, AHMAD, MD 2/7/2020 2/7/2025 UROLOGY SAN ANTONIO TX ACTIVE 2/17/2020 None N/A CHILD AND ADOLESCENT R3025 BABAJIDE, AZEESAT, MD 5/22/2017 5/22/2022 PSYCHIATRY PSYCHIATRY HOUSTON TX ACTIVE 8/16/2017 None N/A BABALOLA, EBENEZER OLUFEMI, OBSTETRICS AND EAST R2275 MD 4/4/2017 4/4/2022 GYNECOLOGY UROGYNECOLOGY SETAUKET NY ACTIVE 4/6/2017 None N/A ENDOCRINOLOGY, DIABETES AND S4261 BABAR, JAWAD, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE METABOLISM ACTIVE 1/23/2020 None N/A ENDOCRINOLOGY, DIABETES AND S4261 BABAR, JAWAD, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE METABOLISM ACTIVE 1/23/2020 None N/A Q6391 BABAR, SAMIA, MD 11/2/2015 11/2/2020 INTERNAL MEDICINE ACTIVE 11/6/2015 None N/A VASCULAR S6569 BABAYEUSKI, RAMAN , MD 5/15/2020 5/15/2025 GENERAL SURGERY SURGERY HARLINGEN TX ACTIVE 5/28/2020 None N/A VASCULAR AND INTERVENTIONAL Q8827 BABAYEV, YURIY, MD 7/1/2016 7/1/2021 RADIOLOGY RADIOLOGY CLEVELAND OH ACTIVE 8/19/2016 None N/A SOUTH Q7528 BABOOLAL, BRENT, MD 3/15/2016 3/15/2021 HOSPITALIST INTERNAL MEDICINE WEYMOUTH MA ACTIVE 3/17/2016 None N/A ANESTHESIOLOGY - Q4895 BABU, VIJAY GUTTI, MD 7/1/2015 7/1/2020 ANESTHESIOLOGY PAIN MANAGEMENT ACTIVE 8/3/2015 None N/A EMERGENCY Q8422 BACA, MARSHALL G JR, DO 6/1/2016 6/1/2021 MEDICINE EL PASO TX ACTIVE 6/3/2016 None N/A DIAGNOSTIC S5833 BACK, STEPHEN, DO 4/3/2020 4/3/2025 RADIOLOGY TULSA OK ACTIVE 4/22/2020 None N/A OBSTETRICS AND S5548 BACKLEY, SAMI , MD 3/20/2020 3/20/2025 GYNECOLOGY HOUSTON TX ACTIVE 3/30/2020 None N/A EMERGENCY LICENSE Q5755 BACKOFEN, GREGORY SCOTT, MD 8/28/2015 8/28/2020 FAMILY MEDICINE MEDICINE ISSUED 8/28/2015 None N/A H4867 BADALAMENTI, JOHN, MD 9/15/2015 9/15/2020 NEPHROLOGY INTERNAL MEDICINE GALVESTON TX ACTIVE 9/17/2015 None N/A EMERGENCY R2046 BADAWY, AMR, DO 3/20/2017 3/20/2022 MEDICINE HOUSTON TX ACTIVE 6/5/2017 None N/A RADIATION R5241 BADIYAN, SHAHED NICOLAS, MD 11/17/2017 11/17/2022 ONCOLOGY BALTIMORE MD ACTIVE 1/31/2018 None N/A ORAL & MAXILLOFACIAL CRANIOFACIAL R6146 BAE, SAM SEOHO, MD 3/2/2018 3/2/2023 SURGERY SURGERY EL PASO TX ACTIVE 3/6/2018 None N/A Page 24 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date BAEZ HERNANDEZ, NATHANYA, PEDIATRICS, R5836 MD 2/2/2018 2/2/2023 PEDIATRICS CARDIOLOGY OAK LAWN IL ACTIVE 2/26/2018 None N/A S6353 BAEZ MATOS, ELDRID, MD 5/1/2020 5/1/2025 NEPHROLOGY DALLAS TX ACTIVE 5/22/2020 None N/A BAGEAC, ALEXANDRU CRISTIAN, DIAGNOSTIC R3998 MD 8/1/2017 8/1/2022 RADIOLOGY NUCLEAR MEDICINE FORT WORTH TX ACTIVE 8/2/2017 None N/A SPORTS MEDICINE R2811 BAGEN, TARA K, MD 5/5/2017 5/5/2022 FAMILY MEDICINE (FAMILY PRACTICE) DALLAS TX ACTIVE 5/15/2017 None N/A DIAGNOSTIC CASA R2812 BAGHERPOUR, ARVIN NAVID, MD 5/5/2017 5/5/2022 RADIOLOGY GRANDE AZ ACTIVE 5/19/2017 None N/A CARDIOTHORACIC S4262 BAGINGITO, EDMUND MARTIN, MD 12/6/2019 12/6/2024 ANESTHESIOLOGY ANESTHESIOLOGY DALLAS TX ACTIVE 12/19/2019 None N/A CARDIOTHORACIC S4262 BAGINGITO, EDMUND MARTIN, MD 12/6/2019 12/6/2024 ANESTHESIOLOGY ANESTHESIOLOGY DALLAS TX ACTIVE 12/19/2019 None N/A NEUROLOGICAL Q5756 BAGLEY, CARLOS ANTONIO, MD 8/28/2015 8/28/2020 SURGERY DALLAS TX ACTIVE 9/4/2015 None N/A UROLOGIC Q8828 BAGRODIA, ADITYA , MD 7/1/2016 7/1/2021 ONCOLOGY UROLOGIC SURGERY DALLAS TX ACTIVE 7/28/2016 None N/A S5549 BAGWELL, THOMAS JAMES, MD 3/20/2020 3/20/2025 ANESTHESIOLOGY DALLAS TX ACTIVE 3/26/2020 None N/A Q5971 BAHAL, PAUL AMIT, MD 9/15/2015 9/15/2020 FAMILY MEDICINE ROUND ROCK TX ACTIVE 11/13/2015 None N/A R4664 BAHETI, DEEPTI RAMESH, MD 9/22/2017 9/22/2022 INTERNAL MEDICINE EAGLE PASS TX ACTIVE 10/23/2017 None N/A PEDIATRIC EMERGENCY Q5972 BAHLING, JOHN, MD 9/15/2015 9/15/2020 MEDICINE (PEDS) AUSTIN TX ACTIVE 12/7/2015 None N/A OTOLARYN & FACIAL HEAD AND NECK S4721 BAHRAMI, ARASH, DO 1/24/2020 1/24/2025 PLASTIC SURGERY SURGERY ACTIVE 4/6/2020 None N/A GERIATRIC Q9288 BAIDYA, MONI, MD 8/1/2016 8/1/2021 PSYCHIATRY PSYCHIATRY LYNCHBURG VA ACTIVE 8/11/2016 None N/A PEDIATRIC HEMATOLOGY/ONCO S5550 BAIG, MUHAMMAD, MD 3/20/2020 3/20/2025 PEDIATRICS LOGY HOUSTON TX ACTIVE 3/25/2020 None N/A Q8017 BAILEY, LAUREN HAYES, MD 5/2/2016 5/2/2021 PEDIATRICS SAN ANTONIO TX ACTIVE 5/9/2016 None N/A S4263 BAILEY, MARSHALL DEVON, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE HOUSTON TX ACTIVE 2/25/2020 None N/A S4263 BAILEY, MARSHALL DEVON, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE HOUSTON TX ACTIVE 2/25/2020 None N/A ANESTHESIOLOGY - Q7835 BAILEY, STEVEN L, MD 4/15/2016 4/15/2021 ANESTHESIOLOGY PAIN MANAGEMENT SAN ANTONIO TX ACTIVE 5/11/2016 None N/A INFECTIOUS Q6494 BAINS, KARANPREET SINGH, MD 11/16/2015 11/16/2020 DISEASES INTERNAL MEDICINE MARKS MS ACTIVE 11/17/2015 None N/A Q7140 BAINS, PAVIT , MD 2/16/2016 2/16/2021 RADIOLOGY ACTIVE 3/23/2016 None N/A NEONATAL- PERINATAL R2277 BAIRD, STEPHEN DANIEL, DO 4/4/2017 4/4/2022 PEDIATRICS MEDICINE DALLAS TX ACTIVE 5/18/2017 None N/A Page 25 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date CRITICAL CARE PULMONARY R0992 BAJAJ, MADHU SATYA, MD 12/16/2016 12/16/2021 MEDICINE (IM) DISEASES ST. LOUIS MO ACTIVE 2/3/2017 None N/A THORACIC CARDIOVASCULAR CARDIOVASCULAR Q9783 BAJONA, PIETRO , MD 8/26/2016 8/26/2021 SURGERY SURGERY DALLAS TX ACTIVE 8/30/2016 None N/A INTERVENTIONAL DIAGNOSTIC Q6145 BAKALIS, CHRISTINA, MD 10/1/2015 10/1/2020 RADIOLOGY RADIOLOGY DESOTO TX ACTIVE 10/5/2015 None N/A OKLAHOMA R3795 BAKER, CARRIE ARLENE, DO 7/17/2017 7/17/2022 PEDIATRICS CITY OK ACTIVE 8/22/2017 None N/A INTERVENTIONAL PEDIATRIC R1929 BAKER, JOE BLUNT IV, MD 3/3/2017 3/3/2022 RADIOLOGY RADIOLOGY AUSTIN TX ACTIVE 3/8/2017 None N/A OBSTETRICS AND Q8243 BAKER, NOELLE AISSA, MD 5/16/2016 5/16/2021 GYNECOLOGY ACTIVE 5/17/2016 None N/A R1698 BALAGNA, JONATHAN TROY, MD 2/22/2017 2/22/2022 CARDIOLOGY INTERNAL MEDICINE TEMPLE TX ACTIVE 3/23/2017 None N/A EMERGENCY Q6146 BALASUBRAMANIAN, DIVYA, DO 10/1/2015 10/1/2020 MEDICINE DALLAS TX ACTIVE 10/14/2015 None N/A

Q8207 BALDWIN, CHRISTINA LAUREN, MD 5/16/2016 5/16/2021 PEDIATRICS TAMPA FL ACTIVE 5/24/2016 None N/A

R2527 BALINGER, KATHRYN JULIA, MD 4/20/2017 4/20/2022 TRAUMATIC SURGERY GENERAL SURGERY ACTIVE 5/19/2017 None N/A R2278 BALLE, LARRY II, MD 4/4/2017 4/4/2022 FAMILY MEDICINE HOUSTON TX ACTIVE 5/5/2017 None N/A Q4897 BALOGH, RYAN PATRICK, MD 7/1/2015 7/1/2020 GENERAL SURGERY FT WORTH TX ACTIVE 7/9/2015 None N/A BALOGUN, OLUSOLA ELIZABETH, EMERGENCY Q6392 MD 11/2/2015 11/2/2020 MEDICINE CHICAGO IL ACTIVE 11/25/2015 None N/A EMERGENCY S4918 BANALA, SRINIVAS REDDY, MD 2/7/2020 2/7/2025 MEDICINE HOUSTON TX ACTIVE 2/20/2020 None N/A R0994 BANDA, NIRANJAN REDDY, MD 12/16/2016 12/16/2021 INTERNAL MEDICINE INTERNAL MEDICINE FORT WORTH TX ACTIVE 2/27/2017 None N/A Q7141 BANDEALI, BARKATALI , DO 2/16/2016 2/16/2021 INTERNAL MEDICINE HOUSTON TX ACTIVE 2/18/2016 None N/A BANDEALI, SALMAN JAMALUDDIN, CARDIOVASCULAR INTERVENTIONAL R2050 MD 3/20/2017 3/20/2022 DISEASES CARDIOLOGY ACTIVE 3/22/2017 None N/A CRITICAL CARE EMERGENCY R2528 BANG, ERICA, MD 4/20/2017 4/20/2022 MEDICINE (IM) MEDICINE ACTIVE 5/2/2017 None N/A S4722 BANG, PAVAN KUMAR, MD 1/24/2020 1/24/2025 PEDIATRICS OPP AL ACTIVE 1/31/2020 None N/A NEONATAL- PERINATAL R2279 BANG, TERRY L, MD 4/4/2017 4/4/2022 PEDIATRICS MEDICINE GALVESTON TX ACTIVE 4/6/2017 None N/A BANGALORE ANNAIAH, PUTTA S6355 SHANKAR, MD 5/1/2020 5/1/2025 ANESTHESIOLOGY ACTIVE 5/6/2020 None N/A R4515 BANGARU, SAROJA DEVI, MD 9/8/2017 9/8/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 9/12/2017 None N/A

Page 26 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PEDIATRIC EMERGENCY Q9121 BANK, DAVID ETHAN, MD 7/15/2016 7/15/2021 MEDICINE (PEDS) PEDIATRICS AUSTIN TX ACTIVE 7/28/2016 None N/A OPHTHALMOLOGY - R4937 BANKER, TANUJ PARENDRA, MD 10/20/2017 10/20/2022 VITREOUS SURGERY ACTIVE 10/30/2017 None N/A BANKOLE, OMOLABAKE R0186 OLORUNTOBILOBA, MD 9/30/2016 9/30/2021 FAMILY MEDICINE BAKERSFIELD CA ACTIVE 10/27/2016 None N/A EMERGENCY Q5148 BANKS, GERALD, MD 7/15/2015 7/15/2020 FAMILY MEDICINE MEDICINE KINGSVILLE TX ACTIVE 7/30/2015 None N/A OBSTETRICS AND LICENSE Q7638 BANNER, JENNA NICOLE, MD 4/1/2016 4/1/2021 GYNECOLOGY ISSUED 4/1/2016 None N/A R4666 BANNIS, ROHAN, MD 9/22/2017 9/22/2022 ANESTHESIOLOGY PAIN MANAGEMENT HARLINGEN TX ACTIVE 9/28/2017 None N/A GASTROENTEROLOG Q7321 BANSAL, PARDEEP, MD 3/4/2016 3/4/2021 INTERNAL MEDICINE Y SCRANTON PA ACTIVE 3/7/2016 None N/A CHILD AND ADOLESCENT LICENSE Q4563 BANSAL, RAHUL, MD 6/1/2015 6/1/2020 PSYCHIATRY PSYCHIATRY ISSUED 6/1/2015 None N/A LICENSE S7005 BANSAL, SUKRITI , MD 6/12/2020 6/12/2025 GENERAL SURGERY ISSUED 6/12/2020 None N/A ANATOMIC/CLINICAL HEMATOLOGY Q9947 BAQAI, JUNAID, MD 9/15/2016 9/15/2021 PATHOLOGY (PATHOLOGY) SPRINGFIELD IL ACTIVE 10/17/2016 None N/A PEDIATRIC ANESTHESIOLOGY R5965 BARACZ, ASHLEY DAWN, MD 2/16/2018 2/16/2023 ANESTHESIOLOGY (PEDS) SAN ANTONIO TX ACTIVE 3/5/2018 None N/A LICENSE Q4564 BARAD, BHAVESH, MD 6/1/2015 6/1/2020 INTERNAL MEDICINE CARDIOLOGY ISSUED 6/1/2015 None N/A BARADIA, MOHAMED HUSSEIN , PHYSICAL MED. & LICENSE S6356 DO 5/1/2020 5/1/2025 REHABILITATION PAIN MANAGEMENT ISSUED 5/1/2020 None N/A BARAJAS DE LA ROCHA, Q7012 FRANCISCO JAVIER, MD 2/1/2016 2/1/2021 INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 2/5/2016 None N/A Q4565 BARAN AKCE, LEYLA , MD 6/1/2015 6/1/2020 PSYCHIATRY HOUSTON TX ACTIVE 6/16/2015 None N/A CARDIOVASCULAR R2280 BARAN, DAVID ALAN, MD 4/4/2017 4/4/2022 DISEASES NEWARK NJ ACTIVE 4/10/2017 None N/A Q8426 BARBARA, MARY, MD 6/1/2016 6/1/2021 INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 6/7/2016 None N/A

S4919 BARBER, LATOYA SHEMEIKA, MD 2/7/2020 2/7/2025 PEDIATRICS SUNRISE FL ACTIVE 2/10/2020 None N/A Q5149 BARBER, LISA MARIE , MD 7/15/2015 7/15/2020 PEDIATRICS HOUSTON TX ACTIVE 8/26/2015 None N/A OBSTETRICS AND MATERNAL AND R4938 BARBOUR, KELLI DIANE, MD 10/20/2017 10/20/2022 GYNECOLOGY FETAL MEDICINE HOUSTON TX ACTIVE 10/27/2017 None N/A

Page 27 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date OBSTETRICS & GYNECOLOGICAL R2529 BARDAWIL, ELISE, MD 4/20/2017 4/20/2022 SURGERY HOUSTON TX ACTIVE 4/25/2017 None N/A EMERGENCY R0995 BARKANIC, EMILY SUE, MD 12/16/2016 12/16/2021 MEDICINE TEMPLE TX ACTIVE 12/22/2016 None N/A SEE CORPUS PREVIOUS Q7836 BARKER, SAMUEL FOX, MD 4/15/2016 4/15/2021 FAMILY PRACTICE CHRISTI TX ACTIVE 4/18/2016 ORDER 3/4/2016 EMERGENCY S5319 BARKLEY, TASHA, MD 3/6/2020 3/6/2025 MEDICINE ALBANY OR ACTIVE 3/25/2020 None N/A ORTHOPEDIC SURGERY OF THE ORTHOPEDIC R3027 BARKOH, KAKU, MD 5/22/2017 5/22/2022 SPINE SURGERY TOMBALL TX ACTIVE 7/27/2017 None N/A S6573 BARNES, BRIE , MD 5/15/2020 5/15/2025 GENERAL SURGERY HOUSTON TX ACTIVE 5/22/2020 None N/A BARNES, CALVIN LANGSTON DIAGNOSTIC MUSCULOSKELETAL R1700 TOURE, MD 2/22/2017 2/22/2022 RADIOLOGY RADIOLOGY SAVANNAH GA ACTIVE 3/1/2017 None N/A EMERGENCY R0356 BARNES, RICHARD RAY, MD 10/14/2016 10/14/2021 MEDICINE PADUCAH KY ACTIVE 11/3/2016 None N/A EMERGENCY R5504 BARNES, ROBERT LYNN, MD 1/5/2018 1/5/2023 MEDICINE DALLAS TX ACTIVE 1/15/2018 None N/A EMERGENCY R4516 BARNEY, JACOB KENT, MD 9/8/2017 9/8/2022 MEDICINE TEMPLE TX ACTIVE 9/20/2017 None N/A PEDIATRIC HEMATOLOGY/ONCOL R5837 BARR, ERIN KELLY, MD 2/2/2018 2/2/2023 OGY PEDIATRICS LUBBOCK TX ACTIVE 2/21/2018 None N/A PULMONARY BARRANTES PEREZ, JAIRO CRITICAL CARE Q8829 HERNANDO, MD 7/1/2016 7/1/2021 MEDICINE SLEEP MEDICINE HOUSTON TX ACTIVE 7/20/2016 None N/A DELINQUEN T-NON R5356 BARRERA, ANDRES III, MD 12/8/2017 12/8/2022 INTERNAL MEDICINE PAYMENT 3/8/2018 None N/A R4811 BARRETO, TYLER, MD 10/6/2017 10/6/2022 FAMILY MEDICINE SAN ANTONIO TX ACTIVE 10/16/2017 None N/A PHYSICAL MED. & Q7639 BARRETT, LISA SHANEL, MD 4/1/2016 4/1/2021 REHABILITATION EL PASO TX ACTIVE 4/4/2016 None N/A URGENT CARE - R3471 BARRON, DOUGLAS JR, DO 6/16/2017 6/16/2022 FAMILY MEDICINE FAMILY PRACTICE ARLINGTON TX ACTIVE 7/3/2017 None N/A R1701 BARRON, GRACE CAROLINE, MD 2/22/2017 2/22/2022 PSYCHIATRY AUSTIN TX ACTIVE 3/3/2017 None N/A HAND SURGERY - ORTHOPEDIC ORTHOPEDIC R4939 BARRON, OTIS ALTON JR, MD 10/20/2017 10/20/2022 SURGERY SURGERY AUSTIN TX ACTIVE 11/6/2017 None N/A

Page 28 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date BARROS, BRITTANY SAMBRANO, THE R3797 MD 7/17/2017 7/17/2022 DERMATOLOGY WOODLANDS TX ACTIVE 8/21/2017 None N/A THE R4186 BARROS, MARK ANDREW, MD 8/15/2017 8/15/2022 PEDIATRICS WOODLANDS TX ACTIVE 8/18/2017 None N/A DIAGNOSTIC INTERVENTIONAL Q7142 BARROW, ANDREW JOSEPH, MD 2/16/2016 2/16/2021 RADIOLOGY RADIOLOGY HOUSTON TX ACTIVE 3/4/2016 None N/A BARSHIKAR, SURENDRA PHYSICAL MED. & Q8019 SHRIKRISHNA, MD 5/2/2016 5/2/2021 REHABILITATION ACTIVE 5/9/2016 None N/A REPRODUCTIVE ENDOCRINOLOGY R1702 BARSKY, MAYA, MD 2/22/2017 2/22/2022 GYNECOLOGY AND INFERTILITY HOUSTON TX ACTIVE 4/3/2017 None N/A R0537 BARSOOM, MEDHAT E, MD 10/31/2016 10/31/2021 INTERNAL MEDICINE BUFFALO NY ACTIVE 11/25/2016 None N/A SPORTS MEDICINE - ORTHOPEDIC ALBUQUERQU S4442 BARTLEY, JUSTIN HULL, MD 12/20/2019 12/20/2024 ORTHOPEDICS SURGERY E NM ACTIVE 1/13/2020 None N/A EMERGENCY R4365 BARTON, KATHERINE, MD 8/25/2017 8/25/2022 MEDICINE ACTIVE 9/11/2017 None N/A BARTOW, CHRISTINE E LANGNER, S4265 DO 12/6/2019 12/6/2024 PSYCHIATRY ACTIVE 1/13/2020 None N/A BARTOW, CHRISTINE E LANGNER, S4265 DO 12/6/2019 12/6/2024 PSYCHIATRY ACTIVE 1/13/2020 None N/A BARTZ, BRETT HAMILTON DIAGNOSTIC PEDIATRIC R0837 HUTCHERSON, MD 12/2/2016 12/2/2021 RADIOLOGY RADIOLOGY ENGLEWOOD CO ACTIVE 12/8/2016 None N/A BARTZ-KURYCKI, MARISA Q9122 ANGELINE, MD 7/15/2016 7/15/2021 GENERAL SURGERY HOUSTON TX ACTIVE 7/27/2016 None N/A PEDIATRIC EMERGENCY R2532 BARUA-NATH, URVASHI, MD 4/20/2017 4/20/2022 MEDICINE (PEDS) PEDIATRICS HOUSTON TX ACTIVE 5/1/2017 None N/A S6792 BARUCH, HILARY , MD 5/29/2020 5/29/2025 FAMILY MEDICINE FORT WORTH TX ACTIVE 6/5/2020 None N/A EMERGENCY R0838 BARUFFI, SETH L, MD 12/2/2016 12/2/2021 MEDICINE PEARLAND TX ACTIVE 12/15/2016 None N/A DELINQUEN T-NON Q9949 BASHEER, SAAD BIN KHALID, MD 9/15/2016 9/15/2021 FAMILY MEDICINE GERIATRICS VALLEJO CA PAYMENT 12/30/2017 None N/A R0189 BASHIR, AYESHA, MD 9/30/2016 9/30/2021 INTERNAL MEDICINE ACTIVE 12/16/2016 None N/A MURFREESBO R2052 BASILICO, LEOPOLDO MARIO, MD 3/20/2017 3/20/2022 INTERNAL MED - PEDS RO TN ACTIVE 3/30/2017 None N/A R4812 BASIT, MUJEEB ABDUL, MD 10/6/2017 10/6/2022 CARDIOLOGY INTERNAL MEDICINE DALLAS TX ACTIVE 10/10/2017 None N/A PEDIATRIC R1703 BASORA ROVIRA, ELISA, MD 2/22/2017 2/22/2022 PEDIATRICS PULMONOLOGY DALLAS TX ACTIVE 5/11/2017 None N/A

Page 29 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PULMONARY PULMONARY CRITICAL CARE CRITICAL CARE Q5151 BASORA, JOSE F, MD 7/15/2015 7/15/2020 MEDICINE MEDICINE GRAPEVINE TX ACTIVE 7/28/2015 None N/A L3240 BASSALI, JOANNE BOTROS, MD 8/14/2015 8/14/2020 PEDIATRICS SAN ANTONIO TX ACTIVE 8/17/2015 None N/A ABDOMINAL Q7143 BASSI, DEEP GAGAN, MD 2/16/2016 2/16/2021 RADIOLOGY RADIOLOGY HOUSTON TX ACTIVE 3/2/2016 None N/A EMERGENCY Q8427 BASSO, MARK ANTHONY, MD 6/1/2016 6/1/2021 MEDICINE TEMPLE TX ACTIVE 6/20/2016 None N/A Q5758 BASSUNER, JURI, MD 8/28/2015 8/28/2020 DERMATOLOGY HOUSTON TX ACTIVE 9/11/2015 None N/A Q9950 BASTIAN, HOLLY M, MD 9/15/2016 9/15/2021 RHEUMATOLOGY ROCKWALL TX ACTIVE 10/19/2016 None N/A CARDIAC ELECTROPHYSIOLOG R2533 BASU RAY, INDRANILL , MD 4/20/2017 4/20/2022 Y CARDIOLOGY HOUSTON TX ACTIVE 5/3/2017 None N/A S6128 BASYAL, SANDHYA, MD 4/17/2020 4/17/2025 INTERNAL MEDICINE TEMPLE TX ACTIVE 4/20/2020 None N/A HEMATOLOGY - S6793 BAT, TAHA, MD 5/29/2020 5/29/2025 INTERNAL MEDICINE ONCOLOGY DALLAS TX ACTIVE 6/5/2020 None N/A EMERGENCY LICENSE Q6605 BATEMAN, JOHN BRIAN, MD 12/4/2015 12/4/2020 MEDICINE ISSUED 12/4/2015 None N/A EMERGENCY Q6605 BATEMAN, JOHN BRIAN, MD 12/4/2015 12/4/2020 MEDICINE ATHENS TX ACTIVE 1/8/2016 None N/A EMERGENCY Q6605 BATEMAN, JOHN BRIAN, MD 12/4/2015 12/4/2020 MEDICINE ATHENS TX ACTIVE 1/8/2016 None N/A R2534 BATES, JERRY ALAN, MD 4/20/2017 4/20/2022 NEUROLOGY DALLAS TX ACTIVE 4/27/2017 None N/A EMERGENCY R3030 BATES, JESSICA SUZANNE, MD 5/22/2017 5/22/2022 MEDICINE SAN ANTONIO TX ACTIVE 5/29/2017 None N/A R5357 BATHINA, JAYA DEEPIKA, MD 12/8/2017 12/8/2022 CARDIOLOGY INTERNAL MEDICINE CLOVIS NM ACTIVE 3/1/2018 None N/A Q8020 BATHINA, RAJYA SHILPA, MD 5/2/2016 5/2/2021 INTERNAL MEDICINE CLOVIS NM ACTIVE 5/3/2016 None N/A SPORTS MEDICINE R0190 BATHINI, LEON JR, MD 9/30/2016 9/30/2021 FAMILY MEDICINE (FAMILY PRACTICE) LUBBOCK TX ACTIVE 10/4/2016 None N/A Q5346 BATHULA, SRIKANTH, MD 8/3/2015 8/3/2020 RHEUMATOLOGY INTERNAL MEDICINE ACTIVE 8/31/2015 None N/A EMERGENCY Q4566 BATMANIS, PAUL STRATO, MD 6/1/2015 6/1/2020 MEDICINE FORTUNA CA ACTIVE 6/9/2015 None N/A Q8831 BATTAGLIA, JENNIFER, MD 7/1/2016 7/1/2021 INTERNAL MEDICINE HOSPITALIST WESTLAKE TX ACTIVE 7/7/2016 None N/A R0359 BATTERTON, NICOLAS JOHN, MD 10/14/2016 10/14/2021 INTERNAL MEDICINE FORT WORTH TX ACTIVE 10/26/2016 None N/A PEDIATRIC Q5152 BAUER, KATHRYN LEIGH, MD 7/15/2015 7/15/2020 ORTHOPEDICS SPORTS MEDICINE PLANO TX ACTIVE 7/29/2015 None N/A S6794 BAUTISTA, ROXANNE IRA, MD 5/29/2020 5/29/2025 INTERNAL MEDICINE AUSTIN TX ACTIVE 6/1/2020 None N/A PEDIATRIC HEMATOLOGY/ONCOL OKLAHOMA S6129 BAVLE, ABHISHEK AMAR, MD 4/17/2020 4/17/2025 OGY PEDIATRICS CITY OK ACTIVE 4/21/2020 None N/A

Page 30 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PHYSICAL MED. & R2535 BAWA, MANISHA, MD 4/20/2017 4/20/2022 REHABILITATION HOUSTON TX ACTIVE 4/25/2017 None N/A MUSCULOSKELETAL R1499 BAWA, PRITISH, MD 2/6/2017 2/6/2022 RADIOLOGY RADIOLOGY ACTIVE 2/8/2017 None N/A R0191 BAWANY, FAUZIA AHMAD, MD 9/30/2016 9/30/2021 ANESTHESIOLOGY ANESTHESIOLOGY BAYTOWN TX ACTIVE 10/5/2016 None N/A DIAGNOSTIC Q5347 BAXI, AMEYA JAGDISH, MD 8/3/2015 8/3/2020 RADIOLOGY BODY IMAGING SAN ANTONIO TX ACTIVE 9/10/2015 None N/A OBSTETRICS AND Q8832 BAXLEY, SARAH EMILY, MD 7/1/2016 7/1/2021 GYNECOLOGY GALVESTON TX ACTIVE 7/12/2016 None N/A Q6730 BAXTER, KHANNAH , MD 12/15/2015 12/15/2020 INTERNAL MEDICINE GALVESTON TX ACTIVE 1/25/2016 None N/A PULMONARY CRITICAL CARE R3032 BAYASI, JED MOHAMMAD, MD 5/22/2017 5/22/2022 MEDICINE SLEEP MEDICINE CHANDLER AZ ACTIVE 5/29/2017 None N/A TEXAS COLON AND RECTAL LICENSE P1447 BAYASI, MOHAMMED , MD 5/2/2016 5/2/2021 SURGERY GENERAL SURGERY GALVESTON TX ISSUED 5/2/2016 None N/A BAYSSA, EYERUSALEM ENGIDA, R2053 MD 3/20/2017 3/20/2022 INTERNAL MEDICINE NEPHROLOGY DALLAS TX ACTIVE 3/30/2017 None N/A R3033 BAZZAZ, OMAR H, MD 5/22/2017 5/22/2022 INTERNAL MEDICINE HOSPITALIST AMARILLO TX ACTIVE 5/29/2017 None N/A EMERGENCY COLLEGE R3799 BEAL, ERIC DAVID, DO 7/17/2017 7/17/2022 MEDICINE STATION TX ACTIVE 7/19/2017 None N/A DIAGNOSTIC CARDIOTHORACIC S4443 BEAL, MICHAEL, MD 12/20/2019 12/20/2024 RADIOLOGY RADIOLOGY SAN ANTONIO TX ACTIVE 12/25/2019 None N/A OPHTHALMOLOGY - S6357 BEALKA, PETER JAMES, MD 5/1/2020 5/1/2025 ANTERIOR SURGERY GATESVILLE TX ACTIVE 5/29/2020 None N/A LICENSE Q5153 BEALL, RAKEL CHANDRA, MD 7/15/2015 7/15/2020 PSYCHIATRY HOUSTON TX ISSUED 7/15/2015 None N/A Q9292 BEAMAN, JESSICA HYESUN, MD 8/1/2016 8/1/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 8/10/2016 None N/A CANC NON- Q9951 BEASLEY, MICHAEL SCOTT, MD 9/15/2016 9/15/2021 OTOLARYNGOLOGY PAYMENT 3/5/2018 None N/A CLINICAL AND LABORATORY IMMUNOLOGY Q7530 BEATTIE, JEANNE LOUISE, MD 3/15/2016 3/15/2021 NEUROLOGY (PEDIATRICS) AUSTIN TX ACTIVE 3/17/2016 None N/A ORTHOPEDIC R3034 BEAVER, CODY RYAN, MD 5/22/2017 5/22/2022 SURGERY LUBBOCK TX ACTIVE 7/3/2017 None N/A EMERGENCY Q7144 BECERRA, ISRAEL, MD 2/16/2016 2/16/2021 MEDICINE FAMILY MEDICINE MCALLEN TX ACTIVE 3/29/2016 None N/A Q8429 BECK, JENNIFER, MD 6/1/2016 6/1/2021 PEDIATRICS HOSPITALIST FORT WORTH TX ACTIVE 6/10/2016 None N/A

Page 31 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date

OPHTHALMOLOGY - R4518 BECK, KINLEY , MD 9/8/2017 9/8/2022 OPHTHALMOLOGY VITREOUS SURGERY SAN ANTONIO TX ACTIVE 9/14/2017 None N/A CRITICAL CARE FORT SAM Q4901 BECKER, TYSON ERIK, MD 7/1/2015 7/1/2020 (TRAUMA) GENERAL SURGERY HOUSTON TX ACTIVE 7/7/2015 None N/A RADIATION S5120 BECKHAM, THOMAS HENDRIX, MD 2/21/2020 2/21/2025 ONCOLOGY ACTIVE 2/27/2020 None N/A ORTHOPEDIC SURGERY OF THE Q4902 BEDERMAN, STACEY SAMUEL, MD 7/1/2015 7/1/2020 SPINE PLANO TX ACTIVE 7/7/2015 None N/A

Q6809 BEDI, HARJANEET SINGH, MD 1/6/2016 1/6/2021 FAMILY MEDICINE SHENANDOAH TX ACTIVE 1/21/2016 None N/A Q4722 BEDNAR, GRACE , MD 6/12/2015 6/12/2020 ANESTHESIOLOGY GALVESTON TX ACTIVE 6/18/2015 None N/A SURGICAL CRITICAL R4813 BEDROS, NICOLE MARY , MD 10/6/2017 10/6/2022 GENERAL SURGERY CARE DALLAS TX ACTIVE 10/16/2017 None N/A PEDIATRIC Q8021 BEDWELL, JOSHUA ROBERT, MD 5/2/2016 5/2/2021 OTOLARYNGOLOGY HOUSTON TX ACTIVE 6/8/2016 None N/A INTERVENTIONAL R4668 BEEDUPALLI, JAGAN, MD 9/22/2017 9/22/2022 CARDIOLOGY CARDIOLOGY SHREVEPORT LA ACTIVE 9/26/2017 None N/A

CLINICAL Q9577 BEERAVOLU, LAKSHMI REDDY, MD 8/15/2016 8/15/2021 NEUROLOGY NEUROPHYSIOLOGY KANSAS CITY MO ACTIVE 8/18/2016 None N/A R2537 BEG, RANA, MD 4/20/2017 4/20/2022 INTERNAL MEDICINE LAREDO TX ACTIVE 5/1/2017 None N/A EMERGENCY R4519 BEHROOZ, NAVID, MD 9/8/2017 9/8/2022 MEDICINE TYLER TX ACTIVE 9/21/2017 None N/A R5507 BELL, JARED , DO 1/5/2018 1/5/2023 ANESTHESIOLOGY LAFAYETTE IN ACTIVE 2/12/2018 None N/A

S4725 BELLO, FATIMAH OLUWAKEMI, MD 1/24/2020 1/24/2025 INTERNAL MEDICINE WESLACO TX ACTIVE 1/30/2020 None N/A HEMATOLOGY/ONCOL Q5348 BELLO, OSAGIE, MD 8/3/2015 8/3/2020 OGY INTERNAL MEDICINE WATERTOWN NY ACTIVE 9/2/2015 None N/A CRITICAL CARE CARDIOTHORACIC S5121 BELLOMY, MELISSA L, MD 2/21/2020 2/21/2025 ANESTHESIOLOGY ANESTHESIOLOGY NASHVILLE TN ACTIVE 4/7/2020 None N/A OBSTETRICS AND LICENSE Q4723 BELLOWS, PATRICIA HARRIS, MD 6/12/2015 6/12/2020 GYNECOLOGY ISSUED 6/12/2015 None N/A K2146 BELOTT, TODD PETER, MD 7/15/2016 7/15/2021 GENERAL SURGERY GRANBURY TX ACTIVE 7/25/2016 None N/A DIAGNOSTIC TM00630 BELTON, DOUGLAS JR, MD 5/16/2016 5/16/2021 RADIOLOGY EDEN PRAIRIE MN ACTIVE 6/2/2016 None N/A OBSTETRICS AND R2539 BELTRAN, FRANS, MD 4/20/2017 4/20/2022 GYNECOLOGY ACTIVE 4/27/2017 None N/A BELUR SHIVANANDA, MADHU R5698 NAGESH, MD 1/19/2018 1/19/2023 INTERNAL MEDICINE HOSPITALIST JACKSON MS ACTIVE 3/5/2018 None N/A Page 32 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date Q9294 BEMALGI, SWAPNA REDDY, MD 8/1/2016 8/1/2021 INTERNAL MEDICINE INTERNAL MEDICINE ACTIVE 8/22/2016 None N/A OBSTETRICS & GYNECOLOGICAL WICHITA R2283 BENAC, DREW DANIEL, MD 4/4/2017 4/4/2022 SURGERY FALLS TX ACTIVE 4/25/2017 None N/A ENDOVASCULAR BENARDETE, ETHAN ALEXANDER, NEUROLOGICAL SURGICAL Q6810 MD 1/6/2016 1/6/2021 SURGERY NEURORADIOLOGY TEMPLE TX ACTIVE 1/7/2016 None N/A ORTHOPEDIC R1173 BENDER, MICHAEL JOSEPH, MD 1/6/2017 1/6/2022 SURGERY HOUSTON TX ACTIVE 1/26/2017 None N/A EMERGENCY R4188 BENDOCK, NICOLE, DO 8/15/2017 8/15/2022 MEDICINE ACTIVE 9/4/2017 None N/A EMERGENCY Q5617 BENHAM, MICHAEL DAVID, MD 8/14/2015 8/14/2020 MEDICINE TEMPLE TX ACTIVE 8/21/2015 None N/A GERIATRIC BENIGNO, DAISY MAY GAMOTIN, MEDICINE (FAMILY Q8022 MD 5/2/2016 5/2/2021 FAMILY MEDICINE PRACTICE) HICKMAN KY ACTIVE 6/13/2016 None N/A R4941 BENITEZ, OMAR, MD 10/20/2017 10/20/2022 UROLOGY FORT MYERS FL ACTIVE 11/17/2017 None N/A BENJAMIN, JENNIFER CHRISTINA, Q9954 MD 9/15/2016 9/15/2021 PEDIATRICS PEDIATRICS ACTIVE 10/3/2016 None N/A R0538 BENNETT, DANIEL NOALL, MD 10/31/2016 10/31/2021 INTERNAL MEDICINE CARDIOLOGY DALLAS TX ACTIVE 11/7/2016 None N/A PHYSICAL MED. & R3273 BENS, SEBASTIAAN MICHAEL, DO 6/2/2017 6/2/2022 REHABILITATION DALLAS TX ACTIVE 6/15/2017 None N/A Q8833 BENSON, DANIEL GREGORY, MD 7/1/2016 7/1/2021 UROLOGY DALLAS TX ACTIVE 7/4/2016 None N/A

Q9956 BENSON, OLAJIDE OLADELE, MD 9/15/2016 9/15/2021 NEUROLOGY OTHER SPECIALTY SHERMAN TX ACTIVE 9/22/2016 None N/A R0192 BENUN, JACQUES, MD 9/30/2016 9/30/2021 PEDIATRICS MANOR TX ACTIVE 10/3/2016 None N/A S6358 BENZING, TRAVIS ROBERT, MD 5/1/2020 5/1/2025 CARDIOLOGY INTERNAL MEDICINE AUSTIN TX ACTIVE 5/22/2020 None N/A BERAS MATOS, JULIO MANUEL, Q7644 MD 4/1/2016 4/1/2021 INTERNAL MEDICINE RHEUMATOLOGY SAN ANTONIO TX ACTIVE 5/2/2016 None N/A S4445 BERENJI, ASHKAN , DO 12/20/2019 12/20/2024 RADIOLOGY HOUSTON TX ACTIVE 12/24/2019 None N/A CHILD AND ADOLESCENT R3036 BERG, ELIN BARTH, MD 5/22/2017 5/22/2022 PSYCHIATRY PSYCHIATRY HOUSTON TX ACTIVE 5/30/2017 None N/A NACOGDOCH R5082 BERG, JAMES , MD 11/3/2017 11/3/2022 OPHTHALMOLOGY ES TX ACTIVE 11/20/2017 None N/A CRITICAL CARE R3274 BERG, JEREMY SCOTT, DO 6/2/2017 6/2/2022 MEDICINE INTERNAL MEDICINE ST. LOUIS MO ACTIVE 7/18/2017 None N/A Q5155 BERGAL, LINDA MICHELLE, MD 7/15/2015 7/15/2020 GENERAL SURGERY BEAUMONT TX ACTIVE 7/21/2015 None N/A

Q6308 BERGAL, MICHAEL, MD 10/15/2015 10/15/2020 FAMILY MEDICINE PORT NECHES TX ACTIVE 11/9/2015 None N/A

Page 33 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date GERIATRIC MEDICINE (FAMILY R0996 BERGER, MARC STUART, MD 12/16/2016 12/16/2021 FAMILY MEDICINE PRACTICE) TAMPA FL ACTIVE 1/13/2017 None N/A BERGES CHEZ, EDDY ENMANUEL, S4923 MD 2/7/2020 2/7/2025 FAMILY MEDICINE MERCEDES TX ACTIVE 2/10/2020 None N/A R5361 BERGES, CHELSEA ELAINE, DO 12/8/2017 12/8/2022 FAMILY PRACTICE OBSTETRICS ACTIVE 12/12/2017 None N/A OBSTETRICS AND MATERNAL AND R4366 BERGH, ERIC PAUL, MD 8/25/2017 8/25/2022 GYNECOLOGY FETAL MEDICINE HOUSTON TX ACTIVE 9/1/2017 None N/A LICENSE S7008 BERGMANN, LIISA LOUISE, MD 6/12/2020 6/12/2025 RADIOLOGY ISSUED 6/12/2020 None N/A Q5760 BERHIL, ANIS, MD 8/28/2015 8/28/2020 INTERNAL MEDICINE HOSPITALIST ST LOUIS MO ACTIVE 9/3/2015 None N/A E9109 BERLIN, ARNOLD IRWIN, MD 6/10/2016 6/10/2021 INTERNAL MEDICINE BROOKLYN NY ACTIVE 6/15/2016 None N/A PEDIATRIC ANESTHESIOLOGY Q9125 BERLOWITZ, ANDREW ALAN, MD 7/15/2016 7/15/2021 ANESTHESIOLOGY (PEDS) EDINBURG TX ACTIVE 7/26/2016 None N/A EMERGENCY R1341 BERMAN, BRIAN LOUIS, MD 1/20/2017 1/20/2022 MEDICINE TALLAHASSEE FL ACTIVE 2/1/2017 None N/A Q5618 BERNAL, NATHAN JAMES, MD 8/14/2015 8/14/2020 FAMILY MEDICINE SAN ANTONIO TX ACTIVE 8/20/2015 None N/A BERNARD, FOLASHADE MODUPE, Q8025 MD 5/2/2016 5/2/2021 INTERNAL MEDICINE ATLANTA GA ACTIVE 5/3/2016 None N/A Q5761 BERNARD, NICOLE LOUISE, MD 8/28/2015 8/28/2020 PEDIATRICS AUSTIN TX ACTIVE 8/31/2015 None N/A PEDIATRIC ANESTHESIOLOGY R1706 BERNELL, MICHAEL , MD 2/22/2017 2/22/2022 ANESTHESIOLOGY (PEDS) NASHVILLE TN ACTIVE 4/26/2017 None N/A ANESTHESIOLOGY - ADDICTION S4924 BERNHARDT, BRIAN EDWARD, MD 2/7/2020 2/7/2025 PAIN MANAGEMENT MEDICINE - PM TRACY CA ACTIVE 2/27/2020 None N/A DIAGNOSTIC LICENSE Q8695 BERNS, DAVID HERSCHEL, MD 6/10/2016 6/10/2021 RADIOLOGY NEURO-RADIOLOGY ISSUED 6/10/2016 None N/A Q5619 BERRY, BREANNA R, DO 8/14/2015 8/14/2020 FAMILY MEDICINE HEREFORD TX ACTIVE 8/18/2015 None N/A ORTHOPEDIC SURGERY OF THE PEDIATRIC LICENSE Q5620 BERRY, CHIRAG ASHOK, MD 8/14/2015 8/14/2020 SPINE ORTHOPEDICS ISSUED 8/14/2015 None N/A EMERGENCY R4942 BERRY, DAMIEN, MD 10/20/2017 10/20/2022 MEDICINE TOMBALL TX ACTIVE 1/8/2018 None N/A DELINQUEN ORTHOPEDIC T-NON Q9295 BERRY, JOHN HUNTER, MD 8/1/2016 8/1/2021 SURGERY SPORTS MEDICINE HOUSTON TX PAYMENT 12/30/2017 None N/A VASCULAR AND INTERVENTIONAL Q9958 BERRY, MAX WAYNE, MD 9/15/2016 9/15/2021 RADIOLOGY RADIOLOGY SUGAR LAND TX ACTIVE 11/16/2016 None N/A

Page 34 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date EMERGENCY Q5349 BERRY, MIKE P JR, MD 8/3/2015 8/3/2020 MEDICINE AMARILLO TX ACTIVE 8/14/2015 None N/A R5968 BERRY, TARA ANN, DO 2/16/2018 2/16/2023 FAMILY PRACTICE FORT WORTH TX ACTIVE 2/27/2018 None N/A PEDIATRIC EMERGENCY EMERGENCY S6134 BERRYMAN, CHAD , MD 4/17/2020 4/17/2025 MEDICINE MEDICINE (EM) EL PASO TX ACTIVE 4/27/2020 None N/A BERRYMAN, KATHRYN ELIZABETH, MATERNAL AND OBSTETRICS AND FORT SAM R4943 MD 10/20/2017 10/20/2022 FETAL MEDICINE GYNECOLOGY HOUSTON TX ACTIVE 11/8/2017 None N/A PEDIATRIC HEMATOLOGY/ONCOL S4925 BERTRAND, KELSEY CAITLAN, MD 2/7/2020 2/7/2025 OGY HOUSTON TX ACTIVE 2/19/2020 None N/A R0839 BESETTY, RAMASHESAI, MD 12/2/2016 12/2/2021 INTERNAL MEDICINE FORT WORTH TX ACTIVE 7/31/2017 None N/A LICENSE Q6151 BEST, ANNA MOORHEAD, MD 10/1/2015 10/1/2020 PATHOLOGY ISSUED 10/1/2015 None N/A CARDIOTHORACIC S6798 BEST, GAVIN TAYLOR, MD 5/29/2020 5/29/2025 ANESTHESIOLOGY ANESTHESIOLOGY HOUSTON TX ACTIVE 6/2/2020 None N/A BETANSKI, FRANK ANTHONY III, FAMILY PRACTICE - LICENSE Q6152 MD 10/1/2015 10/1/2020 FAMILY MEDICINE EMERGENCY MED KILLEEN TX ISSUED 10/1/2015 None N/A OKLAHOMA S6359 BETECK, BESEM , MD 5/1/2020 5/1/2025 VASCULAR SURGERY CITY OK ACTIVE 5/15/2020 None N/A NEW Q7146 BETHI, KRISHNAVENI, MD 2/16/2016 2/16/2021 INTERNAL MEDICINE ORLEANS LA ACTIVE 2/29/2016 None N/A EMERGENCY S4726 BEUERLE, JOHN ROBERT, MD 1/24/2020 1/24/2025 MEDICINE EL PASO TX ACTIVE 1/27/2020 None N/A ORTHOPEDIC ORTHOPEDIC SURGERY OF THE Q6732 BEVEVINO, ADAM JAMES, MD 12/15/2015 12/15/2020 SURGERY SPINE EL PASO TX ACTIVE 1/26/2016 None N/A LICENSE Q6495 BGOYA, KANEZA WALTER, MD 11/16/2015 11/16/2020 INTERNAL MEDICINE ISSUED 11/16/2015 None N/A R3637 BHAGWANDASS, NITHIN , MD 6/30/2017 6/30/2022 INTERNAL MEDICINE ACTIVE 7/7/2017 None N/A GASTROENTEROLOG Q6608 BHAKTA, DIMPAL BABU, MD 3/20/2020 3/20/2025 Y HOUSTON TX ACTIVE 3/27/2020 None N/A

R1176 BHALAKIA, AVNI M, MD 1/6/2017 1/6/2022 PEDIATRICS GENERAL PRACTICE HOUSTON TX ACTIVE 1/11/2017 None N/A OBSTETRICS AND Q7840 BHALALA, REENA U, MD 4/15/2016 4/15/2021 GYNECOLOGY SAN ANTONIO TX ACTIVE 4/21/2016 None N/A PEDIATRIC CRITICAL Q6733 BHALALA, UTPAL S, MD 12/15/2015 12/15/2020 CARE MEDICINE SAN ANTONIO TX ACTIVE 1/11/2016 None N/A BHALANI, KSHITIJ VANRAJBHAI, R3276 MD 6/2/2017 6/2/2022 PEDIATRICS PEDIATRICS HURST TX ACTIVE 6/14/2017 None N/A R0840 BHALLA, AMARPREET, MD 12/2/2016 12/2/2021 PATHOLOGY CYTOPATHOLOGY BUFFALO NY ACTIVE 2/27/2017 None N/A Page 35 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date HEMATOLOGY/ONCO R5245 BHALLA, KAPIL NARAIN, MD 11/17/2017 11/17/2022 INTERNAL MEDICINE LOGY HOUSTON TX ACTIVE 11/27/2017 None N/A R0194 BHAMA, SAMEEKSHA , MD 9/30/2016 9/30/2021 INTERNAL MEDICINE AUSTIN TX ACTIVE 10/4/2016 None N/A BHAMANI, ANWER ALI R2286 SHAMSUDDIN, MD 4/4/2017 4/4/2022 HOSPITALIST INTERNAL MEDICINE SNELLVILLE GA ACTIVE 4/11/2017 None N/A PULMONARY CRITICAL CARE R3277 BHARAT VED PRAKASH, FNU, MD 6/2/2017 6/2/2022 MEDICINE INTERNAL MEDICINE EL PASO TX ACTIVE 7/6/2017 None N/A BHARI JAYADEVAPPA, ABHISHEK, Q7646 MD 4/1/2016 4/1/2021 ANESTHESIOLOGY ANESTHESIOLOGY UPLAND PA ACTIVE 4/5/2016 None N/A CORNEA REFRACTIVE S4601 BHAT, AMAR KRISHNA, MD 1/10/2020 1/10/2025 OPHTHALMOLOGY SURGERY ACTIVE 1/30/2020 None N/A R1501 BHAT, AMBARISH JAYANT, MD 2/6/2017 2/6/2022 HOSPITALIST TULSA OK ACTIVE 2/21/2017 None N/A Q6153 BHAT, MUSHTAQ AHMAD, MD 10/1/2015 10/1/2020 INTERNAL MEDICINE HOSPITALIST FORT WORTH TX ACTIVE 10/8/2015 None N/A R4189 BHAT, UMA KRISHNA, MD 8/15/2017 8/15/2022 INTERNAL MEDICINE INTERNAL MEDICINE HUMBLE TX ACTIVE 9/20/2017 None N/A PEDIATRIC Q7325 BHATNAGAR, SONAL , MD 3/4/2016 3/4/2021 NEPHROLOGY PEDIATRICS HOUSTON TX ACTIVE 3/16/2016 None N/A GASTROENTEROLOG R0539 BHATT, ASMEEN , MD 10/31/2016 10/31/2021 INTERNAL MEDICINE Y GALVESTON TX ACTIVE 11/15/2016 None N/A

OTOLARYN & FACIAL S6135 BHATT, NISHANT, MD 4/17/2020 4/17/2025 PLASTIC SURGERY PLASTIC SURGERY CHAPEL HILL NC ACTIVE 4/22/2020 None N/A R0540 BHATT, SANDEEP, MD 10/31/2016 10/31/2021 INTERNAL MEDICINE ACTIVE 11/10/2016 None N/A ORTHOPEDIC R5700 BHATT, SHIV S, MD 1/19/2018 1/19/2023 SURGERY ACTIVE 2/1/2018 None N/A Q9960 BHATTA, MANGESH, MD 9/15/2016 9/15/2021 INTERNAL MEDICINE HOSPITALIST ACTIVE 12/30/2016 None N/A JACKSONVILL Q6609 BHATTARAI, ALOK, MD 12/4/2015 12/4/2020 INTERNAL MEDICINE E NC ACTIVE 12/8/2015 None N/A Q6609 BHATTARAI, ALOK, MD 12/4/2015 12/4/2020 INTERNAL MEDICINE MIDLAND TX ACTIVE 12/8/2015 None N/A Q6609 BHATTARAI, ALOK, MD 12/4/2015 12/4/2020 INTERNAL MEDICINE MIDLAND TX ACTIVE 12/8/2015 None N/A R6149 BHATTARAI, PARAS MANI, MD 3/2/2018 3/2/2023 CHILD NEUROLOGY PEDIATRICS MEMPHIS TN ACTIVE 3/6/2018 None N/A PHYSICAL MED. & R0841 BHAVSAR, PREMAL KUMAR, MD 12/2/2016 12/2/2021 REHABILITATION NEW YORK NY ACTIVE 12/14/2016 None N/A 7703 FLOYD Q9786 BHAYANA, SUVERTA, MD 8/26/2016 8/26/2021 INTERNAL MEDICINE NEPHROLOGY CURL DR TX ACTIVE 9/7/2016 None N/A PEDIATRIC HEMATOLOGY/ONCO Q6496 BHENDE, KISHOR M, MD 11/16/2015 11/16/2020 PEDIATRICS LOGY ACTIVE 11/19/2015 None N/A R2057 BHOOPATHY, LAVANYA, MD 3/20/2017 3/20/2022 FAMILY MEDICINE HUTCHINSON MN ACTIVE 4/7/2017 None N/A

Page 36 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date CORPUS R2287 BHULA, JITEN JAYANTILAL, MD 4/4/2017 4/4/2022 FAMILY MEDICINE CHRISTI TX ACTIVE 6/22/2017 None N/A PALLIATIVE LICENSE Q5157 BHUSHAN, ANUP, MD 7/15/2015 7/15/2020 INTERNAL MEDICINE MEDICINE ISSUED 7/15/2015 None N/A R6150 BHUSHAN, BHARAT, MD 3/2/2018 3/2/2023 INTERNAL MEDICINE LUBBOCK TX ACTIVE 3/12/2018 None N/A BHUVA, DARPAN GIRISHKUMAR, S5324 MD 3/6/2020 3/6/2025 HOSPITALIST CARROLLTON GA ACTIVE 5/15/2020 None N/A Q7148 BIBINAGAR, DEEPTHI, MD 2/16/2016 2/16/2021 INTERNAL MEDICINE INTERNAL MEDICINE ACTIVE 3/15/2016 None N/A EMERGENCY Q8836 BICETTE, RICHINA D, MD 7/1/2016 7/1/2021 MEDICINE HOUSTON TX ACTIVE 7/12/2016 None N/A PHYSICAL MED. & Q9787 BICKELHAUPT, BRITTANY , MD 8/26/2016 8/26/2021 REHABILITATION SAN ANTONIO TX ACTIVE 8/31/2016 None N/A S5122 BICKI, ALEXANDRA , MD 2/21/2020 2/21/2025 PEDIATRICS AUSTIN TX ACTIVE 3/6/2020 None N/A Q5762 BICKNELL, KENDALL , MD 8/28/2015 8/28/2020 OPHTHALMOLOGY ACTIVE 9/1/2015 None N/A R3038 BICKNELL, LINDSAY M, MD 5/22/2017 5/22/2022 DERMATOLOGY TEMPLE TX ACTIVE 5/26/2017 None N/A Q9580 BIETRY, RAYMOND EMILE III, MD 8/15/2016 8/15/2021 CARDIOLOGY AUSTIN TX ACTIVE 8/31/2016 None N/A

Q6734 BIGGS, GRACE ANNE YANG, MD 12/15/2015 12/15/2020 UROLOGY UROLOGIC SURGERY ACTIVE 1/12/2016 None N/A OBSTETRICS AND R0360 BIGGS, KYLE ANDREW, DO 10/14/2016 10/14/2021 GYNECOLOGY EDINBURG TX ACTIVE 10/17/2016 None N/A Q7647 BILGUTAY, AYLIN , MD 4/1/2016 4/1/2021 UROLOGY HOUSTON TX ACTIVE 5/16/2016 None N/A

R2815 BILOLIKAR, VARSHA SURESH, MD 5/5/2017 5/5/2022 FAMILY PRACTICE ACTIVE 5/8/2017 None N/A Q9296 BINDAL, SAPAN, MD 8/1/2016 8/1/2021 FAMILY MEDICINE HEREFORD TX ACTIVE 8/4/2016 None N/A

AM00157 BINDRA, PAVELJIT SINGH, MD 6/12/2020 6/12/2025 INTERNAL MEDICINE CARDIOLOGY ACTIVE 6/15/2020 None N/A ORTHOPEDIC R1342 BINZ, DANIEL DWIGHT, MD 1/20/2017 1/20/2022 SURGERY HAND SURGERY VICTORIA TX ACTIVE 1/24/2017 None N/A R5513 BIOBAKU, DAVID O, MD 1/5/2018 1/5/2023 INTERNAL MEDICINE ASHLAND KY ACTIVE 2/5/2018 None N/A

OPHTHALMOLOGY - OPHTHALMOLOGY - NACODOGCH R5971 BIRDSONG, ORRY CARLISLE, MD 2/16/2018 2/16/2023 CORNEA ANTERIOR SURGERY ES TX ACTIVE 2/21/2018 None N/A PULMONARY CRITICAL CARE S5325 BIRDWELL, ANGELA LAUREN, DO 3/6/2020 3/6/2025 INTERNAL MEDICINE MEDICINE SAN ANTONIO TX ACTIVE 3/9/2020 None N/A NEUROLOGICAL R5514 BIRINYI, PAUL VINCENT, MD 1/5/2018 1/5/2023 SURGERY ALEXANDRIA LA ACTIVE 2/22/2018 None N/A BIRKENFELD, ELIZABETH MARY, DIAGNOSTIC Q8696 MD 6/10/2016 6/10/2021 RADIOLOGY HOUSTON TX ACTIVE 6/16/2016 None N/A R0195 BIRNBAUM, GILAD DAVID, MD 9/30/2016 9/30/2021 INTERNAL MEDICINE HOUSTON TX ACTIVE 10/4/2016 None N/A

Page 37 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date EMERGENCY Q5353 BIRNBAUM, GLENN, MD 8/3/2015 8/3/2020 MEDICINE AUSTIN TX ACTIVE 8/6/2015 None N/A BIRNBAUM, JACQUELINE S4270 FLORENCE, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE ACTIVE 12/30/2019 None N/A BIRNBAUM, JACQUELINE S4270 FLORENCE, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE ACTIVE 12/30/2019 None N/A Q9297 BIRUNGI, JUDITH FAITH, MD 8/1/2016 8/1/2021 GENERAL SURGERY EAGLE PASS TX ACTIVE 8/10/2016 None N/A RADIATION Q7841 BISHOP, ANDREW J, MD 4/15/2016 4/15/2021 ONCOLOGY HOUSTON TX ACTIVE 4/25/2016 None N/A R4520 BISTA, BIPIN RAJ, MD 9/8/2017 9/8/2022 INTERNAL MEDICINE NEPHROLOGY DALLAS TX ACTIVE 9/11/2017 None N/A S6799 BIUS, DANIELLE FRANTZ, MD 5/29/2020 5/29/2025 PEDIATRICS ACTIVE 6/5/2020 None N/A PEDIATRIC EMERGENCY LICENSE Q5621 BLACK, KELLY DAWN, MD 8/14/2015 8/14/2020 PEDIATRICS MEDICINE (PEDS) ISSUED 8/14/2015 None N/A EMERGENCY Q9298 BLACKABY, DANIEL JOSEPH, DO 8/1/2016 8/1/2021 MEDICINE BETHLEHEM PA ACTIVE 8/3/2016 None N/A ORTHOPEDIC ORTHOPEDIC SURGERY OF THE R0542 BLACKBURN, BRIAN, DO 10/31/2016 10/31/2021 SURGERY SPINE ARLINGTON TX ACTIVE 11/2/2016 None N/A DIAGNOSTIC Q7648 BLACKMON, JOSHUA MARION, MD 4/1/2016 4/1/2021 RADIOLOGY ARLINGTON TX ACTIVE 4/14/2016 None N/A EMERGENCY S5847 BLACKMON, MELODIE MARIAN, DO 4/3/2020 4/3/2025 MEDICINE SAN ANTONIO TX ACTIVE 4/7/2020 None N/A PLASTIC & RECONSTRUCTIVE Q9581 BLAGG, ROSS, MD 8/15/2016 8/15/2021 SURGERY ROUND ROCK TX ACTIVE 8/17/2016 None N/A ORTHOPEDIC R2058 BLALOCK, RICHARD EARL II, MD 3/20/2017 3/20/2022 SURGERY MURRAY KY ACTIVE 4/3/2017 None N/A BLANCO, NOEL SANTIAGO R5367 AGUSTIN, DO 12/8/2017 12/8/2022 GENERAL PRACTICE UNSPECIFIED ACTIVE 12/20/2017 None N/A GYNECOLOGIC OBSTETRICS AND S4730 BLANKENSHIP, LOGAN , MD 1/24/2020 1/24/2025 ONCOLOGY GYNECOLOGY SAN ANTONIO TX ACTIVE 2/4/2020 None N/A S5123 BLASINGAME, JAY MICHAEL, MD 2/21/2020 2/21/2025 GENERAL SURGERY DALLAS TX ACTIVE 3/9/2020 None N/A S5848 BLAU, LANCE NICHOLAS, MD 4/3/2020 4/3/2025 INTERNAL MEDICINE HOUSTON TX ACTIVE 4/20/2020 None N/A Q7149 BLESSING, ADRIENNE LORD, MD 2/16/2016 2/16/2021 FAMILY MEDICINE FAMILY PRACTICE SUGAR LAND TX ACTIVE 3/8/2016 None N/A PEDIATRIC BLUDORN, MATTHEW RICHARD, EMERGENCY EMERGENCY R0999 DO 12/16/2016 12/16/2021 MEDICINE MEDICINE (EM) BRYAN TX ACTIVE 12/22/2016 None N/A S7012 BLUME, JEFFREY , MD 6/12/2020 6/12/2025 FAMILY MEDICINE LUBBOCK TX ACTIVE 6/15/2020 None N/A R0361 BOCANEGRA, ALEJANDRO , MD 10/14/2016 10/14/2021 FAMILY MEDICINE MCALLEN TX ACTIVE 10/17/2016 None N/A R0362 BOCANEGRA, INGRID, MD 10/14/2016 10/14/2021 FAMILY MEDICINE HOUSTON TX ACTIVE 11/1/2016 None N/A Page 38 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date LICENSE S6802 BODAGALA, HIMA, MD 5/29/2020 5/29/2025 PEDIATRICS ISSUED 5/29/2020 None N/A R5085 BODAVULA, PHANI, MD 11/3/2017 11/3/2022 PEDIATRICS RACINE WI ACTIVE 11/13/2017 None N/A ANATOMIC/CLINICAL DERMATOPATHOLO S6137 BODE-OMOLEYE, OLAOLUWA , MD 4/17/2020 4/17/2025 PATHOLOGY GY SAN ANTONIO TX ACTIVE 4/20/2020 None N/A LICENSE Q8213 BODOKY, ANETTE, MD 5/16/2016 5/16/2021 FAMILY MEDICINE ISSUED 5/16/2016 None N/A EMERGENCY EMERGENCY CORPUS R5702 BOEHM, KARL EDWARD, DO 1/19/2018 1/19/2023 MEDICINE MEDICINE CHRISTI TX ACTIVE 1/24/2018 None N/A BOGACHENCHU, SREENIVASULU, LICENSE Q7651 MD 4/1/2016 4/1/2021 INTERNAL MEDICINE ISSUED 4/1/2016 None N/A R6151 BOGAN, SHANNON TRICHEL, MD 3/2/2018 3/2/2023 PEDIATRICS ACTIVE 3/7/2018 None N/A Q8432 BOGUNIEWICZ, JURI , MD 6/1/2016 6/1/2021 PEDIATRICS HOUSTON TX ACTIVE 6/20/2016 None N/A LICENSE S7013 BOHONOS, MELISSA AJUNWA, MD 6/12/2020 6/12/2025 OPHTHALMOLOGY ISSUED 6/12/2020 None N/A NEUROLOGY & R3477 BOKHARI, HAMMAD ALI, DO 6/16/2017 6/16/2022 PSYCHIATRY HOSPITALIST HOUSTON TX ACTIVE 6/20/2017 None N/A BOKKA, JAGAN MOHAN REDDY, Q9126 MD 7/15/2016 7/15/2021 FAMILY MEDICINE MATTOON IL ACTIVE 8/16/2016 None N/A LICENSE Q8433 BOLANOS, ALEXANDER , MD 6/1/2016 6/1/2021 INTERNAL MEDICINE ISSUED 6/1/2016 None N/A BOLT, JACQUELINE ELIZABETH, S5563 MD 3/20/2020 3/20/2025 PEDIATRICS DALLAS TX ACTIVE 4/23/2020 None N/A Q7151 BONAM, RAMI REDDY, MD 2/16/2016 2/16/2021 HOSPITALIST MANSFIELD OH ACTIVE 4/14/2016 None N/A BONFANTI, NATHANIEL PINKHAM, EMERGENCY CRITICAL CARE R5086 MD 11/3/2017 11/3/2022 MEDICINE MEDICINE DALLAS TX ACTIVE 11/7/2017 None N/A URGENT CARE - WESTCHESTE R4191 BONMAN, SHAUNTELLE DENÉ, DO 8/15/2017 8/15/2022 FAMILY MEDICINE FAMILY PRACTICE R CA ACTIVE 9/12/2017 None N/A TEXAS CRITICAL CARE LICENSE M1524 BONVILLE, DANIEL JAMES, DO 6/1/2016 6/1/2021 (SURGERY) GENERAL SURGERY HOUSTON TX ISSUED 6/1/2016 None N/A Q5764 BOOHER, ASHLEY JADE, MD 8/28/2015 8/28/2020 FAMILY PRACTICE FAMILY PRACTICE LUBBOCK TX ACTIVE 9/2/2015 None N/A PEDIATRIC EMERGENCY CORPUS R5087 BOOKS, HEATHER LYNN, MD 11/3/2017 11/3/2022 MEDICINE (EM) CHRISTI TX ACTIVE 12/27/2017 None N/A R2288 BOOLCHAND, JAYANT, MD 4/4/2017 4/4/2022 RADIOLOGY NEURO-RADIOLOGY FORT WORTH TX ACTIVE 4/6/2017 None N/A EMERGENCY R2061 BOONE, MICHAEL WARREN II, MD 3/20/2017 3/20/2022 MEDICINE AMARILLO TX ACTIVE 4/24/2017 None N/A BOOTH, FRANK VICTOR MCLEAN, LICENSE Q6498 MD 11/16/2015 11/16/2020 GENERAL SURGERY ISSUED 11/16/2015 None N/A

Page 39 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date GERIATRIC MEDICINE (FAMILY R4008 BOPARAI, ANUPAM, MD 8/1/2017 8/1/2022 FAMILY MEDICINE PRACTICE) LAKEWAY TX ACTIVE 8/28/2017 None N/A R0363 BORCK, MARGARETE J, MD 10/14/2016 10/14/2021 NEUROLOGY TYLER TX ACTIVE 10/26/2016 None N/A SPORTS MEDICINE R1177 BORREGO, ALEJANDRO , MD 1/6/2017 1/6/2022 FAMILY PRACTICE (FAMILY PRACTICE) EL PASO TX ACTIVE 1/9/2017 None N/A R0842 BOSE, ASHLEY , MD 12/2/2016 12/2/2021 FAMILY MEDICINE SUGARLAND TX ACTIVE 12/26/2016 None N/A PEDIATRIC Q5765 BOSE, KINSHUK, MD 8/28/2015 8/28/2020 PSYCHIATRY PSYCHIATRY AUSTIN TX ACTIVE 9/10/2015 None N/A EMERGENCY S5126 BOSEN, THOMAS REX, MD 2/21/2020 2/21/2025 MEDICINE TEMPLE TX ACTIVE 3/31/2020 None N/A OBSTETRICS AND Q7326 BOSTICK SMITH, CHEVELTA A, DO 3/4/2016 3/4/2021 GYNECOLOGY ERIE PA ACTIVE 4/4/2016 None N/A Q8434 BOSTWICK, BRET LEE, MD 6/1/2016 6/1/2021 MEDICAL GENETICS PEDIATRICS HOUSTON TX ACTIVE 6/6/2016 None N/A PEDIATRIC BOUCHRA HANNA, HANI KHAIRY ANESTHESIOLOGY LICENSE Q5357 ELSAYED, MD 8/3/2015 8/3/2020 ANESTHESIOLOGY (PEDS) ISSUED 8/3/2015 None N/A S5327 BOULIS, EMAN RAMSES, MD 3/6/2020 3/6/2025 RHEUMATOLOGY INTERNAL MEDICINE KNOXVILLE IA ACTIVE 5/27/2020 None N/A MATERNAL AND OBSTETRICS AND S5328 BOULIS, THARWAT STEWART, MD 3/6/2020 3/6/2025 FETAL MEDICINE GYNECOLOGY DES MOINES IA ACTIVE 3/9/2020 None N/A PEDIATRIC EMERGENCY S4733 BOULOS, ANDREW KAMAL, MD 1/24/2020 1/24/2025 PEDIATRICS MEDICINE (PEDS) DALLAS TX ACTIVE 1/27/2020 None N/A PEDIATRIC R3278 BOULOS, SCARLETT, MD 6/2/2017 6/2/2022 DERMATOLOGY DERMATOLOGY HOUSTON TX ACTIVE 6/12/2017 None N/A Q7652 BOUNAMA, AIDA, MD 4/1/2016 4/1/2021 OPHTHALMOLOGY SAN ANTONIO TX ACTIVE 5/2/2016 None N/A PSYCHOSOMATIC R3279 BOURGEOIS, JAMES ALAN, MD 6/2/2017 6/2/2022 MEDICINE PSYCHIATRY TEMPLE TX ACTIVE 6/12/2017 None N/A R0197 BOURNE, THOMAS DAVID, MD 9/30/2016 9/30/2021 PATHOLOGY LITTLE ROCK AR ACTIVE 11/14/2016 None N/A ENDOCRINOLOGY, BOURNE-ARRIAGA, KIMBERLEY DIABETES AND WICHITA R5975 ANN, MD 2/16/2018 2/16/2023 METABOLISM FALLS TX ACTIVE 2/19/2018 None N/A BOUTON, LAUREN KATHARINE Q8435 EBE, MD 6/1/2016 6/1/2021 PEDIATRICS DALLAS TX ACTIVE 6/10/2016 None N/A MOUNT R2289 BOVE, JAMES DANIEL III, DO 4/4/2017 4/4/2022 GENERAL SURGERY PLEASANT TX ACTIVE 5/8/2017 None N/A Q4729 BOWEN, CASEY DANIEL, MD 6/12/2015 6/12/2020 DERMATOLOGY SAN ANTONIO TX ACTIVE 6/15/2015 None N/A R0544 BOWEN, SHAWN KEITH, MD 10/31/2016 10/31/2021 TOXICOLOGY TOXICOLOGY DALLAS TX ACTIVE 11/2/2016 None N/A BOWEN-JALLOW, KANIKA ALAKE, N3512 MD 12/2/2016 12/2/2021 PEDIATRIC SURGERY GENERAL SURGERY GALVESTON TX ACTIVE 12/7/2016 None N/A R4010 BOWERSON, MICHYLA, MD 8/1/2017 8/1/2022 RADIOLOGY SAN ANTONIO TX ACTIVE 8/9/2017 None N/A Page 40 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date MUSCULOSKELETAL MUSCULOSKELETAL S5127 BOWKER, HAROLD DEAN III, MD 2/21/2020 2/21/2025 IMAGING IMAGING ACTIVE 2/25/2020 None N/A EMERGENCY R2540 BOWRY, RIDDHI, MD 4/20/2017 4/20/2022 MEDICINE PLANTATION FL ACTIVE 5/12/2017 None N/A EMERGENCY Q7653 BOYACK, DANE , DO 4/1/2016 4/1/2021 MEDICINE FORT WORTH TX ACTIVE 4/5/2016 None N/A R5977 BOYARS, LISA MAE, MD 2/16/2018 2/16/2023 PSYCHIATRY CHARLESTON SC ACTIVE 2/20/2018 None N/A Q5624 BOYARS, MICHAEL EUGENE, MD 8/14/2015 8/14/2020 INTERNAL MEDICINE HOUSTON TX ACTIVE 8/17/2015 None N/A DIAGNOSTIC R6152 BOYCE, WHITNEY SHAY, MD 3/2/2018 3/2/2023 RADIOLOGY HOUSTON TX ACTIVE 3/8/2018 None N/A DIAGNOSTIC VIRGINIA M8552 BOYD, CHARLES EDWARD JR, MD 2/16/2016 2/16/2021 RADIOLOGY BEACH VA ACTIVE 3/15/2016 None N/A OBSTETRICS AND S6577 BOYD, CURTIS JAMES III, DO 5/15/2020 5/15/2025 GYNECOLOGY CONWAY AR ACTIVE 5/26/2020 None N/A BOYELLA, RAVICHANDRA REDDY, INTERVENTIONAL LICENSE Q6395 MD 11/2/2015 11/2/2020 CARDIOLOGY ISSUED 11/2/2015 None N/A ORTHOPEDIC SURGERY OF THE ORTHOPEDIC Q8697 BOZZIO, ANTHONY, MD 6/10/2016 6/10/2021 SPINE TRAUMA PLANO TX ACTIVE 6/14/2016 None N/A OBSTETRICS AND S5329 BRACKETT, ELIZABETH ERIN, MD 3/6/2020 3/6/2025 GYNECOLOGY SAN ANTONIO TX ACTIVE 4/3/2020 None N/A R1179 BRADLEY, CALVIN , MD 1/6/2017 1/6/2022 FAMILY MEDICINE WACO TX ACTIVE 1/25/2017 None N/A EMERGENCY R5246 BRADLEY, KEEGAN , MD 11/17/2017 11/17/2022 MEDICINE FORT WORTH TX ACTIVE 12/11/2017 None N/A NORTH EMERGENCY RICHLAND R3039 BRADLEY, SHALAKO M, DO 5/22/2017 5/22/2022 MEDICINE FAMILY PRACTICE HILLS TX ACTIVE 6/2/2017 None N/A ADULT ORTHOPEDIC RECONSTRUCTIVE R2544 BRALY, HOUSTON LEE II, MD 4/20/2017 4/20/2022 SURGERY ORTHOPEDICS HOUSTON TX ACTIVE 6/2/2017 None N/A S6366 BRAND, KATHRYN ESTHER, MD 5/1/2020 5/1/2025 PEDIATRICS AUSTIN TX ACTIVE 5/18/2020 None N/A INTERNAL MED - Q5358 BRANDS, CHAD KELLY, MD 8/3/2015 8/3/2020 PEDIATRICS PEDS DALLAS TX ACTIVE 8/5/2015 None N/A R0693 BRANN, JAMES ROBERT II, MD 11/15/2016 11/15/2021 ANESTHESIOLOGY DALLAS TX ACTIVE 12/2/2016 None N/A BRANNON-GOEDEKE, ANGELIQUE OBSTETRICS AND R1181 ANNETTE, MD 1/6/2017 1/6/2022 GYNECOLOGY TYLER TX ACTIVE 1/13/2017 None N/A PLASTIC & RECONSTRUCTIVE Q9962 BRANSKI, LUDWIK , MD 9/15/2016 9/15/2021 SURGERY GALVESTON TX ACTIVE 9/20/2016 None N/A

Page 41 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PEDIATRIC BRANSTETTER, CRISTYN NICOLE, HEMATOLOGY/ONCOL N8893 MD 8/15/2016 8/15/2021 OGY DALLAS TX ACTIVE 9/9/2016 None N/A BRATHWAITE-DINGLE, NICHOLE R3040 RENEE, MD 5/22/2017 5/22/2022 PEDIATRICS ACTIVE 6/7/2017 None N/A CRITICAL CARE Q9963 BRAUN, ANDREA BARBARA, MD 9/15/2016 9/15/2021 MEDICINE (IM) NEPHROLOGY HOUSTON TX ACTIVE 9/19/2016 None N/A Q6736 BRAUN, ERIC LYLE, MD 12/15/2015 12/15/2020 FAMILY MEDICINE WACO TX ACTIVE 12/17/2015 None N/A PEDIATRIC R5846 BRAY, MONICA ANNE, MD 2/2/2018 2/2/2023 RHEUMATOLOGY PEDIATRICS DALLAS TX ACTIVE 3/9/2018 None N/A DIAGNOSTIC Q7654 BRAZEAL, HILARY A, MD 4/1/2016 4/1/2021 RADIOLOGY DALLAS TX ACTIVE 4/18/2016 None N/A ADULT ORTHOPEDIC RECONSTRUCTIVE S5851 BREKKE, ADAM CHARLES, MD 4/3/2020 4/3/2025 SURGERY ORTHOPEDICS FORT WORTH TX ACTIVE 4/9/2020 None N/A EMERGENCY LICENSE S6579 BREMANG, DERRICK BOAKYE, MD 5/15/2020 5/15/2025 MEDICINE ISSUED 5/15/2020 None N/A

NEONATAL- R6154 BRENAN, SHELBY BROOKE, MD 3/2/2018 3/2/2023 PERINATAL MEDICINE DALLAS TX ACTIVE 3/9/2018 None N/A BRESHEARS, JONATHAN DEAN, NEUROLOGICAL SAN R5979 MD 2/16/2018 2/16/2023 SURGERY FRANCISCO CA ACTIVE 2/19/2018 None N/A

R3802 BREUER, GILLIAN REE, DO 7/17/2017 7/17/2022 PALLIATIVE MEDICINE LUBBOCK TX ACTIVE 8/2/2017 None N/A

R5370 BREWER, ELIZABETH CAITLIN, MD 12/8/2017 12/8/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 2/15/2018 None N/A EMERGENCY S4607 BREWER, MATTHEW ROBERT, MD 1/10/2020 1/10/2025 MEDICINE FORT WORTH TX ACTIVE 1/14/2020 None N/A EMERGENCY R2063 BRIA, CARLEY, MD 3/20/2017 3/20/2022 MEDICINE ACTIVE 4/4/2017 None N/A PEDIATRIC BRICENO BRITO, EUDYS ELENA, INFECTIOUS S6805 MD 5/29/2020 5/29/2025 PEDIATRICS DISEASE LUBBOCK TX ACTIVE 6/2/2020 None N/A R3803 BRICKEY, MARK, MD 7/17/2017 7/17/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 8/1/2017 None N/A PLASTIC & RECONSTRUCTIVE Q6933 BRIDGE, KEVIN ALAN, MD 1/15/2016 1/15/2021 SURGERY GENERAL SURGERY ACTIVE 1/20/2016 None N/A OBSTETRICS AND MATERNAL AND R1182 BRIEN, CONNIE AGNEW, MD 1/6/2017 1/6/2022 GYNECOLOGY FETAL MEDICINE HOUSTON TX ACTIVE 1/13/2017 None N/A

Page 42 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date OBSTETRICS & BRIGHTWELL, RACHEL MICHELE, GYNECOLOGIC GYNECOLOGICAL Q9127 MD 7/15/2016 7/15/2021 ONCOLOGY SURGERY AUSTIN TX ACTIVE 7/21/2016 None N/A ORTHOPEDIC SURGERY OF THE R2818 BRINDISE, JOSEPH PATRICK, DO 5/5/2017 5/5/2022 SPINE HOUSTON TX ACTIVE 6/8/2017 None N/A

HEAD AND NECK OTOLARYN & FACIAL LICENSE S7014 BRITT, CHRISTOPHER JOHN, MD 6/12/2020 6/12/2025 SURGERY PLASTIC SURGERY ISSUED 6/12/2020 None N/A ORTHOPEDIC S4608 BRITTEN, TYLER ANDREW, MD 1/10/2020 1/10/2025 SURGERY ACTIVE 3/20/2020 None N/A DIAGNOSTIC R2064 BROCHERT, ADAM JAMES, MD 3/20/2017 3/20/2022 RADIOLOGY SAVANAH GA ACTIVE 3/27/2017 None N/A R6156 BROCK, WHITNEY , DO 3/2/2018 3/2/2023 FAMILY MEDICINE FORT WORTH TX ACTIVE 3/6/2018 None N/A ORAL & BROCKHOFF, HANS CHRISTIAN II, MAXILLOFACIAL LICENSE Q8438 MD 6/1/2016 6/1/2021 SURGERY ISSUED 6/1/2016 None N/A BRODRICK, BROOKS BARRETT, Q7017 MD 2/1/2016 2/1/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 2/8/2016 None N/A PLASTIC & BROOKE, SEBASTIAN MICHAEL RECONSTRUCTIVE CRANIOFACIAL R3804 ACTON, MD 7/17/2017 7/17/2022 SURGERY SURGERY TEMPLE TX ACTIVE 7/31/2017 None N/A RADIATION R5519 BROOKS, CHARLES, MD 1/5/2018 1/5/2023 ONCOLOGY UVALDE TX ACTIVE 1/8/2018 None N/A UROLOGIC Q7330 BROOKS, MICHAEL AUSTIN, MD 3/4/2016 3/4/2021 UROLOGY ONCOLOGY HOUSTON TX ACTIVE 3/8/2016 None N/A R3805 BROWDER, KARIS L , MD 7/17/2017 7/17/2022 PEDIATRICS HOUSTON TX ACTIVE 9/19/2017 None N/A R2819 BROWN, ADAM LEE, DO 5/5/2017 5/5/2022 INTERNAL MEDICINE TEMPLE TX ACTIVE 5/8/2017 None N/A PEDIATRIC Q9301 BROWN, AMANDA GAYLE, MD 8/1/2016 8/1/2021 RHEUMATOLOGY PEDIATRICS HOUSTON TX ACTIVE 8/10/2016 None N/A CHILD AND ADOLESCENT S6806 BROWN, CHARLENE RENEE, MD 5/29/2020 5/29/2025 PSYCHIATRY PSYCHIATRY BRENTWOOD TN ACTIVE 6/5/2020 None N/A DELINQUEN T-NON R4523 BROWN, CHRISTINA ANN, MD 9/8/2017 9/8/2022 FAMILY MEDICINE PAYMENT 12/7/2017 None N/A GASTROENTEROLOG S4271 BROWN, CRISTAL LATANZA, MD 12/6/2019 12/6/2024 HEPATOLOGY Y AUSTIN TX ACTIVE 12/16/2019 None N/A GASTROENTEROLOG S4271 BROWN, CRISTAL LATANZA, MD 12/6/2019 12/6/2024 HEPATOLOGY Y AUSTIN TX ACTIVE 12/16/2019 None N/A Q8439 BROWN, DANA MICHELLE, MD 6/1/2016 6/1/2021 PEDIATRICS HOUSTON TX ACTIVE 6/3/2016 None N/A Page 43 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date

R2820 BROWN, ELIZABETH AUBREY, MD 5/5/2017 5/5/2022 PALLIATIVE MEDICINE FAMILY MEDICINE DALLAS TX ACTIVE 6/16/2017 None N/A R1002 BROWN, JARED , MD 12/16/2016 12/16/2021 ANESTHESIOLOGY SAN ANTONIO TX ACTIVE 12/19/2016 None N/A OBSTETRICS AND Q6310 BROWN, JESSICA LYNN, MD 10/15/2015 10/15/2020 GYNECOLOGY DALLAS TX ACTIVE 10/27/2015 None N/A

NEURO-PHYSIOLOGY R2065 BROWN, KRISTIN ANGELICA, MD 3/20/2017 3/20/2022 NEUROLOGY (NEUROLOGY) HOUSTON TX ACTIVE 4/10/2017 None N/A PEDIATRIC CRITICAL INTERNAL MED - Q8440 BROWN, KYLE ANTHONY, MD 6/1/2016 6/1/2021 CARE MEDICINE PEDS HOUSTON TX ACTIVE 6/13/2016 None N/A PALLIATIVE S4272 BROWN, LISA-MARIE C, MD 12/6/2019 12/6/2024 FAMILY MEDICINE MEDICINE EDINBURG TX ACTIVE 1/9/2020 None N/A PALLIATIVE S4272 BROWN, LISA-MARIE C, MD 12/6/2019 12/6/2024 FAMILY MEDICINE MEDICINE EDINBURG TX ACTIVE 1/9/2020 None N/A EMERGENCY Q6499 BROWN, LOREN ELIZABETH, MD 11/16/2015 11/16/2020 MEDICINE MUSKOGEE OK ACTIVE 12/4/2015 None N/A DIAGNOSTIC ABDOMINAL S6807 BROWN, MARCUS, MD 5/29/2020 5/29/2025 RADIOLOGY RADIOLOGY ENID OK ACTIVE 6/11/2020 None N/A CHILD AND ADOLESCENT Q7018 BROWN, NICOLAS DMITRI, MD 2/1/2016 2/1/2021 PSYCHIATRY PSYCHIATRY HOUSTON TX ACTIVE 2/11/2016 None N/A

R0364 BROWN, ROBERT EDWARD, MD 10/14/2016 10/14/2021 GENERAL SURGERY BROWNWOOD TX ACTIVE 12/23/2016 None N/A LICENSE Q5767 BROWN, ROBERT JAMES DIX, MD 8/28/2015 8/28/2020 NEUROLOGY OTHER SPECIALTY HOUSTON TX ISSUED 8/28/2015 None N/A ENDOCRINOLOGY, BROWN, SPANDANA JAGANNATH, DIABETES AND S4447 MD 12/20/2019 12/20/2024 METABOLISM INTERNAL MEDICINE HOUSTON TX ACTIVE 1/8/2020 None N/A Q8441 BRUCE, KEELIE, DO 6/1/2016 6/1/2021 PEDIATRICS FORT WORTH TX ACTIVE 6/2/2016 None N/A BRUMBACK, AUDREY CHRISTINE, R3283 MD 6/2/2017 6/2/2022 CHILD NEUROLOGY NEUROLOGY AUSTIN TX ACTIVE 6/12/2017 None N/A S6140 BRUNO, MICHAEL , MD 4/17/2020 4/17/2025 PEDIATRICS HOUSTON TX ACTIVE 4/21/2020 None N/A OBSTETRICS AND Q9303 BRUNO, TODD STEPHEN, MD 8/1/2016 8/1/2021 GYNECOLOGY MANSFIELD TX ACTIVE 8/23/2016 None N/A REPRODUCTIVE OBSTETRICS AND ENDOCRINOLOGY PANORAMA R6157 BRUNO-GASTON, JANET, MD 3/2/2018 3/2/2023 GYNECOLOGY AND INFERTILITY CITY CA ACTIVE 3/8/2018 None N/A S5853 BRUNSON, JOHN CLAY JR, MD 4/3/2020 4/3/2025 RADIOLOGY NEURO-RADIOLOGY HUDSON FL ACTIVE 4/7/2020 None N/A

NEONATAL- R5848 BRUNT, AMY LYN, MD 2/2/2018 2/2/2023 PERINATAL MEDICINE PEDIATRICS LITTLE ROCK AR ACTIVE 2/6/2018 None N/A Page 44 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date NEUROMUSCULAR MISSION S5854 BRUSIL, OLGA O, MD 4/3/2020 4/3/2025 NEUROLOGY DISEASE HILLS CA ACTIVE 5/18/2020 None N/A R2291 BRUS-RAMER, MARCEL, MD 4/4/2017 4/4/2022 RADIOLOGY AUSTIN TX ACTIVE 4/6/2017 None N/A DIAGNOSTIC LICENSE S7015 BRYAN, ROY II, MD 6/12/2020 6/12/2025 RADIOLOGY NEURO-RADIOLOGY ISSUED 6/12/2020 None N/A FAMILY R4371 BRYAN, STEPHANIE MARIE, DO 8/25/2017 8/25/2022 PRACTICE/OMM DIMMITT TX ACTIVE 11/23/2017 None N/A BRYCE, YOLANDA CAROLYN- INTERVENTIONAL R2821 DAWN, MD 5/5/2017 5/5/2022 RADIOLOGY BREAST IMAGING NEW YORK NY ACTIVE 7/17/2017 None N/A BRYNDZIA, CHRISTINA PEDIATRIC CRITICAL R3643 HANOWSKY, DO 6/30/2017 6/30/2022 PEDIATRICS CARE MEDICINE HOUSTON TX ACTIVE 7/18/2017 None N/A EMERGENCY Q9964 BUCHHOLZ, KEITH LEE, DO 9/15/2016 9/15/2021 MEDICINE TEMPLE TX ACTIVE 9/21/2016 None N/A Q6157 BUDHARAJU, SUBBARAJU, MD 10/1/2015 10/1/2020 FAMILY MEDICINE HOSPITALIST ACTIVE 10/6/2015 None N/A CHILD AND ADOLESCENT Q9791 BUFORD, USHIMBRA JUVAL, MD 8/26/2016 8/26/2021 PSYCHIATRY PSYCHIATRY TYLER TX ACTIVE 11/1/2016 None N/A CORPUS R2292 BUI, CHRISTINE KIM, DO 4/4/2017 4/4/2022 INTERNAL MEDICINE CHRISTI TX ACTIVE 6/7/2017 None N/A BUITRAGO, WILLIAM FERNANDO, ABDOMINAL Q9305 MD 8/1/2016 8/1/2021 GENERAL SURGERY SURGERY HOUSTON TX ACTIVE 8/3/2016 None N/A R3480 BUJOLD, CRYSTAL ANNE, DO 6/16/2017 6/16/2022 CARDIOLOGY INTERNAL MEDICINE MCKINNEY TX ACTIVE 7/19/2017 None N/A S4736 BUMP, JOHN MICHAEL, DO 1/24/2020 1/24/2025 INTERNAL MEDICINE GRANBURY TX ACTIVE 1/27/2020 None N/A PHYSICAL MED. & R4373 BUNTING, KARA LEIGH, DO 8/25/2017 8/25/2022 REHABILITATION DALLAS TX ACTIVE 9/7/2017 None N/A THE Q4569 BUNYAN, SAYL , MD 6/1/2015 6/1/2020 GENERAL SURGERY WOODLANDS TX ACTIVE 6/3/2015 None N/A PEDIATRIC THORACIC CARDIOTHORACIC CARDIOVASCULAR R4816 BURCH, PHILLIP TODD, MD 10/6/2017 10/6/2022 SURGERY SURGERY FORT WORTH TX ACTIVE 10/16/2017 None N/A ANATOMIC/CLINICAL DERMATOPATHOLO Q4909 BURFORD, HOLLY NORTHAM, MD 7/1/2015 7/1/2020 PATHOLOGY GY BIRMINGHAM AL ACTIVE 7/3/2015 None N/A Q8443 BURGE, LAUREN REAGAN , MD 6/1/2016 6/1/2021 PEDIATRICS HOUSTON TX ACTIVE 6/10/2016 None N/A PEDIATRIC R1346 BURGE, SCOTT DANIEL, MD 1/20/2017 1/20/2022 OTOLARYNGOLOGY HOUSTON TX ACTIVE 2/10/2017 None N/A BURGESS, ANGELA PATRICIA OBSTETRICS AND MATERNAL AND R2067 HAYNES, MD 3/20/2017 3/20/2022 GYNECOLOGY FETAL MEDICINE HOUSTON TX ACTIVE 3/23/2017 None N/A S4448 BURKES, WILLIAM , MD 12/20/2019 12/20/2024 OPHTHALMOLOGY LUBBOCK TX ACTIVE 12/30/2019 None N/A S4737 BURLESON, MEGAN NICOLE, DO 1/24/2020 1/24/2025 FAMILY MEDICINE DENISON TX ACTIVE 2/19/2020 None N/A EMERGENCY LICENSE Q4730 BURNELL, CHARLES PAUL, MD 6/12/2015 6/12/2020 MEDICINE ISSUED 6/12/2015 None N/A Page 45 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date ENDOCRINOLOGY, DIABETES AND MONTGOMER S5567 BURNEY, BASIL OMAR, MD 3/20/2020 3/20/2025 INTERNAL MEDICINE METABOLISM Y AL ACTIVE 3/23/2020 None N/A DIAGNOSTIC CARDIOTHORACIC LICENSE Q7657 BURNS, DAVID, MD 4/1/2016 4/1/2021 RADIOLOGY RADIOLOGY ISSUED 4/1/2016 None N/A S4738 BURRELL, JOY RUTH, MD 1/24/2020 1/24/2025 FAMILY MEDICINE WACO TX ACTIVE 3/13/2020 None N/A NEUROMUSCULAR THE Q9967 BURROWS, GUY TIMOTHY, MD 9/15/2016 9/15/2021 NEUROLOGY DISEASE WOODLANDS TX ACTIVE 9/16/2016 None N/A ORTHOPEDIC SPORTS MEDICINE - R2822 BURRUS, MATTHEW TYRRELL, MD 5/5/2017 5/5/2022 SURGERY ORTHOPEDICS AUSTIN TX ACTIVE 5/8/2017 None N/A

Q7155 BURTON, ANNE WINSJANSEN, DO 2/16/2016 2/16/2021 INTERNAL MEDICINE TULSA OK ACTIVE 4/7/2016 None N/A BURTON, CHRISTIAN ANTHONY, Q5770 MD 8/28/2015 8/28/2020 FAMILY MEDICINE FT WORTH TX ACTIVE 9/3/2015 None N/A R0366 BUSH, TAMIKA CHERRON, DO 10/14/2016 10/14/2021 PEDIATRICS SPRING TX ACTIVE 11/22/2016 None N/A R2293 BUSSIERE, NICOLE , MD 4/4/2017 4/4/2022 FAMILY MEDICINE WACO TX ACTIVE 4/7/2017 None N/A BUSTAMANTE BERNAL, MARCO GASTROENTEROLOG R4017 ANTONIO, MD 8/1/2017 8/1/2022 INTERNAL MEDICINE Y EL PASO TX ACTIVE 8/2/2017 None N/A BUSTAMANTE, GEORGINA LICENSE S7016 MARCEL, MD 6/12/2020 6/12/2025 FAMILY MEDICINE OTHER SPECIALTY ISSUED 6/12/2020 None N/A EMERGENCY Q7659 BUSTI, ANTHONY, MD 4/1/2016 4/1/2021 MEDICINE DALLAS TX ACTIVE 4/5/2016 None N/A Q8215 BUSUEGO, ROBERT SOLIS, MD 5/16/2016 5/16/2021 INTERNAL MEDICINE INTERNAL MEDICINE LUFKIN TX ACTIVE 5/20/2016 None N/A CANCELLE BUTLER, ELIZABETH CATHERINE, D BY Q9968 DO 9/15/2016 9/15/2021 BREAST ONCOLOGY GENERAL SURGERY REQUEST 12/11/2017 None N/A BUTLER-WILLIAMS, SHANNON Q7333 ALAYNA, MD 3/4/2016 3/4/2021 PATHOLOGY CYTOPATHOLOGY HOUSTON TX ACTIVE 3/9/2016 None N/A S4739 BUTT, MARIUM, MD 1/24/2020 1/24/2025 INTERNAL MEDICINE HOSPITALIST LONG GROVE IL ACTIVE 4/7/2020 None N/A BUTTACAVOLI, FRANK ANTHONY, ORTHOPEDIC R3645 MD 6/30/2017 6/30/2022 SURGERY SAN ANTONIO TX ACTIVE 7/3/2017 None N/A BUTTRAM, SANDRA DAWN- PEDIATRIC CRITICAL Q9306 WATANABE, MD 8/1/2016 8/1/2021 CARE MEDICINE DALLAS TX ACTIVE 8/9/2016 None N/A EMERGENCY Q5627 BUTVILAS, KEITH JOHN, DO 8/14/2015 8/14/2020 MEDICINE BEAUMONT TX ACTIVE 8/24/2015 None N/A R5522 BYRAGANI, DIVYA, MD 1/5/2018 1/5/2023 INTERNAL MEDICINE TYLER TX ACTIVE 1/11/2018 None N/A LICENSE R6158 BYRD, ROY TOM, MD 3/2/2018 3/2/2023 INTERNAL MEDICINE ISSUED 3/2/2018 None N/A ANESTHESIOLOGY - R5705 BYRNE, DAVID ALAN, MD 1/19/2018 1/19/2023 ANESTHESIOLOGY PAIN MANAGEMENT PLANO TX ACTIVE 1/29/2018 None N/A R2546 BYRNE, ELIZABETH ANN, MD 4/20/2017 4/20/2022 PEDIATRICS DALLAS TX ACTIVE 4/21/2017 None N/A Page 46 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date OBSTETRICS AND MATERNAL AND R2295 BYRNE, JOHN JOSEPH, MD 4/4/2017 4/4/2022 GYNECOLOGY FETAL MEDICINE DALLAS TX ACTIVE 4/5/2017 None N/A CABRERA GONCALVES, AGUSTIN CORPUS S4740 JOSE, MD 1/24/2020 1/24/2025 PEDIATRICS CHRISTI TX ACTIVE 2/5/2020 None N/A R4195 CAI, ZHENJIAN , MD 8/15/2017 8/15/2022 PATHOLOGY HOUSTON TX ACTIVE 11/14/2017 None N/A FACIAL PLASTIC Q8841 CAIN, JORDAN AUSTIN, MD 7/1/2016 7/1/2021 SURGERY OTOLARYNGOLOGY FRISCO TX ACTIVE 8/26/2016 None N/A Q5981 CAIN, MATTHEW A, MD 9/15/2015 9/15/2020 CARDIOLOGY INTERNAL MEDICINE DALLAS TX ACTIVE 9/17/2015 None N/A CAJAVILCA, CHRISTIAN EDUARDO, R5983 MD 2/16/2018 2/16/2023 NEUROLOGY ACTIVE 3/14/2018 None N/A SURGICAL R2823 CALCATERA, NATALIE ANN, MD 5/5/2017 5/5/2022 GENERAL SURGERY ONCOLOGY WAXAHACHIE TX ACTIVE 5/9/2017 None N/A CALDWELL, JASON DIAGNOSTIC Q7661 CHRISTOPHER, MD 4/1/2016 4/1/2021 RADIOLOGY BODY IMAGING FORT WORTH TX ACTIVE 4/11/2016 None N/A EMERGENCY EMERGENCY R0199 CALLAHAN, AVERY LEE, DO 9/30/2016 9/30/2021 MEDICINE MEDICAL SERVICES SHREVEPORT LA ACTIVE 10/5/2016 None N/A EMERGENCY Q8216 CALLAHAN, BRYON SCOTT, MD 5/16/2016 5/16/2021 MEDICINE HOUSTON TX ACTIVE 6/6/2016 None N/A CALLAN, ALEXANDRA KATHLEEN, ORTHOPEDIC R3285 MD 6/2/2017 6/2/2022 SURGERY ONCOLOGY DALLAS TX ACTIVE 6/13/2017 None N/A S6581 CALLE, SUSANA , MD 5/15/2020 5/15/2025 RADIOLOGY NEURO-RADIOLOGY HOUSTON TX ACTIVE 5/27/2020 None N/A ENDOCRINOLOGY, DIABETES AND LICENSE Q5771 CALLEJAS, LEYDA PENNYNA, MD 8/28/2015 8/28/2020 INTERNAL MEDICINE METABOLISM ISSUED 8/28/2015 None N/A CAMARENA, JULIEANNA ANGEL, Q8030 DO 5/2/2016 5/2/2021 INTERNAL MEDICINE GALVESTON tx ACTIVE 5/4/2016 None N/A

R1931 CAMERON, BENJAMIN JACOB, DO 3/3/2017 3/3/2022 INTERNAL MEDICINE LONGVIEW TX ACTIVE 3/20/2017 None N/A R2298 CAMOSY, CAROLINE , MD 4/4/2017 4/4/2022 PEDIATRICS ACTIVE 4/11/2017 None N/A OBSTETRICS AND S6582 CAMPANO, ROXANA BUTTON, MD 5/15/2020 5/15/2025 GYNECOLOGY LUBBOCK TX ACTIVE 5/25/2020 None N/A CHILD AND ADOLESCENT R4526 CAMPBELL, ADINA , MD 9/8/2017 9/8/2022 PSYCHIATRY PSYCHIATRY SAN ANTONIO TX ACTIVE 9/12/2017 None N/A Q6159 CAMPBELL, CARMEN MARIE, MD 10/1/2015 10/1/2020 RHEUMATOLOGY INTERNAL MEDICINE ACTIVE 10/23/2015 None N/A R2548 CAMPBELL, DANEA , MD 4/20/2017 4/20/2022 RADIOLOGY BREAST IMAGING HOUSTON TX ACTIVE 5/12/2017 None N/A LICENSE Q6400 CAMPBELL, JAMIE RENEE, MD 11/2/2015 11/2/2020 FAMILY PRACTICE ISSUED 11/2/2015 None N/A CHILD AND ADOLESCENT R3287 CAMPBELL, KELLY , MD 6/2/2017 6/2/2022 PSYCHIATRY PSYCHIATRY AUSTIN TX ACTIVE 6/13/2017 None N/A Page 47 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date REPRODUCTIVE CAMPBELL, SUKHKAMAL ENDOCRINOLOGY R1932 BHULLAR, MD 3/3/2017 3/3/2022 AND INFERTILITY HOUSTON TX ACTIVE 4/5/2017 None N/A LICENSE Q5772 CAMPOY, ABRAHAM , MD 8/28/2015 8/28/2020 INTERNAL MEDICINE ISSUED 8/28/2015 None N/A

Q6934 CANALES CHAVEZ, ROBERTO, MD 1/15/2016 1/15/2021 PEDIATRICS EL PASO TX ACTIVE 2/25/2016 None N/A R2070 CANCINO, RAMON S, MD 3/20/2017 3/20/2022 FAMILY MEDICINE BOERNE TX ACTIVE 3/22/2017 None N/A EMERGENCY Q9970 CANION, JONATHAN ADAM , MD 9/15/2016 9/15/2021 MEDICINE TYLER TX ACTIVE 9/21/2016 None N/A CANNONE, SEAN CHRISTOPHER, GERIATRIC MEDICINE Q7537 DO 3/15/2016 3/15/2021 (FAMILY PRACTICE) DALLAS TX ACTIVE 4/13/2016 None N/A CANO PENALOZA, JOSE RAFAEL, S5337 MD 3/6/2020 3/6/2025 FAMILY MEDICINE MCALLEN TX ACTIVE 5/4/2020 None N/A CANO RIVERA, MANUEL CORPUS R5707 ROBERTO, MD 1/19/2018 1/19/2023 PEDIATRICS CHRISTI TX ACTIVE 1/22/2018 None N/A S5135 CANO-GARCIA, ANGELA M, MD 2/21/2020 2/21/2025 FAMILY MEDICINE MCALLEN TX ACTIVE 2/27/2020 None N/A CANTAZARO, BRANDON ROBERT, R5523 MD 1/5/2018 1/5/2023 INTERNAL MEDICINE ACTIVE 1/31/2018 None N/A R2824 CANTONE, ALESSANDRA, MD 5/5/2017 5/5/2022 INTERNAL MEDICINE SUFFOLK VA ACTIVE 5/15/2017 None N/A R5095 CANTU GARCIA, ISMAEL , MD 11/3/2017 11/3/2022 INTERNAL MEDICINE HARLINGEN TX ACTIVE 11/15/2017 None N/A S6368 CANTU, AMANDA NOEMI, MD 5/1/2020 5/1/2025 INTERNAL MEDICINE ODESSA TX ACTIVE 6/8/2020 None N/A Q8843 CANTU, ERIKA , MD 7/1/2016 7/1/2021 PEDIATRICS PEDIATRICS HOUSTON TX ACTIVE 7/7/2016 None N/A R3646 CANTU, JUDY, MD 6/30/2017 6/30/2022 INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 7/3/2017 None N/A PEDIATRIC EMERGENCY PEDIATRIC S6584 CANTU, MARISSA SALAZAR, MD 5/15/2020 5/15/2025 MEDICINE (PEDS) FORENSIC MEDICINE SAN ANTONIO TX ACTIVE 6/15/2020 None N/A JACKSONVILL R1348 CANTVILLE, RYAN C, DO 1/20/2017 1/20/2022 PEDIATRICS E FL ACTIVE 1/30/2017 None N/A GERIATRIC MEDICINE (FAMILY S4449 CANTWAY, CATHERINE, MD 12/20/2019 12/20/2024 FAMILY MEDICINE PRACTICE) DALHART TX ACTIVE 1/2/2020 None N/A HAND SURGERY - ORTHOPEDIC ORTHOPEDIC R1508 CAO, JUE, MD 2/6/2017 2/6/2022 SURGERY SURGERY DALLAS TX ACTIVE 2/13/2017 None N/A PHYSICAL MED. & LICENSE S6810 CAPIZZI, ALLISON NUOVO, MD 5/29/2020 5/29/2025 REHABILITATION ISSUED 5/29/2020 None N/A CAPPIELLO DZIEDZIC, EMERGENCY LICENSE Q6615 JACQUELINE MARIE, DO 12/4/2015 12/4/2020 MEDICINE ISSUED 12/4/2015 None N/A

Page 48 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date DELINQUEN CAPPIELLO DZIEDZIC, EMERGENCY T-NON Q6615 JACQUELINE MARIE, DO 12/4/2015 12/4/2020 MEDICINE PAYMENT 3/3/2016 None N/A DELINQUEN CAPPIELLO DZIEDZIC, EMERGENCY T-NON Q6615 JACQUELINE MARIE, DO 12/4/2015 12/4/2020 MEDICINE PAYMENT 3/3/2016 None N/A

S5572 CARAVELLA, JOSEPH WILLIAM, DO 3/20/2020 3/20/2025 INTERNAL MEDICINE LAREDO TX ACTIVE 4/14/2020 None N/A

Q6160 CARDENAS, CARLOS PATRICK, MD 10/1/2015 10/1/2020 INTERNAL MEDICINE DALLAS TX ACTIVE 10/6/2015 None N/A Q9972 CARDENAS, JOSE MARTIN, MD 9/15/2016 9/15/2021 INTERNAL MEDICINE ROUND ROCK TX ACTIVE 11/8/2016 None N/A

CLINICAL R3647 CARDON, AARON LYNN, MD 6/30/2017 6/30/2022 CHILD NEUROLOGY NEUROPHYSIOLOGY AUSTIN TX ACTIVE 8/18/2017 None N/A NEUROMUSCULAR R3808 CARDON, MEETA WAGLE, MD 7/17/2017 7/17/2022 CHILD NEUROLOGY DISEASE AUSTIN TX ACTIVE 9/6/2017 None N/A R3043 CARDONA, LINA MARIA, MD 5/22/2017 5/22/2022 FAMILY MEDICINE SAN ANTONIO TX ACTIVE 8/8/2017 None N/A EMERGENCY Q8845 CARINO, CHARLES, DO 7/1/2016 7/1/2021 MEDICINE BEAUMONT TX ACTIVE 7/7/2016 None N/A S4450 CARLI, SAMUEL BENJAMIN, MD 12/20/2019 12/20/2024 INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 1/3/2020 None N/A PULMONARY CRITICAL CARE S5136 CARLIN, JOSEPH PATRICK, MD 2/21/2020 2/21/2025 MEDICINE TEMPLE TX ACTIVE 3/9/2020 None N/A R2825 CARLIN, KATIE KUAN-TING, MD 5/5/2017 5/5/2022 PEDIATRICS TEMPLE TX ACTIVE 6/5/2017 None N/A R4948 CARLTON, KISH, MD 10/20/2017 10/20/2022 FAMILY MEDICINE PITTSBURG TX ACTIVE 11/17/2017 None N/A OBSTETRICS AND COLLEGE Q7335 CARLTON, SHARREL MARIE, MD 3/4/2016 3/4/2021 GYNECOLOGY STATION TX ACTIVE 3/8/2016 None N/A PEDIATRIC EMERGENCY EMERGENCY S5338 CARMAN, AUBRI SUE, MD 3/6/2020 3/6/2025 MEDICINE MEDICINE (EM) AUSTIN TX ACTIVE 3/25/2020 None N/A Q8846 CARMICAL, JIM , MD 7/1/2016 7/1/2021 FAMILY MEDICINE ACTIVE 7/6/2016 None N/A R1195 CARMICAL, KATELYN HALIE, MD 1/6/2017 1/6/2022 FAMILY MEDICINE FORT WORTH TX ACTIVE 2/6/2017 None N/A S5339 CARO, CARLOS H, MD 3/6/2020 3/6/2025 FAMILY MEDICINE MCALLEN TX ACTIVE 5/1/2020 None N/A PLASTIC & RECONSTRUCTIVE HAND SURGERY - Q8031 CARRASQUILLO, INES, MD 5/2/2016 5/2/2021 SURGERY PLASTIC SURGERY WAUSAU WI ACTIVE 5/24/2016 None N/A LICENSE Q8218 CARRETE, LOLA , MD 5/16/2016 5/16/2021 INTERNAL MEDICINE ISSUED 5/16/2016 None N/A ORTHOPEDIC R4019 CARSON, JAMES TERRANCE, MD 8/1/2017 8/1/2022 SURGERY HOUSTON TX ACTIVE 8/3/2017 None N/A

Page 49 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date SEE FORENSIC ANATOMIC/CLINICAL PREVIOUS K1383 CARTER, JOYE MAUREEN, MD 12/16/2016 12/16/2021 PATHOLOGY PATHOLOGY HOUSTON TX ACTIVE 2/1/2017 ORDER 4/17/2001 CHILD AND ADOLESCENT Q9974 CARTER, KIA LASHAUN, MD 9/15/2016 9/15/2021 PSYCHIATRY PSYCHIATRY FORT WORTH TX ACTIVE 12/12/2016 None N/A EMERGENCY Q7158 CARTER, SCOTT ALLEN, MD 2/16/2016 2/16/2021 MEDICINE FAMILY PRACTICE PARIS TX ACTIVE 2/19/2016 None N/A SURGICAL BREAST Q5630 CARTER, STACEY ANN , MD 8/14/2015 8/14/2020 GENERAL SURGERY ONCOLOGY ACTIVE 8/20/2015 None N/A EMERGENCY R3289 CARTER, WILLIAM THOMAS, MD 6/2/2017 6/2/2022 MEDICINE HARLINGEN TX ACTIVE 6/27/2017 None N/A OBSTETRICS AND MATERNAL AND P0560 CARVER, ALISSA, MD 4/15/2016 4/15/2021 GYNECOLOGY FETAL MEDICINE MACON GA ACTIVE 4/29/2016 None N/A

R3290 CARVER, JOSEPH G, DO 6/2/2017 6/2/2022 FAMILY MEDICINE GLADEWATER TX ACTIVE 6/26/2017 None N/A PEDIATRIC HEMATOLOGY/ONCO Q9587 CASAS, JESSICA A, MD 8/15/2016 8/15/2021 PALLIATIVE MEDICINE LOGY HOUSTON TX ACTIVE 8/17/2016 None N/A EMERGENCY R0370 CASEY, AHMED , MD 10/14/2016 10/14/2021 FAMILY MEDICINE MEDICINE ODESSA TX ACTIVE 11/16/2016 None N/A Q5632 CASEY, CHRISTINA VU, DO 8/14/2015 8/14/2020 FAMILY MEDICINE DALLAS TX ACTIVE 8/31/2015 None N/A GASTROENTEROLOG R5984 CASH, BROOKS DICKSON, MD 2/16/2018 2/16/2023 Y INTERNAL MEDICINE HOUSTON TX ACTIVE 3/2/2018 None N/A EMERGENCY S4451 CASH, KYLE PATRICK, DO 12/20/2019 12/20/2024 MEDICINE VINELAND NJ ACTIVE 1/17/2020 None N/A Q7159 CASOY, FLAVIO, MD 2/16/2016 2/16/2021 PSYCHIATRY HOUSTON TX ACTIVE 2/18/2016 None N/A CASSELL, NATHANIEL CONLEY, Q7844 MD 4/15/2016 4/15/2021 INTERNAL MEDICINE HOUSTON TX ACTIVE 4/22/2016 None N/A CASTANEDA NERIO, JOSE SAN R5373 ROBERTO, MD 12/8/2017 12/8/2022 INTERNAL MEDICINE ANMTONIO TX ACTIVE 12/14/2017 None N/A

Q4913 CASTANEDA, MELISSA MARIE, MD 7/1/2015 7/1/2020 FAMILY MEDICINE FORT WORTH TX ACTIVE 9/1/2015 None N/A CASTELLUCCI, ALFONSO EMERGENCY LOS R5708 CHARLES, DO 1/19/2018 1/19/2023 MEDICINE ALAMITOS CA ACTIVE 2/8/2018 None N/A N2980 CASTILLO KONTAK, LETICIA, MD 8/14/2015 8/14/2020 CARDIOLOGY INTERNAL MEDICINE BALLWIN MO ACTIVE 8/18/2015 None N/A R2827 CASTILLO, PEDRO JR, MD 5/5/2017 5/5/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 5/11/2017 None N/A R1711 CASTLE, ZACHARY PAUL, DO 2/22/2017 2/22/2022 FAMILY MEDICINE MIDLAND TX ACTIVE 2/23/2017 None N/A CASTRO PENA, NORYS INFECTIOUS Q7022 ALEXANDRA, MD 2/1/2016 2/1/2021 INTERNAL MEDICINE DISEASES SAN ANTONIO TX ACTIVE 3/8/2016 None N/A R5985 CASTRO, PETER LAURENCE, MD 2/16/2018 2/16/2023 ANESTHESIOLOGY ACTIVE 2/26/2018 None N/A Page 50 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date INTERVENTIONAL L4284 CASTRO, VICTOR JULIO, MD 12/16/2016 12/16/2021 CARDIOLOGY CARDIOLOGY MCALLEN TX ACTIVE 12/19/2016 None N/A LICENSE Q8701 CASTRO-URGANUS, SANDRA, MD 6/10/2016 6/10/2021 FAMILY PRACTICE ISSUED 6/10/2016 None N/A EMERGENCY R5374 CAUCHI, ANTHONY , MD 12/8/2017 12/8/2022 MEDICINE LAMAR MO ACTIVE 1/30/2018 None N/A

S6145 CAVALLIN, LUCAS EDGARDO, MD 4/17/2020 4/17/2025 DERMATOLOGY ACTIVE 5/12/2020 None N/A ANESTHESIOLOGY - Q8219 CAVAZOS, ALFONSO JOEL JR, MD 5/16/2016 5/16/2021 ANESTHESIOLOGY PAIN MANAGEMENT TEMPLE TX ACTIVE 5/18/2016 None N/A

Q5633 CAVAZOS, ELOY JR, MD 8/14/2015 8/14/2020 INTERNAL MED - PEDS HOUSTON TX ACTIVE 8/19/2015 None N/A

CAVAZOS, REBECA ELIZABETH, NEONATAL- R3485 MD 6/16/2017 6/16/2022 PERINATAL MEDICINE HOUSTON TX ACTIVE 6/29/2017 None N/A NEONATAL- PERINATAL LICENSE S7021 CAYTON, MADELINE CLAIRE, MD 6/12/2020 6/12/2025 PEDIATRICS MEDICINE ISSUED 6/12/2020 None N/A Q5363 CAZZANIGA, STEFANO, MD 8/3/2015 8/3/2020 INTERNAL MEDICINE ARLINGTON TX ACTIVE 8/4/2015 None N/A R2301 CEBRIAN, YVETTE DIANA, MD 4/4/2017 4/4/2022 PEDIATRICS ACTIVE 4/11/2017 None N/A PEDIATRIC CORPUS Q8221 CECIL, KATHRYN WIESMAN, MD 5/16/2016 5/16/2021 ORTHOPEDICS CHRISTI TX ACTIVE 5/20/2016 None N/A Q5634 CEDARS, ARI MICHAEL, MD 8/14/2015 8/14/2020 CARDIOLOGY DALLAS TX ACTIVE 8/17/2015 None N/A MATERNAL AND E5028 CEDARS, LEONARD ALAN, MD 3/3/2017 3/3/2022 FETAL MEDICINE DALLAS TX ACTIVE 3/7/2017 None N/A R2073 CEFALU, JEREMY, MD 3/20/2017 3/20/2022 OPHTHALMOLOGY DALLAS TX ACTIVE 3/22/2017 None N/A S5858 CEGIELSKI, JUSTIN JOSEPH, MD 4/3/2020 4/3/2025 FAMILY MEDICINE AUSTIN TX ACTIVE 5/4/2020 None N/A R1712 CENA, FRANCES KARAM, MD 2/22/2017 2/22/2022 ANESTHESIOLOGY SAN ANTONIO TX ACTIVE 2/27/2017 None N/A PEDIATRIC Q9588 CEPEDA, CELINA DENISE, MD 8/15/2016 8/15/2021 NEPHROLOGY DALLAS TX ACTIVE 8/22/2016 None N/A NORTH EMERGENCY RICHLAND R5527 CEPHAS, JEROME SIRINGAN, MD 1/5/2018 1/5/2023 MEDICINE HILLS TX ACTIVE 1/22/2018 None N/A

R1185 CERANSKE, ANDREW JACOB, MD 1/6/2017 1/6/2022 RADIOLOGY DALLAS TX ACTIVE 1/24/2017 None N/A Q5773 CERVANTES, TESSA JENE, MD 8/28/2015 8/28/2020 DERMATOLOGY SAN ANTONIO TX ACTIVE 8/31/2015 None N/A CERVANTEZ, SHERRI HEMATOLOGY/ONCOL PALLIATIVE R3044 RAUENZAHN, MD 5/22/2017 5/22/2022 OGY MEDICINE SAN ANTONIO TX ACTIVE 5/31/2017 None N/A LICENSE Q5774 CHA, DAVID JEANGUP, MD 8/28/2015 8/28/2020 GENERAL SURGERY ISSUED 8/28/2015 None N/A

Page 51 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date OBSTETRICS AND R3810 CHABARRIA, KRISTIN , MD 7/17/2017 7/17/2022 GYNECOLOGY HOUSTON TX ACTIVE 7/24/2017 None N/A GASTROENTEROLOG Q9309 CHACKO, ABRAHAM, DO 8/1/2016 8/1/2021 Y TOMBALL TX ACTIVE 8/3/2016 None N/A CHACKO, ELIZABETH MATHEWS, PEDIATRIC Q5985 MD 9/15/2015 9/15/2020 PEDIATRICS ENDOCRINOLOGY ALLENTOWN PA ACTIVE 10/26/2015 None N/A HEMATOLOGY/ONCOL Q8851 CHAE, PHILLIP, MD 7/1/2016 7/1/2021 OGY INTERNAL MEDICINE MIDLAND TX ACTIVE 7/4/2016 None N/A PHYSICAL MED. & R3486 CHAI, GERALD, DO 6/16/2017 6/16/2022 REHABILITATION PAIN MEDICINE SAVANNAH GA ACTIVE 7/5/2017 None N/A Q4915 CHAISSON, JORDAN , MD 7/1/2015 7/1/2020 INTERNAL MEDICINE CARDIOLOGY HOUSTON TX ACTIVE 7/2/2015 None N/A R3487 CHAKER, SANA, MD 6/16/2017 6/16/2022 INTERNAL MEDICINE ACTIVE 7/18/2017 None N/A CHILD AND ADOLESCENT COLLEGE Q8702 CHALLAPALLI, VISHNU P, MD 6/10/2016 6/10/2021 PSYCHIATRY PSYCHIATRY STATION TX ACTIVE 6/13/2016 None N/A INTERVENTIONAL Q4916 CHAMARTHY, MURTHY R, MD 7/1/2015 7/1/2020 RADIOLOGY NUCLEAR MEDICINE DALLAS TX ACTIVE 7/7/2015 None N/A CHAMBERS, CLAUDIA SUZETTE, OBSTETRICS AND LICENSE Q8033 MD 5/2/2016 5/2/2021 GYNECOLOGY ISSUED 5/2/2016 None N/A R3488 CHAMBERS, ELIZABETH J, MD 6/16/2017 6/16/2022 NEUROLOGY DALLAS TX ACTIVE 8/21/2017 None N/A CHILD AND ADOLESCENT R2551 CHAMBERS, SHAWN , MD 4/20/2017 4/20/2022 PSYCHIATRY PSYCHIATRY FORT WORTH TX ACTIVE 7/4/2017 None N/A CHAMPLAIN, JACQUELINE MARIE, R1713 MD 2/22/2017 2/22/2022 FAMILY MEDICINE MANOR TX ACTIVE 2/24/2017 None N/A

Q7539 CHAMSI-PASHA, MOHAMMED, MD 3/15/2016 3/15/2021 INTERNAL MEDICINE CARDIOLOGY OMAHA NE ACTIVE 3/18/2016 None N/A R1187 CHAN, CHRISTINA SNOW, MD 1/6/2017 1/6/2022 NEONATOLOGY PEDIATRICS DALLAS TX ACTIVE 2/17/2017 None N/A HAND SURGERY - ORTHOPEDIC Q8449 CHAN, EDWARD SHEI AHU, MD 6/1/2016 6/1/2021 SURGERY SAN ANTONIO TX ACTIVE 6/6/2016 None N/A

Q5986 CHAN, EDWARD Y H, MD 9/15/2015 9/15/2020 THORACIC SURGERY GENERAL SURGERY HOUSTON TX ACTIVE 9/16/2015 None N/A INFECTIOUS Q7339 CHAN, GALANT AU, MD 3/4/2016 3/4/2021 DISEASES INTERNAL MEDICINE HOUSTON TX ACTIVE 3/23/2016 None N/A GASTROENTEROLOG Q5635 CHAN, JOHANNA LEIGH, MD 8/14/2015 8/14/2020 Y INTERNAL MEDICINE HOUSTON TX ACTIVE 8/17/2015 None N/A PEDIATRIC ANESTHESIOLOGY R0372 CHAN, LISA, MD 10/14/2016 10/14/2021 ANESTHESIOLOGY (PEDS) HOUSTON TX ACTIVE 11/30/2016 None N/A

Page 52 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date OBSTETRICS AND Q6814 CHAN, REXANNA , DO 1/6/2016 1/6/2021 GYNECOLOGY PASADENA TX ACTIVE 2/4/2016 None N/A Q9310 CHAN, WINSTON MING TAK , MD 8/1/2016 8/1/2021 GENERAL SURGERY MANSFIELD TX ACTIVE 8/5/2016 None N/A S6586 CHAN, YVONNE YUH-RU, MD 5/15/2020 5/15/2025 PEDIATRIC UROLOGY ACTIVE 5/25/2020 None N/A CHANCELLOR, JOHN RICHIEDEI, S5575 MD 3/20/2020 3/20/2025 OPHTHALMOLOGY HOUSTON TX ACTIVE 3/24/2020 None N/A OBSTETRICS & GYNECOLOGICAL GYNECOLOGIC Q4917 CHANDLER, JESSICA NICOLE, DO 7/1/2015 7/1/2020 SURGERY SURGERY EL PASO TX ACTIVE 7/9/2015 None N/A EMERGENCY R5250 CHANDLER, MARK ROBINSON, MD 11/17/2017 11/17/2022 MEDICINE MIDVALE UT ACTIVE 12/7/2017 None N/A PEDIATRIC CRITICAL R5528 CHANDRAN, ARJUN, MD 1/5/2018 1/5/2023 CARE MEDICINE PEDIATRICS EL PASO TX ACTIVE 2/5/2018 None N/A INTERVENTIONAL Q7340 CHANDRAPRAKASAM, SATISH, MD 3/4/2016 3/4/2021 CARDIOLOGY CARDIOLOGY FORTWORTH TX ACTIVE 4/21/2016 None N/A CHANDRASHEKHAR, RAVINDRA, Q7024 MD 2/1/2016 2/1/2021 INTERNAL MEDICINE SLEEP MEDICINE ACTIVE 2/10/2016 None N/A R0547 CHANG, ALBERT SHU-SEN, MD 10/31/2016 10/31/2021 RADIOLOGY NEURO-RADIOLOGY TAMPA FL ACTIVE 12/20/2016 None N/A DIAGNOSTIC Q7663 CHANG, I-YUAN JOSEPH, MD 4/1/2016 4/1/2021 RADIOLOGY DALLAS TX ACTIVE 6/2/2016 None N/A R0548 CHANG, JAMES HENRY, MD 10/31/2016 10/31/2021 INTERNAL MEDICINE FORT WORTH TX ACTIVE 11/2/2016 None N/A CRITICAL CARE PULMONARY Q4918 CHANG, JESSE LIMMON, MD 7/1/2015 7/1/2020 MEDICINE (IM) DISEASES SAINT LOUIS MO ACTIVE 7/21/2015 None N/A

PEDIATRIC M3981 CHANG, MICHAEL LEE, MD 7/1/2015 7/1/2020 INFECTIOUS DISEASE HOUSTON TX ACTIVE 7/16/2015 None N/A BLOOD BANKING/TRANSFUSI R1005 CHANG, SHELLEY, MD 12/16/2016 12/16/2021 PATHOLOGY ON MEDICINE CARROLLTON TX ACTIVE 12/20/2016 None N/A NORTH LITTLE Q8852 CHANG, THEODORE SEAN, MD 7/1/2016 7/1/2021 PATHOLOGY ROCK AR ACTIVE 7/13/2016 None N/A LICENSE Q5775 CHANGELA, KINJAL, MD 8/28/2015 8/28/2020 INTERNAL MED - PEDS HOUSTON TX ISSUED 8/28/2015 None N/A

NEONATAL- S5577 CHAO, HOWARD, MD 3/20/2020 3/20/2025 PERINATAL MEDICINE PEDIATRICS HOUSTON TX ACTIVE 3/30/2020 None N/A PEDIATRIC R0697 CHAO, HSIAO-TUAN, MD 11/15/2016 11/15/2021 NEUROLOGY HOUSTON TX ACTIVE 11/21/2016 None N/A HEMATOLOGY/ONCO M7905 CHAO, JU HSIEN, DO 3/20/2017 3/20/2022 INTERNAL MEDICINE LOGY LOUISVILLE KY ACTIVE 3/22/2017 None N/A

Page 53 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PEDIATRIC CHAO-KNIZE, YUAN-JIUN NICOLE, ANESTHESIOLOGY Q8853 MD 7/1/2016 7/1/2021 ANESTHESIOLOGY (PEDS) AUSTIN TX ACTIVE 7/11/2016 None N/A Q9311 CHAPEL, KATHERINE MARIE, MD 8/1/2016 8/1/2021 PSYCHIATRY AUSTIN TX ACTIVE 10/4/2016 None N/A HAND SURGERY - ORTHOPEDIC ORTHOPEDIC Q7846 CHAPEL, ROSS JOSEPH, MD 4/15/2016 4/15/2021 SURGERY SURGERY ACTIVE 4/19/2016 None N/A CHAPMAN, ALLA GRIGOREVNA, FAMILY PRACTICE - URGENT CARE - R4196 MD 8/15/2017 8/15/2022 EMERGENCY MED FAMILY PRACTICE SAN ANTONIO TX ACTIVE 8/21/2017 None N/A CHAPPELL, JEANEEN LICENSE Q6501 ANTOINETTE, MD 11/16/2015 11/16/2020 DERMATOLOGY ISSUED 11/16/2015 None N/A CHILD AND ADOLESCENT R2303 CHARLES, CHRISTINE GRACE, MD 4/4/2017 4/4/2022 PSYCHIATRY PSYCHIATRY HOUSTON TX ACTIVE 7/3/2017 None N/A

Q7664 CHARLES, LORRAINE ALEXIS, MD 4/1/2016 4/1/2021 FAMILY MEDICINE ACTIVE 4/6/2016 None N/A EMERGENCY Q7847 CHARLES, MARVINIA, MD 4/15/2016 4/15/2021 MEDICINE IRVING TX ACTIVE 4/18/2016 None N/A CRITICAL CARE CARDIOVASCULAR R1188 CHATTERJEE, SUBHASIS, MD 1/6/2017 1/6/2022 (SURGERY) SURGERY HOUSTON TX ACTIVE 1/9/2017 None N/A INTERVENTIONAL DIAGNOSTIC Q5162 CHAU, ALEX, MD 7/15/2015 7/15/2020 RADIOLOGY RADIOLOGY LUBBOCK TX ACTIVE 7/16/2015 None N/A EMERGENCY Q4919 CHAU, NHAN PHUOC, MD 7/1/2015 7/1/2020 MEDICINE EL PASO TX ACTIVE 7/14/2015 None N/A Q5776 CHAUDHARY, JESSICA, MD 8/28/2015 8/28/2020 PSYCHIATRY PSYCHIATRY DANBURY CT ACTIVE 9/9/2015 None N/A CHAUDHARY, NABEEL YOUSAF, R0549 MD 10/31/2016 10/31/2021 HOSPITALIST INTERNAL MEDICINE AUSTIN TX ACTIVE 12/8/2016 None N/A GRAND Q6163 CHAUDHRY, AISHA BASHIR, MD 10/1/2015 10/1/2020 FAMILY MEDICINE FORKS ND ACTIVE 10/6/2015 None N/A DELINQUEN HEMATOLOGY/ONCOL T-NON R0205 CHAUDHRY, MARIA , MD 9/30/2016 9/30/2021 OGY INTERNAL MEDICINE HOUSTON TX PAYMENT 12/30/2017 None N/A R4197 CHAUDHRY, NUSRAT IJAZ, MD 8/15/2017 8/15/2022 INTERNAL MEDICINE MARTINEZ CA ACTIVE 10/16/2017 None N/A

S6812 CHAUDHRY, UMAR SHAFIQUE, MD 5/29/2020 5/29/2025 RADIOLOGY NEURO-RADIOLOGY GALVESTON TX ACTIVE 6/10/2020 None N/A Q6816 CHAUDHRY, USMAN UL HAQ, MD 1/6/2016 1/6/2021 FAMILY PRACTICE HOSPITALIST PITTSBURGH PA ACTIVE 1/19/2016 None N/A Q5778 CHAUDRY, SALMANN IMTIAZ, DO 8/28/2015 8/28/2020 HOSPITALIST INTERNAL MEDICINE TEMPLE TX ACTIVE 9/1/2015 None N/A INTERVENTIONAL INTERVENTIONAL S4274 CHAUDRY, SHOEB RAFIQ, MD 12/6/2019 12/6/2024 RADIOLOGY RADIOLOGY FORT WORTH TX ACTIVE 12/10/2019 None N/A INTERVENTIONAL INTERVENTIONAL S4274 CHAUDRY, SHOEB RAFIQ, MD 12/6/2019 12/6/2024 RADIOLOGY RADIOLOGY FORT WORTH TX ACTIVE 12/10/2019 None N/A Page 54 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date S6373 CHAUMP, MICHAEL, MD 5/1/2020 5/1/2025 PATHOLOGY TETERBORO NJ ACTIVE 5/5/2020 None N/A Q9975 CHAVA, PRIYANKA, MD 9/15/2016 9/15/2021 PSYCHIATRY TERRELL TX ACTIVE 9/23/2016 None N/A CHAVARRIA, HUMBERTO JOSE, Q6403 MD 11/2/2015 11/2/2020 FAMILY MEDICINE MCALLEN TX ACTIVE 11/4/2015 None N/A PHYSICAL MED. & R5529 CHAVDA, AVINASH SURESH, MD 1/5/2018 1/5/2023 REHABILITATION DALLAS TX ACTIVE 3/13/2018 None N/A CHAVEZ RUIZ, EDUARDO Q8854 ROBERTO, MD 7/1/2016 7/1/2021 PSYCHIATRY PSYCHIATRY HOUSTON TX ACTIVE 7/11/2016 None N/A EMERGENCY S6813 CHAVEZ, SUMMER, DO 5/29/2020 5/29/2025 MEDICINE HOUSTON TX ACTIVE 6/4/2020 None N/A ENDOCRINOLOGY, CHAVEZ-VELAZQUEZ, ALBERTO DIABETES AND LICENSE Q4733 OMAR, MD 6/12/2015 6/12/2020 INTERNAL MEDICINE METABOLISM ISSUED 6/12/2015 None N/A R2304 CHAWLA, ARTHI, MD 4/4/2017 4/4/2022 FAMILY MEDICINE SEATAC WA ACTIVE 4/11/2017 None N/A CHILD AND DELINQUEN ADOLESCENT T-NON R4817 CHAWLA, JATINDER MOHAN, MD 10/6/2017 10/6/2022 PSYCHIATRY PSYCHIATRY PAYMENT 1/4/2018 None N/A EMERGENCY LICENSE Q8451 CHEELA, SHILPA, MD 6/1/2016 6/1/2021 MEDICINE ISSUED 6/1/2016 None N/A Q8452 CHEEMA, BAKHT SULTAN, MD 6/1/2016 6/1/2021 INTERNAL MEDICINE AUSTIN TX ACTIVE 6/13/2016 None N/A CHEEMA, MOHAMMAD HAMMAD, S4928 MD 2/7/2020 2/7/2025 FAMILY MEDICINE SLEEP MEDICINE ACTIVE 2/24/2020 None N/A R1717 CHEEMA, MUBEEN SULTAN, MD 2/22/2017 2/22/2022 INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 3/2/2017 None N/A OSAGE Q8704 CHEEMA, MUHAMMAD Q, MD 6/10/2016 6/10/2021 NEPHROLOGY INTERNAL MEDICINE BEACH MO ACTIVE 6/16/2016 None N/A CHELLIAH, ANUSHKA OBSTETRICS AND MATERNAL AND R3811 MAGDALENE, MD 7/17/2017 7/17/2022 GYNECOLOGY FETAL MEDICINE HOUSTON TX ACTIVE 8/16/2017 None N/A R5709 CHEMTOB, JOSEF, MD 1/19/2018 1/19/2023 INTERNAL MEDICINE HOSPITALIST BROOKLYN NY ACTIVE 1/25/2018 None N/A OTOLOGY/NEUROTO R0698 CHEN, BRIAN SHINRONG, MD 11/15/2016 11/15/2021 OTOLARYNGOLOGY LOGY EL PASO TX ACTIVE 11/18/2016 None N/A S5138 CHEN, DONG, MD 2/21/2020 2/21/2025 PATHOLOGY ST. LOUIS MO ACTIVE 3/6/2020 None N/A R2305 CHEN, EUGENE, MD 4/4/2017 4/4/2022 GENERAL SURGERY ALTUS OK ACTIVE 4/10/2017 None N/A PHYSICAL MED. & Q8855 CHEN, JASON , DO 7/1/2016 7/1/2021 PAIN MEDICINE REHABILITATION BELLAIRE TX ACTIVE 9/2/2016 None N/A

OPHTHALMOLOGY - R2306 CHEN, JINGHUA, MD 4/4/2017 4/4/2022 OPHTHALMOLOGY VITREOUS SURGERY LOUISVILLE KY ACTIVE 4/11/2017 None N/A S4453 CHEN, LELI LAURIE, MD 12/20/2019 12/20/2024 FAMILY MEDICINE WACO TX ACTIVE 4/1/2020 None N/A Q7541 CHEN, LEON , DO 3/15/2016 3/15/2021 INTERNAL MEDICINE PSYCHIATRY ACTIVE 3/23/2016 None N/A HEMATOLOGY R2552 CHEN, MINGYI, MD 4/20/2017 4/20/2022 PATHOLOGY (PATHOLOGY) DALLAS TX ACTIVE 4/27/2017 None N/A Page 55 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date Q8856 CHEN, MUMING , MD 7/1/2016 7/1/2021 FAMILY MEDICINE JOURDANTON TX ACTIVE 7/11/2016 None N/A ANATOMIC/CLINICAL LICENSE S7023 CHEN, PETER PO TAO, MD 6/12/2020 6/12/2025 PATHOLOGY ISSUED 6/12/2020 None N/A R4021 CHEN, SEAN , MD 8/1/2017 8/1/2022 DERMATOLOGY DALLAS TX ACTIVE 10/3/2017 None N/A S5863 CHEN, VICTORIA IAN, DO 4/3/2020 4/3/2025 FAMILY MEDICINE ACTIVE 6/11/2020 None N/A RUSSELLVILL S6589 CHENYI, CHENYI JEFFREY, MD 5/15/2020 5/15/2025 FAMILY MEDICINE E AL ACTIVE 5/20/2020 None N/A CHEPPALLI, NAGA SURESH ORTHOPEDIC R1511 PRASAD REDDY, MD 2/6/2017 2/6/2022 SURGERY HARTSVILLE SC ACTIVE 2/21/2017 None N/A SUN CITY Q9976 CHERIAN, CECIL, MD 9/15/2016 9/15/2021 FAMILY MEDICINE CENTER FL ACTIVE 9/21/2016 None N/A EMERGENCY R1512 CHERIAN, JUSTIN KORAH, DO 2/6/2017 2/6/2022 MEDICINE AUSTIN TX ACTIVE 3/2/2017 None N/A PEDIATRIC S4275 CHERLOPALLE, SUNEELA, MD 12/6/2019 12/6/2024 PSYCHIATRY PSYCHIATRY AUSTIN TX ACTIVE 12/23/2019 None N/A PEDIATRIC S4275 CHERLOPALLE, SUNEELA, MD 12/6/2019 12/6/2024 PSYCHIATRY PSYCHIATRY AUSTIN TX ACTIVE 12/23/2019 None N/A

R4528 CHERUKU, RAVINDER REDDY, MD 9/8/2017 9/8/2022 ANESTHESIOLOGY ACTIVE 9/12/2017 None N/A S4741 CHERY, FARAH, MD 1/24/2020 1/24/2025 FAMILY MEDICINE SAN DIEGO CA ACTIVE 4/29/2020 None N/A GERIATRICS - Q9978 CHESS, DAVID MARK, MD 9/15/2016 9/15/2021 INTERNAL MEDICINE GERIATRICS STRATFORD CT ACTIVE 9/23/2016 None N/A CHEUNG, MICHAEL SHAU-FUNG, EMERGENCY LICENSE Q6616 MD 12/4/2015 12/4/2020 MEDICINE ISSUED 12/4/2015 None N/A CHEUNG, MICHAEL SHAU-FUNG, EMERGENCY Q6616 MD 12/4/2015 12/4/2020 MEDICINE EL PASO TX ACTIVE 1/6/2016 None N/A CHEUNG, MICHAEL SHAU-FUNG, EMERGENCY Q6616 MD 12/4/2015 12/4/2020 MEDICINE EL PASO TX ACTIVE 1/6/2016 None N/A PEDIATRIC Q9591 CHHABRA, MANPREET SINGH, MD 8/15/2016 8/15/2021 OPHTHALMOLOGY OPHTHALMOLOGY SAN ANTONIO TX ACTIVE 8/16/2016 None N/A EMERGENCY LICENSE Q8706 CHHABRIA, ARUNA JYOTHI, MD 6/10/2016 6/10/2021 FAMILY MEDICINE MEDICINE ISSUED 6/10/2016 None N/A M1584 CHI, CYNTHIA YVONNE, MD 9/15/2016 9/15/2021 PEDIATRICS SAN ANTONIO TX ACTIVE 9/19/2016 None N/A Q6404 CHI, JOSE ALBERTO, MD 11/2/2015 11/2/2020 FAMILY MEDICINE LUBBOCK TX ACTIVE 11/4/2015 None N/A R5530 CHI, MICHELLE, MD 1/5/2018 1/5/2023 PAIN MEDICINE PAIN MEDICINE ACTIVE 1/15/2018 None N/A PLASTIC & RECONSTRUCTIVE S5140 CHIA, CHRISTOPHER, MD 2/21/2020 2/21/2025 SURGERY NEW YORK NY ACTIVE 2/26/2020 None N/A S5343 CHIDESTER, JEFFREY PAUL, MD 3/6/2020 3/6/2025 INTERNAL MEDICINE DALLAS TX ACTIVE 3/17/2020 None N/A Q7665 CHIEJINA, MARIA EZIAFA, MD 4/1/2016 4/1/2021 INTERNAL MEDICINE LONGVIEW TX ACTIVE 5/16/2016 None N/A

Page 56 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date LICENSE S7025 CHIHARA, DAI, MD 6/12/2020 6/12/2025 ONCOLOGY ISSUED 6/12/2020 None N/A LICENSE Q5636 CHILAKAPATI, RAJANI K, MD 8/14/2015 8/14/2020 INTERNAL MEDICINE ISSUED 8/14/2015 None N/A PLASTIC & HAND SURGERY - RECONSTRUCTIVE ORTHOPEDIC R4198 CHIM, HARVEY WEI MING, MD 8/15/2017 8/15/2022 SURGERY SURGERY GAINESVILLE FL ACTIVE 8/25/2017 None N/A WILKES R0374 CHIN, MATTHEW STEVEN, MD 10/14/2016 10/14/2021 RADIOLOGY BARRE PA ACTIVE 10/31/2016 None N/A R4199 CHINDHY, SHAHZAD , MD 8/15/2017 8/15/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 8/17/2017 None N/A INTERVENTIONAL CORPUS Q8857 CHING, KEVIN , MD 7/1/2016 7/1/2021 RADIOLOGY RADIOLOGY CHRISTI TX ACTIVE 7/4/2016 None N/A

S5579 CHINICHIAN, SAHMON DANIEL, DO 3/20/2020 3/20/2025 OPHTHALMOLOGY ARLINGTON TX ACTIVE 3/26/2020 None N/A LICENSE Q5369 CHINNAIYAN, PREMNATH, MD 8/3/2015 8/3/2020 PEDIATRICS ISSUED 8/3/2015 None N/A LICENSE S6591 CHINTALAPALLY, RAGHAV, MD 5/15/2020 5/15/2025 FAMILY MEDICINE ISSUED 5/15/2020 None N/A OBSTETRICS AND R3294 CHISHOLM, PADRAIC BAILEY, MD 6/2/2017 6/2/2022 GYNECOLOGY EDINBURG TX ACTIVE 6/13/2017 None N/A PULMONARY CRITICAL CARE Q7343 CHISHTI, WAQAS AHMED, MD 3/4/2016 3/4/2021 MEDICINE DALLAS TX ACTIVE 3/17/2016 None N/A R1718 CHISLEY, TYWANNA L, MD 2/22/2017 2/22/2022 PEDIATRICS MONROE LA ACTIVE 3/20/2017 None N/A PALLIATIVE S5864 CHIU, ALAN SIMON, MD 4/3/2020 4/3/2025 INTERNAL MEDICINE MEDICINE DALLAS TX ACTIVE 4/14/2020 None N/A ANESTHESIOLOGY - ADDICTION S6593 CHO, SHELDON KEE, MD 5/15/2020 5/15/2025 PAIN MANAGEMENT MEDICINE - PM NAPLES FL ACTIVE 5/18/2020 None N/A CHODKIEWICZ, HUBERT MARTIN, DERMATOLOGIC Q5371 MD 8/3/2015 8/3/2020 DERMATOLOGY SURGERY ACTIVE 8/14/2015 None N/A R0209 CHOI, LAURA HARGIE, MD 9/30/2016 9/30/2021 GENERAL SURGERY BAYTOWN TX ACTIVE 10/5/2016 None N/A SAN S4746 CHOI, OLIVIA, MD 1/24/2020 1/24/2025 DERMATOLOGY FRANCISCO CA ACTIVE 1/29/2020 None N/A EMERGENCY R0210 CHOI, RAYMOND , MD 9/30/2016 9/30/2021 MEDICINE SUGAR LAND TX ACTIVE 10/6/2016 None N/A EMERGENCY LICENSE Q5780 CHOI, SE MYUNG, MD 8/28/2015 8/28/2020 MEDICINE ISSUED 8/28/2015 None N/A CARDIOTHORACIC R1352 CHOI, SIMON , MD 1/20/2017 1/20/2022 ANESTHESIOLOGY ANESTHESIOLOGY DALLAS TX ACTIVE 1/26/2017 None N/A GASTROENTEROLOG Q5372 CHOKSHI, REENA VIJAY, MD 8/3/2015 8/3/2020 Y INTERNAL MEDICINE HOUSTON TX ACTIVE 8/12/2015 None N/A Page 57 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date

CHOLLET, HILLARY ANTHONY GENERAL VASCULAR Q6405 ANDREW, MD 11/2/2015 11/2/2020 GENERAL SURGERY SURGERY HARLINGEN TX ACTIVE 11/5/2015 None N/A DIAGNOSTIC R4951 CHONG, INSUN , MD 10/20/2017 10/20/2022 RADIOLOGY HOUSTON TX ACTIVE 10/23/2017 None N/A EMERGENCY R4376 CHONG, SAMUEL LEE, DO 8/25/2017 8/25/2022 MEDICINE HOUSTON TX ACTIVE 8/28/2017 None N/A PSYCHOSOMATIC Q9592 CHOPRA, DEEPTI ARUN, MD 8/15/2016 8/15/2021 PSYCHIATRY MEDICINE HOUSTON TX ACTIVE 8/25/2016 None N/A PEDIATRIC PEDIATRIC S5580 CHORNEY, STEPHEN REED, MD 3/20/2020 3/20/2025 OTOLARYNGOLOGY OTOLARYNGOLOGY DALLAS TX ACTIVE 6/3/2020 None N/A EMERGENCY EMERGENCY R0699 CHOU, ERIC, MD 11/15/2016 11/15/2021 MEDICINE MEDICINE FORT WORTH TX ACTIVE 11/21/2016 None N/A PHYSICAL MED. & R2555 CHOU, HENRY CHEN PU, DO 4/20/2017 4/20/2022 REHABILITATION PAIN & SPINE HERSHEY PA ACTIVE 5/9/2017 None N/A S4931 CHOUCAIR, ALI K, MD 2/7/2020 2/7/2025 NEUROLOGY NEURO-ONCOLOGY AUSTIN TX ACTIVE 2/11/2020 None N/A GASTROENTEROLOG R2556 CHOUDHARY, ABHISHEK, MD 4/20/2017 4/20/2022 Y INTERNAL MEDICINE KANSAS CITY KS ACTIVE 6/22/2017 None N/A S4455 CHOUDHARY, VIVEK , MD 12/20/2019 12/20/2024 INTERNAL MEDICINE EL PASO TX ACTIVE 3/2/2020 None N/A INFECTIOUS Q8227 CHOW, JEREMY YAN-SHUN, MD 5/16/2016 5/16/2021 DISEASES INTERNAL MEDICINE DALLAS TX ACTIVE 5/19/2016 None N/A R6163 CHOW, TIMOTHY , MD 3/2/2018 3/2/2023 PEDIATRICS DALLAS TX ACTIVE 3/19/2018 None N/A WARRENSVILL R3492 CHOWDHRY, AQEEL, MD 6/16/2017 6/16/2022 RADIOLOGY E HEIGHTS OH ACTIVE 7/17/2017 None N/A R4377 CHRISTENSEN, ANGELA, MD 8/25/2017 8/25/2022 RHEUMATOLOGY EDINBURG TX ACTIVE 10/2/2017 None N/A

Q5781 CHRISTNER, JENNIFER GOLD, MD 8/28/2015 8/28/2020 PEDIATRICS HOUSTON TX ACTIVE 9/4/2015 None N/A PEDIATRIC GASTROENTEROLOG Q8453 CHU, ANDREW, MD 6/1/2016 6/1/2021 PEDIATRICS Y HOUSTON TX ACTIVE 6/8/2016 None N/A Q5639 CHU, DANIELLE DAIYUN, MD 8/14/2015 8/14/2020 PEDIATRICS DALLAS TX ACTIVE 8/21/2015 None N/A R5101 CHU, EUGENE, MD 11/3/2017 11/3/2022 HOSPITALIST DALLAS TX ACTIVE 11/29/2017 None N/A R0551 CHU, JAMIE ROBIN, MD 10/31/2016 10/31/2021 PEDIATRICS HOUSTON TX ACTIVE 11/23/2016 None N/A

CLINICAL R3295 CHU, JENNIFER GRACE, MD 6/2/2017 6/2/2022 NEUROLOGY NEUROPHYSIOLOGY HOUSTON TX ACTIVE 6/12/2017 None N/A DIAGNOSTIC Q4923 CHUA-TUAN, JOHN JAMES, MD 7/1/2015 7/1/2020 RADIOLOGY NEURO-RADIOLOGY ACTIVE 7/6/2015 None N/A R0376 CHUDHARY, AMARA S, MD 10/14/2016 10/14/2021 PSYCHIATRY ANDERSON SC ACTIVE 10/31/2016 None N/A R5102 CHUKWU, EBERE O, MD 11/3/2017 11/3/2022 CARDIOLOGY TEMPLE TX ACTIVE 11/7/2017 None N/A

Page 58 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date CHUKWUMAH, LETITIA DANIELLE, Q8455 MD 6/1/2016 6/1/2021 PSYCHIATRY DALLAS TX ACTIVE 6/14/2016 None N/A R4378 CHUM, SNEHA , MD 8/25/2017 8/25/2022 INTERNAL MEDICINE AUSTIN TX ACTIVE 9/7/2017 None N/A R1720 CHUNG, AMY, DO 2/22/2017 2/22/2022 INTERNAL MEDICINE AUSTIN TX ACTIVE 3/14/2017 None N/A RADIATION R5251 CHUNG, CAROLINE, MD 11/17/2017 11/17/2022 ONCOLOGY HOUSTON TX ACTIVE 12/5/2017 None N/A Q7163 CHUNG, HANNAH LIM, MD 2/16/2016 2/16/2021 RADIOLOGY NUCLEAR MEDICINE HOUSTON TX ACTIVE 2/29/2016 None N/A SPORTS MEDICINE- Q7027 CHUNG, JANE S, MD 2/1/2016 2/1/2021 PEDIATRICS PEDS PLANO TX ACTIVE 2/3/2016 None N/A S5344 CHUNG, MARCIA ANNE, MD 3/6/2020 3/6/2025 GENERAL SURGERY LAREDO TX ACTIVE 5/8/2020 None N/A R3650 CIOLETTI, ANNE CARROLL, MD 6/30/2017 6/30/2022 INTERNAL MEDICINE AUSTIN TX ACTIVE 7/18/2017 None N/A Q5989 CIZENSKI, JEFFREY DAVID, MD 9/15/2015 9/15/2020 DERMATOLOGY DALLAS TX ACTIVE 9/17/2015 None N/A SPORTS MEDICINE S6595 CLAFLIN, ROBERT DANIEL, DO 5/15/2020 5/15/2025 FAMILY MEDICINE (FAMILY PRACTICE) MCALLEN TX ACTIVE 5/18/2020 None N/A S5143 CLAIBORNE, JOSEPH LEVI III, MD 2/21/2020 2/21/2025 INTERNAL MEDICINE ACTIVE 3/11/2020 None N/A Q9593 CLARK, AUDRA TESS, MD 8/15/2016 8/15/2021 GENERAL SURGERY DALLAS TX ACTIVE 8/30/2016 None N/A R4200 CLARK, BENJAMIN JOSEPH, MD 8/15/2017 8/15/2022 INTERNAL MEDICINE HOUSTON TX ACTIVE 8/16/2017 None N/A S5865 CLARK, BRANDI , MD 4/3/2020 4/3/2025 PEDIATRICS AUSTIN TX ACTIVE 4/16/2020 None N/A R2830 CLARK, CHARLES LEROY III, MD 5/5/2017 5/5/2022 OPHTHALMOLOGY ABILENE TX ACTIVE 5/9/2017 None N/A GASTROENTEROLOG R2309 CLARK, MATTHEW TIMOTHY, MD 4/4/2017 4/4/2022 INTERNAL MEDICINE Y SPRING TX ACTIVE 4/17/2017 None N/A EMERGENCY S6596 CLARK, MICHAEL BRADLEY, MD 5/15/2020 5/15/2025 MEDICINE TEMPLE TX ACTIVE 5/26/2020 None N/A PLASTIC & CLARKE, CAROLINE ELIZABETH, RECONSTRUCTIVE Q5375 MD 8/3/2015 8/3/2020 SURGERY CONROE TX ACTIVE 8/4/2015 None N/A Q5782 CLARKE, NICHOLAS , MD 8/28/2015 8/28/2020 GENERAL SURGERY DALLAS TX ACTIVE 9/1/2015 None N/A S6375 CLARY, CODY WADE, MD 5/1/2020 5/1/2025 PEDIATRICS SAN ANTONIO TX ACTIVE 5/4/2020 None N/A EMERGENCY Q7668 CLAVER, HAROLD , DO 4/1/2016 4/1/2021 MEDICINE ACTIVE 4/4/2016 None N/A R0847 CLEE, MARK STEVENS, MD 12/2/2016 12/2/2021 PEDIATRICS ACTIVE 1/11/2017 None N/A

S7032 CLEMENTS, TAYLOR WILLIAM, MD 6/12/2020 6/12/2025 INTERNAL MEDICINE TEMPLE TX ACTIVE 6/16/2020 None N/A

R2074 CLENDENINN, DALLIS JELANI, MD 3/20/2017 3/20/2022 ANESTHESIOLOGY HOUSTON TX ACTIVE 3/23/2017 None N/A OBSTETRICS AND MATERNAL AND R1722 CLIFFORD, COREY, DO 2/22/2017 2/22/2022 GYNECOLOGY FETAL MEDICINE HOUSTON TX ACTIVE 3/6/2017 None N/A HEMATOLOGY/ONCO Q9317 CLIFTON, KATHERINE KEANEY, MD 8/1/2016 8/1/2021 INTERNAL MEDICINE LOGY HOUSTON TX ACTIVE 8/9/2016 None N/A S4933 CLINE, ERIC ALLAN, MD 2/7/2020 2/7/2025 FAMILY MEDICINE WACO TX ACTIVE 3/2/2020 None N/A

Page 59 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PEDIATRIC SPORTS MEDICINE - R3493 CLINE, KELLY ELIZABETH, MD 6/16/2017 6/16/2022 ORTHOPEDICS ORTHOPEDICS ACTIVE 7/19/2017 None N/A Q7670 CLINE, MALLORIE TAYLOR, MD 4/1/2016 4/1/2021 ANESTHESIOLOGY DALLAS TX ACTIVE 4/11/2016 None N/A S4278 CLINE, RACHEL LUNA, MD 12/6/2019 12/6/2024 FAMILY MEDICINE WACO TX ACTIVE 12/25/2019 None N/A S4278 CLINE, RACHEL LUNA, MD 12/6/2019 12/6/2024 FAMILY MEDICINE WACO TX ACTIVE 12/25/2019 None N/A GERIATRIC MEDICINE (FAMILY R1935 CLOR, CASEY, MD 3/3/2017 3/3/2022 FAMILY MEDICINE PRACTICE) LAKEWAY TX ACTIVE 3/23/2017 None N/A URGENT CARE - R4023 CLOUTIER, JEANETTE, MD 8/1/2017 8/1/2022 FAMILY MEDICINE FAMILY PRACTICE LAWRENCE MA ACTIVE 8/15/2017 None N/A CLOWER, MATTHEW SIMPSON, LICENSE Q4736 MD 6/12/2015 6/12/2020 RADIOLOGY ISSUED 6/12/2015 None N/A Q9318 COBB, DANIELLE LOUISE, MD 8/1/2016 8/1/2021 GENERAL PRACTICE SAN ANTONIO TX ACTIVE 8/2/2016 None N/A COBOS, FRANKLIN VERGARA II, S6816 MD 5/29/2020 5/29/2025 ANESTHESIOLOGY ACTIVE 6/2/2020 None N/A COCIANNI, RANNIERI MATHEUS, Q6166 MD 10/1/2015 10/1/2020 INTERNAL MEDICINE HOSPITALIST ACTIVE 10/12/2015 None N/A

S4934 COCKERILL, KATHERINE JEAN, MD 2/7/2020 2/7/2025 UROLOGY UROLOGIC SURGERY ACTIVE 2/17/2020 None N/A EMERGENCY S6817 COHEN, JARED LANDON, MD 5/29/2020 5/29/2025 MEDICINE SAN ANTONIO TX ACTIVE 6/8/2020 None N/A CARDIOVASCULAR INTERVENTIONAL R5532 COHEN, JOEL L, DO 1/5/2018 1/5/2023 DISEASES CARDIOLOGY SAN ANTONIO TX ACTIVE 1/29/2018 None N/A EMERGENCY S4614 COHICK, CONNOR , MD 1/10/2020 1/10/2025 MEDICINE FORT WORTH TX ACTIVE 2/10/2020 None N/A Q6406 COLAN, DAVID ROBERT, MD 11/2/2015 11/2/2020 INTERNAL MEDICINE HOSPITALIST ACTIVE 11/3/2015 None N/A COLBERT, WONDIFUL AUBRAYAI, Q7346 MD 3/4/2016 3/4/2021 FAMILY MEDICINE ANGLETON TX ACTIVE 3/15/2016 None N/A

R3298 COLE, ADAM JAMES, MD 6/2/2017 6/2/2022 PATHOLOGY GENERAL PRACTICE GRAPEVINE TX ACTIVE 6/5/2017 None N/A

OPHTHALMOLOGY - OPHTHALMOLOGY - K0687 COLE, JAMES DWIGHT, MD 3/20/2017 3/20/2022 ANTERIOR SURGERY VITREOUS SURGERY EL PASO TX ACTIVE 3/28/2017 None N/A EMERGENCY Q8862 COLE, SADIE , MD 7/1/2016 7/1/2021 MEDICINE DALLAS TX ACTIVE 7/11/2016 None N/A Q6167 COLEMAN, KIONA P, MD 10/1/2015 10/1/2020 FAMILY MEDICINE ACTIVE 10/6/2015 None N/A LICENSE Q8230 COLEMAN, WYCHE T III, MD 5/16/2016 5/16/2021 OPHTHALMOLOGY ISSUED 5/16/2016 None N/A LAKE S6818 COLLARD, KALYN M, MD 5/29/2020 5/29/2025 PEDIATRICS JACKSON TX ACTIVE 6/2/2020 None N/A

Page 60 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date DIAGNOSTIC Q7544 COLLARD, MICHAEL DAVID, MD 3/15/2016 3/15/2021 RADIOLOGY DALLAS TX ACTIVE 3/17/2016 None N/A COLLIE, CHARLTON EASTON JR, R1009 MD 12/16/2016 12/16/2021 INTERNAL MEDICINE ACTIVE 12/21/2016 None N/A OBSTETRICS AND Q6819 COLLINS, LINDEN REID, MD 1/6/2016 1/6/2021 GYNECOLOGY DALLAS TX ACTIVE 1/20/2016 None N/A OBSTETRICS AND Q7671 COLLINS, SABRINA LEE, MD 4/1/2016 4/1/2021 GYNECOLOGY CEDAR PARK TX ACTIVE 4/6/2016 None N/A R4680 COLMENERO, VICTORIA , MD 9/22/2017 9/22/2022 FAMILY MEDICINE WACO TX ACTIVE 9/29/2017 None N/A R3653 COMPTON, AMANDA , MD 6/30/2017 6/30/2022 FAMILY MEDICINE LUBBOCK TX ACTIVE 7/25/2017 None N/A

R1514 COMPTON, MATTHEW PHILLIP, MD 2/6/2017 2/6/2022 NEONATOLOGY PEDIATRICS LONGVIEW TX ACTIVE 5/5/2017 None N/A

Q7672 CONNEELY, SHANNON ELISE, MD 4/1/2016 4/1/2021 PEDIATRICS HOUSTON TX ACTIVE 4/5/2016 None N/A M3197 CONNELLY, ROSINA AVILA, MD 8/1/2017 8/1/2022 PEDIATRICS PEDIATRICS HOUSTON TX ACTIVE 9/1/2017 None N/A S4456 CONNER, JESSE RYAN, MD 12/20/2019 12/20/2024 GENERAL SURGERY HOUSTON TX ACTIVE 1/16/2020 None N/A PHYSICAL MED. & R1515 CONNOR, JOSEPH LUKE JR, MD 2/6/2017 2/6/2022 REHABILITATION ACTIVE 3/20/2017 None N/A

R3299 CONOLLY, MARGARET ANNE, MD 6/2/2017 6/2/2022 PSYCHIATRY UVALDE TX ACTIVE 6/6/2017 None N/A Q5377 CONRAD, ELIZABETH, MD 8/3/2015 8/3/2020 PEDIATRICS HOUSTON TX ACTIVE 8/5/2015 None N/A Q6168 CONSTANTINE, GREGORY M, MD 10/1/2015 10/1/2020 INTERNAL MEDICINE ACTIVE 10/6/2015 None N/A PEDIATRIC S6597 CONSTAS, ALEXANDER JOHN, MD 5/15/2020 5/15/2025 PEDIATRICS INTENSIVE CARE HOUSTON TX ACTIVE 5/21/2020 None N/A CONTRERAS, VICTORIA R5990 GASCOYNE, MD 2/16/2018 2/16/2023 ANESTHESIOLOGY HOUSTON TX ACTIVE 3/6/2018 None N/A LICENSE S5869 CONWAY, JORDAN WILLIAM, MD 4/3/2020 4/3/2025 FAMILY MEDICINE ISSUED 4/3/2020 None N/A R3654 COOK, CALEB , MD 6/30/2017 6/30/2022 PEDIATRICS HOSPITALIST LUBBOCK TX ACTIVE 7/3/2017 None N/A COOK, DIANA CAROLYN GOMEZ, Q5379 MD 8/3/2015 8/3/2020 FAMILY PRACTICE HUTTO TX ACTIVE 8/10/2015 None N/A RADIATION R4024 COOKE, ELLEN , MD 8/1/2017 8/1/2022 ONCOLOGY WICHITA KS ACTIVE 8/8/2017 None N/A PEDIATRIC HEMATOLOGY/ONCOL R3300 COOKSEY, RAVEN M, MD 6/2/2017 6/2/2022 OGY AUSTIN TX ACTIVE 6/7/2017 None N/A COOLEY, ASHLEY SCHRIEWER, PEDIATRICS, R2075 MD 3/20/2017 3/20/2022 CARDIOLOGY SAN ANTONIO TX ACTIVE 4/26/2017 None N/A Q9322 COONEY, ERIN , MD 8/1/2016 8/1/2021 MEDICAL GENETICS PEDIATRICS HOUSTON TX ACTIVE 8/3/2016 None N/A COOPER, CHRISTOPHER JOHN, SURGICAL CRITICAL Q5380 MD 8/3/2015 8/3/2020 TRAUMATIC SURGERY CARE DALLAS TX ACTIVE 8/4/2015 None N/A Page 61 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date EMERGENCY R2837 COOPER, JOHN K , DO 5/5/2017 5/5/2022 MEDICINE PEDIATRICS DALLAS TX ACTIVE 5/16/2017 None N/A ORTHOPEDIC WINSTON- R4531 COOPER, TYLER NEWELL, MD 9/8/2017 9/8/2022 SURGERY SALEM NC ACTIVE 9/20/2017 None N/A S4748 COOPER, WILLIAM, MD 1/24/2020 1/24/2025 THORACIC SURGERY ACTIVE 1/28/2020 None N/A PULMONARY COPELAND, SAMUEL CRITICAL CARE Q9796 WELLINGTON, MD 8/26/2016 8/26/2021 INTERNAL MEDICINE MEDICINE LUBBOCK TX ACTIVE 8/30/2016 None N/A R5991 COPPOLA, ANDREW ALAN, MD 2/16/2018 2/16/2023 FAMILY MEDICINE GARLAND TX ACTIVE 2/22/2018 None N/A CORADO MONTENEGRO, R1939 HENNETH ANTONIETA, MD 3/3/2017 3/3/2022 INTERNAL MEDICINE ACTIVE 3/20/2017 None N/A EMERGENCY R0848 CORAM, HANNAH, DO 12/2/2016 12/2/2021 MEDICINE LONGVIEW TX ACTIVE 1/18/2017 None N/A R2311 CORBIN, ELORA PATTANAIK, MD 4/4/2017 4/4/2022 CHILD NEUROLOGY FORT WORTH TX ACTIVE 6/13/2017 None N/A Q5381 CORBIN, JUSTIN MICHAEL, MD 8/3/2015 8/3/2020 FAMILY MEDICINE FAMILY MEDICINE DUMAS TX ACTIVE 8/5/2015 None N/A ORTHOPEDIC PEDIATRIC R3816 CORCORAN-SCHWARTZ, IAN, MD 7/17/2017 7/17/2022 SURGERY ORTHOPEDICS DALLAS TX ACTIVE 7/19/2017 None N/A EMERGENCY R0378 CORKER, JOHN ROBERT, MD 10/14/2016 10/14/2021 MEDICINE DALLAS TX ACTIVE 10/21/2016 None N/A PLASTIC & CORNEJO ESQUERRA, AGUSTIN , RECONSTRUCTIVE R3301 MD 6/2/2017 6/2/2022 PLASTIC SURGERY SURGERY SAN ANTONIO TX ACTIVE 6/15/2017 None N/A CORNELIO-FLORES, OSCAR Q9594 ALBERTO, MD 8/15/2016 8/15/2021 FAMILY MEDICINE HOUSTON TX ACTIVE 9/7/2016 None N/A CORONA, HILLE CHARMAINE Q5164 VISITACION, MD 7/15/2015 7/15/2020 PEDIATRICS SAN ANTONIO TX ACTIVE 7/16/2015 None N/A INTERNAL MED - R4201 CORONA, JOSE MARIO, MD 8/15/2017 8/15/2022 EMERGENCY MED INTERNAL MEDICINE BROCKTON MA ACTIVE 8/29/2017 None N/A R3817 CORONADO, YUN ANDREW, MD 7/17/2017 7/17/2022 INTERNAL MEDICINE ROCKWALL TX ACTIVE 7/27/2017 None N/A CORRAL GUERRERO, LUIS R2839 CARLOS, MD 5/5/2017 5/5/2022 INTERNAL MEDICINE ACTIVE 5/12/2017 None N/A S5147 CORREA, MARK ARNOLD, MD 2/21/2020 2/21/2025 DERMATOLOGY AUSTIN TX ACTIVE 3/3/2020 None N/A EMERGENCY R4025 CORRICK, RYAN MARSHALL, MD 8/1/2017 8/1/2022 MEDICINE HOUSTON TX ACTIVE 8/2/2017 None N/A R4953 CORSINI, ERIN M, MD 10/20/2017 10/20/2022 GENERAL SURGERY HOUSTON TX ACTIVE 10/26/2017 None N/A CORTELYOU, CHRISTINE R3818 MICHELLE, MD 7/17/2017 7/17/2022 PEDIATRICS DALLAS TX ACTIVE 7/20/2017 None N/A R4381 CORZO, MERYANN , MD 8/25/2017 8/25/2022 FAMILY MEDICINE KATY TX ACTIVE 9/12/2017 None N/A VASCULAR Q7853 COSSEY, TIFFANY , MD 4/15/2016 4/15/2021 NEUROLOGY NEUROLOGY HOUSTON TX ACTIVE 5/12/2016 None N/A

Page 62 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PEDIATRIC S5589 COSTE, FERDINAND LOUIS III, DO 3/20/2020 3/20/2025 PULMONOLOGY PEDIATRICS AUSTIN TX ACTIVE 3/27/2020 None N/A LICENSE R6168 COSTELLO, KATHLEEN , MD 3/2/2018 3/2/2023 PEDIATRICS ISSUED 3/2/2018 None N/A R0553 COTA, DONNA, DO 10/31/2016 10/31/2021 INTERNAL MEDICINE FORT WORTH TX ACTIVE 1/30/2017 None N/A R2558 COTON, CASEY EDWARD, DO 4/20/2017 4/20/2022 PSYCHIATRY TEMPLE TX ACTIVE 5/1/2017 None N/A Q9324 COTTER, JILL , DO 8/1/2016 8/1/2021 FAMILY MEDICINE OBSTETRICS BRYAN TX ACTIVE 8/9/2016 None N/A Q9138 COTTER, MICHAEL PATRICK, MD 7/15/2016 7/15/2021 PEDIATRICS DALLAS TX ACTIVE 9/22/2016 None N/A R3056 COTTER, TIMOTHY, MD 5/22/2017 5/22/2022 RADIOLOGY EL PASO TX ACTIVE 6/2/2017 None N/A CARDIOTHORACIC Q7170 COUCH, MICHAEL CHRISTIAN, MD 2/16/2016 2/16/2021 ANESTHESIOLOGY ANESTHESIOLOGY DALLAS TX ACTIVE 2/17/2016 None N/A

Q5992 COURSEAULT, JAESON KELLY, MD 9/15/2015 9/15/2020 FAMILY MEDICINE SPORTS MEDICINE WACO TX ACTIVE 10/6/2015 None N/A COLON AND RECTAL Q6820 COURSEY, JOSHUA CHARLES , MD 1/6/2016 1/6/2021 SURGERY GENERAL SURGERY HOUSTON TX ACTIVE 1/11/2016 None N/A INTERVENTIONAL DIAGNOSTIC R4202 COURSEY, RICHARD L JR, MD 8/15/2017 8/15/2022 RADIOLOGY RADIOLOGY FARGO ND ACTIVE 8/31/2017 None N/A ANESTHESIOLOGY - R3302 COUSINEAU, DAVID MICHEL, MD 6/2/2017 6/2/2022 ANESTHESIOLOGY PAIN MANAGEMENT TEMPLE TX ACTIVE 8/4/2017 None N/A NEW R2313 COUVILLION, MEGAN POYNOT, MD 4/4/2017 4/4/2022 DERMATOLOGY ORLEANS LA ACTIVE 5/9/2017 None N/A

R1191 COVAULT, MICHEAL RODNEY, MD 1/6/2017 1/6/2022 ANESTHESIOLOGY JACKSON MS ACTIVE 1/12/2017 None N/A LICENSE Q4738 COVIN, YVONNE NICOLLE, MD 6/12/2015 6/12/2020 INTERNAL MEDICINE HOSPITALIST ISSUED 6/12/2015 None N/A ORTHOPEDIC R5711 COVINGTON, CODY JAMES, MD 1/19/2018 1/19/2023 SURGERY OTHER SPECIALTY TEMPLE TX ACTIVE 2/19/2018 None N/A EMERGENCY R5851 COWNE, CAMILLE KATHERINE, MD 2/2/2018 2/2/2023 MEDICINE CORONADO CA ACTIVE 3/19/2018 None N/A GASTROENTEROLOG R0379 COX, CHARLES GUIDO, MD 10/14/2016 10/14/2021 INTERNAL MEDICINE Y ABILENE TX ACTIVE 12/27/2016 None N/A R1941 COX, JOSHUA AARON, MD 3/3/2017 3/3/2022 PLASTIC SURGERY PLASTIC SURGERY WEBSTER TX ACTIVE 3/6/2017 None N/A BROWNSVILL Q5165 COX, SHANNA MARIE, MD 7/15/2015 7/15/2020 ANESTHESIOLOGY E TX ACTIVE 7/24/2015 None N/A SURGICAL BREAST S5148 COX, SOLANGE ERLYN, MD 2/21/2020 2/21/2025 GENERAL SURGERY ONCOLOGY HOUSTON TX ACTIVE 2/27/2020 None N/A

R4203 COZIER ROSS, DIONNE LEAH, MD 8/15/2017 8/15/2022 PEDIATRICS ACTIVE 9/14/2017 None N/A OBSTETRICS AND OBSTETRICS AND S4616 CRAIN, COURTNEY, MD 1/10/2020 1/10/2025 GYNECOLOGY GYNECOLOGY HOUSTON TX ACTIVE 1/14/2020 None N/A

Page 63 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date CRANE, STEPHANIE MICHELLE, EMERGENCY Q7172 MD 2/16/2016 2/16/2021 MEDICINE DALLAS TX ACTIVE 3/14/2016 None N/A PEDIATRIC CRAWFORD, CATHERINE CLAIRE, HEMATOLOGY/ONCOL Q8235 MD 5/16/2016 5/16/2021 OGY PEDIATRICS DALLAS TX ACTIVE 5/20/2016 None N/A

CRAWFORD, COURTNEY OPHTHALMOLOGY - Q7173 MAURICE, MD 2/16/2016 2/16/2021 OPHTHALMOLOGY VITREOUS SURGERY ABILENE TX ACTIVE 2/29/2016 None N/A CRAWFORD, LAKIESHA KITCHEN, ANESTHESIOLOGY - Q8236 MD 5/16/2016 5/16/2021 ANESTHESIOLOGY PAIN MANAGEMENT ACTIVE 6/13/2016 None N/A CRAWFORD, RHASHELIA R4822 SHANTINI, MD 10/6/2017 10/6/2022 INTERNAL MEDICINE CORSICANA TX ACTIVE 10/11/2017 None N/A OBSTETRICS AND Q9798 CRAWFORD, TALIA NICOLE, MD 8/26/2016 8/26/2021 GYNECOLOGY HOUSTON TX ACTIVE 9/23/2016 None N/A OBSTETRICS AND R4954 CREEDON, DOUGLAS J, MD 10/20/2017 10/20/2022 GYNECOLOGY SAN ANTONIO TX ACTIVE 10/24/2017 None N/A

CRENSHAW, GREGORY GENERAL VASCULAR NEW Q7349 DESHAURN, MD 3/4/2016 3/4/2021 SURGERY GENERAL SURGERY ORLEANS LA ACTIVE 3/9/2016 None N/A WICHITA S4281 CRENSHAW, KYRA DAWN, MD 12/6/2019 12/6/2024 FAMILY MEDICINE FALLS TX ACTIVE 12/11/2019 None N/A WICHITA S4281 CRENSHAW, KYRA DAWN, MD 12/6/2019 12/6/2024 FAMILY MEDICINE FALLS TX ACTIVE 12/11/2019 None N/A THORACIC CARDIOVASCULAR CORPUS S5346 CRESPO-VELEZ, WILFREDO, MD 3/6/2020 3/6/2025 SURGERY GENERAL SURGERY CHRISTI TX ACTIVE 3/10/2020 None N/A CRISMON, CHRISTOPHER CHASE, EMERGENCY Q7350 MD 3/4/2016 3/4/2021 MEDICINE CONROE TX ACTIVE 3/8/2016 None N/A CRITELLI, MARGUERITE JOANNA, NEWPORT S6378 MD 5/1/2020 5/1/2025 DERMATOLOGY BEACH CA ACTIVE 5/5/2020 None N/A DIAGNOSTIC LICENSE TM00607 CROCE, KEVIN JAMES, MD 7/15/2015 7/15/2020 RADIOLOGY ISSUED 7/15/2015 None N/A EMERGENCY R5992 CROOK, JEREMY, MD 2/16/2018 2/16/2023 MEDICINE ACTIVE 2/26/2018 None N/A Q7855 CROOMS, JAMISE , MD 4/15/2016 4/15/2021 INTERNAL MEDICINE HOUSTON TX ACTIVE 5/18/2016 None N/A LICENSE R6169 CROSBY, JOSHUA HOLT, MD 3/2/2018 3/2/2023 GENERAL SURGERY ISSUED 3/2/2018 None N/A EMERGENCY R0381 CROSS, WILLIAM IAN, DO 10/14/2016 10/14/2021 MEDICINE ABILENE TX ACTIVE 10/21/2016 None N/A ORTHOPEDIC Q6937 CRUMBIE, DAVID ANTHONY JR, MD 1/15/2016 1/15/2021 SURGERY HOUSTON TX ACTIVE 3/22/2016 None N/A Page 64 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date LICENSE R5993 CRUZ NAVARRO, JOVANY , MD 2/16/2018 2/16/2023 ANESTHESIOLOGY ISSUED 2/16/2018 None N/A PHYSICAL MED. & S5149 CRUZ, LUIS F, MD 2/21/2020 2/21/2025 REHABILITATION NUTRITION ACTIVE 2/27/2020 None N/A Q7856 CRUZ, RIZA ELAINE, MD 4/15/2016 4/15/2021 FAMILY MEDICINE LUBBOCK TX ACTIVE 4/18/2016 None N/A PHYSICAL MED. & SPINE AND SPORTS Q5166 CUBITT, BRADLEY , MD 7/15/2015 7/15/2020 REHABILITATION MEDICINE ADDISON TX ACTIVE 7/22/2015 None N/A

R0702 CULBERSON, NATHAN JAMES, MD 11/15/2016 11/15/2021 FAMILY MEDICINE ACTIVE 11/17/2016 None N/A ANESTHESIOLOGY - GEORGETOW Q8865 CULLING, BRADLEY V, DO 7/1/2016 7/1/2021 ANESTHESIOLOGY PAIN MANAGEMENT N TX ACTIVE 7/7/2016 None N/A LICENSE Q4739 CULNAN, DEREK MARTIN , MD 6/12/2015 6/12/2020 PLASTIC SURGERY GENERAL SURGERY ISSUED 6/12/2015 None N/A R0554 CUMMINGS, CORY LEE, MD 10/31/2016 10/31/2021 FAMILY MEDICINE TEMPLE TX ACTIVE 11/2/2016 None N/A URGENT CARE - Q5993 CUNG, TAM NHAT, DO 9/15/2015 9/15/2020 FAMILY MEDICINE FAMILY PRACTICE FORT WORTH TX ACTIVE 9/16/2015 None N/A CUNNINGHAM, HOLLY BRIANNE, R5105 MD 11/3/2017 11/3/2022 GENERAL SURGERY DALLAS TX ACTIVE 11/8/2017 None N/A Q4740 CUNNINGHAM, LEIGH ERIN, MD 6/12/2015 6/12/2020 PSYCHIATRY HOUSTON TX ACTIVE 6/15/2015 None N/A OBSTETRICS & CUNNINGHAM, WYNTREA GYNECOLOGICAL R3303 LANEICE, MD 6/2/2017 6/2/2022 SURGERY HOUSTON TX ACTIVE 9/18/2017 None N/A SURGICAL CRITICAL R0213 CURCIO, GARY JOSEPH, MD 9/30/2016 9/30/2021 TRAUMATIC SURGERY CARE FT PIERCE FL ACTIVE 10/5/2016 None N/A EMERGENCY S5872 CURET, ADOLPH BERNARD IV, MD 4/3/2020 4/3/2025 MEDICINE DALLAS TX ACTIVE 4/10/2020 None N/A CURRIE, HILARY SIMONE OBSTETRICS AND S5591 FRANCESCHINI, MD 3/20/2020 3/20/2025 GYNECOLOGY SAN ANTONIO TX ACTIVE 3/24/2020 None N/A R4683 CURRIMBHOY, SHARIF , MD 9/22/2017 9/22/2022 DERMATOLOGY DALLAS TX ACTIVE 9/27/2017 None N/A PLASTIC & RECONSTRUCTIVE CRANIOFACIAL S5592 CURRY, EILEEN, MD 3/20/2020 3/20/2025 SURGERY SURGERY AUSTIN TX ACTIVE 3/24/2020 None N/A S5874 CUVILLIER, JAMES , MD 4/3/2020 4/3/2025 INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 4/15/2020 None N/A R3495 CYRIL, ELIZMARY, MD 6/16/2017 6/16/2022 FAMILY MEDICINE HOSPITALIST FORT WORTH TX ACTIVE 7/6/2017 None N/A VASCULAR S5350 CZAP, ALEXANDRA LESLIE, MD 3/6/2020 3/6/2025 NEUROLOGY NEURO-ONCOLOGY HOUSTON TX ACTIVE 3/24/2020 None N/A EMERGENCY R1730 DAGGUBATI, SUBBA RAO, MD 2/22/2017 2/22/2022 MEDICINE SELMA AL ACTIVE 2/24/2017 None N/A

ANESTHESIOLOGY - SAULT SAINTE S5151 DAHA, ALI KHAN, MD 2/21/2020 2/21/2025 ANESTHESIOLOGY PAIN MANAGEMENT MARIE MI ACTIVE 3/31/2020 None N/A Page 65 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PULMONARY PULMONARY CRITICAL CARE CRITICAL CARE Q5785 DAHDEL, MAHER, MD 8/28/2015 8/28/2020 MEDICINE MEDICINE WEBSTER TX ACTIVE 9/14/2015 None N/A R4824 DAHER, RALPH, MD 10/6/2017 10/6/2022 NEPHROLOGY MORGANTON NC ACTIVE 11/1/2017 None N/A Q4742 DAHU, JIRIES SULEIMAN, MD 6/12/2015 6/12/2020 NEPHROLOGY INTERNAL MEDICINE HOUSTON TX ACTIVE 6/18/2015 None N/A Q5167 DAI, WEIWEI, DO 7/15/2015 7/15/2020 NEUROLOGY TEMPLE TX ACTIVE 7/23/2015 None N/A Q9141 DAKER, RASHAD, MD 7/15/2016 7/15/2021 RADIOLOGY BREAST IMAGING KNOXVILLE TN ACTIVE 7/18/2016 None N/A GASTROENTEROLOG GASTROENTEROLOG S5593 DALAPATHI, VIJAY, MD 3/20/2020 3/20/2025 Y Y ROUND ROCK TX ACTIVE 3/23/2020 None N/A R1010 DALELA, ANSHU, MD 12/16/2016 12/16/2021 PEDIATRICS FORT WORTH TX ACTIVE 12/20/2016 None N/A EMERGENCY Q7352 DALIO, JESSICA PAIGE, MD 3/4/2016 3/4/2021 MEDICINE BELLAIRE TX ACTIVE 3/10/2016 None N/A EMERGENCY Q7353 DALIO, JUSTINO NOEL, DO 3/4/2016 3/4/2021 MEDICINE BELLAIRE TX ACTIVE 3/10/2016 None N/A

Q5786 DAMODARAN, SENTHILKUMAR, MD 8/28/2015 8/28/2020 ONCOLOGY INTERNAL MEDICINE HOUSTON TX ACTIVE 8/31/2015 None N/A RADIATION Q9981 DAN, TU DINH, MD 9/15/2016 9/15/2021 ONCOLOGY DALLAS TX ACTIVE 9/16/2016 None N/A DANAWALA, ZEESHAN ASHRAF, Q5169 MD 7/15/2015 7/15/2020 UROLOGY UROLOGIC SURGERY SHENANDOAH TX ACTIVE 9/9/2015 None N/A Q5640 DANDA, DIVYA REDDY, MD 8/14/2015 8/14/2020 INTERNAL MEDICINE HOUSTON TX ACTIVE 8/19/2015 None N/A FACIAL PLASTIC R4956 DANESHRAD, PAYAM, MD 10/20/2017 10/20/2022 OTOLARYNGOLOGY SURGERY TORRANCE CA ACTIVE 10/27/2017 None N/A LICENSE Q4933 DANFORD, JILL MCHENRY, MD 7/1/2015 7/1/2020 UROGYNECOLOGY GYNECOLOGY ISSUED 7/1/2015 None N/A R5107 DANG, ANNA MARGARET, DO 11/3/2017 11/3/2022 FAMILY MEDICINE ACTIVE 11/7/2017 None N/A Q7354 DANG, DANIEL NGOC, MD 3/4/2016 3/4/2021 PATHOLOGY DALLAS TX ACTIVE 3/7/2016 None N/A R2314 DANG, QUOC BAO NHU, DO 4/4/2017 4/4/2022 GENERAL SURGERY SAN ANTONIO TX ACTIVE 6/13/2017 None N/A STATEN S7035 DANIEL, MINA, MD 6/12/2020 6/12/2025 INTERNAL MEDICINE ISLAND NY ACTIVE 6/15/2020 None N/A BLOOD DANIEL-JOHNSON, JENNIFER LABORATORY BANKING/TRANSFUSI Q7175 ALISON, MD 2/16/2016 2/16/2021 MEDICINE ON MEDICINE SAN ANTONIO TX ACTIVE 5/13/2016 None N/A

R2315 DANIELS, FELICIA CHRISTINE, MD 4/4/2017 4/4/2022 PEDIATRICS EL PASO TX ACTIVE 5/3/2017 None N/A S5351 DANIYAN, OPEOLUWA, MD 3/6/2020 3/6/2025 OTOLARYNGOLOGY ACTIVE 4/6/2020 None N/A ORTHOPEDIC FOOT AND ANKLE, R4535 DANNA, NATALIE R , MD 9/8/2017 9/8/2022 SURGERY ORTHOPEDICS DALLAS TX ACTIVE 9/11/2017 None N/A DAO CAMPI, HAISAR EDUARDO, COLON AND RECTAL Q8458 MD 6/1/2016 6/1/2021 GENERAL SURGERY SURGERY BOSTON MA ACTIVE 6/3/2016 None N/A Q5386 DAO, JASMINE QUYNH, MD 8/3/2015 8/3/2020 PEDIATRICS HOUSTON TX ACTIVE 8/4/2015 None N/A Page 66 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date LICENSE Q8042 DARWIN, ANDREW JORDAN, DO 5/2/2016 5/2/2021 INTERNAL MEDICINE ISSUED 5/2/2016 None N/A LICENSE Q6174 DARWISH, TAREK, MD 10/1/2015 10/1/2020 INTERNAL MEDICINE NEPHROLOGY ISSUED 10/1/2015 None N/A DARZYNKIEWICZ, ROBERT JOHN, EMERGENCY R5994 MD 2/16/2018 2/16/2023 MEDICINE TRUCKEE CA ACTIVE 2/21/2018 None N/A PEDIATRIC CRITICAL Q9596 DAS, ASHIMA RANI, MD 8/15/2016 8/15/2021 PEDIATRICS CARE MEDICINE DALLAS TX ACTIVE 9/9/2016 None N/A

S6381 DAS, CHANDAN KUMAR, MD 5/1/2020 5/1/2025 THORACIC SURGERY GENERAL SURGERY TOLEDO OH ACTIVE 5/18/2020 None N/A LICENSE Q5387 DAS, JISHU KINGKAR, MD 8/3/2015 8/3/2020 INTERNAL MEDICINE ISSUED 8/3/2015 None N/A

CLINICAL R0215 DAS, ROHIT RAU, MD 9/30/2016 9/30/2021 NEUROLOGY NEUROPHYSIOLOGY DALLAS TX ACTIVE 10/4/2016 None N/A Q5995 DATLA, SWATHI, MD 9/15/2015 9/15/2020 FAMILY MEDICINE HOSPITALIST SPRINGFILED OH ACTIVE 9/24/2015 None N/A EMERGENCY Q7673 DATTA, SOUMITRA, DO 4/1/2016 4/1/2021 MEDICINE INTERNAL MEDICINE GARDEN CITY MI ACTIVE 5/20/2016 None N/A S4366 DAVAULT, LINDSAY JANE, MD 12/6/2019 12/6/2024 GENERAL SURGERY DURANT OK ACTIVE 12/17/2019 None N/A S4366 DAVAULT, LINDSAY JANE, MD 12/6/2019 12/6/2024 GENERAL SURGERY DURANT OK ACTIVE 12/17/2019 None N/A Q8044 DAVE, HINA , MD 5/2/2016 5/2/2021 NEUROLOGY ACTIVE 5/18/2016 None N/A GASTROENTEROLOG R2563 DAVEE, ROY T , MD 4/20/2017 4/20/2022 Y INTERNAL MEDICINE HOUSTON TX ACTIVE 5/1/2017 None N/A PEDIATRIC HEMATOLOGY/ONCOL N1344 DAVES, MARLA HAWKINS, MD 7/1/2015 7/1/2020 OGY PEDIATRICS HOUSTON TX ACTIVE 7/7/2015 None N/A EMERGENCY R3496 DAVEY, KEVIN, MD 6/16/2017 6/16/2022 MEDICINE ACTIVE 6/20/2017 None N/A DAVEY-RANASINGHE, NICOLE LEE, R5108 MD 11/3/2017 11/3/2022 RHEUMATOLOGY INTERNAL MEDICINE AMARILLO TX ACTIVE 11/9/2017 None N/A R3824 DAVID, JENNIFER, DO 7/17/2017 7/17/2022 DERMATOLOGY IRVING TX ACTIVE 7/19/2017 None N/A R2564 DAVID, SHERLINE RACHEL, DO 4/20/2017 4/20/2022 PEDIATRICS ACTIVE 5/29/2017 None N/A R1516 DAVIDOFF, ALAN BRETT, MD 2/6/2017 2/6/2022 RADIOLOGY HOUSTON TX ACTIVE 3/17/2017 None N/A Q8867 DAVIDSON, ALLISON JANE, DO 7/1/2016 7/1/2021 NEONATOLOGY HOUSTON TX ACTIVE 7/20/2016 None N/A DAVIDSON, DEEPAK Q8240 MANAPPALLIL, MD 5/16/2016 5/16/2021 PSYCHIATRY ROUND ROCK TX ACTIVE 6/6/2016 None N/A DAVIDSON, RUSSELL GORDON, EMERGENCY LICENSE Q5788 MD 8/28/2015 8/28/2020 MEDICINE ISSUED 8/28/2015 None N/A DAVIES JONES, OLUBUKOLA Q6407 ADUKE, MD 11/2/2015 11/2/2020 INTERNAL MEDICINE DALLAS TX ACTIVE 11/9/2015 None N/A

Page 67 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date CRITICAL CARE GRAND S4284 DAVIES, OLUWASEUN, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE MEDICINE (IM) RAPIDS MI ACTIVE 2/26/2020 None N/A CRITICAL CARE GRAND S4284 DAVIES, OLUWASEUN, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE MEDICINE (IM) RAPIDS MI ACTIVE 2/26/2020 None N/A PEDIATRIC THORACIC CARDIOTHORACIC CARDIOVASCULAR R3497 DAVIES, RYAN R, MD 6/16/2017 6/16/2022 SURGERY SURGERY DALLAS TX ACTIVE 6/20/2017 None N/A LICENSE S6602 DAVIES, TABITHA , DO 5/15/2020 5/15/2025 FAMILY MEDICINE OBSTETRICS ISSUED 5/15/2020 None N/A GERIATRIC MEDICINE R1194 DAVILA LOURIDO, NADYA S, MD 1/6/2017 1/6/2022 (INTERNAL MED) INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 1/23/2017 None N/A R1517 DAVIS, JAMES RICHARD, MD 2/6/2017 2/6/2022 GENERAL SURGERY ACTIVE 3/15/2017 None N/A PEDIATRIC EMERGENCY R4957 DAVIS, JUSTIN RANDOLPH, MD 10/20/2017 10/20/2022 MEDICINE (PEDS) ACTIVE 10/30/2017 None N/A PEDIATRIC CRITICAL R3825 DAVIS, KASEY ILENE, MD 7/17/2017 7/17/2022 CARE MEDICINE ACTIVE 7/19/2017 None N/A OPHTHALMOLOGY - Q5641 DAVIS, LINDSAY TAYLOR, MD 8/14/2015 8/14/2020 OPHTHALMOLOGY GLAUCOMA GRAPEVINE TX ACTIVE 8/28/2015 None N/A SURGICAL CRITICAL R0557 DAVIS, MILLARD ANDREW, MD 10/31/2016 10/31/2021 TRAUMATIC SURGERY CARE HOUSTON TX ACTIVE 12/9/2016 None N/A Q9143 DAVIS, NAOMI J, MD 7/15/2016 7/15/2021 FAMILY MEDICINE MCALLEN TX ACTIVE 8/8/2016 None N/A S5876 DAVIS, ROBERT TAYLOR, MD 4/3/2020 4/3/2025 OPHTHALMOLOGY DALLAS TX ACTIVE 4/17/2020 None N/A DERMATOPATHOLO S5354 DAVIS, TRACY LYNN, MD 3/6/2020 3/6/2025 PATHOLOGY GY TUCSON AZ ACTIVE 3/12/2020 None N/A DAVIS-KANKANAMGE, CHRISTINA OBSTETRICS AND R3059 NICOLE, MD 5/22/2017 5/22/2022 GYNECOLOGY HOUSTON TX ACTIVE 5/31/2017 None N/A DAVULURI, BALA KOTESWARA R1943 RAO, MD 3/3/2017 3/3/2022 NEUROLOGY GREEN BAY WI ACTIVE 5/31/2017 None N/A RADIATION R2317 DAVULURI, RAJAYOGESH, MD 4/4/2017 4/4/2022 ONCOLOGY WEBSTER TX ACTIVE 4/5/2017 None N/A

R4028 DAWSON, AMBER, MD 8/1/2017 8/1/2022 INTERNAL MED - PEDS TYLER TX ACTIVE 8/15/2017 None N/A R1519 DAWSON, JAMES LAGAMO, DO 2/6/2017 2/6/2022 INTERNAL MEDICINE ACTIVE 2/7/2017 None N/A PLASTIC SURGERY WITHIN THE HEAD R4029 DAY, ANDREW THOMAS, MD 8/1/2017 8/1/2022 OTOLARYNGOLOGY AND NECK DALLAS TX ACTIVE 8/4/2017 None N/A JACKSONVILL R4030 DAY, JEREMY , MD 8/1/2017 8/1/2022 FAMILY MEDICINE E TX ACTIVE 8/11/2017 None N/A

Page 68 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date OCCUPATIONAL ENVIRONMENTAL S4286 DAYWALKER, ROSANDRA L, MD 12/6/2019 12/6/2024 GENERAL PRACTICE MEDICINE ACTIVE 12/16/2019 None N/A OCCUPATIONAL ENVIRONMENTAL S4286 DAYWALKER, ROSANDRA L, MD 12/6/2019 12/6/2024 GENERAL PRACTICE MEDICINE ACTIVE 12/16/2019 None N/A DE BENEDETTI ZUNINO, MARIA CARDIOVASCULAR R5109 ELENA, MD 11/3/2017 11/3/2022 INTERNAL MEDICINE DISEASES EL PASO TX ACTIVE 11/7/2017 None N/A DE ERAUSQUIN, GABRIEL R2567 ALEJANDRO, MD 4/20/2017 4/20/2022 NEUROLOGY PSYCHIATRY HARLINGEN TX ACTIVE 4/24/2017 None N/A DE GENT, GUY ELISE CONSTANT, CRITICAL CARE R1196 MD 1/6/2017 1/6/2022 MEDICINE (IM) INTERNAL MEDICINE ST. LOUIS MO ACTIVE 2/3/2017 None N/A R3308 DE HAAN, JOHANNA BLAIR, MD 6/2/2017 6/2/2022 ANESTHESIOLOGY HOUSTON TX ACTIVE 6/6/2017 None N/A PULMONARY DE HOYOS ZAMBRANO, PATRICIO , CRITICAL CARE R6170 MD 3/2/2018 3/2/2023 MEDICINE INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 3/7/2018 None N/A DE HOYOS, ALBERTO LEOPOLDO, NEW J4072 MD 8/3/2015 8/3/2020 THORACIC SURGERY GENERAL SURGERY ORLEANS LA ACTIVE 8/10/2015 None N/A DE JESUS PIZA, GEORGETTE R1734 MARIE, MD 2/22/2017 2/22/2022 PSYCHIATRY LAREDO TX ACTIVE 3/15/2017 None N/A DE LA GARZA, ELIZABETH MARIE, OBSTETRICS AND R2568 MD 4/20/2017 4/20/2022 GYNECOLOGY ACTIVE 5/18/2017 None N/A PREVENTIVE R2569 DE LA TORRE, ALFRED, MD 4/20/2017 4/20/2022 FAMILY MEDICINE MEDICINE CROWLEY TX ACTIVE 4/24/2017 None N/A PALLIATIVE Q5789 DE LEON, ELAINE SAQUI, MD 8/28/2015 8/28/2020 FAMILY MEDICINE MEDICINE HOUSTON TX ACTIVE 9/8/2015 None N/A

R5255 DE PAULA, FRANK PASCUALIN, MD 11/17/2017 11/17/2022 FAMILY MEDICINE SUGAR LAND TX ACTIVE 11/24/2017 None N/A PULMONARY DE SILVA, PALLA MULLA CRITICAL CARE ARANSAS R2841 KAPUGAMAGE RIVI, MD 5/5/2017 5/5/2022 MEDICINE INTERNAL MEDICINE PASS TX ACTIVE 7/21/2017 None N/A DE TRINIDAD CASTRO, JOSIAS BROWNSVILL R0703 GUILLERMO, MD 11/15/2016 11/15/2021 INTERNAL MEDICINE E TX ACTIVE 1/6/2017 None N/A EMERGENCY R1012 DEAKTER, DANIEL ROBERT, MD 12/16/2016 12/16/2021 MEDICINE BOCA RATON FL ACTIVE 12/21/2016 None N/A DEBERARDINO, THOMAS ORTHOPEDIC SPORTS MEDICINE - Q9597 MICHAEL, MD 8/15/2016 8/15/2021 SURGERY ORTHOPEDICS SAN ANTONIO TX ACTIVE 8/22/2016 None N/A PULMONARY CRITICAL CARE R5538 DEBIANE, LABIB GILLES , MD 1/5/2018 1/5/2023 MEDICINE INTERNAL MEDICINE DETROIT MI ACTIVE 1/26/2018 None N/A

Page 69 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date OBSTETRICS AND S4620 DEBNATH, PRIYANKA , MD 1/10/2020 1/10/2025 GYNECOLOGY DALLAS TX ACTIVE 1/14/2020 None N/A DECLAN, ARWEN BEATRICE LONG, EMERGENCY R0705 MD 11/15/2016 11/15/2021 MEDICINE PUEBLO CO ACTIVE 11/29/2016 None N/A GASTROENTEROLOG R3657 DEDANIA, BHAVTOSH KANJI, MD 6/30/2017 6/30/2022 INTERNAL MEDICINE Y HOUSTON TX ACTIVE 7/4/2017 None N/A Q9145 DEGNON, CHRISTINE ANNE, MD 7/15/2016 7/15/2021 FAMILY MEDICINE MCALLEN TX ACTIVE 7/19/2016 None N/A EMERGENCY R1013 DEHNING, MEAGHAN , MD 12/16/2016 12/16/2021 MEDICINE DALLAS TX ACTIVE 1/9/2017 None N/A DELA CRUZ, KRISTOPHER GABAS, R1944 MD 3/3/2017 3/3/2022 INTERNAL MEDICINE ORANGE TX ACTIVE 4/7/2017 None N/A DELBECQ, ERICA STEINVORTH, R3826 MD 7/17/2017 7/17/2022 INTERNAL MED - PEDS HOUSTON TX ACTIVE 7/19/2017 None N/A TRAUMATIC Q6744 DELEON, ASHLEY NICOLE, MD 12/15/2015 12/15/2020 GENERAL SURGERY SURGERY AUSTIN TX ACTIVE 1/19/2016 None N/A S5355 DELEON, KRYSTAL DAWN, MD 3/6/2020 3/6/2025 FAMILY MEDICINE CONROE TX ACTIVE 3/23/2020 None N/A DELGADO RAMOS, FABRIZZIO R5997 ANDRES, MD 2/16/2018 2/16/2023 PSYCHIATRY BRONX NY ACTIVE 3/7/2018 None N/A OBSTETRICS AND Q8460 DENNARD, AUSTIN, DO 6/1/2016 6/1/2021 GYNECOLOGY DALLAS TX ACTIVE 6/6/2016 None N/A R1946 DENNIS, JAKE ANDREW, MD 3/3/2017 3/3/2022 PATHOLOGY DALLAS TX ACTIVE 3/6/2017 None N/A R0851 DEOKER, ABHIZITH, MD 12/2/2016 12/2/2021 INTERNAL MEDICINE EL PASO TX ACTIVE 12/6/2016 None N/A R2843 DEOLAPURE, SANJEEVANI , MD 5/5/2017 5/5/2022 FAMILY MEDICINE OBSTETRICS SAN ANTONIO TX ACTIVE 6/15/2017 None N/A CRITICAL CARE G9448 DEPPE, SCOTT ALLEN, MD 7/1/2016 7/1/2021 INTERNAL MEDICINE MEDICINE (IM) SIOUX FALLS SD ACTIVE 7/19/2016 None N/A

Q5996 DERAMO, JENNIFER SHULER, MD 9/15/2015 9/15/2020 PEDIATRICS DALLAS TX ACTIVE 9/17/2015 None N/A S5157 DERISAVIFARD, SAMIR, MD 2/21/2020 2/21/2025 UROLOGIC SURGERY UROGYNECOLOGY ACTIVE 3/9/2020 None N/A GASTROENTEROLOG R2573 DESAI, AMIT P, MD 4/20/2017 4/20/2022 Y INTERNAL MEDICINE DALLAS TX ACTIVE 7/4/2017 None N/A R0560 DESAI, DIMPLE PATEL, MD 10/31/2016 10/31/2021 FAMILY MEDICINE EDINBURG TX ACTIVE 11/2/2016 None N/A PLASTIC & RECONSTRUCTIVE Q4574 DESAI, KUNJ KISHORE, MD 6/1/2015 6/1/2020 SURGERY HAND SURGERY SAN ANTONIO TX ACTIVE 6/8/2015 None N/A CHILD AND ADOLESCENT Q9148 DESAI, MUKESH INDUBHAI, MD 7/15/2016 7/15/2021 PSYCHIATRY PSYCHIATRY ACTIVE 9/26/2016 None N/A Q5997 DESAI, NINA, MD 9/15/2015 9/15/2020 FAMILY MEDICINE ACTIVE 9/17/2015 None N/A S6603 DESAI, PATHIK JATIN, MD 5/15/2020 5/15/2025 FAMILY MEDICINE ACTIVE 5/21/2020 None N/A PHYSICAL MED. & Q9984 DESAI, SIMA YOGESH, MD 9/15/2016 9/15/2021 REHABILITATION DALLAS TX ACTIVE 9/21/2016 None N/A Page 70 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date NEUROLOGICAL Q9799 DESAI, SOHUM KIRAN, MD 8/26/2016 8/26/2021 SURGERY MCALLEN TX ACTIVE 9/23/2016 None N/A PEDIATRIC Q4938 DESALVO, DANIEL JOSEPH, MD 7/1/2015 7/1/2020 ENDOCRINOLOGY HOUSTON TX ACTIVE 7/15/2015 None N/A DESHMUKH, SATYAJIT EMERGENCY NEW Q5171 HANUMANT, MD 7/15/2015 7/15/2020 MEDICINE INTERNAL MEDICINE BRAUNFELS TX ACTIVE 7/20/2015 None N/A SPORTS MEDICINE - Q7355 DETTLING, JAMES RICHARD, MD 3/4/2016 3/4/2021 ORTHOPEDICS ORTHOPEDICS ACTIVE 3/15/2016 None N/A R3311 DETTORI, AMY B, MD 6/2/2017 6/2/2022 PEDIATRICS DALLAS TX ACTIVE 6/6/2017 None N/A EMERGENCY R3060 DEUTSCH, JEROME CHARLES, DO 5/22/2017 5/22/2022 MEDICINE FAMILY MEDICINE ALLENTOWN PA ACTIVE 6/23/2017 None N/A DEVESH, VARALAKSHMI EMERGENCY Q5389 JHINGADE, MD 8/3/2015 8/3/2020 FAMILY MEDICINE MEDICAL SERVICES GAINESVILLE TX ACTIVE 8/19/2015 None N/A EMERGENCY Q8046 DEVINE, BRENDAN PATRICK, MD 5/2/2016 5/2/2021 MEDICINE HOUSTON TX ACTIVE 5/4/2016 None N/A

Q6823 DEVNANI, AVINASH NANIKRAM, MD 1/6/2016 1/6/2021 RADIOLOGY TUCSON AZ ACTIVE 2/15/2016 None N/A ORTHOPEDIC SPORTS MEDICINE Q5643 DEWAN, ASHVIN KUMAR, MD 8/14/2015 8/14/2020 SURGERY (ORTH SURG) SUGAR LAND TX ACTIVE 8/25/2015 None N/A OPHTHALMOLOGY - Q4939 DEWAN, VINAY NEIL, MD 7/1/2015 7/1/2020 OPHTHALMOLOGY GLAUCOMA DALLAS TX ACTIVE 7/7/2015 None N/A Q5173 DEWATERS, AMI L, MD 7/15/2015 7/15/2020 INTERNAL MEDICINE DALLAS TX ACTIVE 7/17/2015 None N/A R4685 DEWITT, BLAKE ALAN, MD 9/22/2017 9/22/2022 FAMILY MEDICINE TUSCALOOSA AL ACTIVE 10/17/2017 None N/A DHAMDHERE, SAYLEE SHIRISH, PHYSICAL MED. & LICENSE R6171 MD 3/2/2018 3/2/2023 REHABILITATION ISSUED 3/2/2018 None N/A R4830 DHAMI, TEJI SHRIKUMAR, MD 10/6/2017 10/6/2022 INTERNAL MEDICINE LUFKIN TX ACTIVE 10/10/2017 None N/A ANATOMIC/CLINICAL Q5174 DHAMNE, SAGAR ANIL, MD 7/15/2015 7/15/2020 PATHOLOGY PATHOLOGY ACTIVE 7/21/2015 None N/A DHAMOTHARAN, SUNDAR ALVIN, R0218 MD 9/30/2016 9/30/2021 INTERNAL MEDICINE PEARLAND TX ACTIVE 10/11/2016 None N/A

R0385 DHANOA, NARPINDER SINGH, MD 10/14/2016 10/14/2021 INTERNAL MEDICINE TYLER TX ACTIVE 11/22/2016 None N/A Q7859 DHAR, MRINAL, MD 4/15/2016 4/15/2021 UROLOGY HOUSTON TX ACTIVE 4/19/2016 None N/A R1736 DHARAMSI, LATIF M, MD 2/22/2017 2/22/2022 OTOLARYNGOLOGY AUSTIN TX ACTIVE 5/16/2017 None N/A EMERGENCY R5717 DHILLON, BIKRAM S, MD 1/19/2018 1/19/2023 MEDICINE SCHAUMBURG IL ACTIVE 1/23/2018 None N/A PULMONARY DHINGANI, DARSHAN CRITICAL CARE Q9985 RAMESHCHANDRA, MD 9/15/2016 9/15/2021 MEDICINE INTERNAL MEDICINE SACRAMENTO CA ACTIVE 9/16/2016 None N/A

Page 71 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date CARDIAC ELECTROPHYSIOLOG Q8871 DHIR, SUMER, MD 7/1/2016 7/1/2021 Y CARDIOLOGY TOPEKA KS ACTIVE 7/11/2016 None N/A EMERGENCY S4288 DIAB, DIAB, MD 12/6/2019 12/6/2024 MEDICINE ACTIVE 12/20/2019 None N/A EMERGENCY S4288 DIAB, DIAB, MD 12/6/2019 12/6/2024 MEDICINE ACTIVE 12/20/2019 None N/A EMERGENCY Q9331 DIAMANT, PAIGE ALISON, MD 8/1/2016 8/1/2021 MEDICINE FORT WORTH TX ACTIVE 8/31/2016 None N/A PLASTIC & RECONSTRUCTIVE HAND SURGERY - S5596 DIAMOND, SHAWN, MD 3/20/2020 3/20/2025 SURGERY PLASTIC SURGERY EL PASO TX ACTIVE 4/15/2020 None N/A DIAZ REYES, GUSTAVO ADOLFO, OTORHINOLARYNGOL HEAD AND NECK Q9332 MD 8/1/2016 8/1/2021 OGY SURGERY KYLE TX ACTIVE 10/19/2016 None N/A OCCUPATIONAL OCCUPATIONAL ENVIRONMENTAL R3312 DIAZ, JUAN C, MD 6/2/2017 6/2/2022 MEDICINE MEDICINE ANNISTON AL ACTIVE 8/9/2017 None N/A R4210 DIAZ-RIOS, KRISTAN TARA, MD 8/15/2017 8/15/2022 FAMILY MEDICINE MCALLEN TX ACTIVE 9/8/2017 None N/A EMERGENCY R3061 DIB, SASHA MICHAEL, MD 5/22/2017 5/22/2022 MEDICINE FORT WORTH TX ACTIVE 6/5/2017 None N/A ADULT ORTHOPEDIC RECONSTRUCTIVE S5597 DIBRA, FLORIAN FRANCIS, MD 3/20/2020 3/20/2025 SURGERY ORTHOPEDICS FRISCO TX ACTIVE 3/24/2020 None N/A PEDIATRIC HEMATOLOGY/ONCOL R2082 DICKERSON, KATHRYN ELYSE, MD 3/20/2017 3/20/2022 OGY PEDIATRICS DALLAS TX ACTIVE 3/22/2017 None N/A PSYCHOSOMATIC R3660 DIDARIO, MARIE ELIZABETH, DO 6/30/2017 6/30/2022 PSYCHIATRY MEDICINE DALLAS TX ACTIVE 7/6/2017 None N/A CRITICAL CARE Q7177 DIDYUK, OKSANA, MD 2/16/2016 2/16/2021 ANESTHESIOLOGY ANESTHESIOLOGY ACTIVE 2/29/2016 None N/A S5598 DIEP, BRIAN, MD 3/20/2020 3/20/2025 FAMILY MEDICINE CHULA VISTA CA ACTIVE 3/23/2020 None N/A DIETEMANN, DANIEL WEBSTER, EMERGENCY S5881 DO 4/3/2020 4/3/2025 MEDICINE KALAMAZOO MI ACTIVE 4/15/2020 None N/A R2845 DIETLE, EMILY GLASS, MD 5/5/2017 5/5/2022 PEDIATRICS HOUSTON TX ACTIVE 5/10/2017 None N/A

DIETRICH, LESLIE-ANNE JUAREZ, NEONATAL- S5361 MD 3/6/2020 3/6/2025 PERINATAL MEDICINE PEDIATRICS SAN ANTONIO TX ACTIVE 3/18/2020 None N/A R4537 DIETZ, STEPHEN ROBERT, MD 9/8/2017 9/8/2022 PEDIATRICS HOSPITALIST DALLAS TX ACTIVE 9/27/2017 None N/A

R1737 DIGIOVANNI, RYAN ANDREW, MD 2/22/2017 2/22/2022 ANESTHESIOLOGY TEMPLE TX ACTIVE 2/24/2017 None N/A

Page 72 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date

NEURO-PHYSIOLOGY Q5176 DIKE, NNAMDI CHIMA, DO 7/15/2015 7/15/2020 NEUROLOGY (NEUROLOGY) FRISCO TX ACTIVE 7/16/2015 None N/A EMERGENCY Q5790 DILLE, RENEE , MD 8/28/2015 8/28/2020 MEDICINE AUSTIN TX ACTIVE 9/3/2015 None N/A EMERGENCY HARKER R4686 DILLMAN, KELLY MAUREEN, DO 9/22/2017 9/22/2022 MEDICINE HEIGHTS TX ACTIVE 9/27/2017 None N/A ENDOCRINOLOGY, DIABETES AND R2575 DIMACHKIE, PERIHAN, MD 4/20/2017 4/20/2022 INTERNAL MEDICINE METABOLISM DALLAS TX ACTIVE 5/30/2017 None N/A PEDIATRIC HEAD AND NECK R3062 DIMACHKIEH, AMY LI, MD 5/22/2017 5/22/2022 OTOLARYNGOLOGY SURGERY HOUSTON TX ACTIVE 6/1/2017 None N/A HAND SURGERY - ORTHOPEDIC THE R2576 DIMACHKIEH, OMAR SAAD, MD 4/20/2017 4/20/2022 SURGERY WOODLANDS TX ACTIVE 5/1/2017 None N/A PEDIATRIC R4212 DIN, FARID UD, MD 8/15/2017 8/15/2022 NEUROLOGY PEDIATRICS MEMPHIS TN ACTIVE 10/2/2017 None N/A INFECTIOUS LICENSE Q5391 DINARDO, ANDREW R, MD 8/3/2015 8/3/2020 DISEASES ISSUED 8/3/2015 None N/A LICENSE S6822 DINARVAND, PEYMAN , MD 5/29/2020 5/29/2025 PATHOLOGY ISSUED 5/29/2020 None N/A DINASARAPU, CHANDRASEKHAR Q6409 REDDY, MD 11/2/2015 11/2/2020 INTERNAL MEDICINE HOSPITALIST CAMP HILL PA ACTIVE 11/9/2015 None N/A S4289 DING, KAREN , MD 12/6/2019 12/6/2024 PSYCHIATRY HOUSTON TX ACTIVE 12/10/2019 None N/A S4289 DING, KAREN , MD 12/6/2019 12/6/2024 PSYCHIATRY HOUSTON TX ACTIVE 12/10/2019 None N/A R4213 DING, YANLI, MD 8/15/2017 8/15/2022 PATHOLOGY SAN ANTONIO TX ACTIVE 9/6/2017 None N/A OBSTETRICS & GYNECOLOGICAL OBSTETRICS AND R1738 DISARRO, AMANDA LYNN, DO 2/22/2017 2/22/2022 SURGERY GYNECOLOGY AUSTIN TX ACTIVE 3/9/2017 None N/A GYNECOLOGIC R3314 DIVINE, LAURA MICHELLE, MD 6/2/2017 6/2/2022 ONCOLOGY DALLAS TX ACTIVE 6/6/2017 None N/A Q8048 DIVINSKY, IANIR , MD 5/2/2016 5/2/2021 INTERNAL MEDICINE SEQUIM WA ACTIVE 5/3/2016 None N/A CORNEA REFRACTIVE Q9333 DIXIT, LENA AMY, MD 8/1/2016 8/1/2021 OPHTHALMOLOGY SURGERY TAYLOR TX ACTIVE 8/2/2016 None N/A OBSTETRICS AND Q5392 DIXON-SHAMBLEY, KAMILAH , MD 8/3/2015 8/3/2020 GYNECOLOGY RICHMOND TX ACTIVE 9/9/2015 None N/A R0981 DMITROVSKY, ETHAN, MD 12/2/2016 12/2/2021 INTERNAL MEDICINE ONCOLOGY HOUSTON TX ACTIVE 12/8/2016 None N/A OBSTETRICS AND LICENSE S7039 DO, LINH T, MD 6/12/2020 6/12/2025 GYNECOLOGY ISSUED 6/12/2020 None N/A R1016 DO, MEGAN, DO 12/16/2016 12/16/2021 INTERNAL MEDICINE CARDIOLOGY TEXARKANA TX ACTIVE 12/20/2016 None N/A Page 73 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PEDIATRIC GASTROENTEROLOG S5882 DO, PHINGA , MD 4/3/2020 4/3/2025 PEDIATRICS Y DALLAS TX ACTIVE 4/13/2020 None N/A DOCKENDORF, JUSTIN GRAHAM, EMERGENCY R1521 MD 2/6/2017 2/6/2022 MEDICINE FAMILY MEDICINE ACTIVE 2/13/2017 None N/A DODANWALA, HIRANDA SATHITHA ALBUQUERQU S4290 KUMARI, MD 12/6/2019 12/6/2024 RHEUMATOLOGY INTERNAL MEDICINE E NM ACTIVE 1/27/2020 None N/A DODANWALA, HIRANDA SATHITHA ALBUQUERQU S4290 KUMARI, MD 12/6/2019 12/6/2024 RHEUMATOLOGY INTERNAL MEDICINE E NM ACTIVE 1/27/2020 None N/A OBSTETRICS AND R2084 DODARD, CINDY , MD 3/20/2017 3/20/2022 GYNECOLOGY ACTIVE 5/17/2017 None N/A CARDIOVASCULAR S6384 DODD, KATHERINE SUSAN, DO 5/1/2020 5/1/2025 DISEASES SAN ANTONIO TX ACTIVE 5/4/2020 None N/A ORTHOPEDIC SURGERY OF THE Q5177 DODWAD, SHAH-NAWAZ, MD 7/15/2015 7/15/2020 SPINE HOUSTON TX ACTIVE 7/17/2015 None N/A R2577 DOERRE, TERESA, MD 4/20/2017 4/20/2022 ORTHOPEDICS HOUSTON TX ACTIVE 5/12/2017 None N/A ENDOCRINOLOGY, DIABETES AND S4940 DOJKI, FARHEEN KASSIM, MD 2/7/2020 2/7/2025 METABOLISM CHICAGO IL ACTIVE 3/9/2020 None N/A ORTHOPEDIC SPORTS MEDICINE - Q9988 DOLD, ANDREW PETER, MD 9/15/2016 9/15/2021 SURGERY ORTHOPEDICS FRISCO TX ACTIVE 12/14/2016 None N/A DOLGNER, ANNA ELISE TEETER, S6604 MD 5/15/2020 5/15/2025 HOSPITALIST HOUSTON TX ACTIVE 5/25/2020 None N/A DOLLAHITE, HENRY MATTHEW, R2846 MD 5/5/2017 5/5/2022 FAMILY PRACTICE FORT WORTH TX ACTIVE 5/8/2017 None N/A DIAGNOSTIC Q7678 DOMINGUEZ, MARLENE, MD 4/1/2016 4/1/2021 RADIOLOGY HOUSTON TX ACTIVE 5/2/2016 None N/A EMERGENCY Q7549 DOMINICI, PAUL GIOVANNI, MD 3/15/2016 3/15/2021 MEDICINE EDINBURG TX ACTIVE 3/31/2016 None N/A

Q9336 DONALDSON, ERIN ELIZABETH, DO 8/1/2016 8/1/2021 FAMILY MEDICINE DALLAS TX ACTIVE 8/8/2016 None N/A DONALDSON, JANA ELIZABETH, EMERGENCY Q4940 MD 7/1/2015 7/1/2020 MEDICINE DALLAS TX ACTIVE 7/8/2015 None N/A

N5657 DONDAPATI, CHANDRA, DO 2/16/2018 2/16/2023 INTERNAL MEDICINE SLEEP MEDICINE CLEARWATER FL ACTIVE 3/7/2018 None N/A ALLERGY AND S6160 DONEGAN, RAVNEET NAGI, MD 4/17/2020 4/17/2025 PEDIATRICS IMMUNOLOGY AUSTIN TX ACTIVE 5/6/2020 None N/A DONHAM, BENJAMIN POWELSON, EMERGENCY Q5998 MD 9/15/2015 9/15/2020 MEDICINE FORT HOOD TX ACTIVE 9/22/2015 None N/A

Page 74 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date DONKOR, FAUSTINA NANA YAA, Q4576 DO 6/1/2015 6/1/2020 INTERNAL MEDICINE TYLER TX ACTIVE 6/3/2015 None N/A OBSTETRICS AND R3066 DONNA, CYNTHIA , MD 5/22/2017 5/22/2022 GYNECOLOGY ACTIVE 5/31/2017 None N/A ORTHOPEDIC SURGERY OF THE ORTHOPEDIC S5362 DONNALLY, CHESTER JOHN III, MD 3/6/2020 3/6/2025 SPINE SURGERY ADDISON TX ACTIVE 3/16/2020 None N/A

NEUROLOGICAL PEDIATRIC SURGERY S5159 DONOHO, DANIEL AHARON, MD 2/21/2020 2/21/2025 SURGERY (NEUROLOGY) HOUSTON TX ACTIVE 2/24/2020 None N/A PEDIATRIC ANESTHESIOLOGY R2579 DONOVAN, COLIN MATTHEW, DO 4/20/2017 4/20/2022 ANESTHESIOLOGY (PEDS) SAN ANTONIO TX ACTIVE 5/22/2017 None N/A PEDIATRIC INFECTIOUS R3830 DONOVAN, SUMMER DAWN, DO 7/17/2017 7/17/2022 PEDIATRICS DISEASE SAN ANTONIO TX ACTIVE 8/15/2017 None N/A DONTHI REDDY, SRINIVASA LICENSE Q6179 REDDY, MD 10/1/2015 10/1/2020 PSYCHIATRY ISSUED 10/1/2015 None N/A OBSTETRICS AND GYNECOLOGIC R5855 DOOD, ROBERT LEE JR, MD 2/2/2018 2/2/2023 GYNECOLOGY ONCOLOGY HOUSTON TX ACTIVE 2/13/2018 None N/A R2085 DOOLEY, ERIN KATE, MD 3/20/2017 3/20/2022 FAMILY MEDICINE OBSTETRICS SAN ANTONIO TX ACTIVE 4/10/2017 None N/A HEMATOLOGY/ONCOL R0853 DORIUS, TIMOTHY HANCOCK, MD 12/2/2016 12/2/2021 OGY INTERNAL MEDICINE SHERMAN TX ACTIVE 12/6/2016 None N/A PEDIATRIC Q9151 DORMANS, JOHN PAUL, MD 7/15/2016 7/15/2021 ORTHOPEDICS HOUSTON TX ACTIVE 7/27/2016 None N/A LICENSE Q6316 DOSSUL, AMENA, MD 10/15/2015 10/15/2020 PEDIATRICS ISSUED 10/15/2015 None N/A DOSSUMBEKOVA, ANAR ALLERGY AND R0220 ASKAROVNA, MD 9/30/2016 9/30/2021 INTERNAL MEDICINE IMMUNOLOGY GALVESTON TX ACTIVE 10/4/2016 None N/A GERIATRIC DOSUMU, REMILEKUN SHARIZA, MEDICINE (INTERNAL FORT Q5393 MD 8/3/2015 8/3/2020 INTERNAL MEDICINE MED) WASHINGTON MD ACTIVE 8/7/2015 None N/A CHILD AND ADOLESCENT CORPUS R3831 DOTSON, CANDES LYNNE, DO 7/17/2017 7/17/2022 PSYCHIATRY CHRISTI TX ACTIVE 7/24/2017 None N/A R3067 DOTT, DALTRY, MD 5/22/2017 5/22/2022 PAIN MANAGEMENT ANESTHESIOLOGY DALLAS TX ACTIVE 6/22/2017 None N/A SURGICAL Q8465 DOUGHTIE, CATHRYN ANNE, MD 6/1/2016 6/1/2021 ONCOLOGY GENERAL SURGERY AMARILLO TX ACTIVE 6/2/2016 None N/A EMERGENCY R1018 DOYLE, DAVID ANTHONY, MD 12/16/2016 12/16/2021 MEDICINE DALLAS TX ACTIVE 1/5/2017 None N/A

Page 75 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date OBSTETRICS AND Q7180 DOZIER, JAMES HARLEY, MD 2/16/2016 2/16/2021 GYNECOLOGY LONGVIEW TX ACTIVE 3/16/2016 None N/A EMERGENCY Q4747 DRAGANN, BRENDAN, DO 6/12/2015 6/12/2020 MEDICINE AUSTIN TX ACTIVE 6/17/2015 None N/A PHYSICAL MED. & R0854 DRAGOJLOVIC, NIKOLA , DO 12/2/2016 12/2/2021 REHABILITATION HOUSTON TX ACTIVE 12/6/2016 None N/A DRAKSHARAM, PADMA LAKSHMI, HEMATOLOGY/ONCOL Q7181 MD 2/16/2016 2/16/2021 OGY INTERNAL MEDICINE BROOKLYN NY ACTIVE 3/1/2016 None N/A PEDIATRIC THE R3821 D'SOUZA, JILL N, MD 7/17/2017 7/17/2022 OTOLARYNGOLOGY WOODLANDS TX ACTIVE 8/28/2017 None N/A N0833 D'SOUZA, PENNY LYNN , DO 7/1/2015 7/1/2020 CARDIOLOGY TOMBALL TX ACTIVE 7/2/2015 None N/A

S4941 DUBOSE, DANIEL DALTON, MD 2/7/2020 2/7/2025 PAIN MANAGEMENT ANESTHESIOLOGY WILLOW PARK TX ACTIVE 2/11/2020 None N/A EMERGENCY FORT R3663 DUBROVICH, GREGORY, DO 6/30/2017 6/30/2022 MEDICINE LAUDERDALE FL ACTIVE 7/21/2017 None N/A EMERGENCY S6162 DUCACH, GREGORY JOHN, MD 4/17/2020 4/17/2025 MEDICINE HOUSTON TX ACTIVE 5/7/2020 None N/A DUCHICELA, KEEGAN AUTACHI, R4687 MD 9/22/2017 9/22/2022 FAMILY MEDICINE SAN DIEGO CA ACTIVE 9/27/2017 None N/A GASTROENTEROLOG N1309 DUDDEMPUDI, SUSHIL , MD 2/6/2017 2/6/2022 Y INTERNAL MEDICINE ROUND ROCK TX ACTIVE 2/13/2017 None N/A EMERGENCY LICENSE Q5791 DUDLEY, LEE ANTHONY, DO 8/28/2015 8/28/2020 MEDICINE INTERNAL MEDICINE ISSUED 8/28/2015 None N/A ANATOMIC/CLINICAL R0389 DUFFY, MAUREEN MEGAN, DO 10/14/2016 10/14/2021 PATHOLOGY PHOENIX AZ ACTIVE 10/21/2016 None N/A DUFURRENA, QUINN ALEXANDER, S6163 MD 4/17/2020 4/17/2025 INTERNAL MEDICINE ACTIVE 4/20/2020 None N/A SURGICAL CRITICAL R3664 DULTZ, LINDA ANN, MD 6/30/2017 6/30/2022 TRAUMATIC SURGERY CARE DALLAS TX ACTIVE 7/3/2017 None N/A ENDOCRINOLOGY, DIABETES AND Q4941 DUMITRU, CRISTINA IOANA, MD 7/1/2015 7/1/2020 METABOLISM INTERNAL MEDICINE HOUSTON TX ACTIVE 8/25/2015 None N/A EMERGENCY Q9598 DUMPIT, ANTHONY PANELO, MD 8/15/2016 8/15/2021 MEDICINE ROUND ROCK TX ACTIVE 8/17/2016 None N/A ADDICTION S5601 DUNATOV, DEVIN PATRICK, MD 3/20/2020 3/20/2025 PSYCHIATRY PSYCHIATRY DALLAS TX ACTIVE 4/1/2020 None N/A DUNCAN, BARRETT WILLCOX DIAGNOSTIC R0390 CATON, MD 10/14/2016 10/14/2021 RADIOLOGY DALLAS TX ACTIVE 10/17/2016 None N/A ORTHOPEDIC SURGERY OF THE ORTHOPEDIC LICENSE Q5793 DUNCAN, JONATHAN SCOTT, MD 8/28/2015 8/28/2020 SPINE SURGERY ISSUED 8/28/2015 None N/A Page 76 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date OPHTHALMOLOGY - Q8049 DUNCAN, JOSHUA KYLE, DO 5/2/2016 5/2/2021 OPHTHALMOLOGY CORNEA HOUSTON TX ACTIVE 5/3/2016 None N/A S6164 DUNCAN, RACHEL LYNN, MD 4/17/2020 4/17/2025 INTERNAL MEDICINE DALLAS TX ACTIVE 4/29/2020 None N/A DUNHAM, STEVEN RICHARD JR, Q7679 MD 4/1/2016 4/1/2021 NEUROLOGY HOUSTON TX ACTIVE 4/25/2016 None N/A ANESTHESIOLOGY - LICENSE Q6623 DUNSON, TEDDRICK LOVELL, MD 12/4/2015 12/4/2020 PAIN MANAGEMENT ANESTHESIOLOGY ISSUED 12/4/2015 None N/A SEE ANESTHESIOLOGY - PREVIOUS Q6623 DUNSON, TEDDRICK LOVELL, MD 12/4/2015 12/4/2020 PAIN MANAGEMENT ANESTHESIOLOGY FORT WORTH TX ACTIVE 12/14/2015 ORDER 12/7/2015 SEE ANESTHESIOLOGY - PREVIOUS Q6623 DUNSON, TEDDRICK LOVELL, MD 12/4/2015 12/4/2020 PAIN MANAGEMENT ANESTHESIOLOGY FORT WORTH TX ACTIVE 12/14/2015 ORDER 12/7/2015 LICENSE S7041 DUPREE, PHYLICIA DANIELLE, MD 6/12/2020 6/12/2025 GENERAL SURGERY ISSUED 6/12/2020 None N/A DURAN SIERRA, PAULA ANDREA, Q7036 MD 2/1/2016 2/1/2021 INTERNAL MEDICINE NEPHROLOGY TEMPLE TX ACTIVE 2/12/2016 None N/A CARDIOTHORACIC Q7359 DURAN, CIHAN , MD 3/4/2016 3/4/2021 RADIOLOGY RADIOLOGY HOUSTON TX ACTIVE 3/11/2016 None N/A FAMILY R0708 DURAN, CRESENCIO JR, DO 11/15/2016 11/15/2021 FAMILY MEDICINE PRACTICE/OMM SAN ANTONIO TX ACTIVE 11/17/2016 None N/A Q6180 DURAN, HILCIAS, MD 10/1/2015 10/1/2020 ANESTHESIOLOGY HOUSTON TX ACTIVE 10/20/2015 None N/A PEDIATRICS, Q8466 DURAN, SILVESTRE ROBERTO, MD 6/1/2016 6/1/2021 PEDIATRICS CARDIOLOGY DALLAS TX ACTIVE 6/7/2016 None N/A PLASTIC & RECONSTRUCTIVE R5856 DURAND, PAUL, MD 2/2/2018 2/2/2023 SURGERY DALLAS TX ACTIVE 2/5/2018 None N/A UNDER DURAYAPPAH, DEZIREE BOARD S4292 ANGELITA, DO 12/6/2019 12/6/2024 GENERAL PRACTICE FAMILY PRACTICE ACTIVE 12/16/2019 ORDER 11/21/2019 UNDER DURAYAPPAH, DEZIREE BOARD S4292 ANGELITA, DO 12/6/2019 12/6/2024 GENERAL PRACTICE FAMILY PRACTICE ACTIVE 12/16/2019 ORDER 11/21/2019

NEURO-PHYSIOLOGY Q5395 DURGAM, PREETHI , DO 8/3/2015 8/3/2020 NEUROLOGY (NEUROLOGY) ACTIVE 8/5/2015 None N/A PHYSICAL MED. & R5541 DURGAM, ROSHNI, MD 1/5/2018 1/5/2023 REHABILITATION SUGAR LAND NY ACTIVE 1/8/2018 None N/A OBSTETRICS AND R3499 DURRANI, SADIA AMAN, MD 6/16/2017 6/16/2022 GYNECOLOGY RICHMOND TX ACTIVE 7/10/2017 None N/A

Page 77 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date EMERGENCY Q7360 DURSO, PETER JOHN, MD 3/4/2016 3/4/2021 MEDICINE ACTIVE 3/10/2016 None N/A

S4293 DURSTELER, KINDRA WALKER, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE TEMPLE TX ACTIVE 12/17/2019 None N/A

S4293 DURSTELER, KINDRA WALKER, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE TEMPLE TX ACTIVE 12/17/2019 None N/A DUSHKU, PATRICIA BILLINGSLEY, OBSTETRICS AND S6165 MD 4/17/2020 4/17/2025 GYNECOLOGY FORT WORTH TX ACTIVE 4/23/2020 None N/A

R2087 DUTRA DE ABREU, IZABELLA , MD 3/20/2017 3/20/2022 PSYCHIATRY DALLAS TX ACTIVE 3/27/2017 None N/A Q6181 DUTTER, TAMARA LYNN, MD 10/1/2015 10/1/2020 ANESTHESIOLOGY ACTIVE 11/17/2015 None N/A PEDIATRIC LICENSE R6179 DUXBURY, GILBERT SHAWN, MD 3/2/2018 3/2/2023 ORTHOPEDICS ORTHOPEDICS ISSUED 3/2/2018 None N/A

S5364 DWIVEDI, KATYAYAN, MD 3/6/2020 3/6/2025 INTERNAL MEDICINE INDIANAPOLIS IN ACTIVE 3/10/2020 None N/A COLON AND RECTAL R2582 DWYER, CHRISTOPHER RYAN, MD 4/20/2017 4/20/2022 SURGERY DALLAS TX ACTIVE 6/15/2017 None N/A EMERGENCY Q6504 EADEH, HANNA, MD 11/16/2015 11/16/2020 MEDICINE HOUSTON TX ACTIVE 12/1/2015 None N/A SURGICAL CRITICAL Q7862 EAGLETON, AUSTIN , MD 4/15/2016 4/15/2021 CARE GENERAL SURGERY ACTIVE 4/26/2016 None N/A AEROSPACE LICENSE R6180 EAKIN, JOHN LARKIN, MD 3/2/2018 3/2/2023 GENERAL PRACTICE MEDICINE ISSUED 3/2/2018 None N/A OTORHINOLARYNGOL PEDIATRIC Q9152 EARLEY, MARISA ANNE, MD 7/15/2016 7/15/2021 OGY OTOLARYNGOLOGY SAN ANTONIO TX ACTIVE 7/22/2016 None N/A LICENSE Q6624 EARLY, MARSHALL DON, DO 12/4/2015 12/4/2020 GENERAL SURGERY ISSUED 12/4/2015 None N/A VASCULAR Q6624 EARLY, MARSHALL DON, DO 12/4/2015 12/4/2020 GENERAL SURGERY SURGERY CHESTER PA ACTIVE 1/18/2016 None N/A VASCULAR Q6624 EARLY, MARSHALL DON, DO 12/4/2015 12/4/2020 GENERAL SURGERY SURGERY CHESTER PA ACTIVE 1/18/2016 None N/A EASTERLING, CHRISTOPHER R2322 RYAN, MD 4/4/2017 4/4/2022 FAMILY MEDICINE FORT WORTH TX ACTIVE 4/6/2017 None N/A SURGICAL CRITICAL Q4749 EBADAT, AILEEN , MD 6/12/2015 6/12/2020 GENERAL SURGERY CARE AUSTIN TX ACTIVE 6/17/2015 None N/A Q6000 EBOH, NGOZI IHUOMA, MD 9/15/2015 9/15/2020 PEDIATRICS LUBBOCK TX ACTIVE 9/25/2015 None N/A GASTROENTEROLOG R4961 EBRAHIM, VIVIAN SAMI, MD 10/20/2017 10/20/2022 Y INTERNAL MEDICINE DALLAS TX ACTIVE 11/15/2017 None N/A

S4942 EBUEKU-SMITH, MARY , MD 2/7/2020 2/7/2025 INTERNAL MED - PEDS PEARLAND TX ACTIVE 2/11/2020 None N/A Q9338 ECCLES, RICHARD EUGENE, MD 8/1/2016 8/1/2021 PEDIATRICS INTERNAL MEDICINE HOUSTON TX ACTIVE 10/24/2016 None N/A Page 78 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date R2323 ECHEAZU, ODERA DALE, MD 4/4/2017 4/4/2022 FAMILY MEDICINE LEBANON PA ACTIVE 4/6/2017 None N/A J3090 ECKHARDT, SUE GAIL, MD 7/17/2017 7/17/2022 INTERNAL MEDICINE ONCOLOGY AUSTIN TX ACTIVE 7/20/2017 None N/A PEDIATRIC HEMATOLOGY/ONCOL R1200 ECKRICH, MICHAEL JAMES, MD 1/6/2017 1/6/2022 OGY SAN ANTONIO TX ACTIVE 1/18/2017 None N/A R0222 EDE, CHINEDU DONATUS, MD 9/30/2016 9/30/2021 FAMILY MEDICINE ACTIVE 11/22/2016 None N/A S5605 EDGCOMB, MARK, DO 3/20/2020 3/20/2025 GENERAL SURGERY HOUSTON TX ACTIVE 4/9/2020 None N/A R3502 EDGE, COLLEEN DOWNS, MD 6/16/2017 6/16/2022 PEDIATRICS MESQUITE TX ACTIVE 8/10/2017 None N/A PHYSICAL MED. & R2324 EDGE, DARSHE CHENEL, MD 4/4/2017 4/4/2022 REHABILITATION ACTIVE 4/14/2017 None N/A EDIONWE, SUSAN OMWANGHE, OTORHINOLARYNGOL Q4943 MD 7/1/2015 7/1/2020 OGY RHINOLOGY RICHMOND TX ACTIVE 7/17/2015 None N/A R4832 EDMONDS, SONJA LYNNE, MD 10/6/2017 10/6/2022 PEDIATRICS LONGVIEW TX ACTIVE 10/11/2017 None N/A S4296 EDOKPOLO, OSAMEDE, MD 12/6/2019 12/6/2024 PSYCHIATRY SPRINGFIELD MO ACTIVE 12/16/2019 None N/A S4296 EDOKPOLO, OSAMEDE, MD 12/6/2019 12/6/2024 PSYCHIATRY SPRINGFIELD MO ACTIVE 12/16/2019 None N/A FAMILY PRACTICE - EMERGENCY Q7863 EDWARDS, FRANK DAMON, MD 4/15/2016 4/15/2021 EMERGENCY MED MEDICINE LONGVIEW TX ACTIVE 4/19/2016 None N/A Q7864 EDWARDS, JASON TRAVIS, MD 4/15/2016 4/15/2021 ANESTHESIOLOGY DALLAS TX ACTIVE 4/25/2016 None N/A EMERGENCY R4962 EDWARDS, JOHN WARREN, MD 10/20/2017 10/20/2022 MEDICINE PORTSMOUTH VA ACTIVE 11/20/2017 None N/A SPORTS MEDICINE - Q8713 EDWARDS, JORDAN WILLIAM, MD 6/10/2016 6/10/2021 INTERNAL MEDICINE IM HENRIETTA TX ACTIVE 6/20/2016 None N/A ADOLESCENT Q5397 EFURIBE, CHINWE OYERONKE, MD 8/3/2015 8/3/2020 PEDIATRICS MEDICINE - PD WOOBURY MN ACTIVE 8/5/2015 None N/A ANATOMIC/CLINICAL R3070 EGAN, JENNIFER ANNE, MD 5/22/2017 5/22/2022 PATHOLOGY DURHAM NC ACTIVE 9/1/2017 None N/A EMERGENCY R2089 EGAN, MATTHEW CHARLES, MD 3/20/2017 3/20/2022 MEDICINE WACO TX ACTIVE 3/23/2017 None N/A Q9989 EGBUONU, NONSO ERNEST, MD 9/15/2016 9/15/2021 INTERNAL MEDICINE DERRY NH ACTIVE 10/17/2016 None N/A CHILD AND ADOLESCENT R0563 EGUSQUIZA, BENJAMIN LUIS, MD 10/31/2016 10/31/2021 PSYCHIATRY PSYCHIATRY DALLAS TX ACTIVE 11/8/2016 None N/A EGWAIKHIDE, OHIGBAI AILENDE, Q9803 MD 8/26/2016 8/26/2021 INTERNAL MED - PEDS HOSPITALIST HOUSTON TX ACTIVE 11/22/2016 None N/A Q7680 EHASZ, MONA, DO 4/1/2016 4/1/2021 ANESTHESIOLOGY HARLINGEN TX ACTIVE 4/4/2016 None N/A S6826 EHRLICH, CODI DIANE, MD 5/29/2020 5/29/2025 FAMILY MEDICINE FORT WORTH TX ACTIVE 6/16/2020 None N/A PREVENTIVE - OCCUPATIONAL - EHSANZADEH CHEEMEH, OCCUPATIONAL ENVIRONMENTAL Q7183 PARVANEH , MD 2/16/2016 2/16/2021 MEDICINE MED HOUSTON TX ACTIVE 2/29/2016 None N/A

Page 79 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date ANESTHESIOLOGY - S7042 EIDELSON, DAVID , MD 6/12/2020 6/12/2025 PAIN MANAGEMENT PAIN MANAGEMENT WAXAHACHIE TX ACTIVE 6/16/2020 None N/A CARDIAC ELECTROPHYSIOLOG M5696 EIFLING, MICHAEL DENNIS, MD 1/19/2018 1/19/2023 Y CARDIOLOGY BEDFORD TX ACTIVE 1/29/2018 None N/A ORTHOPEDIC SPORTS MEDICINE Q7681 EILERS, MARK AARON, MD 4/1/2016 4/1/2021 SURGERY (ORTH SURG) ACTIVE 4/11/2016 None N/A EISENHAUER, CHRISTOPHER N, Q9601 MD 8/15/2016 8/15/2021 FAMILY MEDICINE AMARILLO TX ACTIVE 8/17/2016 None N/A PULMONARY EISSA, KHALED ELSAYED AHMED, CRITICAL CARE Q7184 MD 2/16/2016 2/16/2021 INTERNAL MEDICINE MEDICINE HOUSTON TX ACTIVE 4/8/2016 None N/A EMERGENCY Q9340 EJESIEME, NNENNA CYNTHIA, DO 8/1/2016 8/1/2021 MEDICINE DALLAS TX ACTIVE 9/15/2016 None N/A LICENSE Q6182 EKPENIKE, ANTHONIA, MD 10/1/2015 10/1/2020 INTERNAL MEDICINE ISSUED 10/1/2015 None N/A S4943 EKPO, FELICIA, DO 2/7/2020 2/7/2025 DERMATOLOGY RICHARDSON TX ACTIVE 4/16/2020 None N/A S6607 EKWEANI, ADAOBI, MD 5/15/2020 5/15/2025 PEDIATRICS HOUSTON TX ACTIVE 6/4/2020 None N/A GASTROENTEROLOG NEW S4625 EL CHAFIC, ABDUL HAMID, MD 1/10/2020 1/10/2025 Y ORLEANS LA ACTIVE 1/20/2020 None N/A

NEURO-PHYSIOLOGY LICENSE Q4577 EL FEKI, AMRO, MD 6/1/2015 6/1/2020 NEUROLOGY (NEUROLOGY) ISSUED 6/1/2015 None N/A

OPHTHALMOLOGY - R4963 EL HADAD, CHRISTIAN, MD 10/20/2017 10/20/2022 OPHTHALMOLOGY RECONST SURGERY ACTIVE 12/5/2017 None N/A EL TAYEB, MARAWAN MOHAMED, R3316 MD 6/2/2017 6/2/2022 UROLOGY UROLOGIC SURGERY TEMPLE TX ACTIVE 6/5/2017 None N/A PULMONARY CRITICAL CARE CEDAR R4037 EL-BAKUSH, AMAL , MD 8/1/2017 8/1/2022 INTERNAL MEDICINE MEDICINE RAPIDS IA ACTIVE 8/14/2017 None N/A

R0856 ELHAJ, CHRISTIAN , MD 12/2/2016 12/2/2021 FAMILY MEDICINE GENERAL PRACTICE ACTIVE 12/7/2016 None N/A S7043 ELHALWAGI, RAMY BAHER, DO 6/12/2020 6/12/2025 INTERNAL MEDICINE ACTIVE 6/16/2020 None N/A DIAGNOSTIC S5606 ELHALWAGI, SHEREEF , MD 3/20/2020 3/20/2025 RADIOLOGY INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 4/17/2020 None N/A PEDIATRICS, PEDIATRIC CRITICAL Q8714 ELHOFF, JUSTIN JEFFREY, MD 6/10/2016 6/10/2021 CARDIOLOGY CARE MEDICINE HOUSTON TX ACTIVE 6/15/2016 None N/A GASTROENTEROLOG Q8052 ELIAS, GEORG , MD 5/2/2016 5/2/2021 INTERNAL MEDICINE Y HERRIN IL ACTIVE 5/9/2016 None N/A Q9805 ELISCO, ANTHONY JOHN III, DO 8/26/2016 8/26/2021 UROLOGY GREENVILLE TX ACTIVE 9/22/2016 None N/A Page 80 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date CORPUS Q6183 ELIZONDO, CARLOS , MD 10/1/2015 10/1/2020 FAMILY PRACTICE CHRISTI TX ACTIVE 10/8/2015 None N/A Q7682 ELKHATIB, RANIA , MD 4/1/2016 4/1/2021 PSYCHIATRY ACTIVE 4/4/2016 None N/A EMERGENCY Q9807 ELLIS, NICOLAS, MD 8/26/2016 8/26/2021 MEDICINE BEAUMONT TX ACTIVE 9/19/2016 None N/A ELECTROPHYSIOLO R1743 ELLIS, STEVEN PHILLIP JR, MD 2/22/2017 2/22/2022 NEUROLOGY GY SAN ANTONIO TX ACTIVE 2/24/2017 None N/A GASTROENTEROLOG S6170 ELLISON, ASHTON , MD 4/17/2020 4/17/2025 INTERNAL MEDICINE Y DALLAS TX ACTIVE 5/28/2020 None N/A R5258 ELMAHI, MUTAZ A, MD 11/17/2017 11/17/2022 INTERNAL MEDICINE HOSPITALIST ACTIVE 12/18/2017 None N/A PEDIATRIC HEMATOLOGY/ONCOL Q9604 EL-MALLAWANY, NADER KIM, MD 8/15/2016 8/15/2021 OGY HOUSTON TX ACTIVE 8/16/2016 None N/A HEMATOLOGY/ONCOL R0223 EL-OSTA, HAZEM , MD 9/30/2016 9/30/2021 OGY INTERNAL MEDICINE HOUSTON TX ACTIVE 10/3/2016 None N/A ELSBERND, BENJAMIN R2092 LAWRENCE, MD 3/20/2017 3/20/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 4/25/2017 None N/A ELSHAIKH, ABUBAKER ANATOMIC/CLINICAL S4944 ABDELGADIR AHMED, MD 2/7/2020 2/7/2025 PATHOLOGY HOUSTON TX ACTIVE 2/11/2020 None N/A ADULT ORTHOPEDIC RECONSTRUCTIVE R3318 ELSHARKAWY, KARIM A, MD 6/2/2017 6/2/2022 SURGERY ORTHOPEDICS PLANO TX ACTIVE 8/14/2017 None N/A ELSHATORY, KAREEM MOHAMED, EMERGENCY Q6828 MD 1/6/2016 1/6/2021 INTERNAL MEDICINE MEDICINE ACTIVE 1/11/2016 None N/A ELSIESY, HUSSIEN ABDELRASOUL, GASTROENTEROLOG R2585 MD 4/20/2017 4/20/2022 Y HEPATOLOGY FORT WORTH TX ACTIVE 7/11/2017 None N/A NEONATAL- PERINATAL R5383 ELTAHA, CHADI, MD 12/8/2017 12/8/2022 PEDIATRICS MEDICINE LUBBOCK TX ACTIVE 12/15/2017 None N/A LICENSE S6828 ELTELBANY, AHMED, MD 5/29/2020 5/29/2025 INTERNAL MEDICINE ISSUED 5/29/2020 None N/A R4690 ELTEMSAH, NAGI I JR, MD 9/22/2017 9/22/2022 PEDIATRICS JERSEY CITY NJ ACTIVE 9/28/2017 None N/A R2586 ELTZSCHIG, HOLGER KLAUS, MD 4/20/2017 4/20/2022 ANESTHESIOLOGY HOUSTON TX ACTIVE 5/5/2017 None N/A HEMATOLOGY/ONCOL S6389 ELURI, MADHULIKA, MD 5/1/2020 5/1/2025 OGY HOUSTON TX ACTIVE 5/21/2020 None N/A GASTROENTEROLOG Q8468 ELWIR, SALEH, MD 6/1/2016 6/1/2021 INTERNAL MEDICINE Y DALLAS TX ACTIVE 6/13/2016 None N/A R5858 EL-ZAYATY, SHADY AHMED, MD 2/2/2018 2/2/2023 PATHOLOGY DALLAS TX ACTIVE 2/5/2018 None N/A RADIATION Q9990 EMANDI, SANJAY KUMAR, MD 9/15/2016 9/15/2021 ONCOLOGY PARIS TX ACTIVE 9/19/2016 None N/A

Page 81 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date EMECHEBE-KENNEDY, OBINNA C, ANESTHESIOLOGY - Q5398 MD 8/3/2015 8/3/2020 PAIN MANAGEMENT ANESTHESIOLOGY TEXARKANA TX ACTIVE 8/24/2015 None N/A CARDIAC CARDIOVASCULAR ELECTROPHYSIOLO Q9342 EMERENINI, UZODINMA, MD 8/1/2016 8/1/2021 DISEASES GY HOUSTON TX ACTIVE 9/13/2016 None N/A DELINQUEN T-NON R1523 EMERY, LETTY ROCHA, MD 2/6/2017 2/6/2022 FAMILY MEDICINE PAYMENT 5/7/2017 None N/A

CLINICAL WINSTON Q8877 EMMADY, PRABHU DAYAL, MD 7/1/2016 7/1/2021 NEUROLOGY NEUROPHYSIOLOGY SALEM NC ACTIVE 11/27/2017 None N/A R0225 EMONO, OJOMAH ANGELA, MD 9/30/2016 9/30/2021 FAMILY MEDICINE HUNTSVILLE TX ACTIVE 10/4/2016 None N/A COLON AND RECTAL R1201 EMUAKHAGBON, VALERIE, MD 1/6/2017 1/6/2022 SURGERY ACTIVE 2/13/2017 None N/A ENAKPENE, EVBU OMOYEMWEN, INTERVENTIONAL R0710 MD 11/15/2016 11/15/2021 CARDIOLOGY CARDIOLOGY SLC UT ACTIVE 11/28/2016 None N/A ENCALADA, SANTIAGO ENRIQUE, PEDIATRIC CORPUS R4834 MD 10/6/2017 10/6/2022 PULMONOLOGY PEDIATRICS CHRISTI TX ACTIVE 10/27/2017 None N/A ENGLAND, CHRISTOPHER RAY, OTORHINOLARYNGO Q6184 MD 10/1/2015 10/1/2020 OTOLARYNGOLOGY LOGY EL PASO TX ACTIVE 10/14/2015 None N/A OBSTETRICS AND MATERNAL AND Q6746 ENGLAND, JOEY ANN, MD 12/15/2015 12/15/2020 GYNECOLOGY FETAL MEDICINE ACTIVE 3/25/2016 None N/A CARDIOTHORACIC R1948 EOH, EUN JEONG, MD 3/3/2017 3/3/2022 ANESTHESIOLOGY ANESTHESIOLOGY AUSTIN TX ACTIVE 3/7/2017 None N/A SPORTS MEDICINE - FOOT AND ANKLE, Q9010 ERARD, UMA ELIZABETH, DO 7/1/2016 7/1/2021 ORTHOPEDICS ORTHOPEDICS SAN ANTONIO TX ACTIVE 7/12/2016 None N/A

R3836 ERB, EDWARD, DO 7/17/2017 7/17/2022 VASCULAR SURGERY KERRVILLE OH ACTIVE 11/30/2017 None N/A ERIAN, MARC-FERNAND RALPH, S4297 MD 12/6/2019 12/6/2024 RADIOLOGY BREAST IMAGING SAN ANTONIO TX ACTIVE 12/17/2019 None N/A ERIAN, MARC-FERNAND RALPH, S4297 MD 12/6/2019 12/6/2024 RADIOLOGY BREAST IMAGING SAN ANTONIO TX ACTIVE 12/17/2019 None N/A Q6829 ERICKSON, KEVIN FURMAN, MD 1/6/2016 1/6/2021 NEPHROLOGY INTERNAL MEDICINE HOUSTON TX ACTIVE 1/11/2016 None N/A EMERGENCY CORPUS Q9343 ERIKSSON, HANS OLOF, MD 8/1/2016 8/1/2021 MEDICINE CHRISTI TX ACTIVE 8/2/2016 None N/A PEDIATRIC CRITICAL Q7038 ESANGBEDO, IVIE DORIS, MD 2/1/2016 2/1/2021 CARE MEDICINE DALLAS TX ACTIVE 2/19/2016 None N/A EMERGENCY LICENSE R6002 ESCAMILLA, ANDREW, MD 2/16/2018 2/16/2023 MEDICINE ISSUED 2/16/2018 None N/A ESCOBAR BOTERO, ANA MARIA, OBSTETRICS AND S6173 MD 4/17/2020 4/17/2025 GYNECOLOGY SAN ANTONIO TX ACTIVE 5/1/2020 None N/A Page 82 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date ESCOBAR JIMENEZ, DANIEL OBSTETRICS AND S6390 ALEJANDRO, MD 5/1/2020 5/1/2025 GYNECOLOGY SAN ANTONIO TX ACTIVE 5/4/2020 None N/A R3837 ESCOBAR, CASEY , MD 7/17/2017 7/17/2022 PEDIATRICS ACTIVE 8/21/2017 None N/A

R4038 ESCOBEDO, MARCO ANTONIO, MD 8/1/2017 8/1/2022 FAMILY MEDICINE MCALLEN TX ACTIVE 8/2/2017 None N/A Q9837 ESEDDI, JOAD, MD 8/26/2016 8/26/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 8/29/2016 None N/A ESFAHANI, FATEMEH LICENSE Q4750 BAGHERIANNEJAD, MD 6/12/2015 6/12/2020 INTERNAL MEDICINE ISSUED 6/12/2015 None N/A R4217 ESHENRODER, NATHAN, MD 8/15/2017 8/15/2022 FAMILY PRACTICE FLORESVILLE TX ACTIVE 9/1/2017 None N/A Q4946 ESPINOZA, DAVID ROBERTO, MD 7/1/2015 7/1/2020 FAMILY MEDICINE SAN ANTONIO TX ACTIVE 7/20/2015 None N/A OBSTETRICS AND MATERNAL AND Q9344 ESPINOZA, JIMMY, MD 8/1/2016 8/1/2021 GYNECOLOGY FETAL MEDICINE HOUSTON TX ACTIVE 8/3/2016 None N/A INTERVENTIONAL S6609 ESPLIN, CORDELL ALMA, MD 5/15/2020 5/15/2025 RADIOLOGY MIDWAY UT ACTIVE 5/21/2020 None N/A R4218 ESPY, PAUL GOODMAN, MD 8/15/2017 8/15/2022 UROLOGY WACO TX ACTIVE 10/12/2017 None N/A ESQUIVEL, HEATHER MICHELE, Q7362 MD 3/4/2016 3/4/2021 FAMILY MEDICINE DALLAS TX ACTIVE 4/4/2016 None N/A MISSOURI R0226 ESSEL, JOSHUA AMPIAH, MD 9/30/2016 9/30/2021 PEDIATRICS CITY TX ACTIVE 10/14/2016 None N/A H0333 ESSEX, THOMAS W, DO 2/21/2020 2/21/2025 INTERNAL MEDICINE CHICKASHA OK ACTIVE 2/25/2020 None N/A INFECTIOUS R5112 ESTELLE, CAROLEE D, MD 11/3/2017 11/3/2022 DISEASES INTERNAL MEDICINE DALLAS TX ACTIVE 11/7/2017 None N/A Q6185 ESTRADA, KRYSTAL A, MD 10/1/2015 10/1/2020 FAMILY MEDICINE FAMILY MEDICINE WACO TX ACTIVE 10/7/2015 None N/A Q9991 ESTRADA, NELLY MASSIEL, MD 9/15/2016 9/15/2021 RADIOLOGY SAN ANTONIO TX ACTIVE 9/23/2016 None N/A ETTINGER, NICHOLAS ANDREAS, PEDIATRIC CRITICAL Q6186 MD 10/1/2015 10/1/2020 PEDIATRICS CARE MEDICINE HOUSTON TX ACTIVE 10/5/2015 None N/A ORTHOPEDIC SPORTS MEDICINE R0566 EUBANKS, AARON CHRISTIAN, MD 10/31/2016 10/31/2021 SURGERY (ORTH SURG) SOUTHLAKE TX ACTIVE 11/10/2016 None N/A EUNGDAMRONG, NARAT JOHN, R4964 MD 10/20/2017 10/20/2022 DERMATOLOGY MILWAUKEE WI ACTIVE 1/17/2018 None N/A NEUROLOGICAL R3073 EVANS, LINTON THOMAS , MD 5/22/2017 5/22/2022 SURGERY NEURO-ONCOLOGY HOUSTON TX ACTIVE 8/4/2017 None N/A SURGICAL CRITICAL R0857 EVANS, PAUL MICHAEL, MD 12/2/2016 12/2/2021 TRAUMATIC SURGERY CARE AUSTIN TX ACTIVE 12/15/2016 None N/A EMERGENCY S6833 EVERITT, BRYAN , MD 5/29/2020 5/29/2025 MEDICINE SAN ANTONIO TX ACTIVE 6/3/2020 None N/A NEUROLOGICAL Q7685 EVERSON, RICHARD GEORGE, MD 4/1/2016 4/1/2021 SURGERY HOUSTON TX ACTIVE 4/13/2016 None N/A Q9154 EWAIDA, NADER, MD 7/15/2016 7/15/2021 INTERNAL MEDICINE DENTON TX ACTIVE 7/19/2016 None N/A GASTROENTEROLOG R3503 EWELUKWA, OFORBUIKE, MD 6/16/2017 6/16/2022 Y INTERNAL MEDICINE HOUSTON TX ACTIVE 9/6/2017 None N/A Page 83 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date DELINQUEN T-NON R5387 EXTINE, JAMES HARLEY, DO 12/8/2017 12/8/2022 ORTHOPEDICS PAYMENT 3/8/2018 None N/A EZE NLIAM, CHETE MARGARET, R4965 MD 10/20/2017 10/20/2022 CARDIOLOGY INTERNAL MEDICINE CLEVELAND OH ACTIVE 12/18/2017 None N/A R1747 EZIGBO, CHIKA AMUCHE, MD 2/22/2017 2/22/2022 INTERNAL MEDICINE HOSPITALIST ACTIVE 3/15/2017 None N/A PEDIATRIC GASTROENTEROLOG LICENSE S6834 EZIRIKE LADIPO, JENNIFER, MD 5/29/2020 5/29/2025 Y ISSUED 5/29/2020 None N/A OBSTETRICS AND FALLS Q9345 EZIRIM, NKECHI, MD 8/1/2016 8/1/2021 GYNECOLOGY CHURCH VA ACTIVE 9/9/2016 None N/A FADAYOMI, OLADIPO BAMIDELE, R4836 MD 10/6/2017 10/6/2022 HOSPITALIST ACTIVE 10/9/2017 None N/A EMERGENCY R5388 FAGAN, SCOTT, MD 12/8/2017 12/8/2022 GENERAL PRACTICE MEDICINE MANSFIELD LA ACTIVE 12/18/2017 None N/A FAGBAMIYE, BABATUNDE R3504 FRANCIS, MD 6/16/2017 6/16/2022 PSYCHIATRY TEMPLE TX ACTIVE 6/28/2017 None N/A R1524 FAGBEMI, RUTH IYUN, MD 2/6/2017 2/6/2022 FAMILY MEDICINE CAMERON TX ACTIVE 2/7/2017 None N/A CARDIAC ELECTROPHYSIOLOG R3074 FAHED, JOE, MD 5/22/2017 5/22/2022 Y CARDIOLOGY HOUSTON TX ACTIVE 5/29/2017 None N/A PULMONARY CRITICAL CARE Q6187 FAHOUM, SAMER HANNA, MD 10/1/2015 10/1/2020 MEDICINE INTERNAL MEDICINE FORTWORTH TX ACTIVE 10/5/2015 None N/A EMERGENCY R3667 FAILES, LORI ELIZABETH, DO 6/30/2017 6/30/2022 MEDICINE AMARILLO TX ACTIVE 7/25/2017 None N/A TRANSPLANT CRITICAL CARE R4219 FAIR, JEFFREY HASKELL, MD 8/15/2017 8/15/2022 SURGERY (SURGERY) GALVESTON TX ACTIVE 8/16/2017 None N/A R4538 FAISAL, SHAHZAD, MD 9/8/2017 9/8/2022 INTERNAL MEDICINE SEAFORD DE ACTIVE 9/12/2017 None N/A ANATOMIC/CLINICAL R5261 FAJARDO, DANIEL ADRIAN, MD 11/17/2017 11/17/2022 PATHOLOGY BRUNSWICK GA ACTIVE 11/21/2017 None N/A RADIATION R6183 FAKHREDDINE, MOHAMAD , MD 3/2/2018 3/2/2023 ONCOLOGY SAN ANTONIO TX ACTIVE 3/14/2018 None N/A FALCE, KRISTIN MAI-ANH LUONG, OBSTETRICAL R0712 MD 11/15/2016 11/15/2021 ANESTHESIOLOGY ANESTHESIA HOUSTON TX ACTIVE 11/16/2016 None N/A EMERGENCY Q4947 FALCON, JACOB , MD 7/1/2015 7/1/2020 MEDICINE KYLE TX ACTIVE 7/2/2015 None N/A FALEBITA, OLUWATOYIN TOLANI, CARRIZO Q5648 MD 8/14/2015 8/14/2020 FAMILY MEDICINE SPRING TX ACTIVE 8/24/2015 None N/A FREDERICKSB Q8881 FALLA, JULIAN R, MD 7/1/2016 7/1/2021 INTERNAL MEDICINE URG TX ACTIVE 7/7/2016 None N/A Page 84 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date FALLAHZADEH ABARGHOUEI, R4039 MOHAMMAD KAZEM , MD 8/1/2017 8/1/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 8/3/2017 None N/A R4966 FAN, CHUAN-LI, DO 10/20/2017 10/20/2022 FAMILY MEDICINE ACTIVE 11/29/2017 None N/A S5611 FAN, ROGER RUOJIE, MD 3/20/2020 3/20/2025 INTERNAL MEDICINE DALLAS TX ACTIVE 3/30/2020 None N/A OBSTETRICS AND P9425 FAPOHUNDA, TEMITOPE, MD 9/15/2016 9/15/2021 GYNECOLOGY ACTIVE 9/22/2016 None N/A Q4578 FARACH, LAURA SCHOCH, MD 6/1/2015 6/1/2020 MEDICAL GENETICS PEDIATRICS HOUSTON TX ACTIVE 6/3/2015 None N/A PEDIATRIC CRITICAL LICENSE R5544 FARAG GALLEON, ANAS, MD 1/5/2018 1/5/2023 PEDIATRICS CARE MEDICINE ISSUED 1/5/2018 None N/A CARDIOVASCULAR R4386 FARAH, FAHMI JASMIN, MD 8/25/2017 8/25/2022 DISEASES INTERNAL MEDICINE LONGVIEW TX ACTIVE 9/20/2017 None N/A FARAH, NOURELHODA IBRAHIM, R0227 MD 9/30/2016 9/30/2021 PEDIATRICS HOUSTON TX ACTIVE 10/11/2016 None N/A NEUROLOGICAL S6611 FARAJI, AMIR HUSSEIN, MD 5/15/2020 5/15/2025 SURGERY HOUSTON TX ACTIVE 5/25/2020 None N/A Q5649 FARDAL, JOHN PATRICK, DO 8/14/2015 8/14/2020 FAMILY MEDICINE AUSTIN TX ACTIVE 8/27/2015 None N/A S6174 FAREED, KHALED , MD 4/17/2020 4/17/2025 UROLOGIC SURGERY UROLOGY SCOTTSDALE AZ ACTIVE 4/22/2020 None N/A PEDIATRIC CRITICAL R3508 FARHAT, ABDELAZIZ , MD 6/16/2017 6/16/2022 PEDIATRICS CARE MEDICINE ACTIVE 8/1/2017 None N/A EMERGENCY Q5650 FARHAT, DAVID WILLIAM, MD 8/14/2015 8/14/2020 MEDICINE TEXARKANA TX ACTIVE 8/24/2015 None N/A FARIAS KOVAC, MARIO CRITICAL CARE S6612 HERMOGENES, MD 5/15/2020 5/15/2025 ANESTHESIOLOGY ANESTHESIOLOGY HOUSTON TX ACTIVE 5/20/2020 None N/A

R6003 FARIAS, JUDY ANN, MD 2/16/2018 2/16/2023 UROLOGY UROLOGIC SURGERY SAN ANTONIO TX ACTIVE 3/19/2018 None N/A R0568 FARLEY, DANNY JR, MD 10/31/2016 10/31/2021 FAMILY MEDICINE CONROE TX ACTIVE 12/15/2016 None N/A EMERGENCY S4947 FARMER, CHARLES ALTON, MD 2/7/2020 2/7/2025 MEDICINE ACTIVE 2/11/2020 None N/A

S4467 FAROOQ, ABID MOHAMMED , DO 12/20/2019 12/20/2024 INTERNAL MEDICINE ACTIVE 2/7/2020 None N/A RADIATION S5893 FAROOQI, AHSAN , MD 4/3/2020 4/3/2025 ONCOLOGY HOUSTON TX ACTIVE 4/6/2020 None N/A FAROOQUI, MUHAMMAD TALHA, R4691 MD 9/22/2017 9/22/2022 HOSPITALIST HOUSTON TX ACTIVE 9/26/2017 None N/A R4220 FAROOQUI, OZER, MD 8/15/2017 8/15/2022 INTERNAL MEDICINE NEWARK NJ ACTIVE 8/22/2017 None N/A SURGICAL Q6412 FARR, DEBORAH ELAINE, MD 11/2/2015 11/2/2020 BREAST ONCOLOGY ONCOLOGY DALLAS TX ACTIVE 11/3/2015 None N/A

Q4948 FARR, NORMAN MILES, MD 7/1/2015 7/1/2020 INTERNAL MED - PEDS TEXAS CITY TX ACTIVE 7/3/2015 None N/A CRITICAL CARE R2097 FARRIS, LANDON KYLE, MD 3/20/2017 3/20/2022 ANESTHESIOLOGY ANESTHESIOLOGY HOUSTON TX ACTIVE 3/21/2017 None N/A Page 85 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date S5367 FARTHING, JOSHUA, MD 3/6/2020 3/6/2025 ANESTHESIOLOGY DALLAS TX ACTIVE 3/12/2020 None N/A Q8473 FATIMA, ANEES, MD 6/1/2016 6/1/2021 FAMILY MEDICINE ACTIVE 6/6/2016 None N/A PEDIATRICS, R3669 FATUSIN, OLUWATOSIN, MD 6/30/2017 6/30/2022 PEDIATRICS CARDIOLOGY HOUSTON TX ACTIVE 7/3/2017 None N/A

S5614 FAVAZZA, TERENCE, MD 3/20/2020 3/20/2025 UROLOGY UROLOGIC SURGERY SAN ANTONIO TX ACTIVE 3/25/2020 None N/A FEATHERSTONE-UWAGUE, PREVENTIVE R4040 AMBER DENISE, MD 8/1/2017 8/1/2022 FAMILY MEDICINE MEDICINE AUSTIN TX ACTIVE 8/7/2017 None N/A Q5181 FEDSON, SAVITRI, MD 7/15/2015 7/15/2020 CARDIOLOGY INTERNAL MEDICINE ACTIVE 7/22/2015 None N/A Q6506 FEETHAM, HATTIE JILL, MD 11/16/2015 11/16/2020 DERMATOLOGY DERMATOLOGY DALLAS TX ACTIVE 11/17/2015 None N/A FEHLIS, KIMBERLY CATHERINE, MARBLE Q5183 MD 7/15/2015 7/15/2020 PEDIATRICS FALLS TX ACTIVE 7/27/2015 None N/A Q7364 FEINGOLD, WILLIAM ISAAC, DO 3/4/2016 3/4/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 3/16/2016 None N/A R6184 FEINSTEIN, ROBERT E, MD 3/2/2018 3/2/2023 PSYCHIATRY NEUROLOGY AUSTIN TX ACTIVE 3/5/2018 None N/A OBSTETRICS AND MATERNAL AND Q7687 FEINSTEIN, STEVEN J, MD 4/1/2016 4/1/2021 GYNECOLOGY FETAL MEDICINE EL PASO TX ACTIVE 4/6/2016 None N/A OBSTETRICS AND R0231 FEKRY, SAMUEL, MD 9/30/2016 9/30/2021 GYNECOLOGY ACTIVE 1/30/2018 None N/A PEDIATRIC Q9809 FENTON, AMBER STURGES, MD 8/26/2016 8/26/2021 OPHTHALMOLOGY AUSTIN TX ACTIVE 11/22/2016 None N/A EMERGENCY R3322 FERENC, MACIEJ, DO 6/2/2017 6/2/2022 MEDICINE ACTIVE 6/12/2017 None N/A

CLINICAL R0232 FERENZ, GREGORY JOHN, DO 9/30/2016 9/30/2021 NEUROLOGY NEUROPHYSIOLOGY LONGMONT CO ACTIVE 10/3/2016 None N/A Q7365 FERGUSON, CHRIS-GERALD, MD 3/4/2016 3/4/2021 FAMILY MEDICINE SAN ANGELO TX ACTIVE 3/7/2016 None N/A FERGUSON, JAMES EDWARD III, UROLOGIC Q7040 MD 2/1/2016 2/1/2021 ONCOLOGY UROLOGY HOUSTON TX ACTIVE 4/4/2016 None N/A EMERGENCY R3078 FERLA, VANESSA E, MD 5/22/2017 5/22/2022 MEDICINE PITTSBURGH PA ACTIVE 5/26/2017 None N/A FERNANDEZ PALMER, MANUEL Q4949 AGUSTIN, MD 7/1/2015 7/1/2020 INTERNAL MEDICINE DALLAS TX ACTIVE 7/28/2015 None N/A FERNANDEZ RODRIGUEZ, R2330 FRANCISCO TOMAS, MD 4/4/2017 4/4/2022 INTERNAL MEDICINE EL PASO TX ACTIVE 5/8/2017 None N/A FERNANDEZ RUIZ, MARIA PEDIATRIC R2331 CRISTINA, MD 4/4/2017 4/4/2022 OPHTHALMOLOGY HOUSTON TX ACTIVE 4/10/2017 None N/A PEDIATRIC FERNANDEZ SANCHEZ, JOSAURA HEMATOLOGY/ONCO S5895 VANESSA, MD 4/3/2020 4/3/2025 PEDIATRICS LOGY MIAMI FL ACTIVE 4/15/2020 None N/A

R4540 FERNANDEZ, ALICIA BEATRIZ, MD 9/8/2017 9/8/2022 INTERNAL MEDICINE SLEEP MEDICINE LOUISVILLE KY ACTIVE 10/27/2017 None N/A Page 86 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date TRANSPLANT Q8882 FERNANDEZ, HOYLAN , MD 7/1/2016 7/1/2021 SURGERY GENERAL SURGERY DALLAS TX ACTIVE 7/12/2016 None N/A EMERGENCY Q5400 FERNANDEZ, WILLIAM, MD 8/3/2015 8/3/2020 MEDICINE HOUSTON TX ACTIVE 8/20/2015 None N/A Q9606 FERRAROTTO, RENATA , MD 8/15/2016 8/15/2021 ONCOLOGY INTERNAL MEDICINE HOUSTON TX ACTIVE 9/12/2016 None N/A FERREIRA BOTELHO, MARCOS PEDIATRIC CARDIOVASCULAR R4837 PAULO, MD 10/6/2017 10/6/2022 RADIOLOGY IMAGING HOUSTON TX ACTIVE 1/2/2018 None N/A OPHTHALMOLOGY - LICENSE S7045 FERREIRA, CLAUDIO ARAUJO, MD 6/12/2020 6/12/2025 VITREOUS SURGERY ISSUED 6/12/2020 None N/A OTORHINOLARYNGOL HEAD AND NECK R3839 FERRELL, JAY KYRLE, MD 7/17/2017 7/17/2022 OGY SURGERY SAN ANTONIO TX ACTIVE 7/20/2017 None N/A Q9607 FESSEHA, ASSAF KAHSAI, MD 8/15/2016 8/15/2021 FAMILY MEDICINE SAN ANTONIO TX ACTIVE 8/22/2016 None N/A PREVENTIVE R4541 FIAZUDDIN, FARAZ , MD 9/8/2017 9/8/2022 INTERNAL MEDICINE MEDICINE SAN ANTONIO TX ACTIVE 10/11/2017 None N/A S5896 FIGUEROA, ELISADEL , MD 4/3/2020 4/3/2025 FAMILY MEDICINE ACTIVE 6/2/2020 None N/A Q4950 FIKE, FRANKIE BETH, MD 7/1/2015 7/1/2020 PEDIATRIC SURGERY DALLAS TX ACTIVE 7/9/2015 None N/A FINDLEY, CLARENCE MAURICE, INTERVENTIONAL CARDIOVASCULAR S5368 MD 3/6/2020 3/6/2025 CARDIOLOGY DISEASES ACTIVE 3/9/2020 None N/A HEMATOLOGY Q5185 FIRAN, MIHAIL , MD 7/15/2015 7/15/2020 PATHOLOGY (PATHOLOGY) HOUSTON TX ACTIVE 7/28/2015 None N/A CRITICAL CARE Q5401 FISHER, BETH ANN, MD 8/3/2015 8/3/2020 MEDICINE (IM) INTERNAL MEDICINE ST. LOUIS MO ACTIVE 8/6/2015 None N/A R3672 FISHER, IAN, MD 6/30/2017 6/30/2022 RADIOLOGY EL PASO TX ACTIVE 7/28/2017 None N/A S6393 FISHER, JOHN THOMAS II, MD 5/1/2020 5/1/2025 FAMILY MEDICINE FAMILY MEDICINE BRYAN TX ACTIVE 5/19/2020 None N/A ANESTHESIOLOGY - R4544 FITZGERALD, COLE ANDREW, MD 9/8/2017 9/8/2022 PAIN MANAGEMENT ANESTHESIOLOGY ACTIVE 9/11/2017 None N/A FITZGERALD, MEKESHIA Q9812 SHUNETTA, DO 8/26/2016 8/26/2021 HOSPITALIST HOUSTON TX ACTIVE 8/31/2016 None N/A S4948 FITZPATRICK, JAMES KEVIN, MD 2/7/2020 2/7/2025 ANESTHESIOLOGY ACTIVE 2/26/2020 None N/A NEONATAL- PERINATAL R3081 FLEIG, LINDSAY, MD 5/22/2017 5/22/2022 PEDIATRICS MEDICINE HOUSTON TX ACTIVE 5/26/2017 None N/A PEDIATRIC ANESTHESIOLOGY Q9813 FLEMING, KAREN , MD 8/26/2016 8/26/2021 (PEDS) HOUSTON TX ACTIVE 9/9/2016 None N/A EMERGENCY Q7191 FLEMING, MICHAEL JAMES, MD 2/16/2016 2/16/2021 MEDICINE BEAUMONT TX ACTIVE 3/14/2016 None N/A S4949 FLEMING, RYAN, MD 2/7/2020 2/7/2025 HOSPITALIST DALLAS TX ACTIVE 2/26/2020 None N/A CAMP Q8054 FLETCHER, JAMES, MD 5/2/2016 5/2/2021 PALLIATIVE MEDICINE NEPHROLOGY LEJEUNE NC ACTIVE 5/11/2016 None N/A

Page 87 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date EMERGENCY R3510 FLETCHER, MICHELLE , DO 6/16/2017 6/16/2022 MEDICINE FT WORTH TX ACTIVE 6/27/2017 None N/A INFECTIOUS Q8717 FLOM, JUDITH, MD 6/10/2016 6/10/2021 INTERNAL MEDICINE DISEASES ACTIVE 6/15/2016 None N/A EMERGENCY CORPUS R1025 FLORA, MARK REED JR, MD 12/16/2016 12/16/2021 MEDICINE CHRISTI TX ACTIVE 12/30/2016 None N/A R1951 FLORA, MONICA KAUR, MD 3/3/2017 3/3/2022 FAMILY MEDICINE TOLEDO OH ACTIVE 3/6/2017 None N/A OBSTETRICS AND GYNECOLOGIC Q8475 FLORES AGUAYO, ANDRES A, MD 6/1/2016 6/1/2021 GYNECOLOGY SURGERY EL PASO TX ACTIVE 6/3/2016 None N/A R5391 FLORES, ABEL MORENO, MD 12/8/2017 12/8/2022 FAMILY MEDICINE HOUSTON TX ACTIVE 1/15/2018 None N/A FAMILY S6395 FLORES, ANTONIO , DO 5/1/2020 5/1/2025 FAMILY PRACTICE PRACTICE/OMM AMARILLO TX ACTIVE 5/4/2020 None N/A Q9994 FLORES, ELEAZAR , MD 9/15/2016 9/15/2021 FAMILY MEDICINE BAYTOWN TX ACTIVE 9/16/2016 None N/A R0570 FLORES, JAMES TAYLOR, MD 10/31/2016 10/31/2021 FAMILY MEDICINE ODESSA TX ACTIVE 11/2/2016 None N/A EMERGENCY Q6831 FLORES, ROBERTO III, MD 1/6/2016 1/6/2021 MEDICINE WACO TX ACTIVE 1/7/2016 None N/A S6396 FLORES, ROSALINDA, MD 5/1/2020 5/1/2025 NEUROLOGY MOBILE AL ACTIVE 5/5/2020 None N/A PEDIATRIC CRITICAL PEDIATRICS, Q9814 FLORES, SAUL, MD 8/26/2016 8/26/2021 CARE MEDICINE CARDIOLOGY HOUSTON TX ACTIVE 9/2/2016 None N/A ORTHOPEDIC SPORTS MEDICINE - Q8884 FLORES, STEPHEN ANDREW, MD 7/1/2016 7/1/2021 SURGERY ORTHOPEDICS LUBBOCK TX ACTIVE 7/15/2016 None N/A S5618 FLORIO, DAVID FRANCIS, MD 3/20/2020 3/20/2025 PEDIATRICS ACTIVE 3/26/2020 None N/A ORTHOPEDIC SPORTS MEDICINE - Q9611 FLOWERS, CHRISTOPHER W, MD 8/15/2016 8/15/2021 SURGERY ORTHOPEDICS DENTON TX ACTIVE 10/18/2016 None N/A EMERGENCY R3082 FLOWERS, DAMIAN M, MD 5/22/2017 5/22/2022 MEDICINE CLEARWATER FL ACTIVE 6/2/2017 None N/A OBSTETRICS AND R3511 FLOWERS, MAUREEN E, MD 6/16/2017 6/16/2022 GYNECOLOGY DALLAS TX ACTIVE 6/19/2017 None N/A GERIATRIC Q5797 FLOYD, CARALYN JEAN, DO 8/28/2015 8/28/2020 PSYCHIATRY PSYCHIATRY ACTIVE 9/1/2015 None N/A S4761 FLOYD, MORGAN , MD 1/24/2020 1/24/2025 GENERAL SURGERY DALLAS TX ACTIVE 1/30/2020 None N/A CARDIOTHORACIC R6004 FLOYD, THOMAS FREDERICK, MD 2/16/2018 2/16/2023 ANESTHESIOLOGY ANESTHESIOLOGY DALLAS TX ACTIVE 2/21/2018 None N/A Q7366 FLYNN, ADAM NEILL, MD 3/4/2016 3/4/2021 FAMILY MEDICINE HOSPITALIST WICHITA KS ACTIVE 3/21/2016 None N/A R4693 FLYNT, LESLEY, MD 9/22/2017 9/22/2022 NUCLEAR MEDICINE HOUSTON TX ACTIVE 10/9/2017 None N/A S4631 FOGELMAN, SANDRA, MD 1/10/2020 1/10/2025 INTERNAL MEDICINE ACTIVE 1/20/2020 None N/A

R2852 FOLEY, LISA SUE, MD 5/5/2017 5/5/2022 VASCULAR SURGERY DALLAS TX ACTIVE 7/11/2017 None N/A ENDOCRINOLOGY, DIABETES AND R6187 FOLKARD, CAMILLE, MD 3/2/2018 3/2/2023 METABOLISM ACTIVE 3/19/2018 None N/A Page 88 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date

OPHTHALMOLOGY - Q8476 FONG, AMELIA ANN, MD 6/1/2016 6/1/2021 OPHTHALMOLOGY RECONST SURGERY DALLAS TX ACTIVE 6/6/2016 None N/A EMERGENCY R4547 FONG, DANIEL JIHYI, MD 9/8/2017 9/8/2022 MEDICINE LAFAYETTE CO ACTIVE 9/13/2017 None N/A DEVELOPMENTAL- BEHAVIORAL R3841 FONSECA, ANACANI, MD 7/17/2017 7/17/2022 PEDIATRICS PEDIATRICS EL PASO TX ACTIVE 9/8/2017 None N/A Q5186 FORAGE, JOHN WILLIAM, MD 7/15/2015 7/15/2020 INTERNAL MEDICINE AMARILLO TX ACTIVE 7/23/2015 None N/A R4407 FORCE, BAHAR KAPOOR, MD 8/25/2017 8/25/2022 INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 8/28/2017 None N/A EMERGENCY Q8244 FORD, JONATHAN ROSS, MD 5/16/2016 5/16/2021 MEDICINE FORT WORTH TX ACTIVE 5/20/2016 None N/A Q9156 FORDE, RUTH SYDNEY, MD 7/15/2016 7/15/2021 FAMILY MEDICINE EL PASO TX ACTIVE 9/13/2016 None N/A S6397 FOREMAN, ADAM , MD 5/1/2020 5/1/2025 NEUROLOGY SLEEP MEDICINE LAFAYETTE LA ACTIVE 5/6/2020 None N/A FORERO MEDINA, NUBIA PAOLA, R2100 MD 3/20/2017 3/20/2022 INTERNAL MEDICINE ACTIVE 4/6/2017 None N/A FORERO, JULIE FREDERICKSON, LICENSE Q8056 DO 5/2/2016 5/2/2021 DERMATOLOGY ISSUED 5/2/2016 None N/A PHYSICAL MED. & J9034 FORREST, ELIZABETH GREER, MD 5/22/2017 5/22/2022 REHABILITATION HOUSTON TX ACTIVE 5/29/2017 None N/A R0714 FORSE, ROBERT ARMOUR, MD 11/15/2016 11/15/2021 GENERAL SURGERY EDINBURG TX ACTIVE 11/22/2016 None N/A S6178 FORSON, JENIFFER, MD 4/17/2020 4/17/2025 PEDIATRICS BROOKLYN NY ACTIVE 5/11/2020 None N/A GASTROENTEROLOG R0571 FOSTER, C JONATHAN DAVID, DO 10/31/2016 10/31/2021 Y INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 11/2/2016 None N/A DIAGNOSTIC PEDIATRIC S4762 FOSTER, JEFFREY LINN, MD 1/24/2020 1/24/2025 RADIOLOGY RADIOLOGY SAN ANTONIO TX ACTIVE 3/23/2020 None N/A OBSTETRICS AND L2889 FOSTER, RAYMOND TODD SR, MD 4/20/2017 4/20/2022 UROGYNECOLOGY GYNECOLOGY COLUMBIA MO ACTIVE 5/1/2017 None N/A FOWLER, TERRY KENNETH R1751 BRUCE, DO 2/22/2017 2/22/2022 FAMILY MEDICINE IRVING TX ACTIVE 3/1/2017 None N/A FOX, CHRISTINA ARETI DIAGNOSTIC LICENSE Q4751 GOUGOUTAS, MD 6/12/2015 6/12/2020 RADIOLOGY BREAST IMAGING ISSUED 6/12/2015 None N/A R0715 FOX, DANIEL PETER, MD 11/15/2016 11/15/2021 OTOLARYNGOLOGY HOUSTON TX ACTIVE 11/21/2016 None N/A DIAGNOSTIC S4950 FOX, KENNETH HARRISON, MD 2/7/2020 2/7/2025 RADIOLOGY PASADENA TX ACTIVE 2/21/2020 None N/A EMERGENCY R0572 FOX, WILLIAM RICHARD, MD 10/31/2016 10/31/2021 MEDICINE DALLAS TX ACTIVE 11/4/2016 None N/A R4221 FRAKES, MARK WAYNE, MD 8/15/2017 8/15/2022 FAMILY MEDICINE BRYAN TX ACTIVE 8/24/2017 None N/A Q5798 FRANCE, ADRIAN KAY, MD 8/28/2015 8/28/2020 PEDIATRICS HOUSTON TX ACTIVE 9/3/2015 None N/A

Page 89 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PEDIATRIC GASTROENTEROLOG R4695 FRANCIS, DENEASE, MD 9/22/2017 9/22/2022 Y PEDIATRICS EL PASO TX ACTIVE 9/25/2017 None N/A PEDIATRIC R5392 FRANCIS, GARY LEE, MD 12/8/2017 12/8/2022 ENDOCRINOLOGY PEDIATRICS SAN ANTONIO TX ACTIVE 12/12/2017 None N/A FRANCIS, JENNY K RODRIGUEZ, ADOLESCENT R3512 MD 6/16/2017 6/16/2022 PEDIATRICS MEDICINE - GP DALLAS TX ACTIVE 7/5/2017 None N/A HAND SURGERY - ORTHOPEDIC ORTHOPEDIC Q7192 FRANCISCO, BEN SCOTT, MD 2/16/2016 2/16/2021 SURGERY SURGERY SAN ANTONIO TX ACTIVE 2/17/2016 None N/A INFECTIOUS S7048 FRANCO PINO, MARIA PIA, MD 6/12/2020 6/12/2025 INTERNAL MEDICINE DISEASES MINNEAPOLIS MN ACTIVE 6/15/2020 None N/A FRANCO VEGA, MARIA CECILIA, R2590 MD 4/20/2017 4/20/2022 INTERNAL MEDICINE HOUSTON TX ACTIVE 6/23/2017 None N/A EMERGENCY R3084 FRANK, DANIEL SCOTT, MD 5/22/2017 5/22/2022 MEDICINE HOUSTON TX ACTIVE 5/23/2017 None N/A OPHTHALMOLOGY - R0716 FRANKEL, RODDY A, MD 11/15/2016 11/15/2021 OPHTHALMOLOGY CORNEA GRAYSLAKE IL ACTIVE 12/9/2016 None N/A SWEETWATE Q8885 FRANKLIN, JORDANNA , MD 7/1/2016 7/1/2021 PEDIATRICS R TX ACTIVE 7/6/2016 None N/A R0397 FRAZIER, WINFRED TAYLOR, MD 10/14/2016 10/14/2021 FAMILY MEDICINE GALVESTON TX ACTIVE 10/18/2016 None N/A ALLERGY AND R0398 FREEDLE, KAREN ANN, MD 10/14/2016 10/14/2021 PEDIATRICS IMMUNOLOGY ACTIVE 10/24/2016 None N/A SURGICAL CRITICAL R4840 FREEMAN, JENNIFER JEAN, MD 10/6/2017 10/6/2022 GENERAL SURGERY CARE FORT WORTH TX ACTIVE 10/11/2017 None N/A R1027 FREEMAN, KIRSTEN ANN, MD 12/16/2016 12/16/2021 GENERAL SURGERY ACTIVE 12/19/2016 None N/A EMERGENCY R1207 FREEMAN, MARTIN PAUL, MD 1/6/2017 1/6/2022 MEDICINE ACTIVE 2/8/2017 None N/A CRITICAL CARE R3842 FREEMAN, RACHEL , MD 7/17/2017 7/17/2022 ANESTHESIOLOGY ANESTHESIOLOGY SAN ANTONIO TX ACTIVE 8/22/2017 None N/A FREEMAN, RICHARD BENTON JR, TRANSPLANT Q7371 MD 3/4/2016 3/4/2021 SURGERY GENERAL SURGERY AUSTIN TX ACTIVE 4/19/2016 None N/A R4043 FRENCH, TRACI, MD 8/1/2017 8/1/2022 FAMILY PRACTICE BELTON TX ACTIVE 8/9/2017 None N/A SEE EMERGENCY PREVIOUS R4044 FRIEBERTSHAUSER, LUKE , DO 8/1/2017 8/1/2022 MEDICINE AUSTIN TX ACTIVE 8/14/2017 ORDER 3/30/2016 PLASTIC & RECONSTRUCTIVE HAND SURGERY - S6615 FRIEDMAN, ANDREW CRAIG, MD 5/15/2020 5/15/2025 SURGERY PLASTIC SURGERY EL PASO TX ACTIVE 5/19/2020 None N/A DIAGNOSTIC Q8887 FRIEMEL, STEFAN , MD 7/1/2016 7/1/2021 RADIOLOGY TEMPLE TX ACTIVE 7/4/2016 None N/A Page 90 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PEDIATRIC EMERGENCY EMERGENCY Q4752 FRIESEN, PHILLIP AUSTEN, DO 6/12/2015 6/12/2020 MEDICINE MEDICINE (EM) AUSTIN TX ACTIVE 6/15/2015 None N/A PLASTIC & RECONSTRUCTIVE CRANIOFACIAL R3844 FROMMER, SARAH ANNE, MD 7/17/2017 7/17/2022 SURGERY SURGERY AUSTIN TX ACTIVE 7/19/2017 None N/A Q5802 FRONTZ, REBECCA LEAH, DO 8/28/2015 8/28/2020 PEDIATRICS KATY TX ACTIVE 9/1/2015 None N/A FRUCHTMAN, PARINDA R1752 KANAIYALAL, MD 2/22/2017 2/22/2022 FAMILY MEDICINE ACTIVE 3/5/2018 None N/A Q8057 FU, QIUYU , MD 5/2/2016 5/2/2021 FAMILY MEDICINE HOSPITALIST TEXARKANA TX ACTIVE 5/3/2016 None N/A

S6181 FUBARA, DEBORAH SOTONYE, MD 4/17/2020 4/17/2025 ANESTHESIOLOGY DALLAS TX ACTIVE 5/4/2020 None N/A ORTHOPEDIC FOOT AND ANKLE, Q8058 FUCHS, DANIEL JOSEPH, MD 5/2/2016 5/2/2021 SURGERY ORTHOPEDICS DALLAS TX ACTIVE 5/4/2016 None N/A Q6939 FULLER, AUDRA JANE, MD 1/15/2016 1/15/2021 INTERNAL MEDICINE LUBBOCK TX ACTIVE 1/28/2016 None N/A ANESTHESIOLOGY - BEVERLY Q6011 FULLER, NICHOLAS S, MD 9/15/2015 9/15/2020 PAIN MANAGEMENT ANESTHESIOLOGY HILLS CA ACTIVE 9/21/2015 None N/A

Q5803 FUSI, STEFANO, MD 8/28/2015 8/28/2020 PLASTIC SURGERY GENERAL SURGERY GUILFORD CT ACTIVE 9/2/2015 None N/A GABANI, PRASHANT SHANTILAL, RADIATION S5619 MD 3/20/2020 3/20/2025 ONCOLOGY RADIATION THERAPY ACTIVE 3/24/2020 None N/A PHYSICAL MED. & S6183 GABRIEL, SHAUN, MD 4/17/2020 4/17/2025 PAIN MEDICINE REHABILITATION LONE TREE CO ACTIVE 6/9/2020 None N/A

R2853 GABRIELSEN, JOSEPH SCOTT, MD 5/5/2017 5/5/2022 UROLOGIC SURGERY UROLOGY HOUSTON TX ACTIVE 6/5/2017 None N/A CARDIOVASCULAR INTERVENTIONAL R4698 GADDAM, SAINATH, MD 9/22/2017 9/22/2022 DISEASES CARDIOLOGY MANSFIELD TX ACTIVE 9/25/2017 None N/A R0399 GADDAM, SRIKANTH, MD 10/14/2016 10/14/2021 FAMILY MEDICINE HOSPITALIST MESQUITE TX ACTIVE 10/24/2016 None N/A INTERVENTIONAL CARDIOVASCULAR R0717 GADGIL, JAY YESHAWANT, MD 11/15/2016 11/15/2021 CARDIOLOGY DISEASES ACTIVE 11/17/2016 None N/A Q6012 GADGIL, MEGHANA, MD 9/15/2015 9/15/2020 INTERNAL MEDICINE HOSPITALIST AUSTIN TX ACTIVE 9/16/2015 None N/A TEXAS LICENSE N1638 GADHIA, MONIKA, MD 11/16/2015 11/16/2020 NEONATOLOGY DALLAS TX ISSUED 11/16/2015 None N/A VASCULAR R0573 GADHIA, RAJAN RAMJI, MD 10/31/2016 10/31/2021 NEUROLOGY NEUROLOGY HOUSTON TX ACTIVE 11/23/2016 None N/A Q9998 GADIPARTHI, CHIRANJEEVI , MD 9/15/2016 9/15/2021 INTERNAL MEDICINE HEPATOLOGY MEMPHIS TN ACTIVE 10/10/2016 None N/A PEDIATRIC ANESTHESIOLOGY Q5804 GAINOR, ROBERT EDWARD, MD 8/28/2015 8/28/2020 ANESTHESIOLOGY (PEDS) FRESNO CA ACTIVE 9/14/2015 None N/A

Page 91 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date GAITONDE, SHRAWAN GAJANAN, SURGICAL R4699 MD 9/22/2017 9/22/2022 ONCOLOGY GENERAL SURGERY MCKINNEY TX ACTIVE 9/26/2017 None N/A Q4580 GAJANAYAKA, RANIL, MD 6/1/2015 6/1/2020 INTERNAL MEDICINE NEPHROLOGY ACTIVE 6/12/2015 None N/A Q9351 GAJENDRAN, MAHESH, MD 8/1/2016 8/1/2021 INTERNAL MEDICINE EL PASO TX ACTIVE 8/23/2016 None N/A

S6184 GAJJAR, SAMEER RAJENDRA, MD 4/17/2020 4/17/2025 PEDIATRICS SAN ANTONIO TX ACTIVE 4/20/2020 None N/A MUSCULOSKELETAL ABDOMINAL LICENSE Q4753 GALANTE, NICHOLAS JOSEPH, MD 6/12/2015 6/12/2020 IMAGING RADIOLOGY ISSUED 6/12/2015 None N/A FACIAL PLASTIC R6005 GALE, DERRICK CRIPPS, MD 2/16/2018 2/16/2023 SURGERY OTOLARYNGOLOGY SAN ANTONIO TX ACTIVE 2/28/2018 None N/A S6839 GALES, JORDAN MICHAEL, MD 5/29/2020 5/29/2025 INTERNAL MEDICINE CARDIOLOGY HOUSTON TX ACTIVE 6/2/2020 None N/A LICENSE R5549 GALI, KRISHNA KANTH, MD 1/5/2018 1/5/2023 INTERNAL MEDICINE HOSPITALIST ISSUED 1/5/2018 None N/A GYNECOLOGIC GYNECOLOGIC R0860 GALIC, VIJAYA LAKSHMI, MD 12/2/2016 12/2/2021 ONCOLOGY SURGERY EL PASO TX ACTIVE 1/11/2017 None N/A LICENSE S6840 GALLAGHER, MARIAM, DO 5/29/2020 5/29/2025 FAMILY MEDICINE ISSUED 5/29/2020 None N/A GALLEGO SANCHEZ, HECTOR D, WEST S7050 MD 6/12/2020 6/12/2025 INTERNAL MEDICINE MONROE LA ACTIVE 6/17/2020 None N/A EMERGENCY Q8479 GALLEGOS, ANALYSA, MD 6/1/2016 6/1/2021 MEDICINE NASSAU BAY TX ACTIVE 6/16/2016 None N/A LICENSE Q5405 GALLEGOS, CINTHIA , MD 8/3/2015 8/3/2020 INTERNAL MEDICINE ISSUED 8/3/2015 None N/A RADIATION S5899 GALVAN, EVA MERCEDES, MD 4/3/2020 4/3/2025 ONCOLOGY SAN ANTONIO TX ACTIVE 4/20/2020 None N/A ABDOMINAL LICENSE S6618 GALVANI, CARLOS ALBERTO, MD 5/15/2020 5/15/2025 GENERAL SURGERY SURGERY ISSUED 5/15/2020 None N/A GALVEZ ESCOBAR, JOSE S6619 ROBERTO, MD 5/15/2020 5/15/2025 INTERNAL MEDICINE EL PASO TX ACTIVE 5/20/2020 None N/A R5862 GALVEZ, LENOY, MD 2/2/2018 2/2/2023 PSYCHIATRY PSYCHIATRY SUMMIT NJ ACTIVE 2/19/2018 None N/A ANATOMIC/CLINICAL R0861 GAMEZ, ROBERTO GABRIEL, MD 12/2/2016 12/2/2021 PATHOLOGY EL PASO TX ACTIVE 12/9/2016 None N/A R2338 GAMMONS, SARAH , MD 4/4/2017 4/4/2022 PEDIATRICS DALLAS TX ACTIVE 4/7/2017 None N/A DELINQUEN DIAGNOSTIC T-NON R5394 GAN, FANG-YUN, MD 12/8/2017 12/8/2022 RADIOLOGY NUCLEAR MEDICINE PAYMENT 3/8/2018 None N/A CORPUS S6185 GANDHI, ARPIT HARSHAD, MD 4/17/2020 4/17/2025 RADIOLOGY NEURO-RADIOLOGY CHRISTI TX ACTIVE 4/30/2020 None N/A Q6627 GANDHI, AVANTI LATTHE, MD 12/4/2015 12/4/2020 INTERNAL MEDICINE ACTIVE 12/8/2015 None N/A Q6627 GANDHI, AVANTI LATTHE, MD 12/4/2015 12/4/2020 INTERNAL MEDICINE ACTIVE 12/8/2015 None N/A Q6627 GANDHI, AVANTI LATTHE, MD 12/4/2015 12/4/2020 INTERNAL MEDICINE ACTIVE 12/8/2015 None N/A Page 92 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date

NEONATAL- Q5654 GANDHI, BHERU BHARAT, MD 8/14/2015 8/14/2020 PERINATAL MEDICINE PEDIATRICS HOUSTON TX ACTIVE 8/25/2015 None N/A R3675 GANDHI, JEET , MD 6/30/2017 6/30/2022 INTERNAL MEDICINE NEPHROLOGY ACTIVE 7/26/2017 None N/A RADIATION R0400 GANDHI, SAUMIL, MD 10/14/2016 10/14/2021 ONCOLOGY HOUSTON TX ACTIVE 10/27/2016 None N/A R0333 GANDHIR, ANKITA, MD 9/30/2016 9/30/2021 NEPHROLOGY INTERNAL MEDICINE BAYTOWN TX ACTIVE 10/3/2016 None N/A R3514 GANESHAN, DEEPA, MD 6/16/2017 6/16/2022 PEDIATRICS DANBURY CT ACTIVE 6/19/2017 None N/A GANGANI, KISHORBHAI R1208 JADAVBHAI, MD 1/6/2017 1/6/2022 INTERNAL MEDICINE ARLINGTON TX ACTIVE 1/27/2017 None N/A CARDIAC ELECTROPHYSIOLO N2081 GANGASANI, ASHISH , MD 4/1/2016 4/1/2021 CARDIOLOGY GY TYLER TX ACTIVE 4/22/2016 None N/A Q8059 GANIM, NIDAL MAZEN, MD 5/2/2016 5/2/2021 INTERNAL MEDICINE ACTIVE 5/6/2016 None N/A ORAL & MAXILLOFACIAL S5902 GANTI, AJAY, MD 4/3/2020 4/3/2025 SURGERY WYLIE TX ACTIVE 4/7/2020 None N/A MEDICAL TOXICOLOGY EMERGENCY (EMERGENCY LICENSE S7052 GAO, HAN TONY, MD 6/12/2020 6/12/2025 MEDICINE MEDICINE) ISSUED 6/12/2020 None N/A GASTROENTEROLOG GASTROENTEROLOG R5116 GAO, HONG, MD 11/3/2017 11/3/2022 Y Y TALLAHASSEE FL ACTIVE 12/18/2017 None N/A S4473 GAO, HUI, MD 12/20/2019 12/20/2024 FAMILY MEDICINE AUSTIN TX ACTIVE 2/3/2020 None N/A Q5406 GARAGHTY, ANNIE TOUNG, DO 8/3/2015 8/3/2020 FAMILY MEDICINE ACTIVE 8/17/2015 None N/A GARAY CLAUDIO, MARIA ELENA, PEMBROKE R1368 MD 1/20/2017 1/20/2022 PEDIATRICS PINES FL ACTIVE 1/30/2017 None N/A S5903 GARAY, KAREN LEE, MD 4/3/2020 4/3/2025 PEDIATRICS SAN ANTONIO TX ACTIVE 4/14/2020 None N/A Q9816 GARAY, RAUL, MD 8/26/2016 8/26/2021 FAMILY MEDICINE BONHAM TX ACTIVE 9/13/2016 None N/A VASCULAR AND INTERVENTIONAL Q4581 GARBETT, DONALD LEE, MD 6/1/2015 6/1/2020 RADIOLOGY RADIOLOGY CYPRESS TX ACTIVE 6/2/2015 None N/A EMERGENCY R0574 GARBO, GRANT, MD 10/31/2016 10/31/2021 MEDICINE SAN ANTONIO TX ACTIVE 11/3/2016 None N/A GARCIA FAJARDO, CARLOS Q6014 ERNESTO, MD 9/15/2015 9/15/2020 FAMILY MEDICINE SAN ANTONIO TX ACTIVE 9/17/2015 None N/A S6842 GARCIA GIL, MAURILIO, MD 5/29/2020 5/29/2025 UROLOGY SAN ANTONIO TX ACTIVE 6/5/2020 None N/A GARCIA JACQUES, JESUS PEDIATRIC CRITICAL R4224 ROGELIO, MD 8/15/2017 8/15/2022 PEDIATRICS CARE MEDICINE SAN ANTONIO TX ACTIVE 8/22/2017 None N/A

Page 93 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date OBSTETRICS & GARCIA SOTO, ARLENE ESTHER, GYNECOLOGIC GYNECOLOGICAL Q7372 MD 3/4/2016 3/4/2021 ONCOLOGY SURGERY DALLAS TX ACTIVE 3/21/2016 None N/A PEDIATRIC ANESTHESIOLOGY Q6940 GARCIA, GERALD MATTHEW, DO 1/15/2016 1/15/2021 ANESTHESIOLOGY (PEDS) PLANO TX ACTIVE 1/27/2016 None N/A LICENSE Q4754 GARCIA, JAYNE MARIN, MD 6/12/2015 6/12/2020 INTERNAL MEDICINE HOSPITALIST ISSUED 6/12/2015 None N/A CORPUS R4045 GARCIA, MARIA ANTONIETTA, MD 8/1/2017 8/1/2022 FAMILY MEDICINE CHRISTI TX ACTIVE 8/3/2017 None N/A R4390 GARCIA, MARLENE , MD 8/25/2017 8/25/2022 CARDIOLOGY SAN ANTONIO TX ACTIVE 10/4/2017 None N/A PHYSICAL MED. & LICENSE Q4755 GARCIA, OMAR , MD 6/12/2015 6/12/2020 REHABILITATION ISSUED 6/12/2015 None N/A Q6190 GARCIA, RICARDO JR, DO 10/1/2015 10/1/2020 FAMILY PRACTICE BRYAN TX ACTIVE 10/19/2015 None N/A INACTIVE- OBSTETRICS & PRELIM TO GARCIA-OCASIO, RAFAEL GYNECOLOGICAL BECOMING R2103 EDUARDO, MD 3/20/2017 3/20/2022 SURGERY HIALEAH FL CN/CR 1/31/2018 None N/A Q7875 GARDINER, LESLEY , MD 4/15/2016 4/15/2021 PEDIATRICS TEMPLE TX ACTIVE 4/26/2016 None N/A R5263 GAREE-DEXTER, JADE , MD 11/17/2017 11/17/2022 PEDIATRICS SAN ANTONIO TX ACTIVE 1/5/2018 None N/A EMERGENCY Q7876 GARFF, ANDREW STEWART, MD 4/15/2016 4/15/2021 MEDICINE ACTIVE 4/25/2016 None N/A R0575 GARG, ANJALI, MD 10/31/2016 10/31/2021 INTERNAL MEDICINE HOUSTON TX ACTIVE 11/9/2016 None N/A Q9157 GARG, SONIA, MD 7/15/2016 7/15/2021 CARDIOLOGY INTERNAL MEDICINE DALLAS TX ACTIVE 8/9/2016 None N/A EMERGENCY R2593 GARGANO, TABITHA JANE, MD 4/20/2017 4/20/2022 MEDICINE SAN ANTONIO TX ACTIVE 5/12/2017 None N/A INTERVENTIONAL Q9158 GARIKIPATI, SIREESHA , MD 7/15/2016 7/15/2021 CARDIOLOGY CARDIOLOGY LUFKIN TX ACTIVE 7/19/2016 None N/A

S6399 GARLAND, MYRIAM ANDREA, MD 5/1/2020 5/1/2025 PEDIATRICS ACTIVE 5/13/2020 None N/A R3846 GARLAPATI, VINAY REDDY, MD 7/17/2017 7/17/2022 HOSPITALIST ACTIVE 10/9/2017 None N/A R4701 GAROFALO, JAMES H, MD 9/22/2017 9/22/2022 ANESTHESIOLOGY ALTOONA PA ACTIVE 9/28/2017 None N/A RADIATION Q6413 GARREN, JOSHUA DAVID, MD 11/2/2015 11/2/2020 ONCOLOGY DALLAS TX ACTIVE 11/3/2015 None N/A Q7553 GARREPALLI, SWAPNA, MD 3/15/2016 3/15/2021 INTERNAL MEDICINE BRONX NY ACTIVE 3/21/2016 None N/A S6400 GARRETT, DAVID LEE, MD 5/1/2020 5/1/2025 INTERNAL MEDICINE HOUSTON TX ACTIVE 5/12/2020 None N/A GARRIDO MORALES, JUAN PABLO, Q9613 MD 8/15/2016 8/15/2021 INTERNAL MEDICINE AMARILLO TX ACTIVE 8/16/2016 None N/A OBSTETRICS & OBSTETRICS AND GYNECOLOGICAL LICENSE S6189 GARZA CAVAZOS, ARTURO, MD 4/17/2020 4/17/2025 GYNECOLOGY SURGERY ISSUED 4/17/2020 None N/A Page 94 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date GARZA ROMERO, AARON CALEV, Q6015 MD 9/15/2015 9/15/2020 RHEUMATOLOGY INTERNAL MEDICINE NEW YORK NY ACTIVE 10/8/2015 None N/A GARZA SALINAS, FRANCISCO R1955 RAUL, MD 3/3/2017 3/3/2022 FAMILY MEDICINE SAN MARCOS TX ACTIVE 3/13/2017 None N/A EMERGENCY S5622 GARZA, ANNA ALICIA, MD 3/20/2020 3/20/2025 MEDICINE ACTIVE 3/24/2020 None N/A SPORTS MEDICINE R2595 GARZA, EDUARDO JESUS, MD 4/20/2017 4/20/2022 FAMILY MEDICINE (FAMILY PRACTICE) ACTIVE 4/21/2017 None N/A OBSTETRICS AND GYNECOLOGIC LICENSE Q8482 GARZA, ERICA CELINA, MD 6/1/2016 6/1/2021 GYNECOLOGY SURGERY ISSUED 6/1/2016 None N/A CORPUS Q8247 GARZA, ERIK , MD 5/16/2016 5/16/2021 FAMILY MEDICINE CHRISTI TX ACTIVE 5/24/2016 None N/A R2339 GARZA, JESSICA ERIN, MD 4/4/2017 4/4/2022 INTERNAL MEDICINE TEMPLE TX ACTIVE 4/13/2017 None N/A R5396 GARZA, JOSE, MD 12/8/2017 12/8/2022 INTERNAL MEDICINE ACTIVE 12/11/2017 None N/A PLASTIC & RECONSTRUCTIVE Q9159 GARZA, RAMON III, MD 7/15/2016 7/15/2021 SURGERY MICROSURGERY SAN ANTONIO TX ACTIVE 7/22/2016 None N/A GASCOIGNE, RICHARD HOLT JR, SALT LAKE AM00071 MD 6/1/2016 6/1/2021 FAMILY MEDICINE CITY UT ACTIVE 6/14/2016 None N/A GATCLIFFE, CHELSEA ANN MARY, PEDIATRIC S4763 MD 1/24/2020 1/24/2025 PULMONOLOGY ACTIVE 2/3/2020 None N/A S4474 GAUTAM, SHOVENDRA, MD 12/20/2019 12/20/2024 INTERNAL MEDICINE HOSPITALIST NEW BRITAIN CT ACTIVE 1/13/2020 None N/A GRAND Q4956 GAVALDA, JUAN CARLOS, MD 7/1/2015 7/1/2020 FAMILY MEDICINE PRAIRIE TX ACTIVE 7/6/2015 None N/A Q6192 GAVINO, CHRISTINE KAY, DO 10/1/2015 10/1/2020 FAMILY MEDICINE BAYTOWN TX ACTIVE 10/8/2015 None N/A PEDIATRIC DELINQUEN GAVIRIA AGUDELO, CLAUDIA INFECTIOUS T-NON Q0443 LORENA, MD 11/3/2017 11/3/2022 PEDIATRICS DISEASE PAYMENT 2/1/2018 None N/A JOHNSON Q8890 GAVIRNENI, MADHAVI, MD 7/1/2016 7/1/2021 PEDIATRICS CITY TN ACTIVE 8/4/2016 None N/A R3676 GAVITO, DAVID ALFONSO, MD 6/30/2017 6/30/2022 PSYCHIATRY ROUND ROCK TX ACTIVE 7/3/2017 None N/A CLINICAL Q7373 GAVVALA, JAY R, MD 3/4/2016 3/4/2021 NEUROPHYSIOLOGY NEUROLOGY HOUSTON TX ACTIVE 3/14/2016 None N/A Q7194 GAVVALA, SHEELA LAXMI, DO 2/16/2016 2/16/2021 PEDIATRICS AUSTIN TX ACTIVE 3/2/2016 None N/A FP/OSTEO MANIPULATION R6194 GAZI, ISRAT JAHAN, DO 3/2/2018 3/2/2023 MEDICINE ACTIVE 3/12/2018 None N/A PLASTIC & RECONSTRUCTIVE CRANIOFACIAL R3677 GBULIE, UZOMA BEN, MD 6/30/2017 6/30/2022 SURGERY SURGERY ACTIVE 8/3/2017 None N/A Q9354 GEHI, DIVYA , MD 8/1/2016 8/1/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 8/3/2016 None N/A Page 95 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date COLON AND RECTAL LICENSE Q8483 GEISLER, DANIEL PHILLIP, MD 6/1/2016 6/1/2021 SURGERY ISSUED 6/1/2016 None N/A PULMONARY CRITICAL CARE S6843 GEKHMAN, DANIIL , DO 5/29/2020 5/29/2025 MEDICINE INTERNAL MEDICINE HOUSTON TX ACTIVE 6/1/2020 None N/A GELLMAN BISKAMP, SARAH ROSE, S5168 MD 2/21/2020 2/21/2025 PEDIATRICS ACTIVE 3/23/2020 None N/A PEDIATRIC Q5407 GELONECK, MEGAN MCREE, MD 8/3/2015 8/3/2020 OPHTHALMOLOGY HOUSTON TX ACTIVE 8/5/2015 None N/A GELPI-HAMMERSCHMIDT, UROLOGIC Q6415 FRANCISCO JOSE, MD 11/2/2015 11/2/2020 UROLOGY ONCOLOGY HOUSTON TX ACTIVE 11/4/2015 None N/A Q4583 GEORGE, CHRISTINA M, MD 6/1/2015 6/1/2020 FAMILY MEDICINE HOUSTON TX ACTIVE 6/10/2015 None N/A OPHTHALMOLOGY - LICENSE S6844 GEORGE, ROSHAN THOMAS, MD 5/29/2020 5/29/2025 VITREOUS SURGERY ISSUED 5/29/2020 None N/A THORACIC CARDIOVASCULAR CARDIOVASCULAR Q7879 GEORGE, TIMOTHY JACOB, MD 4/15/2016 4/15/2021 SURGERY SURGERY PLANO TX ACTIVE 4/25/2016 None N/A Q6834 GEORGE, VERGHESE , MD 1/6/2016 1/6/2021 RADIOLOGY NUCLEAR MEDICINE HOUSTON TX ACTIVE 1/18/2016 None N/A GEORGESCU, MARIA MAGDALENA, R1956 MD 3/3/2017 3/3/2022 PATHOLOGY NEURO-PATHOLOGY SHREVEPORT LA ACTIVE 3/8/2017 None N/A R4392 GEORGIEV, ANTON L, DO 8/25/2017 8/25/2022 GENERAL SURGERY BERWICK PA ACTIVE 9/11/2017 None N/A ORTHOPEDIC R4046 GERKEN, NICHOLAS EDWARD, MD 8/1/2017 8/1/2022 SURGERY SAN ANTONIO TX ACTIVE 8/3/2017 None N/A OTORHINOLARYNGOL R1370 GERMANI, ROSS MICHAEL, MD 1/20/2017 1/20/2022 OGY RHINOLOGY GREENVILLE SC ACTIVE 1/31/2017 None N/A HAND SURGERY - ORTHOPEDIC ORTHOPEDIC Q9355 GEROLD, FRANK JOSEPH, MD 8/1/2016 8/1/2021 SURGERY SURGERY MCALLEN TX ACTIVE 8/12/2016 None N/A PEDIATRIC CARDIOVASCULAR CARDIOTHORACIC R1029 GERRAH, RABIN, MD 12/16/2016 12/16/2021 SURGERY SURGERY DALLAS TX ACTIVE 12/22/2016 None N/A Q7374 GERTSCH, MATTHEW C, MD 3/4/2016 3/4/2021 ANESTHESIOLOGY LUBBOCK TX ACTIVE 3/21/2016 None N/A Q5655 GESLANI, JOANNA LEUNG, DO 8/14/2015 8/14/2020 RHEUMATOLOGY DALLAS TX ACTIVE 8/24/2015 None N/A S5623 GEURINK, KYLE ROBERT, MD 3/20/2020 3/20/2025 CARDIOLOGY INTERNAL MEDICINE DALLAS TX ACTIVE 3/27/2020 None N/A SPORTS MEDICINE MUNFORDVILL R0864 GHAFFAR, MUTEEB, MD 12/2/2016 12/2/2021 FAMILY MEDICINE (FAMILY PRACTICE) E KY ACTIVE 12/21/2016 None N/A Q7044 GHALAMBOR, OMID, MD 2/1/2016 2/1/2021 ANESTHESIOLOGY PAIN MANAGEMENT EFFINGHAM IL ACTIVE 2/9/2016 None N/A GASTROENTEROLOG L2898 GHALEB, ALINE, MD 7/15/2016 7/15/2021 Y ROUND ROCK TX ACTIVE 8/16/2016 None N/A

Page 96 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date THORACIC CARDIOVASCULAR R0576 GHANTA, RAVI KIRAN, MD 10/31/2016 10/31/2021 SURGERY MC 390 TX ACTIVE 1/30/2017 None N/A PEDIATRICS, DELINQUEN ALLERGY & T-NON Q7045 GHARFEH, MAYA , MD 2/1/2016 2/1/2021 PEDIATRICS IMMUNOLOGY PAYMENT 5/1/2016 None N/A MATERNAL AND R5264 GHARTEY, JENY, DO 11/17/2017 11/17/2022 OBSTETRICS FETAL MEDICINE AUSTIN TX ACTIVE 12/20/2017 None N/A OBSTETRICS AND MATERNAL AND R3516 GHARTEY, KOBINA, MD 6/16/2017 6/16/2022 GYNECOLOGY FETAL MEDICINE AUSTIN TX ACTIVE 6/28/2017 None N/A INTERVENTIONAL Q5408 GHATAK, ABHIJIT, MD 8/3/2015 8/3/2020 CARDIOLOGY CARDIOLOGY LAS CRUCES NM ACTIVE 9/7/2015 None N/A Q7375 GHAWI, HANI, MD 3/4/2016 3/4/2021 CARDIOLOGY DOHA ACTIVE 3/11/2016 None N/A OBSTETRICS AND R1757 GHAZAL, SAIMA, MD 2/22/2017 2/22/2022 GYNECOLOGY COLUMBUS TX ACTIVE 5/1/2017 None N/A R0719 GHORI, ABDULLA KHAN, MD 11/15/2016 11/15/2021 PEDIATRICS CLEVELAND OH ACTIVE 1/19/2017 None N/A DIAGNOSTIC R2104 GHORI, SAIMA, MD 3/20/2017 3/20/2022 RADIOLOGY NEURO-RADIOLOGY HOUSTON TX ACTIVE 3/23/2017 None N/A S4764 GHOSN, JEAN , MD 1/24/2020 1/24/2025 FAMILY MEDICINE RICHMOND TX ACTIVE 1/30/2020 None N/A NEUROLOGY/DIAGNO STIC RAD/NEURORADIOLO INTERVENTIONAL S6401 GHOSTINE, JIMMY, MD 5/1/2020 5/1/2025 GY RADIOLOGY MONTREAL ACTIVE 5/4/2020 None N/A Q8485 GHOTRA, AMANINDERAPAL , MD 6/1/2016 6/1/2021 INTERNAL MEDICINE INTERNAL MEDICINE ACTIVE 6/17/2016 None N/A PEDIATRIC CRITICAL R0235 GIAMBRUNO, CLARA, MD 9/30/2016 9/30/2021 CARE MEDICINE HARLINGEN TX ACTIVE 10/27/2016 None N/A

Q5409 GIAMPAOLO, JENNIFER RETH, MD 8/3/2015 8/3/2020 PSYCHIATRY DALLAS TX ACTIVE 8/5/2015 None N/A ORTHOPEDIC Q7880 GIANG, ERIC LE, DO 4/15/2016 4/15/2021 SURGERY DALLAS TX ACTIVE 4/21/2016 None N/A R3327 GIBBONS, SARAH KATHRYN, DO 6/2/2017 6/2/2022 NEUROLOGY DALLAS TX ACTIVE 6/9/2017 None N/A ORTHOPEDIC SPORTS MEDICINE N7924 GIBBS, JOHNNY MANOON, MD 4/20/2017 4/20/2022 SURGERY (ORTH SURG) LAKELAND FL ACTIVE 5/5/2017 None N/A GIBBS, RANDOLPH DOUGLAS II, HAND SURGERY - R5119 MD 11/3/2017 11/3/2022 GENERAL SURGERY SURGERY BRYAN TX ACTIVE 11/15/2017 None N/A PULMONARY CRITICAL CARE N8296 GIBSON, RACHELE ANN, MD 8/28/2015 8/28/2020 MEDICINE INTERNAL MEDICINE HOUSTON TX ACTIVE 9/2/2015 None N/A R1531 GIBSON, SARA , MD 2/6/2017 2/6/2022 PEDIATRICS AUSTIN TX ACTIVE 2/17/2017 None N/A PEDIATRIC CRITICAL S5625 GIL, DANNY VELA, MD 3/20/2020 3/20/2025 CARE MEDICINE ATLANTA GA ACTIVE 5/4/2020 None N/A Page 97 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date EMERGENCY R4843 GILBERT, ASHLEY JANE, MD 10/6/2017 10/6/2022 MEDICINE SAN ANTONIO TX ACTIVE 10/9/2017 None N/A Q6017 GILBERT, LOUIS , DO 9/15/2015 9/15/2020 FAMILY MEDICINE HOUSTON TX ACTIVE 9/22/2015 None N/A

R5120 GILES, MERCEDES ANTONIA, MD 11/3/2017 11/3/2022 FAMILY MEDICINE ACTIVE 1/8/2018 None N/A EMERGENCY R2106 GILIBERTO, BRIANNE, DO 3/20/2017 3/20/2022 MEDICINE AZLE TX ACTIVE 3/28/2017 None N/A INTERVENTIONAL R2856 GILL, GUNVIR SINGH, MD 5/5/2017 5/5/2022 RADIOLOGY RADIOLOGY GALVESTON TX ACTIVE 6/8/2017 None N/A PEDIATRIC HEMATOLOGY/ONCOL R3085 GILL, JONATHAN BENJAMIN, MD 5/22/2017 5/22/2022 OGY HOUSTON TX ACTIVE 6/8/2017 None N/A R1533 GILL, RAHUL , MD 2/6/2017 2/6/2022 INTERNAL MEDICINE ACTIVE 2/8/2017 None N/A FAMILY PRACTICE - FAMILY PRACTICE - R0005 GILL, SHABAZ QUMAR, MD 9/15/2016 9/15/2021 EMERGENCY MED EMERGENCY MED VICTORIA TX ACTIVE 9/22/2016 None N/A R0236 GILLESPIE, MICHAEL , MD 9/30/2016 9/30/2021 PSYCHIATRY GALVESTON TX ACTIVE 10/5/2016 None N/A EMERGENCY S4954 GILLILAND, BLAKE AARON, MD 2/7/2020 2/7/2025 MEDICINE SAN ANTONIO TX ACTIVE 2/13/2020 None N/A Q7555 GILLIS, HOLLY CATHERINE, MD 3/15/2016 3/15/2021 PEDIATRICS HOUSTON TX ACTIVE 3/29/2016 None N/A CORPUS R4227 GILLIS, NATHAN , DO 8/15/2017 8/15/2022 INTERNAL MEDICINE CHRISTI TX ACTIVE 8/17/2017 None N/A R1030 GILLISON, MAURA LIANNE, MD 12/16/2016 12/16/2021 ONCOLOGY HOUSTON TX ACTIVE 1/5/2017 None N/A ORTHOPEDIC Q4957 GILLMAN, BRAD M, MD 7/1/2015 7/1/2020 SURGERY SAN ANTONIO TX ACTIVE 7/2/2015 None N/A PEDIATRIC EMERGENCY R2107 GILLON, JASON THOMAS, MD 3/20/2017 3/20/2022 MEDICINE (PEDS) PEDIATRICS AUSTIN TX ACTIVE 3/22/2017 None N/A Q4958 GILLORY, LAUREN ANN, MD 7/1/2015 7/1/2020 GENERAL SURGERY HOUSTON TX ACTIVE 9/4/2015 None N/A EMERGENCY R5555 GILMAN, LAURA ANNE, MD 1/5/2018 1/5/2023 MEDICINE ACTIVE 1/11/2018 None N/A OBSTETRICS AND Q9162 GINGRICH, TINA MARIE, MD 7/15/2016 7/15/2021 GYNECOLOGY MARYVILLE IL ACTIVE 7/25/2016 None N/A DELINQUEN T-NON Q7046 GINNE, PURSHOTHAM REDDY, MD 2/1/2016 2/1/2021 INTERNAL MEDICINE HOSPITALIST PAYMENT 5/1/2016 None N/A EMERGENCY R2108 GIORDANO, JONATHAN, DO 3/20/2017 3/20/2022 MEDICINE HOUSTON TX ACTIVE 3/22/2017 None N/A GIRJASHANKER, RAMESH NARINE, URGENT CARE COCOA R1371 MD 1/20/2017 1/20/2022 INTERNAL MEDICINE MEDICINE BEACH FL ACTIVE 1/25/2017 None N/A

Page 98 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date

FACIAL PLASTIC OTOLARYN & FACIAL S6622 GIVENS, VICTORIA BRIGHTON, MD 5/15/2020 5/15/2025 SURGERY PLASTIC SURGERY AUSTIN TX ACTIVE 6/8/2020 None N/A R4968 GIVNER, SARAH, MD 10/20/2017 10/20/2022 PEDIATRICS CEDAR PARK TX ACTIVE 12/7/2017 None N/A FAMILY PRACTICE - R4704 GIYANANI, RACHEL MICHELLE, MD 9/22/2017 9/22/2022 EMERGENCY MED CULLMAN AL ACTIVE 10/6/2017 None N/A R1031 GLASS, DARREN ROBERT, MD 12/16/2016 12/16/2021 GENERAL SURGERY ODESSA TX ACTIVE 12/23/2016 None N/A URGENT CARE Q7376 GLASS, ERIC EDWARD, MD 3/4/2016 3/4/2021 GENERAL PRACTICE MEDICINE EL PASO TX ACTIVE 3/14/2016 None N/A Q6018 GLASS, KRISTINE MUNOZ, MD 9/15/2015 9/15/2020 PSYCHIATRY EL PASO TX ACTIVE 9/17/2015 None N/A PEDIATRIC F6669 GLASSER, LOREN MATTHEW, MD 10/14/2016 10/14/2021 PULMONOLOGY SLEEP MEDICINE DALLAS TX ACTIVE 12/16/2016 None N/A DIAGNOSTIC Q4960 GLASSER, SCOTT ANDREW, MD 7/1/2015 7/1/2020 RADIOLOGY LAKEWOOD CO ACTIVE 7/8/2015 None N/A CRITICAL CARE LICENSE S4766 GLAVEY, EDWARD JOSEPH III, DO 1/24/2020 1/24/2025 GENERAL SURGERY (TRAUMA) ISSUED 1/24/2020 None N/A Q6835 GLEASON, ADAM KESLING, MD 1/6/2016 1/6/2021 RADIOLOGY DALLAS TX ACTIVE 1/15/2016 None N/A GLEASON, MIRANDA KIMBERLY, Q6836 MD 1/6/2016 1/6/2021 RADIOLOGY DALLAS TX ACTIVE 1/15/2016 None N/A DIAGNOSTIC R0006 GLEASON, THOMAS ROSS, DO 9/15/2016 9/15/2021 RADIOLOGY BODY IMAGING PLANO TX ACTIVE 9/20/2016 None N/A ORTHOPEDIC R5728 GLEBUS, GEOFFREY PAUL, DO 1/19/2018 1/19/2023 SURGERY SAN ANTONIO TX ACTIVE 2/6/2018 None N/A

S5626 GLEGHORN, KRISTYNA LENEE, MD 3/20/2020 3/20/2025 DERMATOLOGY ACTIVE 6/15/2020 None N/A EMERGENCY R0577 GLENN, JARED W, MD 10/31/2016 10/31/2021 MEDICINE TEMPLE TX ACTIVE 11/23/2016 None N/A R0578 GLENN, TERRELL LYLES III, MD 10/31/2016 10/31/2021 FAMILY MEDICINE BRYAN TX ACTIVE 11/7/2016 None N/A OSTEO MANIPULATIVE R4228 GLICK, JESSICA NU, DO 8/15/2017 8/15/2022 FAMILY MEDICINE MEDICINE CONROE TX ACTIVE 9/5/2017 None N/A ANESTHESIOLOGY - CHAMBERSBU Q8893 GLINIANSKI, MICHAL, MD 7/1/2016 7/1/2021 ANESTHESIOLOGY PAIN MANAGEMENT RG PA ACTIVE 8/31/2016 None N/A HAND SURGERY - ORTHOPEDIC R6195 GLOCK, CHRISTOPHER R, MD 3/2/2018 3/2/2023 SURGERY AMARILLO TX ACTIVE 3/6/2018 None N/A CRITICAL CARE R4705 GLODOWSKI, SETH DAVID, MD 9/22/2017 9/22/2022 MEDICINE ANESTHESIOLOGY SAINT LOUIS MO ACTIVE 12/11/2017 None N/A GLOVER, PORTER HUDSON SR, LICENSE Q8486 MD 6/1/2016 6/1/2021 INTERNAL MEDICINE ISSUED 6/1/2016 None N/A Q8251 GLOYD, TIMOTHY, MD 5/16/2016 5/16/2021 FAMILY MEDICINE ACTIVE 6/2/2016 None N/A Page 99 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date R3849 GLUCK, DANIELLE MARIN, MD 7/17/2017 7/17/2022 ANESTHESIOLOGY HOUSTON TX ACTIVE 7/25/2017 None N/A EMERGENCY R3328 GLUECKERT, LINDSEY NOEL, MD 6/2/2017 6/2/2022 MEDICINE AUBREY TX ACTIVE 6/7/2017 None N/A R2599 GNECO WILAMO, CYNTHIA, MD 4/20/2017 4/20/2022 INTERNAL MEDICINE GERIATRICS SAN ANTONIO TX ACTIVE 5/30/2017 None N/A S5627 GOATES, CHRISTOPHER, MD 3/20/2020 3/20/2025 INTERNAL MEDICINE HOUSTON TX ACTIVE 6/5/2020 None N/A Q9359 GOCKE, KARNA, MD 8/1/2016 8/1/2021 FAMILY MEDICINE DERMATOLOGY PROSPER TX ACTIVE 8/19/2016 None N/A Q8487 GODARA, POOJA, MD 6/1/2016 6/1/2021 OPHTHALMOLOGY CEDAR PARK TX ACTIVE 6/6/2016 None N/A HEMATOLOGY/ONCOL R2342 GODAY, SWAPNA, MD 4/4/2017 4/4/2022 OGY DALLAS TX ACTIVE 6/15/2017 None N/A R1372 GODFREY, CODY , DO 1/20/2017 1/20/2022 FAMILY MEDICINE AUSTIN TX ACTIVE 2/6/2017 None N/A GERIATRIC GODIGAMUWA, KUMARI MEDICINE (FAMILY S5628 KAUSHALYA, MD 3/20/2020 3/20/2025 FAMILY MEDICINE PRACTICE) AUSTIN TX ACTIVE 3/24/2020 None N/A Q9360 GOEBEL, MELANIE, MD 8/1/2016 8/1/2021 INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 8/3/2016 None N/A S4305 GOEL, BINDU, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE ABILENE TX ACTIVE 12/11/2019 None N/A S4305 GOEL, BINDU, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE ABILENE TX ACTIVE 12/11/2019 None N/A LICENSE Q6196 GOEL, SUMINA, MD 10/1/2015 10/1/2020 NUCLEAR MEDICINE ISSUED 10/1/2015 None N/A Q9163 GOENKA, ANAMIKA, MD 7/15/2016 7/15/2021 HOSPITALIST INTERNAL MEDICINE DALLAS TX ACTIVE 7/25/2016 None N/A Q9163 GOENKA, ANAMIKA, MD 5/15/2020 5/15/2025 INTERNAL MEDICINE HOSPITALIST FORT WORTH TX ACTIVE 5/18/2020 None N/A Q5412 GOFFI, ADRIANO ENRICO, MD 8/3/2015 8/3/2020 FAMILY MEDICINE HOSPITALIST HEREFORD TX ACTIVE 8/5/2015 None N/A ENDOCRINOLOGY, DIABETES AND LICENSE Q4585 GOGINENI, JYOTHI, MD 6/1/2015 6/1/2020 METABOLISM INTERNAL MEDICINE ISSUED 6/1/2015 None N/A Q8252 GOHAR, SALMAN , MD 5/16/2016 5/16/2021 CARDIOLOGY INTERNAL MEDICINE ROANOKE VA ACTIVE 5/23/2016 None N/A CORPUS Q9164 GOITIA SERPA, VERONICA , MD 7/15/2016 7/15/2021 PEDIATRICS CHRISTI TX ACTIVE 8/11/2016 None N/A CHILD AND ADOLESCENT S4478 GOLDBERG, ADAM JASON , MD 12/20/2019 12/20/2024 PSYCHIATRY PSYCHIATRY HOUSTON TX ACTIVE 3/3/2020 None N/A GOLDBERG, BARUCH RAPHAEL , PEDIATRIC R4551 MD 9/8/2017 9/8/2022 RHEUMATOLOGY PEDIATRICS HOUSTON TX ACTIVE 9/14/2017 None N/A GOLDEN, DOLL LAUREN S4955 ALEXANDRA, MD 2/7/2020 2/7/2025 INTERNAL MEDICINE HOUSTON TX ACTIVE 2/17/2020 None N/A INFECTIOUS S4767 GOLDEN, KEVIN BERT, MD 1/24/2020 1/24/2025 DISEASES INTERNAL MEDICINE DALLAS TX ACTIVE 1/28/2020 None N/A LICENSE Q4586 GOLDEN, OTASHE NYOKU, MD 6/1/2015 6/1/2020 HOSPITALIST FAMILY MEDICINE ISSUED 6/1/2015 None N/A Q5806 GOLDSMITH, SHAINA JILL, MD 8/28/2015 8/28/2020 PEDIATRICS HOUSTON TX ACTIVE 9/2/2015 None N/A GOLDSMITH, WILLIAM WALTER, CRITICAL CARE Q9619 DO 8/15/2016 8/15/2021 ANESTHESIOLOGY ANESTHESIOLOGY BOCA RATON FL ACTIVE 8/30/2016 None N/A Page 100 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date Q6838 GOLDSON, TOVE MARTINE, MD 1/6/2016 1/6/2021 FAMILY MEDICINE GALVESTON TX ACTIVE 1/15/2016 None N/A S5171 GOLI, HIMAN, MD 2/21/2020 2/21/2025 INTERNAL MEDICINE HOSPITALIST CHEVERLY MD ACTIVE 6/8/2020 None N/A LICENSE Q8488 GOLI, KIRAN, MD 6/1/2016 6/1/2021 INTERNAL MEDICINE NEPHROLOGY ISSUED 6/1/2016 None N/A Q8489 GOLI, NEETA MUDLAGIRI, MD 6/1/2016 6/1/2021 PEDIATRICS GARLAND TX ACTIVE 6/8/2016 None N/A EMERGENCY R0402 GOLLAPALLI, ESLI ELIAS, DO 10/14/2016 10/14/2021 MEDICINE ACTIVE 10/20/2016 None N/A GOLOD, GEORGE VADIMOVICH, R2601 MD 4/20/2017 4/20/2022 FAMILY MEDICINE FAMILY PRACTICE KATY TX ACTIVE 6/5/2017 None N/A Q5413 GOLOVAC, STANLEY , MD 8/3/2015 8/3/2020 PAIN MEDICINE MERRITT ISL. FL ACTIVE 8/5/2015 None N/A R1759 GOLWALA, AMOL BHARAT, DO 2/22/2017 2/22/2022 FAMILY MEDICINE RICHARDSON TX ACTIVE 3/16/2017 None N/A DIAGNOSTIC Q8253 GOMES, NATHAN, MD 5/16/2016 5/16/2021 RADIOLOGY SAYRE PA ACTIVE 5/23/2016 None N/A

R1760 GOMEZ, ADAM CHRISTOPHER, MD 2/22/2017 2/22/2022 HOSPITALIST EL PASO TX ACTIVE 3/1/2017 None N/A OBSTETRICS & OBSTETRICS AND GYNECOLOGICAL FORT R1761 GOMEZ, DANIEL, MD 2/22/2017 2/22/2022 GYNECOLOGY SURGERY LAUDERDALE FL ACTIVE 3/7/2017 None N/A OPHTHALMOLOGY - Q8490 GOMEZ, JESSICA, MD 6/1/2016 6/1/2021 VITREOUS SURGERY HOUSTON TX ACTIVE 6/13/2016 None N/A Q5656 GOMEZ, LAURA , MD 8/14/2015 8/14/2020 FAMILY MEDICINE AMARILLO TX ACTIVE 8/25/2015 None N/A CARDIOVASCULAR R1373 GONG, TIMOTHY ALLAN, MD 1/20/2017 1/20/2022 DISEASES INTERNAL MEDICINE DALLAS TX ACTIVE 1/23/2017 None N/A R1211 GONZALES, ALBERT , MD 1/6/2017 1/6/2022 FAMILY MEDICINE ACTIVE 1/9/2017 None N/A GONZALES, CHRISTOPHER RAY, LICENSE S6848 MD 5/29/2020 5/29/2025 FAMILY MEDICINE ISSUED 5/29/2020 None N/A EMERGENCY R5121 GONZALES, IRENE, MD 11/3/2017 11/3/2022 MEDICINE EL PASO TX ACTIVE 1/10/2018 None N/A ENDOCRINOLOGY, GONZALEZ CAMPOS, ALEJANDRO DIABETES AND Q9620 , MD 8/15/2016 8/15/2021 METABOLISM INTERNAL MEDICINE EDINBURG TX ACTIVE 8/19/2016 None N/A

LICENSE SUPERSED ED - OTHER LICENSE TM00651 GONZALEZ LUQUIS, ALEXIS T, MD 11/15/2016 11/15/2021 PSYCHIATRY LUFKIN TX ISSUED 3/16/2018 None N/A Q9361 GONZALEZ, CELSIO , MD 8/1/2016 8/1/2021 INTERNAL MEDICINE HOUSTON TX ACTIVE 8/16/2016 None N/A GONZALEZ, CHRISTIAN EUNICE, R2858 MD 5/5/2017 5/5/2022 PEDIATRICS SAN ANTONIO TX ACTIVE 5/16/2017 None N/A

Page 101 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date BLOOD GONZALEZ, CHRISTOPHER LEWIS, BANKING/TRANSFUSI CLINICAL R1534 MD 2/6/2017 2/6/2022 ON MEDICINE PATHOLOGY BALTIMORE MD ACTIVE 2/8/2017 None N/A EMERGENCY R0239 GONZALEZ, DAVID, MD 9/30/2016 9/30/2021 MEDICINE SAN ANTONIO TX ACTIVE 10/20/2016 None N/A S6623 GONZALEZ, JAZMIN, MD 5/15/2020 5/15/2025 PEDIATRICS ACTIVE 5/20/2020 None N/A GONZALEZ, JOSE ROLANDO JR, R4393 MD 8/25/2017 8/25/2022 INTERNAL MEDICINE EL CAMPO TX ACTIVE 9/4/2017 None N/A S4307 GONZALEZ, JUAN DIEGO, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE ACTIVE 2/21/2020 None N/A S4307 GONZALEZ, JUAN DIEGO, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE ACTIVE 2/21/2020 None N/A GONZALEZ, MARIA GUILLERMINA, R5864 MD 2/2/2018 2/2/2023 INTERNAL MEDICINE HOUSTON TX ACTIVE 3/2/2018 None N/A CHILD AND ADOLESCENT SAN ANTONIO R2859 GONZALEZ, MERLITA ARIANY, MD 5/5/2017 5/5/2022 PSYCHIATRY PSYCHIATRY TEXAS TX ACTIVE 5/9/2017 None N/A GONZALEZ, VICTOR MANUEL JR, R4707 MD 9/22/2017 9/22/2022 PSYCHIATRY AUSTIN TX ACTIVE 10/9/2017 None N/A EMERGENCY R1033 GOODMAN, CLARKE WORLEY, MD 12/16/2016 12/16/2021 MEDICINE ACTIVE 12/26/2016 None N/A Q8480 GOODWIN, ANNIE GAO, MD 6/1/2016 6/1/2021 PEDIATRICS HOUSTON TX ACTIVE 6/3/2016 None N/A GOOLSBAY, LAUREN ALEXANDRA, R2345 DO 4/4/2017 4/4/2022 PEDIATRICS ACTIVE 4/13/2017 None N/A LICENSE Q6508 GOPAL, ARUN, MD 11/16/2015 11/16/2020 HOSPITALIST INTERNAL MEDICINE ISSUED 11/16/2015 None N/A LICENSE Q6509 GOPAL, JEGAN, MD 11/16/2015 11/16/2020 GENERAL SURGERY OTHER SPECIALTY ISSUED 11/16/2015 None N/A S5630 GOPITO, BELINDA GRACE, DO 3/20/2020 3/20/2025 HOSPITALIST HOSPITALIST FORT WORTH TX ACTIVE 3/26/2020 None N/A S4957 GORADIA, RITU , MD 2/7/2020 2/7/2025 GENERAL PRACTICE TEXARKANA TX ACTIVE 2/10/2020 None N/A GORANTLA, KALYAN CHOWDARY, R6197 MD 3/2/2018 3/2/2023 GENERAL SURGERY ACTIVE 3/19/2018 None N/A

Q4963 GORDON, CARLA RASHELLE, MD 7/1/2015 7/1/2020 PEDIATRICS HOUSTON TX ACTIVE 7/10/2015 None N/A GORDON, JESSE DAWN-FRAZIER, R3519 DO 6/16/2017 6/16/2022 FAMILY MEDICINE GALVESTON TX ACTIVE 7/18/2017 None N/A

S5631 GORDON, NADINE CYRILLA, MD 3/20/2020 3/20/2025 INTERNAL MED - PEDS HOUSTON TX ACTIVE 5/19/2020 None N/A GORDON, RICHARD DENNIS JR, EMERGENCY R3090 MD 5/22/2017 5/22/2022 MEDICINE HOUSTON TX ACTIVE 5/30/2017 None N/A PSYCHOSOMATIC R5558 GORDON, SCOTT M, MD 1/5/2018 1/5/2023 PSYCHIATRY MEDICINE CHICAGO IL ACTIVE 2/2/2018 None N/A Q8066 GORDON, STEVEN LARS, MD 5/2/2016 5/2/2021 PLASTIC SURGERY HOUSTON TX ACTIVE 5/10/2016 None N/A Page 102 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date DELINQUEN T-NON R3850 GORDON, TRACY ALAN, MD 7/17/2017 7/17/2022 ANESTHESIOLOGY PAYMENT 12/4/2017 None N/A GORIPARTHI, TULASI SRINIVASA QUEENS, NEW R5559 KUMAR, MD 1/5/2018 1/5/2023 PSYCHIATRY YORK NY ACTIVE 2/9/2018 None N/A PEDIATRIC HEMATOLOGY/ONCO R1375 GORLICK, RICHARD GREG, MD 1/20/2017 1/20/2022 PEDIATRICS LOGY HOUSTON TX ACTIVE 1/23/2017 None N/A GASTROENTEROLOG Q9362 GOROSPE, EMMANUEL CRUZ, MD 8/1/2016 8/1/2021 Y INTERNAL MEDICINE EL PASO TX ACTIVE 8/2/2016 None N/A PEDIATRIC R6198 GORSAGE, DANIEL MICHAEL, MD 3/2/2018 3/2/2023 RADIOLOGY DALLAS TX ACTIVE 3/7/2018 None N/A PULMONARY CRITICAL CARE S5375 GOSS, KARA, MD 3/6/2020 3/6/2025 MEDICINE DALLAS TX ACTIVE 3/13/2020 None N/A ORTHOPEDIC LICENSE Q4587 GOTHA, HEATHER ELIZABETH, MD 6/1/2015 6/1/2020 SURGERY ISSUED 6/1/2015 None N/A EMERGENCY R1034 GOTTESMAN, BRENT, MD 12/16/2016 12/16/2021 MEDICINE NEW YORK NY ACTIVE 12/19/2016 None N/A GASTROENTEROLOG R4708 GOU, ERIC , MD 9/22/2017 9/22/2022 INTERNAL MEDICINE Y GALVESTON TX ACTIVE 10/25/2017 None N/A R0580 GOUGLER, PAMELA JEAN, MD 10/31/2016 10/31/2021 FAMILY PRACTICE ROCKDALE TX ACTIVE 1/16/2017 None N/A Q5807 GOULD, ROBERT JOHN, MD 8/28/2015 8/28/2020 RADIOLOGY NEURO-RADIOLOGY MEQUON WI ACTIVE 9/4/2015 None N/A GRAND R1376 GOULD, SHAUN PATRICK, DO 1/20/2017 1/20/2022 FAMILY MEDICINE PRAIRIE TX ACTIVE 1/30/2017 None N/A REPRODUCTIVE ENDOCRINOLOGY OBSTETRICS AND R6199 GOULET, EMILY JEAN, MD 3/2/2018 3/2/2023 AND INFERTILITY GYNECOLOGY FRISCO TX ACTIVE 3/7/2018 None N/A Q6941 GOUNDEN, RENEE , MD 1/15/2016 1/15/2021 FAMILY MEDICINE ACTIVE 2/2/2016 None N/A DELINQUEN HEMATOLOGY/ONCO T-NON R4141 GOWDA, LOHITH, MD 8/1/2017 8/1/2022 INTERNAL MEDICINE LOGY PAYMENT 12/4/2017 None N/A LICENSE Q8491 GOYAL, MITALI, MD 6/1/2016 6/1/2021 INTERNAL MEDICINE ISSUED 6/1/2016 None N/A PEDIATRIC CRITICAL NEW R3520 GRADIDGE, ELEANOR, MD 6/16/2017 6/16/2022 CARE MEDICINE PEDIATRICS ORLEANS LA ACTIVE 9/1/2017 None N/A

R2109 GRAHAM, JENNIFER BLADES, MD 3/20/2017 3/20/2022 GENERAL PRACTICE ACTIVE 3/28/2017 None N/A NEUROLOGICAL R1378 GRAHAM, RANDALL BERTON, MD 1/20/2017 1/20/2022 SURGERY DALLAS TX ACTIVE 1/30/2017 None N/A

Page 103 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date GRAHAM, REBECCA BECKY GAIL, OBSTETRICS AND Q7049 DO 2/1/2016 2/1/2021 GYNECOLOGY TYLER TX ACTIVE 2/9/2016 None N/A EMERGENCY Q7882 GRAMMATICO, ROBERT JOHN, MD 4/15/2016 4/15/2021 MEDICINE BEAUMONT TX ACTIVE 4/19/2016 None N/A ENDOCRINOLOGY, GRANDA-RODRIGUEZ, RAMONA, DIABETES AND NEW R3093 MD 5/22/2017 5/22/2022 METABOLISM INTERNAL MEDICINE ORLEANS LA ACTIVE 5/26/2017 None N/A NEUROLOGICAL Q5808 GRANDHI, RAMESH, MD 8/28/2015 8/28/2020 SURGERY SAN ANTONIO TX ACTIVE 8/31/2015 None N/A CRITICAL CARE Q9621 GRANT, JENNIFER, MD 8/15/2016 8/15/2021 (SURGERY) DALLAS TX ACTIVE 9/12/2016 None N/A PEDIATRIC HEMATOLOGY/ONCOL Q9820 GRAUL-CONROY, AMANDA JO, MD 8/26/2016 8/26/2021 OGY HOUSTON TX ACTIVE 10/20/2016 None N/A P8671 GRAY, CHRISTOPHER, MD 3/20/2020 3/20/2025 FAMILY PRACTICE BRENHAM TX ACTIVE 4/16/2020 None N/A Q5657 GRAY, MEGAN JANE, MD 8/14/2015 8/14/2020 PEDIATRICS WASHINGTON DC ACTIVE 8/31/2015 None N/A R1037 GRAZIANO, CHRISTOPHER , MD 12/16/2016 12/16/2021 UROLOGY HOUSTON TX ACTIVE 12/26/2016 None N/A Q9365 GREEN, DANIEL , DO 8/1/2016 8/1/2021 PEDIATRICS TEMPLE TX ACTIVE 8/9/2016 None N/A

R0240 GREEN, KEVIN BRADLEY, MD 9/30/2016 9/30/2021 PATHOLOGY NEW LONDON CT ACTIVE 10/4/2016 None N/A RADIATION LICENSE Q6199 GREENFIELD, BRAD JOSEPH, MD 10/1/2015 10/1/2020 ONCOLOGY ISSUED 10/1/2015 None N/A PEDIATRIC EMERGENCY R2604 GREENFIELD, BRYAN WILLIAM, MD 4/20/2017 4/20/2022 MEDICINE (PEDS) HOUSTON TX ACTIVE 5/2/2017 None N/A PEDIATRIC CARDIOTHORACIC R3851 GREENLEAF, CHRISTOPHER E, MD 7/17/2017 7/17/2022 SURGERY HOUSTON TX ACTIVE 9/6/2017 None N/A GREGERSON, BRYCE GUSTAVE, EMERGENCY Q5415 MD 8/3/2015 8/3/2020 MEDICINE TEMPLE TX ACTIVE 8/12/2015 None N/A GREGG, COURTNEY ELIZABETH, Q4964 MD 7/1/2015 7/1/2020 PEDIATRICS HOUSTON TX ACTIVE 7/8/2015 None N/A R2605 GREGG, JUSTIN ROBERT, MD 4/20/2017 4/20/2022 UROLOGIC SURGERY ACTIVE 4/24/2017 None N/A EMERGENCY URGENT CARE R0241 GREGSTON, JAY, MD 9/30/2016 9/30/2021 MEDICINE MEDICINE DUNCAN OK ACTIVE 10/3/2016 None N/A

R1536 GREIFER, KRISTYN MICHELLE, MD 2/6/2017 2/6/2022 INTERNAL MEDICINE HOSPITALIST HOUSTON TX ACTIVE 4/19/2017 None N/A HAND SURGERY - ORTHOPEDIC ORTHOPEDIC S4958 GRENIER, GREGORY ROGER, DO 2/7/2020 2/7/2025 SURGERY SURGERY ACTIVE 2/12/2020 None N/A

Page 104 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date

Q4965 GREWAL, GAGANPREET KAUR, MD 7/1/2015 7/1/2020 ANESTHESIOLOGY DALLAS TX ACTIVE 7/3/2015 None N/A CRITICAL CARE Q5658 GREWAL, NAVNEET KAUR, MD 8/14/2015 8/14/2020 ANESTHESIOLOGY MEDICINE HOUSTON TX ACTIVE 8/18/2015 None N/A ANESTHESIOLOGY - LICENSE Q8067 GREWAL, PRABHDEEP KAUR, MD 5/2/2016 5/2/2021 ANESTHESIOLOGY PAIN MANAGEMENT ISSUED 5/2/2016 None N/A R4395 GRIBBONS, MEGAN , MD 8/25/2017 8/25/2022 PEDIATRICS DALLAS TX ACTIVE 9/19/2017 None N/A FAMILY PRACTICE - R4709 GRIDER, ABBY MARIE, MD 9/22/2017 9/22/2022 EMERGENCY MED SUNNYVALE TX ACTIVE 9/26/2017 None N/A PREVENTIVE LICENSE R5729 GRIEGER, DARA , MD 1/19/2018 1/19/2023 MEDICINE GENERAL PRACTICE ISSUED 1/19/2018 None N/A OBSTETRICS AND S5376 GRIFFIN, PHOEBE GISELE, MD 3/6/2020 3/6/2025 GYNECOLOGY ACTIVE 3/30/2020 None N/A OCCUPATIONAL GENERAL ENVIRONMENTAL PREVENTIVE Q7051 GRIFFITH, MARGARET IRENE, MD 2/1/2016 2/1/2021 MEDICINE MEDICINE JERSEY CITY NJ ACTIVE 4/21/2016 None N/A GASTROENTEROLOG Q7052 GRIGG-GUTIERREZ, NICOLE M, MD 2/1/2016 2/1/2021 Y INTERNAL MEDICINE CHARLOTTE NC ACTIVE 2/2/2016 None N/A CRITICAL CARE PULMONARY Q5809 GRIGORIYAN, ARTUR , MD 8/28/2015 8/28/2020 MEDICINE (IM) MEDICINE PIKEVILLE KY ACTIVE 9/4/2015 None N/A EMERGENCY R5561 GRIGORYAN, GAYANA, DO 1/5/2018 1/5/2023 MEDICINE BRYAN TX ACTIVE 1/16/2018 None N/A EMERGENCY Q6840 GRIGSBY, EMILY WYATT, MD 1/6/2016 1/6/2021 MEDICINE ACTIVE 2/5/2016 None N/A

S6629 GRISALES, TAMARA, MD 5/15/2020 5/15/2025 UROGYNECOLOGY GYNECOLOGY LOS ANGELES CA ACTIVE 5/27/2020 None N/A LICENSE Q5659 GROISBERG, ROMAN , MD 8/14/2015 8/14/2020 INTERNAL MEDICINE ISSUED 8/14/2015 None N/A GROOTERS, CHARLES EMERSON, ORTHOPEDIC Q4967 MD 7/1/2015 7/1/2020 SURGERY LONGVIEW TX ACTIVE 8/26/2015 None N/A PALLIATIVE S4772 GROULS, ASTRID, MD 1/24/2020 1/24/2025 INTERNAL MEDICINE MEDICINE HOUSTON TX ACTIVE 1/27/2020 None N/A S4310 GROWNEY, DANIEL JOHN, MD 12/6/2019 12/6/2024 GENERAL SURGERY YORK NE ACTIVE 12/16/2019 None N/A S4310 GROWNEY, DANIEL JOHN, MD 12/6/2019 12/6/2024 GENERAL SURGERY YORK NE ACTIVE 12/16/2019 None N/A DELINQUEN GRUNDMANN, NICOLAS EMERGENCY T-NON R4554 KRASOVEC, MD 9/8/2017 9/8/2022 MEDICINE PAYMENT 12/7/2017 None N/A GRZANKOWSKI, KASSONDRA GYNECOLOGIC LICENSE S5634 SUZANNE, MD 3/20/2020 3/20/2025 ONCOLOGY GYNECOLOGY AUSTIN TX ISSUED 3/20/2020 None N/A GUADAMUD PACHECO, MARTHA R3853 ELIZABETH, MD 7/17/2017 7/17/2022 FAMILY MEDICINE SAN ANTONIO TX ACTIVE 7/19/2017 None N/A Page 105 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date OBSTETRICS & OBSTETRICS AND GYNECOLOGICAL R4555 GUARDIA RULLAN, GIANNINA, MD 9/8/2017 9/8/2022 GYNECOLOGY SURGERY EDINBURG TX ACTIVE 9/12/2017 None N/A PEDIATRIC EMERGENCY Q8896 GUBBINS, NICHOLE RAE, MD 7/1/2016 7/1/2021 MEDICINE (PEDS) OTHER SPECIALTY HOUSTON TX ACTIVE 7/7/2016 None N/A

R2606 GUCWA, ANGELA LEAH, MD 4/20/2017 4/20/2022 VASCULAR SURGERY GENERAL SURGERY LANHAM MD ACTIVE 5/9/2017 None N/A

GUENENA, MOHAMED AHMED OPHTHALMOLOGY - OPHTHALMOLOGY - R1379 SALAH ELDIN, MD 1/20/2017 1/20/2022 CORNEA ANTERIOR SURGERY EL PASO TX ACTIVE 2/13/2017 None N/A Q4968 GUERRA, MEGAN CASKEY, MD 7/1/2015 7/1/2020 PEDIATRICS SAN ANTONIO TX ACTIVE 7/3/2015 None N/A GUERRERO, ANNE MARIE S4960 SJURSEN, MD 2/7/2020 2/7/2025 PEDIATRICS HOUSTON TX ACTIVE 5/14/2020 None N/A Q6943 GUERRERO, KAREN TARM, MD 1/15/2016 1/15/2021 DERMATOLOGY ACTIVE 1/22/2016 None N/A GUERRERO, MANRIQUE ALBERTO, SURGICAL CRITICAL S5636 DO 3/20/2020 3/20/2025 GENERAL SURGERY CARE DALLAS TX ACTIVE 4/9/2020 None N/A GUERRERO-MIRANDA, CESAR CARDIOVASCULAR Q9623 YVAN, MD 8/15/2016 8/15/2021 DISEASES CARDIOLOGY DALLAS TX ACTIVE 8/19/2016 None N/A EMERGENCY EMERGENCY R2110 GUERRIERO, DAVID JOSEPH, MD 3/20/2017 3/20/2022 MEDICINE MEDICINE OXFORD OH ACTIVE 4/13/2017 None N/A ORTHOPEDIC S5377 GUEVARA, JONATHAN, MD 3/6/2020 3/6/2025 SURGERY ACTIVE 3/12/2020 None N/A HAND SURGERY - ORTHOPEDIC ORTHOPEDIC Q8255 GUILLEN, PHILLIP TOMAS, MD 5/16/2016 5/16/2021 SURGERY SURGERY MIDLAND TX ACTIVE 5/23/2016 None N/A Q9366 GUIRGUIS, JONATHAN, DO 8/1/2016 8/1/2021 INTERNAL MEDICINE HUMBLE TX ACTIVE 8/9/2016 None N/A ANESTHESIOLOGY - LICENSE S7057 GUIRGUIS, MAGED NABIL AZIZ, MD 6/12/2020 6/12/2025 PAIN MANAGEMENT ISSUED 6/12/2020 None N/A GASTROENTEROLOG CANC NON- R0243 GUIVATCHIAN, TANNAZ, MD 9/30/2016 9/30/2021 Y INTERNAL MEDICINE PAYMENT 3/5/2018 None N/A LICENSE S7058 GUL, ZUNAIRA, MD 6/12/2020 6/12/2025 INTERNAL MEDICINE ISSUED 6/12/2020 None N/A THORACIC CARDIOVASCULAR LICENSE S7059 GULATI, RAJEEV, MD 6/12/2020 6/12/2025 SURGERY ISSUED 6/12/2020 None N/A PEDIATRIC Q8497 GULERIA, SAURABH, MD 6/1/2016 6/1/2021 RADIOLOGY RADIOLOGY AUSTIN TX ACTIVE 6/2/2016 None N/A HEMATOLOGY/ONCO R4231 GULHATI, PRATEEK , MD 8/15/2017 8/15/2022 INTERNAL MEDICINE LOGY HOUSTON TX ACTIVE 12/12/2017 None N/A R2112 GULLATT, THOMAS RYAN, MD 3/20/2017 3/20/2022 INTERNAL MEDICINE GALVESTON TX ACTIVE 4/12/2017 None N/A Page 106 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date HEMATOLOGY/ONCO R3095 GULVIN, JOSHUA MICHAEL , MD 5/22/2017 5/22/2022 INTERNAL MEDICINE LOGY HOUSTON TX ACTIVE 5/25/2017 None N/A LICENSE Q5660 GUNAWAN, JONAS , MD 8/14/2015 8/14/2020 HOSPITALIST ISSUED 8/14/2015 None N/A EMERGENCY CRITICAL CARE Q5193 GUNDERT, EMILY E, MD 7/15/2015 7/15/2020 MEDICINE MEDICINE DALLAS TX ACTIVE 8/13/2015 None N/A GASTROENTEROLOG R4710 GUNN, NADEGE TACHA, MD 9/22/2017 9/22/2022 Y HEPATOLOGY AUSTIN TX ACTIVE 9/25/2017 None N/A ORTHOPEDIC FOOT AND ANKLE, R2861 GUNNELL, LEA, MD 5/5/2017 5/5/2022 SURGERY ORTHOPEDICS LUBBOCK TX ACTIVE 5/15/2017 None N/A RADIATION R2350 GUNTHER, JILLIAN REBECCA, MD 4/4/2017 4/4/2022 ONCOLOGY HOUSTON TX ACTIVE 4/27/2017 None N/A R0722 GUPTA, ARJUN , MD 11/15/2016 11/15/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 11/22/2016 None N/A S5637 GUPTA, ASHISH DUSHANT, MD 3/20/2020 3/20/2025 INTERNAL MEDICINE HOSPITALIST HOUSTON TX ACTIVE 3/26/2020 None N/A LICENSE Q4590 GUPTA, DIVYA, MD 6/1/2015 6/1/2020 INTERNAL MEDICINE ISSUED 6/1/2015 None N/A ENDOCRINOLOGY, DIABETES AND R2113 GUPTA, KRITI, MD 3/20/2017 3/20/2022 METABOLISM FREDERICK MD ACTIVE 4/3/2017 None N/A Q8256 GUPTA, MONALI, MD 5/16/2016 5/16/2021 RADIOLOGY HOUSTON TX ACTIVE 5/25/2016 None N/A R0405 GUPTA, NAGENDRA, MD 10/14/2016 10/14/2021 INTERNAL MEDICINE DECATUR TX ACTIVE 10/20/2016 None N/A R4971 GUPTA, PREETI , MD 10/20/2017 10/20/2022 INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 10/23/2017 None N/A LICENSE Q4758 GUPTA, ROHAN , DO 6/12/2015 6/12/2020 INTERNAL MEDICINE ISSUED 6/12/2015 None N/A PEDIATRICS, P0221 GUPTA, UMANG, MD 4/4/2017 4/4/2022 CARDIOLOGY PEDIATRICS BUFFALO NY ACTIVE 5/4/2017 None N/A Q7556 GURRAM, SRINIVASA R, MD 3/15/2016 3/15/2021 INTERNAL MEDICINE LUFKIN TX ACTIVE 3/17/2016 None N/A DIAGNOSTIC LICENSE R5732 GURUSAMY, VARSHANA , MD 1/19/2018 1/19/2023 RADIOLOGY ISSUED 1/19/2018 None N/A EMERGENCY R0009 GUTFREUND, YORAM DOV, MD 9/15/2016 9/15/2021 MEDICINE MIAMI FL ACTIVE 11/22/2016 None N/A GUTIERREZ BARELA, KRISTINA, ALBUQUERQU S6630 MD 5/15/2020 5/15/2025 PEDIATRICS E NM ACTIVE 6/12/2020 None N/A GUTIERREZ BONILLA, ANALYDIA , R2609 MD 4/20/2017 4/20/2022 PEDIATRICS DALLAS TX ACTIVE 6/9/2017 None N/A GUTIERREZ RAMAL, MITSI LISET, R1038 MD 12/16/2016 12/16/2021 FAMILY MEDICINE ACTIVE 12/20/2016 None N/A LICENSE Q6320 GUTIERREZ, ARMANDO I, MD 10/15/2015 10/15/2020 FAMILY MEDICINE ISSUED 10/15/2015 None N/A GUTIERREZ, CHRISTINA MARIE, EMERGENCY S5174 MD 2/21/2020 2/21/2025 MEDICINE SAN ANTONIO TX ACTIVE 3/9/2020 None N/A Page 107 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date

Q6021 GUTIERREZ, JAMES JOSEPH, MD 9/15/2015 9/15/2020 NEUROLOGY LAREDO TX ACTIVE 9/16/2015 None N/A OBSTETRICS AND R4972 GUTIERREZ, JULIE FARUGIA, MD 10/20/2017 10/20/2022 GYNECOLOGY HOUSTON TX ACTIVE 10/23/2017 None N/A OBSTETRICS AND R3334 GUTIERREZ, LAURA CRISTINA, MD 6/2/2017 6/2/2022 GYNECOLOGY EL PASO TX ACTIVE 6/12/2017 None N/A Q8498 GUTIERREZ, NORA , MD 6/1/2016 6/1/2021 ANESTHESIOLOGY HOUSTON TX ACTIVE 6/13/2016 None N/A R4232 GUTIERREZ, TIMOTHY , MD 8/15/2017 8/15/2022 GENERAL SURGERY ACTIVE 8/24/2017 None N/A G9747 GUTKNECHT, MICHAEL G, MD 12/2/2016 12/2/2021 RADIOLOGY EL PASO TX ACTIVE 12/8/2016 None N/A ENDOCRINOLOGY, DIABETES AND Q7883 GUTTENBERG, KATIE BATES, MD 4/15/2016 4/15/2021 METABOLISM HOUSTON TX ACTIVE 4/25/2016 None N/A GASTROENTEROLOG R0723 GUTURU, PRAVEEN, MD 11/15/2016 11/15/2021 Y INTERNAL MEDICINE GALVESTON TX ACTIVE 1/9/2017 None N/A CARDIOVASCULAR INTERVENTIONAL TM00701 GUZZO, JOSEPH ANTHONY, MD 2/16/2018 2/16/2023 DISEASES CARDIOLOGY RALEIGH NC ACTIVE 2/26/2018 None N/A LICENSE Q4591 GWIN, TAYLOR S, MD 6/1/2015 6/1/2020 VASCULAR SURGERY GENERAL SURGERY ISSUED 6/1/2015 None N/A S5379 HA, CHRISTINA, MD 3/6/2020 3/6/2025 PEDIATRICS HOUSTON TX ACTIVE 3/9/2020 None N/A Q6201 HABIB, FAROOQ, MD 10/1/2015 10/1/2020 PEDIATRICS PEDIATRICS ACTIVE 10/22/2015 None N/A CARDIOVASCULAR INTERVENTIONAL R4711 HABIB, HABIB, MD 9/22/2017 9/22/2022 DISEASES CARDIOLOGY ELPASO TX ACTIVE 10/4/2017 None N/A R4712 HABIB, PHILLIP JAMES, MD 9/22/2017 9/22/2022 CARDIOLOGY INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 9/28/2017 None N/A URGENT CARE - PALM R0010 HACKING, SCOTT WYNN, MD 9/15/2016 9/15/2021 FAMILY MEDICINE FAMILY PRACTICE HARBOR FL ACTIVE 9/23/2016 None N/A R4051 HACKMAN, SARAH DENISE, MD 8/1/2017 8/1/2022 PATHOLOGY SAN ANTONIO TX ACTIVE 8/3/2017 None N/A CRITICAL CARE PULMONARY Q4593 HACKNER, DANI, MD 6/1/2015 6/1/2020 MEDICINE DISEASES HOUSTON TX ACTIVE 6/9/2015 None N/A G5135 HACKSHAW, KEVIN VICTOR, MD 2/7/2020 2/7/2025 INTERNAL MEDICINE RHEUMATOLOGY AUSTIN TX ACTIVE 2/10/2020 None N/A HACOPIAN, ALEXANDER GARNICK, S4962 MD 2/7/2020 2/7/2025 OPHTHALMOLOGY ABILENE TX ACTIVE 2/10/2020 None N/A R3854 HADAWAY, ASHLEY NAVA, MD 7/17/2017 7/17/2022 UROLOGY SAN ANTONIO TX ACTIVE 8/3/2017 None N/A LICENSE S7060 HADDAD, JEBRAN MICHAEL, MD 6/12/2020 6/12/2025 ANESTHESIOLOGY ISSUED 6/12/2020 None N/A S5638 HADDAD, PETER SOUHEIL, MD 3/20/2020 3/20/2025 INTERNAL MEDICINE ACTIVE 3/30/2020 None N/A R2351 HAFEEZ, FARAZ SYED, DO 4/4/2017 4/4/2022 HOSPITALIST INTERNAL MEDICINE ACTIVE 4/10/2017 None N/A

S5640 HAFEEZ, MUHAMMAD UBAID , MD 3/20/2020 3/20/2025 NEUROLOGY HOUSTON TX ACTIVE 4/6/2020 None N/A PSYCHOSOMATIC Q9625 HAFLIGER, SILVIA, MD 8/15/2016 8/15/2021 PSYCHIATRY MEDICINE HOUSTON TX ACTIVE 8/22/2016 None N/A

Page 108 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date ORTHOPEDIC PEDIATRIC Q6022 HAGAG, AHMED THABET, MD 9/15/2015 9/15/2020 SURGERY ORTHOPEDICS EL PASO TX ACTIVE 10/19/2015 None N/A ORTHOPEDIC R2862 HAGEDORN, JOHN C II, MD 5/5/2017 5/5/2022 TRAUMA GALVESTON TX ACTIVE 5/15/2017 None N/A Q5194 HAGEN, MICHAEL PETER JR, MD 7/15/2015 7/15/2020 FAMILY MEDICINE ACTIVE 7/27/2015 None N/A Q7200 HAGER, JONATHAN LEE, MD 2/16/2016 2/16/2021 OPHTHALMOLOGY SEGUIN TX ACTIVE 2/18/2016 None N/A S7061 HAGIGI, MERSHAD, MD 6/12/2020 6/12/2025 RADIOLOGY RIDGEWOOD NJ ACTIVE 6/15/2020 None N/A HAGLER, ANNA K KOWALCZYK, CARDIOTHORACIC Q7727 MD 4/1/2016 4/1/2021 ANESTHESIOLOGY IRVING TX ACTIVE 4/5/2016 None N/A

OPHTHALMOLOGY - OPHTHALMOLOGY - S6407 HAHN, TARA ELIZABETH, MD 5/1/2020 5/1/2025 GLAUCOMA ANTERIOR SURGERY HOUSTON TX ACTIVE 5/20/2020 None N/A ENDOCRINOLOGY, GERIATRICS - DIABETES AND Q6752 HAIDER, ADNAN , MD 12/15/2015 12/15/2020 INTERNAL MEDICINE METABOLISM ODESSA TX ACTIVE 12/16/2015 None N/A INFECTIOUS Q7884 HAIDER, ALIYA, MD 4/15/2016 4/15/2021 DISEASES INTERNAL MEDICINE ACTIVE 4/26/2016 None N/A GASTROENTEROLOG S4311 HAJAR, NASSER, MD 12/6/2019 12/6/2024 Y SYLVANIA OH ACTIVE 12/16/2019 None N/A GASTROENTEROLOG S4311 HAJAR, NASSER, MD 12/6/2019 12/6/2024 Y SYLVANIA OH ACTIVE 12/16/2019 None N/A ORTHOPEDIC R2115 HALAWI, MOHAMAD JAMAL, MD 3/20/2017 3/20/2022 SURGERY FARMINGTON CT ACTIVE 3/22/2017 None N/A R2863 HALAWI, RACHA, MD 5/5/2017 5/5/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 5/25/2017 None N/A OBSTETRICS AND R5865 HALDER, GABRIELA EUGENIA, MD 2/2/2018 2/2/2023 GYNECOLOGY AUSTIN TX ACTIVE 2/12/2018 None N/A R0406 HALDERMAN, ASHLEIGH A, MD 10/14/2016 10/14/2021 RHINOLOGY DALLAS TX ACTIVE 10/18/2016 None N/A Q8897 HALE, ZACHARY DAVID , MD 7/1/2016 7/1/2021 INTERNAL MEDICINE CARDIOLOGY HOUSTON TX ACTIVE 9/5/2016 None N/A Q6023 HALL, CHAD MAXWELL, MD 9/15/2015 9/15/2020 GENERAL SURGERY TEMPLE TX ACTIVE 9/17/2015 None N/A TRANSPLANT Q5420 HALL, DAVID RYAN, MD 8/3/2015 8/3/2020 SURGERY GENERAL SURGERY HOUSTON TX ACTIVE 9/10/2015 None N/A Q5421 HALL, ELIZABETH ANNE, MD 8/3/2015 8/3/2020 PEDIATRICS HOUSTON TX ACTIVE 8/4/2015 None N/A EMERGENCY LAWRENCEVIL S4963 HALL, JERRY KEITH, MD 2/7/2020 2/7/2025 MEDICINE LE GA ACTIVE 3/4/2020 None N/A

R1213 HALL, JOHN JACOBS, MD 1/6/2017 1/6/2022 GENERAL SURGERY GENERAL SURGERY HOUSTON TX ACTIVE 1/25/2017 None N/A PEDIATRIC REHABILITATION PHYSICAL MED. & R0407 HALL, STACEY LYNN, DO 10/14/2016 10/14/2021 MEDICINE REHABILITATION HOUSTON TX ACTIVE 11/11/2016 None N/A

Page 109 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date

OPHTHALMOLOGY - OPHTHALMOLOGY - Q4761 HALLAHAN, KATIE MARIE , MD 6/12/2015 6/12/2020 CORNEA ANTERIOR SURGERY HOUSTON TX ACTIVE 6/17/2015 None N/A HALLETT, THAO-PHUONG R2610 CHRISTY, MD 4/20/2017 4/20/2022 PEDIATRICS SAN ANTONIO TX ACTIVE 5/8/2017 None N/A

S4485 HALLIBURTON, CHARLES R III, MD 12/20/2019 12/20/2024 FAMILY MEDICINE LAFAYETTE LA ACTIVE 3/16/2020 None N/A Q6024 HALLMARK, CHRISTOPHER, MD 9/15/2015 9/15/2020 RADIOLOGY CYPRESS TX ACTIVE 9/17/2015 None N/A

OPHTHALMOLOGY - R2354 HAMAD, ABDUALRAHMAN, MD 4/4/2017 4/4/2022 OPHTHALMOLOGY VITREOUS SURGERY HOUSTON TX ACTIVE 6/1/2017 None N/A PEDIATRIC EMERGENCY Q8070 HAMAD, ALIA I, DO 5/2/2016 5/2/2021 MEDICINE (PEDS) HOUSTON TX ACTIVE 5/5/2016 None N/A R2117 HAMADEH, ANAS, MD 3/20/2017 3/20/2022 INTERNAL MEDICINE CARDIOLOGY DALLAS MA ACTIVE 4/13/2017 None N/A R5123 HAMAKER, JEFFREY SCOTT, MD 11/3/2017 11/3/2022 GENERAL SURGERY TEMPLE TX ACTIVE 11/8/2017 None N/A PEDIATRIC LICENSE R5735 HAMDAN, HISHAM , MD 1/19/2018 1/19/2023 PEDIATRICS PULMONOLOGY ISSUED 1/19/2018 None N/A R1216 HAMDI, HAMID SHARFUDDIN, MD 1/6/2017 1/6/2022 NEUROLOGY SUGAR LAND TX ACTIVE 1/9/2017 None N/A WICHITA Q4970 HAMES, CHRISTAL CRAMER, MD 7/1/2015 7/1/2020 GENERAL SURGERY FALLS TX ACTIVE 8/20/2015 None N/A

R2865 HAMES, ERIC CHRISTOPHER, MD 5/5/2017 5/5/2022 FAMILY PRACTICE FORT WORTH TX ACTIVE 5/10/2017 None N/A R2866 HAMID, FATIMA, MD 5/5/2017 5/5/2022 INTERNAL MEDICINE INTERNAL MEDICINE HOUSTON TX ACTIVE 5/10/2017 None N/A ENDOVASCULAR NEUROLOGY & SURGICAL S5914 HAMID, TARIQ, MD 4/3/2020 4/3/2025 PSYCHIATRY NEURORADIOLOGY SAINT CLOUD MN ACTIVE 4/6/2020 None N/A Q7382 HAMILL, ANDREW, DO 3/4/2016 3/4/2021 FAMILY MEDICINE MCKINNEY TX ACTIVE 3/15/2016 None N/A ORTHOPEDIC SPORTS MEDICINE S5380 HAMILTON, JOHN MICHAEL, MD 3/6/2020 3/6/2025 SURGERY (ORTH SURG) TEMPLE TX ACTIVE 3/16/2020 None N/A OBSTETRICS AND R3335 HAMILTON, ZACHARY, MD 6/2/2017 6/2/2022 GYNECOLOGY TULSA OK ACTIVE 6/26/2017 None N/A

R0724 HAMMAD AL TAQ, HIBA, MD 11/15/2016 11/15/2021 INTERNAL MED - PEDS PLANO TX ACTIVE 11/17/2016 None N/A Q7886 HAMMAD, TAREK, MD 4/15/2016 4/15/2021 CARDIOLOGY INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 4/19/2016 None N/A Q9626 HAMMERS, HANS JOERG, MD 8/15/2016 8/15/2021 ONCOLOGY DALLAS TX ACTIVE 8/17/2016 None N/A HAMMOND, JAMES DOUGLAS II, LICENSE S6199 MD 4/17/2020 4/17/2025 PEDIATRICS ISSUED 4/17/2020 None N/A WEST LAKE R2119 HAMMOND, MATTHEW DAVID, MD 3/20/2017 3/20/2022 OPHTHALMOLOGY HILLS TX ACTIVE 3/27/2017 None N/A

Page 110 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PULMONARY CRITICAL CARE Q8499 HAMMOUDEH, FADI , MD 6/1/2016 6/1/2021 MEDICINE INTERNAL MEDICINE SUGAR LAND TX ACTIVE 6/8/2016 None N/A Q8899 HAMNER, JENNIFER JOY, DO 7/1/2016 7/1/2021 UROGYNECOLOGY DALLAS TX ACTIVE 7/5/2016 None N/A CORPUS R2611 HAMO, VINCENT ROBERT, DO 4/20/2017 4/20/2022 FAMILY MEDICINE CHRISTI TX ACTIVE 4/28/2017 None N/A HAMPOLE, HEMANTH NAGARAJA, Q7201 MD 2/16/2016 2/16/2021 INTERNAL MEDICINE NEPHROLOGY HOUSTON TX ACTIVE 2/17/2016 None N/A R4975 HAN, DEREK Y, MD 10/20/2017 10/20/2022 OPHTHALMOLOGY LUBBOCK TX ACTIVE 11/8/2017 None N/A ADDICTION Q8071 HAN, SHAOJIE, MD 5/2/2016 5/2/2021 PSYCHIATRY PSYCHIATRY HOUSTON TX ACTIVE 5/3/2016 None N/A HANCOCK FRIESEN, CAMILLE CARDIOVASCULAR Q9628 LOUISA, MD 8/15/2016 8/15/2021 SURGERY PEDIATRIC SURGERY AUSTIN TX ACTIVE 9/30/2016 None N/A HEMATOLOGY - LICENSE S5381 HANCOCK, JOHN MATTHEW, MD 3/6/2020 3/6/2025 INTERNAL MEDICINE INTERNAL MEDICINE ISSUED 3/6/2020 None N/A TEXAS HEMATOLOGY/ONCO LICENSE H5450 HANCOCK, MARK, MD 12/4/2015 12/4/2020 ONCOLOGY LOGY MISSOULA MT ISSUED 12/4/2015 None N/A HEMATOLOGY/ONCO H5450 HANCOCK, MARK, MD 12/4/2015 12/4/2020 ONCOLOGY LOGY AURORA CO ACTIVE 2/3/2016 None N/A HEMATOLOGY/ONCO H5450 HANCOCK, MARK, MD 12/4/2015 12/4/2020 ONCOLOGY LOGY AURORA CO ACTIVE 2/3/2016 None N/A PEDIATRIC S6200 HANDOKO, MAUREEN , MD 4/17/2020 4/17/2025 NEUROLOGY HOUSTON TX ACTIVE 4/22/2020 None N/A ORAL & MAXILLOFACIAL R0011 HANNA, ANDREW EMAD, MD 9/15/2016 9/15/2021 SURGERY COSMETIC SURGERY SAN ANTONIO TX ACTIVE 9/22/2016 None N/A Q4596 HANNA, MINA FAWZI FAHIM, MD 6/1/2015 6/1/2020 RADIOLOGY DALLAS TX ACTIVE 6/10/2015 None N/A NEONATAL- PERINATAL S5915 HANNA, MORCOS, DO 4/3/2020 4/3/2025 PEDIATRICS MEDICINE HOUSTON TX ACTIVE 4/16/2020 None N/A S4487 HANNA, SAMEH WILLIAM, MD 12/20/2019 12/20/2024 ANESTHESIOLOGY PAIN MANAGEMENT LAWTON OK ACTIVE 1/13/2020 None N/A PEDIATRIC HEMATOLOGY/ONCOL CORPUS R1767 HANRAHAN, JEFFERY DAVID, MD 2/22/2017 2/22/2022 OGY PEDIATRICS CHRISTI TX ACTIVE 2/24/2017 None N/A R0244 HANSEN, LAURA WORTH, DO 9/30/2016 9/30/2021 FAMILY MEDICINE BRYAN TX ACTIVE 10/4/2016 None N/A LICENSE S6201 HANSEN, TODD PHILLIP, MD 4/17/2020 4/17/2025 INTERNAL MEDICINE ISSUED 4/17/2020 None N/A S4313 HANSON, ALLYSON AYN, MD 12/6/2019 12/6/2024 FAMILY MEDICINE HOPE AR ACTIVE 2/3/2020 None N/A S4313 HANSON, ALLYSON AYN, MD 12/6/2019 12/6/2024 FAMILY MEDICINE HOPE AR ACTIVE 2/3/2020 None N/A

Page 111 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date EMERGENCY EMERGENCY CORPUS R4847 HANSON, GABRIEL SETH, DO 10/6/2017 10/6/2022 MEDICINE MEDICINE CHRISTI TX ACTIVE 10/9/2017 None N/A EMERGENCY Q7887 HANUDEL, MATTHEW WAYNE, MD 4/15/2016 4/15/2021 MEDICINE MARSHALL TX ACTIVE 5/2/2016 None N/A Q9822 HAQ, IMRAN UL, MD 8/26/2016 8/26/2021 GENERAL SURGERY ACTIVE 12/21/2016 None N/A CHILD AND ADOLESCENT R1538 HAQUE, DANISH , MD 2/6/2017 2/6/2022 PSYCHIATRY PSYCHIATRY EL PASO TX ACTIVE 2/10/2017 None N/A CORNEA REFRACTIVE R2867 HAQUE, MAHEEN, MD 5/5/2017 5/5/2022 OPHTHALMOLOGY SURGERY DALLAS TX ACTIVE 5/11/2017 None N/A ANESTHESIOLOGY - R1959 HARANDI, SHERVIN , MD 3/3/2017 3/3/2022 PAIN MEDICINE PAIN MANAGEMENT HOUSTON TX ACTIVE 4/18/2017 None N/A S4964 HARBIE, KHALIL ANTONIO, MD 2/7/2020 2/7/2025 OPHTHALMOLOGY ACTIVE 2/25/2020 None N/A HARBOLD, JEFFREY SCOTT JR, R2868 DO 5/5/2017 5/5/2022 DERMATOLOGY MCALLEN TX ACTIVE 6/16/2017 None N/A PEDIATRIC HEMATOLOGY/ONCOL R3523 HARDEN, AVIS , MD 6/16/2017 6/16/2022 OGY PEDIATRICS HOUSTON TX ACTIVE 6/20/2017 None N/A PEDIATRIC PHYSICAL MED. & REHABILITATION Q8500 HARDEN, JEANNIE K, MD 6/1/2016 6/1/2021 REHABILITATION MEDICINE ACTIVE 6/3/2016 None N/A R4054 HARDMAN, BAILOR L, MD 8/1/2017 8/1/2022 ANESTHESIOLOGY DALLAS TX ACTIVE 8/2/2017 None N/A EMERGENCY S5916 HARDY, JONATHAN NORMAN, DO 4/3/2020 4/3/2025 MEDICINE FORT WORTH TX ACTIVE 4/8/2020 None N/A Q6202 HAREL, TAMAR , MD 10/1/2015 10/1/2020 MEDICAL GENETICS ACTIVE 10/7/2015 None N/A R6017 HARFOUCH, BADR , MD 2/16/2018 2/16/2023 INTERNAL MEDICINE HARLINGEN TX ACTIVE 2/23/2018 None N/A CARDIOTHORACIC SAN R4713 HARIKA, RICKY SINGH, MD 9/22/2017 9/22/2022 ANESTHESIOLOGY FRANCISCO CA ACTIVE 9/25/2017 None N/A VASCULAR R2137 HARIS KAMAL, FNU, MD 3/20/2017 3/20/2022 NEUROLOGY NEUROLOGY HOUSTON TX ACTIVE 3/22/2017 None N/A INTERVENTIONAL R4055 HARMOUSH, SAMER , MD 8/1/2017 8/1/2022 RADIOLOGY RADIOLOGY NEDERLAND TX ACTIVE 8/3/2017 None N/A PULMONARY CRITICAL CARE PULMONARY S4965 HAROON, AYESHA, MD 2/7/2020 2/7/2025 MEDICINE MEDICINE HOUSTON TX ACTIVE 2/19/2020 None N/A TEXAS HAROON, MUHAMMAD SALMAN, HEMATOLOGY/ONCOL LICENSE L2302 MD 4/15/2016 4/15/2021 OGY TREMONT NE ISSUED 4/15/2016 None N/A DIAGNOSTIC WICHITA Q8502 HARPER, HOWARD DALE, MD 6/1/2016 6/1/2021 RADIOLOGY RADIOLOGY FALLS TX ACTIVE 6/8/2016 None N/A Page 112 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date EMERGENCY R0584 HARPER, LEVI KEITH, MD 10/31/2016 10/31/2021 FAMILY MEDICINE MEDICINE ABILENE TX ACTIVE 1/18/2017 None N/A EMERGENCY S6203 HARRIS, CHRISTOPHER JR, MD 4/17/2020 4/17/2025 MEDICINE ACTIVE 4/27/2020 None N/A DIAGNOSTIC R4848 HARRIS, MERISSA GARVEY, MD 10/6/2017 10/6/2022 RADIOLOGY INTERNAL MEDICINE DALLAS TX ACTIVE 12/28/2017 None N/A Q5663 HARRIS, REX LEE JR, MD 8/14/2015 8/14/2020 FAMILY MEDICINE WACO TX ACTIVE 8/21/2015 None N/A

Q7699 HARRIS, RICHARD EDWARD II, MD 4/1/2016 4/1/2021 INTERNAL MEDICINE RICHMOND TX ACTIVE 4/5/2016 None N/A HARRIS, STEPHANIE ELIZABETH, R0410 MD 10/14/2016 10/14/2021 UROLOGY ACTIVE 10/25/2016 None N/A OBSTETRICS AND LICENSE Q5664 HARRIS, TARA JACQUELINE, MD 8/14/2015 8/14/2020 GYNECOLOGY ISSUED 8/14/2015 None N/A PLASTIC & RECONSTRUCTIVE R1218 HARRISON, BRIDGET , MD 1/6/2017 1/6/2022 SURGERY HAND SURGERY HOUSTON TX ACTIVE 1/10/2017 None N/A OBSTETRICS AND Q5423 HARRISON, MARY ELIZABETH, MD 8/3/2015 8/3/2020 GYNECOLOGY ROUND ROCK TX ACTIVE 8/4/2015 None N/A R4234 HARRISON, REBECCA ANNE, MD 8/15/2017 8/15/2022 NEURO-ONCOLOGY NEUROLOGY HOUSTON TX ACTIVE 10/4/2017 None N/A GYNECOLOGIC GYNECOLOGIC S5917 HARRISON, ROSS FERGUS, MD 4/3/2020 4/3/2025 ONCOLOGY ONCOLOGY HOUSTON TX ACTIVE 4/28/2020 None N/A PFLUGERVILL R3679 HART, ADAM DAVIS, MD 6/30/2017 6/30/2022 OPHTHALMOLOGY E TX ACTIVE 7/11/2017 None N/A CORPUS S5647 HART, MAURENE ELIZABETH, DO 3/20/2020 3/20/2025 FAMILY MEDICINE CHRISTI TX ACTIVE 4/6/2020 None N/A UNDER EMERGENCY LICENSE BOARD Q5812 HART, RODERICK, MD 8/28/2015 8/28/2020 MEDICINE FAMILY MEDICINE ISSUED 8/28/2015 ORDER 8/28/2015 EMERGENCY ADMINISTRATIVE Q6323 HARTFELDER, BRIAN SCOTT, MD 10/15/2015 10/15/2020 MEDICINE MEDICINE SAN ANTONIO TX ACTIVE 10/16/2015 None N/A CORPUS Q9630 HARTQUIST, CARA M, DO 8/15/2016 8/15/2021 FAMILY MEDICINE CHRISTI TX ACTIVE 8/18/2016 None N/A NEUROLOGICAL P3342 HARVEY, ADRIAN TIMOTHY, DO 12/8/2017 12/8/2022 SURGERY FORT WORTH TX ACTIVE 1/16/2018 None N/A DIAGNOSTIC R1219 HARVEY, HARLAN BENJAMIN, MD 1/6/2017 1/6/2022 RADIOLOGY NEURO-RADIOLOGY HOUSTON TX ACTIVE 3/17/2017 None N/A Q7700 HARVEY, RYAN JOSEPH, MD 4/1/2016 4/1/2021 ANESTHESIOLOGY GALVESTON TX ACTIVE 4/7/2016 None N/A LICENSE Q5813 HASAN, ASMA, MD 8/28/2015 8/28/2020 INTERNAL MEDICINE HOSPITALIST ISSUED 8/28/2015 None N/A PEDIATRIC CRITICAL ORMOND R1383 HASAN, MUHAMMAD YOUSUF, MD 1/20/2017 1/20/2022 PEDIATRICS CARE MEDICINE BEACH FL ACTIVE 1/31/2017 None N/A Page 113 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date INFECTIOUS R5402 HASAN, SAQIB IRSHAD, MD 12/8/2017 12/8/2022 DISEASES INTERNAL MEDICINE FLINT MI ACTIVE 12/25/2017 None N/A EMERGENCY R1539 HASAN, SYED DANISH, MD 2/6/2017 2/6/2022 FAMILY MEDICINE MEDICINE IRVING TX ACTIVE 3/3/2017 None N/A EMERGENCY R5124 HASAN, SYED, DO 11/3/2017 11/3/2022 MEDICINE RICHMOND VA ACTIVE 1/15/2018 None N/A PEDIATRICS, Q8902 HASBANI, KEREN, MD 7/1/2016 7/1/2021 CARDIOLOGY PEDIATRICS AUSTIN TX ACTIVE 8/24/2016 None N/A

SPORTS MEDICINE - HASELHORST, ALEXANDRIA PHYSICAL MED. & PHYSICAL MEDICINE S4490 JOANN, DO 12/20/2019 12/20/2024 REHABILITATION & REHABILITATION AUSTIN TX ACTIVE 1/13/2020 None N/A CRITICAL CARE R2614 HASHIMOTO, YOHEY, MD 4/20/2017 4/20/2022 GENERAL SURGERY (SURGERY) DOTHAN AL ACTIVE 7/17/2017 None N/A EMERGENCY S5919 HASHMI, MOHAMMEDALI, DO 4/3/2020 4/3/2025 MEDICINE DALLAS TX ACTIVE 4/6/2020 None N/A JEFFERSONVI Q8504 HASNAIN, FARHEEN JAMIL, MD 6/1/2016 6/1/2021 INTERNAL MEDICINE GENERAL PRACTICE LLE IN ACTIVE 6/17/2016 None N/A S6634 HASSAN, ANAM , MD 5/15/2020 5/15/2025 INTERNAL MEDICINE HOSPITALIST ACTIVE 5/18/2020 None N/A HEMATOLOGY/ONCOL R1769 HASSAN, ANISA, MD 2/22/2017 2/22/2022 OGY OTHER SPECIALTY JOPLIN MO ACTIVE 2/28/2017 None N/A R2870 HASSAN, RASHEED , DO 5/5/2017 5/5/2022 INTERNAL MEDICINE HOSPITALIST ABILENE TX ACTIVE 5/24/2017 None N/A GASTROENTEROLOG Q4975 HASSAN, SOHAIB, MD 7/1/2015 7/1/2020 INTERNAL MEDICINE Y HOUSTON TX ACTIVE 7/27/2015 None N/A R3337 HASSAN, SYED-AZHAR , MD 6/2/2017 6/2/2022 INTERNAL MEDICINE MIDLAND TX ACTIVE 6/9/2017 None N/A PEDIATRIC ANESTHESIOLOGY Q8258 HASSANPOUR, ALI, MD 5/16/2016 5/16/2021 (PEDS) ANESTHESIOLOGY HOUSTON TX ACTIVE 6/20/2016 None N/A ORTHOPEDIC R2871 HASSINGER, SEAN MICHAEL, MD 5/5/2017 5/5/2022 SURGERY IRVING TX ACTIVE 5/12/2017 None N/A HASSOUN, LAUREN ALEXANDRIA, S4491 MD 12/20/2019 12/20/2024 HOSPITALIST ACTIVE 12/30/2019 None N/A CARDIOTHORACIC Q8072 HASTIE, DAVID GEORGE, MD 5/2/2016 5/2/2021 ANESTHESIOLOGY ANESTHESIOLOGY DALLAS TX ACTIVE 5/9/2016 None N/A OBSTETRICS AND R3856 HATEM, HATEM, MD 7/17/2017 7/17/2022 GYNECOLOGY ACTIVE 7/19/2017 None N/A R3098 HATTENBACH, SEAN , MD 5/22/2017 5/22/2022 FAMILY MEDICINE LUBBOCK TX ACTIVE 5/24/2017 None N/A DERMATOLOGIC R1540 HAU, JENNIFER T, MD 2/6/2017 2/6/2022 DERMATOLOGY SURGERY SUGAR LAND TX ACTIVE 2/27/2017 None N/A LICENSE Q7702 HAUGHTON, NICOLE, MD 4/1/2016 4/1/2021 PEDIATRICS ISSUED 4/1/2016 None N/A Page 114 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PEDIATRIC EMERGENCY S4967 HAVERLAND, JOSHUA, MD 2/7/2020 2/7/2025 MEDICINE (PEDS) PLANO TX ACTIVE 2/10/2020 None N/A EMERGENCY R0017 HAVLICK, JOHN, DO 9/15/2016 9/15/2021 MEDICINE AUSTIN TX ACTIVE 9/16/2016 None N/A ANATOMIC/CLINICAL R2872 HAWKINS, MONTY A, MD 5/5/2017 5/5/2022 PATHOLOGY HOUSTON TX ACTIVE 5/9/2017 None N/A OBSTETRICS AND FREDERICKSB Q5424 HAWS, BLAIR , MD 8/3/2015 8/3/2020 GYNECOLOGY URG TX ACTIVE 8/4/2015 None N/A HAND SURGERY - ORTHOPEDIC ORTHOPEDIC Q6843 HAY, DAVID CLARK, MD 1/6/2016 1/6/2021 SURGERY SURGERY ACTIVE 2/5/2016 None N/A S5383 HAYAT, QURATULAIN, DO 3/6/2020 3/6/2025 FAMILY MEDICINE MIAMI FL ACTIVE 3/20/2020 None N/A

S4969 HAYDEN, FRANK RICHARD JR, MD 2/7/2020 2/7/2025 RADIOLOGY LAWTON OK ACTIVE 4/8/2020 None N/A CRITICAL CARE PALLIATIVE Q9631 HAYES, EARLE W, DO 8/15/2016 8/15/2021 MEDICINE MEDICINE PASADENA TX ACTIVE 8/25/2016 None N/A R3857 HAYS, WILLIAM ANTHONY, MD 7/17/2017 7/17/2022 FAMILY MEDICINE DALLAS TX ACTIVE 7/18/2017 None N/A R4979 HAYWARD, CHRISTIANA , MD 10/20/2017 10/20/2022 INTERNAL MEDICINE HOUSTON TX ACTIVE 10/31/2017 None N/A OPHTHALMOLOGY - MURRELLS L1607 HAZELTON, JOHN RONALD, MD 3/6/2020 3/6/2025 OPHTHALMOLOGY GLAUCOMA INLET SC ACTIVE 3/9/2020 None N/A Q9634 HE, CHAOYING , MD 8/15/2016 8/15/2021 ANESTHESIOLOGY MINOT ND ACTIVE 8/25/2016 None N/A ORTHOPEDIC S6408 HEABERLIN, JAMES RYAN, MD 5/1/2020 5/1/2025 SURGERY DALLAS TX ACTIVE 5/4/2020 None N/A EMERGENCY Q6844 HEALY, MCKENNA BALDINI, MD 1/6/2016 1/6/2021 MEDICINE ACTIVE 3/7/2016 None N/A R1220 HEAP, JAMES CASEY, MD 1/6/2017 1/6/2022 FAMILY MEDICINE WACO TX ACTIVE 1/16/2017 None N/A HEARD, CHRISTOPHER MICHAEL CRITICAL CARE R4557 BRYAN, MD 9/8/2017 9/8/2022 ANESTHESIOLOGY ANESTHESIOLOGY ACTIVE 9/25/2017 None N/A R4558 HEAVENER, TRACE , DO 9/8/2017 9/8/2022 INTERNAL MEDICINE TEMPLE TX ACTIVE 9/11/2017 None N/A R1771 HECHANOVA, LISA AIMEE, MD 2/22/2017 2/22/2022 NEPHROLOGY INTERNAL MEDICINE EL PASO TX ACTIVE 2/28/2017 None N/A R0411 HECKER, GRACE MARIE, MD 10/14/2016 10/14/2021 FAMILY MEDICINE WACO TX ACTIVE 10/21/2016 None N/A EMERGENCY R5737 HEDMAN, TYLER JAMES, MD 1/19/2018 1/19/2023 MEDICINE FORT WORTH TX ACTIVE 1/22/2018 None N/A LICENSE S7063 HEGDE, BRITTANY NICOLE, MD 6/12/2020 6/12/2025 GENERAL SURGERY ISSUED 6/12/2020 None N/A THORACIC CARDIOVASCULAR S6637 HEID, CHRISTOPHER , MD 5/15/2020 5/15/2025 GENERAL SURGERY SURGERY DALLAS TX ACTIVE 5/18/2020 None N/A HEINZELMANN, MORGAN S6204 MICHELLE, MD 4/17/2020 4/17/2025 NEUROLOGY DALLAS TX ACTIVE 4/20/2020 None N/A Page 115 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date R1542 HEIPLE, DREW COURTNEY, MD 2/6/2017 2/6/2022 NEPHROLOGY INTERNAL MEDICINE ARLINGTON TX ACTIVE 2/23/2017 None N/A R1040 HELLER, RICHARD E, MD 12/16/2016 12/16/2021 RADIOLOGY HOUSTON TX ACTIVE 1/4/2017 None N/A S5181 HELLMAN, ERIC , MD 2/21/2020 2/21/2025 FAMILY MEDICINE LUBBOCK TX ACTIVE 3/4/2020 None N/A ANESTHESIOLOGY - R4237 HELLMAN, MATTHEW JOEL, MD 8/15/2017 8/15/2022 ANESTHESIOLOGY PAIN MANAGEMENT AUSTIN TX ACTIVE 8/23/2017 None N/A R5270 HELM, COLE , MD 11/17/2017 11/17/2022 ANESTHESIOLOGY SAN ANTONIO TX ACTIVE 12/4/2017 None N/A R4980 HEMADRI, AMIT, MD 10/20/2017 10/20/2022 INTERNAL MEDICINE PITTSBURGH PA ACTIVE 1/15/2018 None N/A R3680 HEMANI, UMAIR , DO 6/30/2017 6/30/2022 PSYCHIATRY HOUSTON TX ACTIVE 7/7/2017 None N/A EMERGENCY Q8722 HEMERKA, JOSEPH NICKOLAS, MD 6/10/2016 6/10/2021 MEDICINE AUSTIN TX ACTIVE 6/14/2016 None N/A HENDERSON, CHARLES GERRY, R3858 MD 7/17/2017 7/17/2022 PEDIATRIC UROLOGY UROLOGIC SURGERY PENSACOLA FL ACTIVE 8/14/2017 None N/A HENDERSON, MICHELLE REINA PEDIATRIC CRITICAL Q5425 BOSLEY, MD 8/3/2015 8/3/2020 CARE MEDICINE PEDIATRICS DALLAS TX ACTIVE 8/25/2015 None N/A HENDREN, NICHOLAS STEPHEN, R0726 MD 11/15/2016 11/15/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 11/28/2016 None N/A HENNESSY, SARA SURGICAL CRITICAL Q4976 ABDOLLAHZADEH, MD 7/1/2015 7/1/2020 GENERAL SURGERY CARE DALLAS TX ACTIVE 7/9/2015 None N/A PEDIATRIC ORTHOPEDIC R0412 HENNING, AMY ELIZABETH, DO 10/14/2016 10/14/2021 ORTHOPEDICS SURGERY LUBBOCK TX ACTIVE 10/18/2016 None N/A PEDIATRIC ANESTHESIOLOGY LICENSE S7065 HENRY, TEKESHA T, DO 6/12/2020 6/12/2025 ANESTHESIOLOGY (PEDS) ISSUED 6/12/2020 None N/A R0868 HENSEN, ERIC LOGAN, DO 12/2/2016 12/2/2021 OTOLARYNGOLOGY OXFORD AL ACTIVE 3/28/2017 None N/A UROLOGIC S4781 HENSLEY, PATRICK JOSEPH, MD 1/24/2020 1/24/2025 UROLOGY ONCOLOGY ACTIVE 2/25/2020 None N/A LICENSE Q6425 HERBERT, GARTH, MD 11/2/2015 11/2/2020 GENERAL SURGERY ISSUED 11/2/2015 None N/A S5651 HERBISON, ALICIA BLAKE, MD 3/20/2020 3/20/2025 PEDIATRICS HOUSTON TX ACTIVE 3/23/2020 None N/A S7066 HERLIHY, JOHN DANIEL IV, MD 6/12/2020 6/12/2025 INTERNAL MEDICINE EL PASO TX ACTIVE 6/15/2020 None N/A DIAGNOSTIC MORTON Q8074 HERMAN, BRIAN ARTHUR, MD 5/2/2016 5/2/2021 RADIOLOGY GROVE IL ACTIVE 6/6/2016 None N/A INTERVENTIONAL CARDIOVASCULAR Q4977 HERMANN, DANIEL GENE, MD 7/1/2015 7/1/2020 CARDIOLOGY DISEASES HOUSTON TX ACTIVE 7/13/2015 None N/A PHYSICAL MED. & SPINAL CORD R0019 HERNANDEZ JIMENEZ, ISAAC , MD 9/15/2016 9/15/2021 REHABILITATION INJURY MEDICINE HOUSTON TX ACTIVE 10/17/2016 None N/A HEAD AND NECK R3338 HERNANDEZ, DAVID J, MD 6/2/2017 6/2/2022 OTOLARYNGOLOGY SURGERY HOUSTON TX ACTIVE 6/5/2017 None N/A HERNANDEZ, FERNANDO SPORTS MEDICINE R3527 ENRIQUE, MD 6/16/2017 6/16/2022 FAMILY MEDICINE (FAMILY PRACTICE) LUBBOCK TX ACTIVE 7/3/2017 None N/A

Page 116 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date OBSTETRICS AND LICENSE Q5667 HERNANDEZ, OSCAR, MD 8/14/2015 8/14/2020 GYNECOLOGY ISSUED 8/14/2015 None N/A HERNANDEZ, RICARDO JAVIER, Q5668 MD 8/14/2015 8/14/2020 INTERNAL MEDICINE ACTIVE 8/20/2015 None N/A HERRARTE FORNOS, SCARLET INFECTIOUS R3339 YALILE, MD 6/2/2017 6/2/2022 DISEASES INTERNAL MEDICINE BURLESON TX ACTIVE 6/5/2017 None N/A R0020 HERRERA, JAIME ROBERTO, MD 9/15/2016 9/15/2021 PEDIATRICS HOUSTON TX ACTIVE 9/26/2016 None N/A EMERGENCY Q8903 HERRERA, JESSICA MARIE, MD 7/1/2016 7/1/2021 MEDICINE DALLAS TX ACTIVE 9/19/2016 None N/A HERRERA, SEBASTIAN RAMON, NEUROLOGICAL Q4978 MD 7/1/2015 7/1/2020 SURGERY TUCSON AZ ACTIVE 7/30/2015 None N/A NEUROMUSCULOSK HERSHBERGER, NATHAN JOEL, FAMILY ELETAL R4850 DO 10/6/2017 10/6/2022 PRACTICE/OMM MEDICINE/OMT FORT WORTH TX ACTIVE 10/12/2017 None N/A Q6846 HERTEL, ADAM , MD 1/6/2016 1/6/2021 FAMILY MEDICINE TYLER TX ACTIVE 1/22/2016 None N/A R2619 HERZIK, MICHAEL ANTHONY, MD 4/20/2017 4/20/2022 INTERNAL MEDICINE ACTIVE 4/24/2017 None N/A ANESTHESIOLOGY - R1544 HESS, CHRISTOPHER AARON, MD 2/6/2017 2/6/2022 ANESTHESIOLOGY PAIN MANAGEMENT ADDISON TX ACTIVE 2/13/2017 None N/A

Q4599 HESSLER, PAUL C, MD 6/1/2015 6/1/2020 PEDIATRICS FORT WORTH, TX ACTIVE 6/4/2015 None N/A Q6028 HESSLER, RONALD JASON, MD 9/15/2015 9/15/2020 OPHTHALMOLOGY WACO TX ACTIVE 9/17/2015 None N/A PALLIATIVE R4714 HEUNG, YVONNE , MD 9/22/2017 9/22/2022 INTERNAL MEDICINE MEDICINE HOUSTON TX ACTIVE 12/12/2017 None N/A CORPUS R0869 HEUSNER BANKS, KYLA, MD 12/2/2016 12/2/2021 FAMILY MEDICINE CHRISTI TX ACTIVE 1/2/2017 None N/A DIAGNOSTIC R4059 HEWETT, LEE , MD 8/1/2017 8/1/2022 RADIOLOGY ACTIVE 9/6/2017 None N/A ORTHOPEDIC PEDIATRIC Q8075 HEYDEMANN, JOHN ALBERT, MD 5/2/2016 5/2/2021 SURGERY ORTHOPEDICS HOUSTON TX ACTIVE 5/3/2016 None N/A PLASTIC & RECONSTRUCTIVE R0870 HEYMANN, HANS BARRON, MD 12/2/2016 12/2/2021 OPHTHALMOLOGY SURGERY SAN ANTONIO TX ACTIVE 12/19/2016 None N/A ADDICTION Q8505 HEYNE, NICHOLAS GREGORY, MD 6/1/2016 6/1/2021 PSYCHIATRY PSYCHIATRY DALLAS TX ACTIVE 6/8/2016 None N/A R3860 HIBBERT, CASTEL BRADLEY, MD 7/17/2017 7/17/2022 INTERNAL MEDICINE HOSPITALIST ACTIVE 7/19/2017 None N/A Q7557 HICKS, ALBERT JAMES III, MD 3/15/2016 3/15/2021 CARDIOLOGY INTERNAL MEDICINE TEMPLE TX ACTIVE 4/25/2016 None N/A HIDALGO ARMENTA, GRACE S6207 IVETH, MD 4/17/2020 4/17/2025 PEDIATRICS ACTIVE 4/20/2020 None N/A S4782 HIEBERT, MICHAEL, DO 1/24/2020 1/24/2025 INTERNAL MEDICINE ACTIVE 1/27/2020 None N/A EMERGENCY R5738 HIGGINS, TYSON JAY, MD 1/19/2018 1/19/2023 MEDICINE FORT WORTH TX ACTIVE 1/31/2018 None N/A Page 117 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date ORTHOPEDIC SPORTS MEDICINE - R4716 HIGGS, GEOFFREY BESSOM, MD 9/22/2017 9/22/2022 SURGERY ORTHOPEDICS PLANO TX ACTIVE 9/26/2017 None N/A PEDIATRIC GASTROENTEROLOG R4397 HIJAZ, NADIA MAZEN, MD 8/25/2017 8/25/2022 PEDIATRICS Y JOPLIN MO ACTIVE 9/25/2017 None N/A EMERGENCY Q6325 HIJAZI, BILAL , MD 10/15/2015 10/15/2020 FAMILY MEDICINE MEDICINE MEMPHIS TN ACTIVE 11/5/2015 None N/A OBSTETRICS AND MATERNAL AND R3862 HILL, DEMETRICE LAMOTTE, MD 7/17/2017 7/17/2022 GYNECOLOGY FETAL MEDICINE DALLAS TX ACTIVE 7/18/2017 None N/A INFECTIOUS MEDICAL Q9373 HILL, EMILIE VERONICA, MD 8/1/2016 8/1/2021 DISEASES MICROBIOLOGY DALLAS TX ACTIVE 8/11/2016 None N/A DIAGNOSTIC S5925 HILL, ERIK , MD 4/3/2020 4/3/2025 RADIOLOGY HOUSTON TX ACTIVE 4/20/2020 None N/A OBSTETRICS AND MATERNAL AND R0021 HILL, JAMES BERNARD, MD 9/15/2016 9/15/2021 GYNECOLOGY FETAL MEDICINE SAN ANTONIO TX ACTIVE 9/16/2016 None N/A EMERGENCY GEORGETOW S5182 HILL, MALONE VINCENT III, MD 2/21/2020 2/21/2025 MEDICINE N TX ACTIVE 3/4/2020 None N/A Q7388 HILL, RONALD CLAIR, MD 3/4/2016 3/4/2021 ANESTHESIOLOGY SEBRING FL ACTIVE 3/16/2016 None N/A DELINQUEN T-NON R0727 HILL, TIFFANY DARCELL, MD 11/15/2016 11/15/2021 FAMILY MEDICINE PAYMENT 12/30/2017 None N/A PEDIATRIC REHABILITATION R4398 HILLEBRAND, MARIELLA , MD 8/25/2017 8/25/2022 MEDICINE HOUSTON TX ACTIVE 10/13/2017 None N/A EMERGENCY EMERGENCY R1385 HILTON, CONRAD THOMAS, DO 1/20/2017 1/20/2022 MEDICINE MEDICINE ACTIVE 2/3/2017 None N/A M2180 HIMMELVO, JANE THU, MD 4/4/2017 4/4/2022 FAMILY PRACTICE AUSTIN TX ACTIVE 4/5/2017 None N/A HINCHCLIFF, KATHARINE MOSS, S5386 MD 3/6/2020 3/6/2025 HAND SURGERY DALLAS TX ACTIVE 4/30/2020 None N/A MISSOURI Q7205 HINCKS, KERRY LIN, DO 2/16/2016 2/16/2021 FAMILY MEDICINE CITY TX ACTIVE 2/18/2016 None N/A ENDOCRINOLOGY, DIABETES AND R0586 HINDI, SAHAR M, MD 10/31/2016 10/31/2021 METABOLISM INTERNAL MEDICINE DALLAS TX ACTIVE 11/14/2016 None N/A GERIATRIC MEDICINE (INTERNAL R5867 HINER, JULIA ALEXANDRA, MD 2/2/2018 2/2/2023 INTERNAL MEDICINE MED) HOUSTON TX ACTIVE 2/20/2018 None N/A R2873 HINES, CLAYTON ROBERT, MD 5/5/2017 5/5/2022 ANESTHESIOLOGY BEAUMONT TX ACTIVE 5/8/2017 None N/A R3101 HINES, VALERIE CRISTINA, MD 5/22/2017 5/22/2022 PEDIATRICS CHICAGO IL ACTIVE 6/2/2017 None N/A S4316 HINKAMP, COLIN ANDREW, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE DALLAS TX ACTIVE 2/24/2020 None N/A S4316 HINKAMP, COLIN ANDREW, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE DALLAS TX ACTIVE 2/24/2020 None N/A Page 118 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date R1041 HINOJOSA, BARBARA ROEL, MD 12/16/2016 12/16/2021 INTERNAL MEDICINE EL PASO TX ACTIVE 12/22/2016 None N/A PLASTIC & HINOJOSA, CASSIDY DOUGLAS RECONSTRUCTIVE R5739 WRIGHT, MD 1/19/2018 1/19/2023 SURGERY COLUMBIA MO ACTIVE 2/6/2018 None N/A HINSHAW, SHIRLEY JEANETTE, OBSTETRICS AND Q8507 MD 6/1/2016 6/1/2021 GYNECOLOGY DAVENPORT IA ACTIVE 6/9/2016 None N/A R0248 HIPPELI, ANGELA NICOLE, MD 9/30/2016 9/30/2021 PEDIATRICS ACTIVE 10/6/2016 None N/A PHYSICAL MED. & LICENSE S7068 HIRANI, SALMAN , MD 6/12/2020 6/12/2025 REHABILITATION PAIN MEDICINE ISSUED 6/12/2020 None N/A EMERGENCY LICENSE Q5815 HITE, PAMELA RENE, MD 8/28/2015 8/28/2020 MEDICINE ISSUED 8/28/2015 None N/A APPLIED FOR OBSTETRICS AND RELICENSU Q9640 HJORT, AMY NICHOLE, MD 8/15/2016 8/15/2021 GYNECOLOGY RE 2/15/2018 None N/A Q5816 HLAING, CRYSTAL , MD 8/28/2015 8/28/2020 INTERNAL MEDICINE MCKINNEY TX ACTIVE 9/1/2015 None N/A CORPUS R1772 HLAING, KYIN, MD 2/22/2017 2/22/2022 INTERNAL MEDICINE CHRISTI TX ACTIVE 3/3/2017 None N/A EMERGENCY R1222 HO, AMY FAITH, MD 1/6/2017 1/6/2022 MEDICINE FORT WORTH TX ACTIVE 1/18/2017 None N/A EMERGENCY S6851 HO, CALVIN, MD 5/29/2020 5/29/2025 MEDICINE ACTIVE 6/2/2020 None N/A EMERGENCY R5868 HO, ERIC JUSTIN, DO 2/2/2018 2/2/2023 MEDICINE PHILADELPHIA PA ACTIVE 2/7/2018 None N/A DIAGNOSTIC Q6029 HO, JEFFREY C, MD 9/15/2015 9/15/2020 RADIOLOGY NEURO-RADIOLOGY PLANO TX ACTIVE 9/23/2015 None N/A PLASTIC & RECONSTRUCTIVE R3343 HO, TRUNG QUANG, MD 6/2/2017 6/2/2022 SURGERY HAND SURGERY GALVESTON TX ACTIVE 6/9/2017 None N/A Q8508 HOAK, DAVID ARNOLD, DO 6/1/2016 6/1/2021 NEUROLOGY AUSTIN TX ACTIVE 6/16/2016 None N/A Q6847 HOANG, CHRISTINE , MD 1/6/2016 1/6/2021 PEDIATRICS ACTIVE 2/15/2016 None N/A S6210 HOANG, HUNG HUU, MD 4/17/2020 4/17/2025 INTERNAL MEDICINE ACTIVE 4/24/2020 None N/A R3103 HOANG, JOHN , DO 5/22/2017 5/22/2022 INTERNAL MEDICINE FORT WORTH TX ACTIVE 6/5/2017 None N/A S6852 HOANG, LINH THI, DO 5/29/2020 5/29/2025 FAMILY MEDICINE HOUSTON TX ACTIVE 6/1/2020 None N/A DIAGNOSTIC Q9376 HOANG, LON , DO 8/1/2016 8/1/2021 RADIOLOGY NEURO-RADIOLOGY PLANO TX ACTIVE 9/5/2016 None N/A NEONATAL- PERINATAL LICENSE Q4601 HOBBS, JANICE ELIZABETH, MD 6/1/2015 6/1/2020 PEDIATRICS MEDICINE ISSUED 6/1/2015 None N/A PEDIATRICS, R5405 HODA, MEHAR, MD 12/8/2017 12/8/2022 PEDIATRICS CARDIOLOGY AMARILLO TX ACTIVE 2/9/2018 None N/A Page 119 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date EMERGENCY R5406 HODGE, TIMOTHY, DO 12/8/2017 12/8/2022 MEDICINE LANSING MI ACTIVE 12/14/2017 None N/A ORTHOPEDIC ORTHOPEDIC CORPUS S6853 HODGES, BRIAN NEIL, DO 5/29/2020 5/29/2025 TRAUMA SURGERY CHRISTI TX ACTIVE 6/5/2020 None N/A HODGES, CAMILLE MERCEDES, S5387 DO 3/6/2020 3/6/2025 ANESTHESIOLOGY GALVESTON TX ACTIVE 3/9/2020 None N/A NEUROLOGICAL Q6204 HODGES, TIFFANY RENEE, MD 10/1/2015 10/1/2020 SURGERY HOUSTON TX ACTIVE 10/27/2015 None N/A CORPUS S6411 HOEFERLIN, KATIE MARIE, MD 5/1/2020 5/1/2025 FAMILY MEDICINE CHRISTI TX ACTIVE 5/5/2020 None N/A CARDIOVASCULAR INTERVENTIONAL Q8904 HOFF, JAMES GEORGE, MD 7/1/2016 7/1/2021 DISEASES CARDIOLOGY TYLER TX ACTIVE 7/4/2016 None N/A HOFFMAN, MALLORY MICHELLE , OBSTETRICS AND Q8723 MD 6/10/2016 6/10/2021 GYNECOLOGY HOUSTON TX ACTIVE 6/21/2016 None N/A SURGICAL CRITICAL Q8905 HOFFMAN, MARCUS KEITH, MD 7/1/2016 7/1/2021 GENERAL SURGERY CARE HOUSTON TX ACTIVE 8/3/2016 None N/A PULMONARY CRITICAL CARE R1774 HOFFMAN, TERRI, MD 2/22/2017 2/22/2022 INTERNAL MEDICINE MEDICINE TYLER TX ACTIVE 2/24/2017 None N/A EMERGENCY EMERGENCY S4640 HOGAN, ANDREW NEAL, MD 1/10/2020 1/10/2025 MEDICINE MEDICAL SERVICES DALLAS TX ACTIVE 6/2/2020 None N/A ORTHOPEDIC Q8906 HOGAN, CHARLES, MD 7/1/2016 7/1/2021 SURGERY HOUSTON TX ACTIVE 8/8/2016 None N/A

R4060 HOGE, MARGARET KATHRYN, MD 8/1/2017 8/1/2022 PEDIATRICS DALLAS TX ACTIVE 8/4/2017 None N/A Q8077 HOGUE, MICHAEL ANDREW, MD 5/2/2016 5/2/2021 OPHTHALMOLOGY EDMOND OK ACTIVE 5/12/2016 None N/A EMERGENCY R1386 HOLDER, DAVID MICHAEL, MD 1/20/2017 1/20/2022 MEDICINE LEXINGTON NC ACTIVE 2/24/2017 None N/A Q6754 HOLINEJ, SHARISSE, MD 12/15/2015 12/15/2020 FAMILY MEDICINE CORSICANA TX ACTIVE 12/24/2015 None N/A ENDOCRINOLOGY, HOLLAND, SOEMIWATI WEIDRIS, DIABETES AND Q6513 MD 11/16/2015 11/16/2020 INTERNAL MEDICINE METABOLISM TEMPLE TX ACTIVE 11/24/2015 None N/A EMERGENCY R1223 HOLLENSTEINER, CASEY, MD 1/6/2017 1/6/2022 MEDICINE ACTIVE 1/16/2017 None N/A RADIATION Q8078 HOLLIDAY, EMMA BREY, MD 5/2/2016 5/2/2021 ONCOLOGY HOUSTON TX ACTIVE 5/16/2016 None N/A R4399 HOLT, BILLY DON, DO 8/25/2017 8/25/2022 FAMILY PRACTICE OZARK MO ACTIVE 9/4/2017 None N/A INTERVENTIONAL CARDIOVASCULAR S4495 HOMAN, DAVID JOHN, MD 12/20/2019 12/20/2024 CARDIOLOGY DISEASES OPELOUSAS LA ACTIVE 3/2/2020 None N/A

Page 120 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PLASTIC & RECONSTRUCTIVE HAND SURGERY - R1775 HOMAS, DALLAS W, MD 2/22/2017 2/22/2022 SURGERY PLASTIC SURGERY SAN ANTONIO TX ACTIVE 5/22/2017 None N/A Q8908 HOMONOFF, MARK C, MD 7/1/2016 7/1/2021 NEUROLOGY DALLAS TX ACTIVE 8/23/2016 None N/A S5656 HON, MARY CATHERINE, MD 3/20/2020 3/20/2025 INTERNAL MEDICINE DALLAS TX ACTIVE 4/30/2020 None N/A R3865 HONG, ARTHUR SEOKJAE, MD 7/17/2017 7/17/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 7/19/2017 None N/A

R4563 HONG, CLAUDIA, MD 9/8/2017 9/8/2022 PEDIATRICS SHENANDOAH TX ACTIVE 10/23/2017 None N/A EMERGENCY R3866 HONG, MICHELLE, MD 7/17/2017 7/17/2022 MEDICINE HOUSTON TX ACTIVE 7/20/2017 None N/A R4718 HONG, PETER J, MD 9/22/2017 9/22/2022 PEDIATRICS DALLAS TX ACTIVE 10/3/2017 None N/A GERIATRIC MEDICINE (INTERNAL R5565 HONG, PETER KOOGHEE, DO 1/5/2018 1/5/2023 PALLIATIVE MEDICINE MED) DALLAS TX ACTIVE 2/5/2018 None N/A R0729 HONG, SUK , MD 11/15/2016 11/15/2021 ANESTHESIOLOGY DALLAS TX ACTIVE 1/9/2017 None N/A ANESTHESIOLOGY - R3104 HONG, THOMAS, DO 5/22/2017 5/22/2022 ANESTHESIOLOGY PAIN MANAGEMENT ACTIVE 5/30/2017 None N/A PEDIATRIC HONSINGER, CHARLES PAUL III, ANESTHESIOLOGY R2623 MD 4/20/2017 4/20/2022 (PEDS) ANESTHESIOLOGY FORT WORTH TX ACTIVE 5/3/2017 None N/A PEDIATRIC R1965 HONSINGER, KRISTEN LYNN, MD 3/3/2017 3/3/2022 OTOLARYNGOLOGY OTOLARYNGOLOGY COLUMBUS OH ACTIVE 3/14/2017 None N/A ABDOMINAL OKLAHOMA S5657 HOOPER, ELIZABETH A, MD 3/20/2020 3/20/2025 GENERAL SURGERY SURGERY CITY OK ACTIVE 3/25/2020 None N/A PEDIATRICS, R2358 HOPE, KYLE DAVID, MD 4/4/2017 4/4/2022 CARDIOLOGY HOUSTON TX ACTIVE 4/10/2017 None N/A R3528 HOPEN, MICHAEL, MD 6/16/2017 6/16/2022 OPHTHALMOLOGY EL PASO TX ACTIVE 7/7/2017 None N/A INTERVENTIONAL DIAGNOSTIC R2126 HOPFER, KARI D, DO 3/20/2017 3/20/2022 RADIOLOGY RADIOLOGY ACTIVE 1/5/2018 None N/A HOPKINS, EMILY ANN MOONEY, S4973 MD 2/7/2020 2/7/2025 PEDIATRICS HOUSTON TX ACTIVE 2/13/2020 None N/A Q6848 HOQUE, RUMANA , MD 1/6/2016 1/6/2021 FAMILY MEDICINE LUBBOCK TX ACTIVE 1/18/2016 None N/A OBSTETRICS AND S4496 HORNE, JAZMIN UNIQUE, MD 12/20/2019 12/20/2024 GYNECOLOGY FORT WORTH TX ACTIVE 1/6/2020 None N/A PEDIATRIC EMERGENCY Q9824 HORTON, COURTNEY , MD 8/26/2016 8/26/2021 MEDICINE (PEDS) SAN ANTONIO TX ACTIVE 9/7/2016 None N/A EMERGENCY Q7390 HORTON, RYAN , MD 3/4/2016 3/4/2021 MEDICINE AUSTIN TX ACTIVE 4/4/2016 None N/A HEMATOLOGY/ONCOL S6412 HOSSAIN, ANEESHA, MD 5/1/2020 5/1/2025 OGY INTERNAL MEDICINE AUSTIN TX ACTIVE 5/19/2020 None N/A Page 121 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date Q4602 HOSSAIN, SHABBIR MAJID, MD 6/1/2015 6/1/2020 INTERNAL MEDICINE DALLAS TX ACTIVE 6/2/2015 None N/A R2127 HOSSIN, MD SHAKHAWAT, MD 3/20/2017 3/20/2022 INTERNAL MEDICINE ACTIVE 4/3/2017 None N/A PHYSICAL MED. & R4719 HOU, SAIYUN , MD 9/22/2017 9/22/2022 REHABILITATION ACTIVE 12/4/2017 None N/A LICENSE Q8509 HOUCK, KIMBERLY , MD 6/1/2016 6/1/2021 CHILD NEUROLOGY HOUSTON TX ISSUED 6/1/2016 None N/A EMERGENCY RICHMOND S5183 HOUNG, SAMUEL, DO 2/21/2020 2/21/2025 MEDICINE HEIGHTS OH ACTIVE 3/16/2020 None N/A CORNEA HOUSER, KOURTNEY REFRACTIVE Q7558 HENDERSON, MD 3/15/2016 3/15/2021 OPHTHALMOLOGY SURGERY HOUSTON TX ACTIVE 3/31/2016 None N/A DELINQUEN T-NON R1776 HOUSTON, COLE JACKSON, MD 2/22/2017 2/22/2022 FAMILY MEDICINE PAYMENT 5/23/2017 None N/A S6643 HOUSTON, SARA, MD 5/15/2020 5/15/2025 PEDIATRICS ACTIVE 5/27/2020 None N/A EMERGENCY Q8909 HOVERSTADT, PHILLIP J, MD 7/1/2016 7/1/2021 MEDICINE HOUSTON TX ACTIVE 7/4/2016 None N/A Q9825 HOWARD, AMY JO, MD 8/26/2016 8/26/2021 PEDIATRICS SAN ANTONIO TX ACTIVE 9/5/2016 None N/A R3106 HOWARD, AUSTIN ARCHIE III, MD 5/22/2017 5/22/2022 CARDIOLOGY INTERNAL MEDICINE HOUSTON TX ACTIVE 5/23/2017 None N/A S7070 HOWARD, FRANCES LIVIER, MD 6/12/2020 6/12/2025 PSYCHIATRY MIAMI FL ACTIVE 6/17/2020 None N/A OBSTETRICS & GYNECOLOGICAL S6854 HOWARD, TERA FREDERICK, MD 5/29/2020 5/29/2025 SURGERY AUSTIN TX ACTIVE 6/9/2020 None N/A SEE CRITICAL CARE PREVIOUS Q5817 HOWE, JARETT KENT, MD 8/28/2015 8/28/2020 PEDIATRIC SURGERY (SURGERY) EL PASO TX ACTIVE 9/9/2015 ORDER 8/31/2015 Q6944 HOWZE, SHERI LAKEITHA, MD 1/15/2016 1/15/2021 PEDIATRICS EL PASO TX ACTIVE 4/1/2016 None N/A S4975 HOYE, DOUGLAS JOSEPH, MD 2/7/2020 2/7/2025 ANESTHESIOLOGY DALLAS TX ACTIVE 2/13/2020 None N/A R3867 HOYER, AIMEE, MD 7/17/2017 7/17/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 8/9/2017 None N/A NEUROLOGICAL LICENSE R5566 HRUSKA, ROB THOMAS, MD 1/5/2018 1/5/2023 SURGERY ISSUED 1/5/2018 None N/A PEDIATRIC HEMATOLOGY/ONCOL S4641 HSIEH, EMILY , MD 1/10/2020 1/10/2025 OGY HOUSTON TX ACTIVE 1/15/2020 None N/A R3683 HSU, CHIH-HSIN , MD 6/30/2017 6/30/2022 INTERNAL MEDICINE SAN ANGELO TX ACTIVE 7/11/2017 None N/A CRITICAL CARE R1966 HSU, STEVEN HUAN LING, MD 3/3/2017 3/3/2022 MEDICINE INTERNAL MEDICINE HOUSTON TX ACTIVE 3/13/2017 None N/A R5133 HU, AUSTIN HUNG-HUAN, MD 11/3/2017 11/3/2022 INTERNAL MEDICINE HOUSTON TX ACTIVE 11/6/2017 None N/A HEMATOLOGY/ONCOL Q6427 HU, BEI , MD 11/2/2015 11/2/2020 OGY HOUSTON TX ACTIVE 11/3/2015 None N/A

Page 122 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date FARMERS R4239 HU, TIANSHEN , MD 8/15/2017 8/15/2022 RADIOLOGY INTERNAL MEDICINE BRANCH TX ACTIVE 11/8/2017 None N/A PHYSICAL MED. & S5930 HUA, JASON , DO 4/3/2020 4/3/2025 REHABILITATION ACTIVE 6/8/2020 None N/A HUANG, ALBERT YUNG-HSIANG, Q8911 MD 7/1/2016 7/1/2021 GENERAL SURGERY HOUSTON TX ACTIVE 7/6/2016 None N/A HEAD AND NECK R3869 HUANG, ANDREW TSAO, MD 7/17/2017 7/17/2022 OTOLARYNGOLOGY SURGERY HOUSTON TX ACTIVE 8/17/2017 None N/A R3345 HUANG, CHIENYAO, MD 6/2/2017 6/2/2022 ANESTHESIOLOGY DALLAS TX ACTIVE 6/9/2017 None N/A Q6945 HUANG, ERYONG, MD 1/15/2016 1/15/2021 PEDIATRICS ACTIVE 1/28/2016 None N/A R5134 HUANG, JONATHAN , MD 11/3/2017 11/3/2022 ANESTHESIOLOGY HOUSTON TX ACTIVE 11/27/2017 None N/A ORAL & MAXILLOFACIAL HEAD AND NECK R3107 HUANG, MICHAEL FEI, MD 5/22/2017 5/22/2022 SURGERY SURGERY HOUSTON TX ACTIVE 5/30/2017 None N/A PEDIATRIC R0250 HUANG, ZHEN , MD 9/30/2016 9/30/2021 OTOLARYNGOLOGY HOUSTON TX ACTIVE 10/4/2016 None N/A CORPUS R2878 HUBER, KRISTEN ANDERSON, MD 5/5/2017 5/5/2022 FAMILY MEDICINE CHRISTI TX ACTIVE 5/22/2017 None N/A NEONATAL- PERINATAL R0417 HUDA, SHEHZAD A, MD 10/14/2016 10/14/2021 PEDIATRICS MEDICINE ALEXANDRIA LA ACTIVE 10/18/2016 None N/A HUDDLESTON, ASHLEY MALCOM, EMERGENCY Q4603 MD 6/1/2015 6/1/2020 MEDICINE FORT WORTH TX ACTIVE 6/4/2015 None N/A Q9379 HUDDLESTON, GEORGE IV, MD 8/1/2016 8/1/2021 HOSPITALIST HARLINGEN TX ACTIVE 10/12/2016 None N/A INFECTIOUS INTERNAL MED - Q7560 HUDSON, FRANK PARKER III, MD 3/15/2016 3/15/2021 DISEASES PEDS ACTIVE 3/17/2016 None N/A R1777 HUDSON, JERRYCE MARIE, MD 2/22/2017 2/22/2022 FAMILY MEDICINE SUGAR LAND TX ACTIVE 3/20/2017 None N/A HUDSON, KATHRYN ELIZABETH, HEMATOLOGY/ONCOL Q7561 MD 3/15/2016 3/15/2021 OGY AUSTIN TX ACTIVE 3/21/2016 None N/A HUDSON, MARJORIE ELLEN BLAIR, S5389 MD 3/6/2020 3/6/2025 FAMILY MEDICINE TEXARKANA AR ACTIVE 4/16/2020 None N/A R3346 HUERTAS, ROBERTO, MD 6/2/2017 6/2/2022 ANESTHESIOLOGY SCRANTON PA ACTIVE 6/23/2017 None N/A THORACIC CARDIOVASCULAR R3531 HUERTER, MARY ELISE, MD 6/16/2017 6/16/2022 GENERAL SURGERY SURGERY DALLAS TX ACTIVE 6/19/2017 None N/A EMERGENCY Q5432 HUFF, MATTHEW RAY, DO 8/3/2015 8/3/2020 MEDICINE WACO TX ACTIVE 8/5/2015 None N/A

R1387 HUFFMAN, KRISTY MICHELLE, DO 1/20/2017 1/20/2022 ANESTHESIOLOGY LOGAN WV ACTIVE 2/13/2017 None N/A Q9826 HUFFMAN, LANDON , DO 8/26/2016 8/26/2021 PEDIATRICS TEMPLE TX ACTIVE 9/6/2016 None N/A

Page 123 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date HUGHES BASS, ANN CATHERINE, R4983 MD 10/20/2017 10/20/2022 FAMILY MEDICINE LUBBOCK TX ACTIVE 10/23/2017 None N/A

S5390 HUGHES, ANDREA BREANNA, DO 3/6/2020 3/6/2025 FAMILY MEDICINE ACTIVE 4/1/2020 None N/A PEDIATRIC Q9166 HUGHES, CHARLES ANTHONY, MD 7/15/2016 7/15/2021 OTOLARYNGOLOGY OTOLARYNGOLOGY HOUSTON TX ACTIVE 7/19/2016 None N/A PULMONARY CRITICAL CARE R2625 HUGHES, MEGAN MICHELLE, MD 4/20/2017 4/20/2022 INTERNAL MEDICINE MEDICINE HOUSTON TX ACTIVE 4/21/2017 None N/A DERMATOPATHOLO Q9167 HUGHES, STEPHEN MARK, MD 7/15/2016 7/15/2021 PATHOLOGY GY FAYETTEVILLE AR ACTIVE 8/5/2016 None N/A Q9827 HUH, HANNA , MD 8/26/2016 8/26/2021 PEDIATRICS HOUSTON TX ACTIVE 10/7/2016 None N/A OBSTETRICS AND R2879 HULIN, CHARITY , MD 5/5/2017 5/5/2022 GYNECOLOGY RICHMOND TX ACTIVE 6/13/2017 None N/A OBSTETRICS AND S5660 HULL, ELISE , MD 3/20/2020 3/20/2025 GYNECOLOGY AUSTIN TX ACTIVE 3/25/2020 None N/A PULMONARY CRITICAL CARE JBSA FT SAM R2129 HULL, JAMES EDWARD, DO 3/20/2017 3/20/2022 MEDICINE HOUSTON TX ACTIVE 3/22/2017 None N/A R2361 HULSEY, MATTHEW W, MD 4/4/2017 4/4/2022 ANESTHESIOLOGY DALLAS TX ACTIVE 4/10/2017 None N/A HUMMEL, CHRISTOPHER EMERGENCY Q4984 JONATHAN, DO 7/1/2015 7/1/2020 MEDICINE DALLAS TX ACTIVE 7/8/2015 None N/A LICENSE Q4769 HUMPHREY, JENNA, MD 6/12/2015 6/12/2020 PEDIATRICS ISSUED 6/12/2015 None N/A HEMATOLOGY/ONCO R4564 HUNG, ANNIE KWOK, MD 9/8/2017 9/8/2022 INTERNAL MEDICINE LOGY SAN ANTONIO TX ACTIVE 9/12/2017 None N/A OTORHINOLARYNGOL OTOLOGY/NEUROTO Q8264 HUNTER, JACOB, MD 5/16/2016 5/16/2021 OGY LOGY DALLAS TX ACTIVE 5/18/2016 None N/A Q4985 HUNTER, NOTA, MD 7/1/2015 7/1/2020 FAMILY MEDICINE CONROE TX ACTIVE 7/3/2015 None N/A S4498 HUNTER, TIMOTHY ANDREW, MD 12/20/2019 12/20/2024 INTERNAL MEDICINE HOSPITALIST EL PASO TX ACTIVE 1/6/2020 None N/A DELINQUEN T-NON R4062 HUQ, PHILIP FUAD, MD 8/1/2017 8/1/2022 INTERNAL MEDICINE PAYMENT 12/4/2017 None N/A PEDIATRIC R5869 HURD, ANDREW WAYNE, MD 2/2/2018 2/2/2023 NEUROLOGY PEDIATRICS DALLAS TX ACTIVE 2/8/2018 None N/A EMERGENCY R5741 HURST, JACOB , MD 1/19/2018 1/19/2023 MEDICINE FORT WORTH TX ACTIVE 2/2/2018 None N/A PEDIATRIC ANESTHESIOLOGY LICENSE Q8512 HUSAIN, KAMRAN, MD 6/1/2016 6/1/2021 ANESTHESIOLOGY (PEDS) ISSUED 6/1/2016 None N/A Q9380 HUSE, JASON THOMAS, MD 8/1/2016 8/1/2021 NEURO-PATHOLOGY HOUSTON TX ACTIVE 9/2/2016 None N/A Page 124 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date CARDIOVASCULAR Q9381 HUSSAIN, IMAD, MD 8/1/2016 8/1/2021 DISEASES INTERNAL MEDICINE HOUSTON TX ACTIVE 8/12/2016 None N/A INFECTIOUS R5870 HUSSAIN, NOMAN AKHTAR, MD 2/2/2018 2/2/2023 DISEASES INTERNAL MEDICINE DETROIT MI ACTIVE 3/1/2018 None N/A R3871 HUSSAIN, SAAD SYED, MD 7/17/2017 7/17/2022 INTERNAL MEDICINE EL PASO TX ACTIVE 7/18/2017 None N/A R5742 HUSSAIN, SAAD YOUSUF, MD 1/19/2018 1/19/2023 INTERNAL MEDICINE AUSTIN TX ACTIVE 3/19/2018 None N/A Q7562 HUSSAIN, SHAHID, MD 3/15/2016 3/15/2021 PSYCHIATRY ACTIVE 6/14/2016 None N/A URGENT CARE - R1390 HUSSAIN, SOPHIA, MD 1/20/2017 1/20/2022 FAMILY MEDICINE FAMILY PRACTICE GARLAND TX ACTIVE 2/1/2017 None N/A L4831 HUSSAIN, SYED ATHER, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE NEPHROLOGY LEXINGTON KY ACTIVE 12/16/2019 None N/A L4831 HUSSAIN, SYED ATHER, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE NEPHROLOGY LEXINGTON KY ACTIVE 12/16/2019 None N/A Q7710 HUSSAIN, SYED SHOIB, DO 4/1/2016 4/1/2021 FAMILY MEDICINE ACTIVE 6/13/2016 None N/A R5135 HUSSEIN, ALI , MD 11/3/2017 11/3/2022 INTERNAL MEDICINE ACTIVE 12/26/2017 None N/A

R0589 HUSSEIN, MOHAMED GINAWI, MD 10/31/2016 10/31/2021 INTERNAL MEDICINE FORTWORTH TX ACTIVE 11/2/2016 None N/A ADULT RECONSTRUCTIVE ORTHOPEDIC R2881 HUSTON, JAMES C, MD 5/5/2017 5/5/2022 ORTHOPEDICS SURGERY HOUSTON TX ACTIVE 5/10/2017 None N/A S6212 HUYNH, HUONG NGOC HOAI, DO 4/17/2020 4/17/2025 FAMILY MEDICINE SAN ANTONIO TX ACTIVE 4/20/2020 None N/A Q7208 HUYNH, MYLIEN , MD 2/16/2016 2/16/2021 FAMILY MEDICINE ACTIVE 3/10/2016 None N/A EMERGENCY Q5820 HUYNH, QUYEN , MD 8/28/2015 8/28/2020 MEDICINE HOUSTON TX ACTIVE 9/7/2015 None N/A DIAGNOSTIC R3109 HUYNH, THACH , MD 5/22/2017 5/22/2022 RADIOLOGY HOUSTON TX ACTIVE 5/30/2017 None N/A R3110 HWANG, MARK CHIAWEI, MD 5/22/2017 5/22/2022 INTERNAL MEDICINE RHEUMATOLOGY HOUSTON TX ACTIVE 6/5/2017 None N/A NEW R5137 HWANG, MICHAEL CHANGMIN, MD 11/3/2017 11/3/2022 INTERNAL MEDICINE BRUNSWICK NJ ACTIVE 1/9/2018 None N/A

OPHTHALMOLOGY - Q9382 HWANG, RICHARD YI-JEN, MD 8/1/2016 8/1/2021 OPHTHALMOLOGY VITREOUS SURGERY EL PASO TX ACTIVE 8/2/2016 None N/A LICENSE Q5672 HWANG, WILLY, MD 8/14/2015 8/14/2020 RADIOLOGY ISSUED 8/14/2015 None N/A R1046 HYUN, CHRISTIAN, MD 12/16/2016 12/16/2021 INTERNAL MEDICINE WAXAHACHIE TX ACTIVE 12/22/2016 None N/A IBE, ARMSTRONG OBSTETRICS AND S6415 CHUKWUNONSO, MD 5/1/2020 5/1/2025 GYNECOLOGY ACTIVE 6/8/2020 None N/A R3684 IBEKWE, CHIMA OKWUDIRI, MD 6/30/2017 6/30/2022 INTERNAL MEDICINE ACTIVE 7/25/2017 None N/A R0874 IBRAHIM AYOUB, HAJAR, MD 12/2/2016 12/2/2021 UROLOGIC SURGERY HOUSTON TX ACTIVE 12/23/2016 None N/A S5662 IBRAHIM, HASSANA, MD 3/20/2020 3/20/2025 RADIOLOGY NEURO-RADIOLOGY BEACHWOOD OH ACTIVE 3/25/2020 None N/A R2628 IBRAHIM, MOHAMED ALI, MD 4/20/2017 4/20/2022 ANESTHESIOLOGY ANESTHESIOLOGY GALVESTON TX ACTIVE 5/1/2017 None N/A R2629 IBRAHIM, SAQUIB, MD 4/20/2017 4/20/2022 INTERNAL MEDICINE HOSPITALIST PLAINVIEW NY ACTIVE 6/6/2017 None N/A

Page 125 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date LICENSE Q7711 IBRAHIM, SYED TARIQ, MD 4/1/2016 4/1/2021 PSYCHIATRY INTERNAL MEDICINE ISSUED 4/1/2016 None N/A IDICULA, WINSLO PEDIATRIC R0023 KALLUPARAMPIL, MD 9/15/2016 9/15/2021 OTOLARYNGOLOGY OTOLARYNGOLOGY LUBBOCK TX ACTIVE 10/11/2016 None N/A R0024 IDRIZOVIC, AZRA, DO 9/15/2016 9/15/2021 OPHTHALMOLOGY DALLAS TX ACTIVE 9/20/2016 None N/A IDROVO, ALEXANDRA CAROLINA, Q9169 MD 7/15/2016 7/15/2021 PEDIATRICS HOUSTON TX ACTIVE 7/18/2016 None N/A LICENSE R5871 IFEDI, BENEDICT , MD 2/2/2018 2/2/2023 FAMILY MEDICINE ISSUED 2/2/2018 None N/A NEUROLOGICAL S4784 IGBASEIMOKUMO, USIAKIMI , MD 1/24/2020 1/24/2025 SURGERY LUBBOCK TX ACTIVE 1/30/2020 None N/A

SPORTS MEDICINE - PHYSICAL MED. & PHYSICAL MEDICINE S6645 IGBINIGIE, SHERRY , MD 5/15/2020 5/15/2025 REHABILITATION & REHABILITATION DALLAS TX ACTIVE 5/18/2020 None N/A IGBOKWE, MELITA NONYEREM, CRITICAL CARE PULMONARY R4722 MD 9/22/2017 9/22/2022 MEDICINE (IM) DISEASES GLENVIEW IL ACTIVE 11/8/2017 None N/A R5743 IGHALO, OMONMEN OFURE, MD 1/19/2018 1/19/2023 FAMILY MEDICINE GARLAND TX ACTIVE 1/23/2018 None N/A

R1967 IGLEHART, ELENA IBARGUEN, MD 3/3/2017 3/3/2022 INTERNAL MEDICINE LONGVIEW TX ACTIVE 5/12/2017 None N/A R0251 IGLESIAS, MICHELLE , MD 9/30/2016 9/30/2021 FAMILY PRACTICE EL PASO TX ACTIVE 10/4/2016 None N/A PULMONARY CRITICAL CARE Q7058 IJAZ, MOHSIN, MD 2/1/2016 2/1/2021 INTERNAL MEDICINE MEDICINE ACTIVE 2/12/2016 None N/A Q5821 IKEKPEAZU, NKEMAKONAM, MD 8/28/2015 8/28/2020 GENERAL SURGERY ACTIVE 9/14/2015 None N/A IKONOMAKOU-NIKOLAIDIS, CARDIOTHORACIC R2883 STAVROULA , MD 5/5/2017 5/5/2022 ANESTHESIOLOGY ANESTHESIOLOGY TEMPLE TX ACTIVE 5/18/2017 None N/A R3534 IKPEAMA, CHINELO , MD 6/16/2017 6/16/2022 DERMATOLOGY GALVESTON TX ACTIVE 7/26/2017 None N/A LICENSE S6646 IKRAM, FARUKH GABRIEL, MD 5/15/2020 5/15/2025 INTERNAL MEDICINE ISSUED 5/15/2020 None N/A Q7712 IKUGBAGBE, OLAOLUWAPO, MD 4/1/2016 4/1/2021 FAMILY MEDICINE HOUSTON TX ACTIVE 5/2/2016 None N/A S6416 ILINENI, VISHNU KARTHIK, MD 5/1/2020 5/1/2025 HOSPITALIST FORT WORTH TX ACTIVE 5/4/2020 None N/A ENDOCRINOLOGY, ILLURI, VIDHYA DEVI SRINIVASAN, DIABETES AND Q4604 MD 6/1/2015 6/1/2020 METABOLISM INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 6/10/2015 None N/A R5138 ILO, SHERIFFDEEN, DO 11/3/2017 11/3/2022 INTERNAL MEDICINE HOSPITALIST TUPELO MS ACTIVE 11/23/2017 None N/A ORTHOPEDIC LICENSE S6856 ILYAS, HAARISS BIN, MD 5/29/2020 5/29/2025 SURGERY ISSUED 5/29/2020 None N/A PULMONARY CRITICAL CARE S5663 IMAM, JAAFER SAADI, MD 3/20/2020 3/20/2025 MEDICINE INTERNAL MEDICINE LEAGUE CITY TX ACTIVE 3/24/2020 None N/A Page 126 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date L4005 IMAM, TABASSUM ZAFFAR, MD 8/28/2015 8/28/2020 PEDIATRICS KATY TX ACTIVE 9/4/2015 None N/A EMERGENCY R0419 IMANI, GLAREH, DO 10/14/2016 10/14/2021 MEDICINE HILLSBORO TX ACTIVE 10/21/2016 None N/A CHILD AND ADOLESCENT R0252 IMMANUEL, JOSEPHA, MD 9/30/2016 9/30/2021 PSYCHIATRY PSYCHIATRY HOUSTON TX ACTIVE 12/6/2016 None N/A R4985 IMOISI, AROBOYI VERONICA, MD 10/20/2017 10/20/2022 FAMILY MEDICINE FAMILY MEDICINE LAS CRUCES NM ACTIVE 10/27/2017 None N/A R5275 INANO, HEATHER LEE, MD 11/17/2017 11/17/2022 PSYCHIATRY AUSTIN TX ACTIVE 1/9/2018 None N/A PHYSICAL MED. & Q7059 INANO, STEVEN, MD 2/1/2016 2/1/2021 REHABILITATION SACRAMENTO CA ACTIVE 2/22/2016 None N/A R0420 INCHANI, LISA ROSE, MD 10/14/2016 10/14/2021 HOSPITALIST TEMPLE TX ACTIVE 10/25/2016 None N/A Q6947 INDIRA, PRIYA PILLAI, MD 1/15/2016 1/15/2021 FAMILY MEDICINE FAMILY MEDICINE SAN ANTONIO TX ACTIVE 2/8/2016 None N/A INGKANISORN, WORAKARN SUN CITY R4855 VICTOR, MD 10/6/2017 10/6/2022 INTERNAL MEDICINE WEST AZ ACTIVE 10/16/2017 None N/A EMERGENCY S4501 INGRAM, DAVID BURT, MD 12/20/2019 12/20/2024 MEDICINE TEMPLE TX ACTIVE 2/11/2020 None N/A Q7564 INGRIM, JOEL ANDREW, MD 3/15/2016 3/15/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 3/31/2016 None N/A PLASTIC & RECONSTRUCTIVE Q4987 INTSIFUL, HARRY HUBERTUS, MD 7/1/2015 7/1/2020 SURGERY HAND SURGERY GREAT NECK NY ACTIVE 7/31/2015 None N/A PEDIATRIC PEDIATRIC S6857 IOREMBER, FRANCA MNGU, MD 5/29/2020 5/29/2025 NEPHROLOGY NEPHROLOGY SAN ANTONIO TX ACTIVE 6/8/2020 None N/A IOVETTZ-TERESHCHENKO, NADIA EMERGENCY Q4773 SKY, MD 6/12/2015 6/12/2020 MEDICINE KNOXVILLE TN ACTIVE 6/17/2015 None N/A EMERGENCY BATON S6647 IP, MICHAEL, MD 5/15/2020 5/15/2025 MEDICINE ROUGE LA ACTIVE 5/18/2020 None N/A PULMONARY CRITICAL CARE LICENSE Q8728 IQBAL, ABID SHEIKH, MD 6/10/2016 6/10/2021 INTERNAL MEDICINE MEDICINE ISSUED 6/10/2016 None N/A S5933 IQBAL, ADNAN, MD 4/3/2020 4/3/2025 PSYCHIATRY ARLINGTON TX ACTIVE 4/6/2020 None N/A EMERGENCY S4785 IQBAL, JAVERIA JAVED, DO 1/24/2020 1/24/2025 FAMILY MEDICINE MEDICINE MASON CITY IA ACTIVE 2/13/2020 None N/A Q6033 IQBAL, NAYYER, MD 9/15/2015 9/15/2020 PSYCHIATRY NEUROLOGY PENSACOLA FL ACTIVE 10/26/2015 None N/A INTERVENTIONAL Q7713 IQBAL, SAAD, MD 4/1/2016 4/1/2021 RADIOLOGY KINGWOOD TX ACTIVE 5/5/2016 None N/A

R2131 IRISH, MARY GAINES WALKER, MD 3/20/2017 3/20/2022 INTERNAL MEDICINE TEMPLE TX ACTIVE 3/27/2017 None N/A PULMONARY CRITICAL CARE WEATHERFOR R1780 IRUKULLA, PAVAN KUMAR, MD 2/22/2017 2/22/2022 MEDICINE INTERNAL MEDICINE D TX ACTIVE 2/23/2017 None N/A

Page 127 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PEDIATRIC EMERGENCY Q8913 IRWIN, WHITNEY WELLBORN, MD 7/1/2016 7/1/2021 MEDICINE (PEDS) AUSTIN TX ACTIVE 7/7/2016 None N/A MUSCULOSKELETAL ORTHOPEDIC R3349 ISAAC, CHRISTIAN, MD 6/2/2017 6/2/2022 ONCOLOGY SURGERY DALLAS TX ACTIVE 9/1/2017 None N/A RADIATION R2886 ISHAQ, OMAR, MD 5/5/2017 5/5/2022 ONCOLOGY INTERNAL MEDICINE TEXARKANA TX ACTIVE 5/9/2017 None N/A LICENSE Q5436 ISKANDAR, SANDIA , MD 8/3/2015 8/3/2020 INTERNAL MEDICINE ISSUED 8/3/2015 None N/A PEDIATRIC ANESTHESIOLOGY R0421 ISKANDER, INGY, MD 10/14/2016 10/14/2021 ANESTHESIOLOGY (PEDS) DALLAS TX ACTIVE 10/17/2016 None N/A R4240 ISLAM, SUMBUL , MD 8/15/2017 8/15/2022 INTERNAL MEDICINE SHERMAN TX ACTIVE 9/13/2017 None N/A DELINQUEN T-NON R2364 ISLAM, SYED SAQUIB, MD 4/4/2017 4/4/2022 INTERNAL MEDICINE RHEUMATOLOGY PAYMENT 7/3/2017 None N/A R5139 ISMAIL, NAZISH, MD 11/3/2017 11/3/2022 HOSPITALIST YORK PA ACTIVE 11/24/2017 None N/A R4241 ISRAEL, KATHERINE ANNE, MD 8/15/2017 8/15/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 8/17/2017 None N/A HEMATOLOGY/ONCOL R3686 ISSA, GHAYAS C, MD 6/30/2017 6/30/2022 OGY INTERNAL MEDICINE HOUSTON TX ACTIVE 7/7/2017 None N/A LICENSE TM00883 ISUANI, GUSTAVO LUIS, MD 6/12/2020 6/12/2025 RADIOLOGY NEURO-RADIOLOGY ISSUED 6/12/2020 None N/A INTERVENTIONAL CARDIOVASCULAR R0026 ITURBE, JOSE MIGUEL , MD 9/15/2016 9/15/2021 CARDIOLOGY DISEASES SAN ANTONIO TX ACTIVE 9/20/2016 None N/A ITURRIZAGA MURRIETA, JOSE CARDIOVASCULAR S6858 CARLOS, MD 5/29/2020 5/29/2025 INTERNAL MEDICINE DISEASES GALVESTON TX ACTIVE 6/8/2020 None N/A HEMATOLOGY/ONCO LICENSE Q8514 ITWARU, SANDY ANN, MD 6/1/2016 6/1/2021 INTERNAL MEDICINE LOGY ISSUED 6/1/2016 None N/A OBSTETRICS AND LICENSE Q5437 IVANOV, GENNADIY, MD 8/3/2015 8/3/2020 GYNECOLOGY ISSUED 8/3/2015 None N/A FAMILY Q6948 IVANOVA, NATALIA, DO 1/15/2016 1/15/2021 PRACTICE/OMM FAMILY MEDICINE LUMBERTON TX ACTIVE 4/13/2016 None N/A CRITICAL CARE VASCULAR Q5438 IVANUKOFF, VICTORIA , DO 8/3/2015 8/3/2020 (TRAUMA) SURGERY ACTIVE 9/7/2015 None N/A

R2365 IYENGAR, SUMATHY NAGRAJ, MD 4/4/2017 4/4/2022 INTERNAL MEDICINE MASON CITY IA ACTIVE 6/26/2017 None N/A R3874 JABBAR, DANISH ABDUL, MD 7/17/2017 7/17/2022 INTERNAL MEDICINE ARNOLD MO ACTIVE 7/24/2017 None N/A R0731 JABBAR, FURRUKH, MD 11/15/2016 11/15/2021 GENERAL SURGERY WYANDOTTE MI ACTIVE 12/5/2016 None N/A JABCUGA, CHRISTINE ELIZABETH, HEMATOLOGY R2630 MD 4/20/2017 4/20/2022 PATHOLOGY (PATHOLOGY) HOUSTON TX ACTIVE 5/8/2017 None N/A

Page 128 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date EMERGENCY Q6518 JABER, NOOR MAHMOUD, MD 11/16/2015 11/16/2020 MEDICINE HUMBLE TX ACTIVE 11/17/2015 None N/A Q8914 JACAMAN, MELISSA MARTIN, MD 7/1/2016 7/1/2021 FAMILY MEDICINE SAN ANTONIO TX ACTIVE 7/7/2016 None N/A Q6329 JACKMAN, KYLE CHRISTIAN, DO 10/15/2015 10/15/2020 FAMILY MEDICINE BRYAN TX ACTIVE 10/22/2015 None N/A R4401 JACKS, STEPHANIE KARIN, MD 8/25/2017 8/25/2022 DERMATOLOGY HOUSTON TX ACTIVE 9/7/2017 None N/A JACKSON, ANGALENE DEAPEN, OBSTETRICS AND Q9384 DO 8/1/2016 8/1/2021 GYNECOLOGY FORT WORTH TX ACTIVE 8/19/2016 None N/A Q9831 JACKSON, JAY M, MD 8/26/2016 8/26/2021 FAMILY MEDICINE WACO TX ACTIVE 9/13/2016 None N/A

OPHTHALMOLOGY - S5393 JACKSON, JENELL CURNESE, MD 3/6/2020 3/6/2025 OPHTHALMOLOGY RECONST SURGERY HICKORY NC ACTIVE 3/13/2020 None N/A ENDOCRINOLOGY, DIABETES AND S5935 JACKSON, KRISTEN, MD 4/3/2020 4/3/2025 METABOLISM DALLAS TX ACTIVE 4/24/2020 None N/A Q7714 JACKSON, MAISIE LEE, MD 4/1/2016 4/1/2021 ANESTHESIOLOGY HOUSTON TX ACTIVE 4/4/2016 None N/A Q6852 JACKSON, RUTH ELAINE, MD 1/6/2016 1/6/2021 INTERNAL MEDICINE HOSPITALIST LONGVIEW TX ACTIVE 2/16/2016 None N/A R4565 JACKSON, XOCHITL LAURA, MD 9/8/2017 9/8/2022 PEDIATRICS FORT WORTH TX ACTIVE 9/12/2017 None N/A DIAGNOSTIC LANDSTUHL, Q7211 JACO, JOHN WILLIAM, MD 2/16/2016 2/16/2021 RADIOLOGY GERMANY AE ACTIVE 2/18/2016 None N/A R0255 JACOBS, DANNY ODELL, MD 9/30/2016 9/30/2021 GENERAL SURGERY NUTRITION GALVESTON TX ACTIVE 10/4/2016 None N/A R4723 JACOBSON, RACHAEL , MD 9/22/2017 9/22/2022 INTERNAL MEDICINE HOUSTON TX ACTIVE 10/3/2017 None N/A LAKE Q9832 JACOBY, LAUREN BROOKE, DO 8/26/2016 8/26/2021 INTERNAL MEDICINE HOSPITALIST CHARLES LA ACTIVE 10/31/2016 None N/A OBSTETRICS AND MATERNAL AND CORPUS R2133 JAEKLE, RONALD KENNETH, MD 3/20/2017 3/20/2022 GYNECOLOGY FETAL MEDICINE CHRISTI TX ACTIVE 3/29/2017 None N/A S4318 JAFAR, SALEHA, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE ACTIVE 1/9/2020 None N/A S4318 JAFAR, SALEHA, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE ACTIVE 1/9/2020 None N/A TEXAS INTERVENTIONAL CARDIOVASCULAR LICENSE J9109 JAFARY, FAHIM H, MD 4/17/2020 4/17/2025 CARDIOLOGY DISEASES ISSUED 4/17/2020 None N/A ANATOMIC/CLINICAL R4986 JAFFAR, REEMA, MD 10/20/2017 10/20/2022 PATHOLOGY CRANFORD NJ ACTIVE 10/24/2017 None N/A FOOT AND ANKLE, Q7715 JAFFE, DAVID ERIC, MD 4/1/2016 4/1/2021 ORTHOPEDICS DALLAS TX ACTIVE 4/8/2016 None N/A CRITICAL CARE EMERGENCY S5815 JAFFE, JONATHAN TYLER, MD 3/20/2020 3/20/2025 MEDICINE MEDICINE SUGAR LAND TX ACTIVE 3/23/2020 None N/A

S4503 JAFREE, KAMRAN ADIL, MD 12/20/2019 12/20/2024 VASCULAR SURGERY CENTERVILLE OH ACTIVE 1/23/2020 None N/A R3687 JAFRI, ASKARI HYDER, MD 6/30/2017 6/30/2022 INTERNAL MEDICINE HOUSTON TX ACTIVE 10/27/2017 None N/A HEMATOLOGY/ONCOL S5666 JAFRI, MOHAMMAD ALI SYED, MD 3/20/2020 3/20/2025 OGY ASHLAND KY ACTIVE 3/31/2020 None N/A Page 129 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date R3537 JAFRI, SAIMA NASIR, DO 6/16/2017 6/16/2022 PEDIATRICS HOUSTON TX ACTIVE 10/27/2017 None N/A PULMONARY CRITICAL CARE R3875 JAFRI, SAMIM SYED , MD 7/17/2017 7/17/2022 INTERNAL MEDICINE MEDICINE HOUSTON TX ACTIVE 9/26/2017 None N/A HEMATOLOGY/ONCO R0878 JAGGERNAUTH, SIMEON, DO 12/2/2016 12/2/2021 ONCOLOGY LOGY ROGERS AR ACTIVE 12/6/2016 None N/A Q7892 JAHOOR, ANIL FAROOK, DO 4/15/2016 4/15/2021 FAMILY MEDICINE ACTIVE 4/20/2016 None N/A ANESTHESIOLOGY - S5190 JAIN, AYESHA , MD 2/21/2020 2/21/2025 PAIN MANAGEMENT ANESTHESIOLOGY ACTIVE 3/23/2020 None N/A OTORHINOLARYNGOL HEAD AND NECK Q5440 JAIN, KUNAL SUDHIR, MD 8/3/2015 8/3/2020 OGY SURGERY HOUSTON TX ACTIVE 8/6/2015 None N/A Q6034 JAIN, RUBY, MD 9/15/2015 9/15/2020 INTERNAL MEDICINE ACTIVE 9/24/2015 None N/A PEDIATRIC R6212 JAIN, SEEMA , MD 3/2/2018 3/2/2023 PEDIATRICS ENDOCRINOLOGY HOUSTON TX ACTIVE 3/8/2018 None N/A Q5441 JAIN, SIDHARTH, MD 8/3/2015 8/3/2020 INTERNAL MEDICINE MARSHALL TX ACTIVE 8/7/2015 None N/A HEMATOLOGY/ONCOL R1782 JAISWAL, DEEPNA DEEPAK, DO 2/22/2017 2/22/2022 OGY INTERNAL MEDICINE ARLINGTON TX ACTIVE 3/21/2017 None N/A GASTROENTEROLOG R4065 JALA, VIKRAM R, MD 8/1/2017 8/1/2022 INTERNAL MEDICINE Y GLAVESTON TX ACTIVE 8/18/2017 None N/A PALLIATIVE Q4989 JALAL, REZA THULKARNAI, MD 7/1/2015 7/1/2020 INTERNAL MEDICINE MEDICINE ACTIVE 8/17/2015 None N/A LICENSE Q5198 JALAL, ZULEKHA, MD 7/15/2015 7/15/2020 PEDIATRICS ISSUED 7/15/2015 None N/A NEUROLOGICAL R0879 JALALI, ALI , MD 12/2/2016 12/2/2021 SURGERY HOUSTON TX ACTIVE 12/9/2016 None N/A R1783 JALANDHARA, PRIYANKA, MD 2/22/2017 2/22/2022 RHEUMATOLOGY ACTIVE 5/12/2017 None N/A R5411 JALIL, ABDUL, MD 12/8/2017 12/8/2022 NEUROLOGY EVANSTON IL ACTIVE 12/20/2017 None N/A PREVENTIVE Q7212 JAMAL, NAIOMI, MD 2/16/2016 2/16/2021 FAMILY MEDICINE MEDICINE GALVESTON TX ACTIVE 2/23/2016 None N/A ENDOCRINOLOGY, DIABETES AND S4786 JAMAL, UMARA ZAHIR, MD 1/24/2020 1/24/2025 INTERNAL MEDICINE METABOLISM GALVESTON TX ACTIVE 1/28/2020 None N/A

Q7716 JAMEEL, NASEER IBRAHEEM, MD 4/1/2016 4/1/2021 INTERNAL MEDICINE SANTA ROSA CA ACTIVE 4/21/2016 None N/A OBSTETRICS AND Q5199 JAMERSON, SANA, MD 7/15/2015 7/15/2020 GYNECOLOGY KERRVILLE TX ACTIVE 7/17/2015 None N/A

Q4990 JAMES, ARTHUR, MD 7/1/2015 7/1/2020 INTERNAL MED - PEDS ACTIVE 7/14/2015 None N/A R4242 JAMES, LAUREN , DO 8/15/2017 8/15/2022 PSYCHIATRY TEMPLE TX ACTIVE 8/21/2017 None N/A EMERGENCY Q8081 JAMESON, STEPHEN JOHN, MD 5/2/2016 5/2/2021 MEDICINE SAINT CLOUD MN ACTIVE 5/10/2016 None N/A Page 130 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date R0028 JAMIL, MUHAMMAD OMAR, MD 9/15/2016 9/15/2021 INTERNAL MEDICINE HOSPITALIST ACTIVE 11/7/2016 None N/A JANGANGARI, SWETHA REDDY, R2633 MD 4/20/2017 4/20/2022 INTERNAL MEDICINE ODESSA TX ACTIVE 5/1/2017 None N/A GASTROENTEROLOG S5396 JANGOUK, PARASTOO, MD 3/6/2020 3/6/2025 Y INTERNAL MEDICINE ROUND ROCK TX ACTIVE 6/9/2020 None N/A INTERVENTIONAL Q4992 JANI, TAPAN , DO 7/1/2015 7/1/2020 CARDIOLOGY CARDIOLOGY DALLAS TX ACTIVE 7/3/2015 None N/A Q4993 JANJUA, EJAZ A, DO 7/1/2015 7/1/2020 INTERNAL MEDICINE HOUSTON TX ACTIVE 9/10/2015 None N/A

S4644 JANJUA, MUHAMMAD IMRAN F, MD 1/10/2020 1/10/2025 FAMILY MEDICINE HOSPITALIST SEAFORD DE ACTIVE 1/27/2020 None N/A DIAGNOSTIC Q9387 JANSEN, JOSHUA , MD 8/1/2016 8/1/2021 RADIOLOGY OKC OK ACTIVE 8/24/2016 None N/A PEDIATRIC JAQUISS, ROBERT DOUGLAS CARDIOTHORACIC R1549 BENJAMIN, MD 2/6/2017 2/6/2022 SURGERY DALLAS TX ACTIVE 2/8/2017 None N/A JARAMILLO, CARLOS ANTHONY, PHYSICAL MED. & R4243 MD 8/15/2017 8/15/2022 REHABILITATION SAN ANTONIO TX ACTIVE 8/18/2017 None N/A Q5442 JARIDO, VERONICA TAISHA, MD 8/3/2015 8/3/2020 INTERNAL MEDICINE TEMPLE TX ACTIVE 8/11/2015 None N/A OBSTETRICS AND Q9388 JARIN, JASON , MD 8/1/2016 8/1/2021 GYNECOLOGY GYNECOLOGY DALLAS TX ACTIVE 10/4/2016 None N/A JAROSZEWSKI, DAWN ELIZABETH, M0445 MD 6/1/2016 6/1/2021 THORACIC SURGERY GENERAL SURGERY PHOENIX AZ ACTIVE 6/13/2016 None N/A INTERVENTIONAL Q9643 JASTI, BABU RAO, MD 8/15/2016 8/15/2021 CARDIOLOGY CARDIOLOGY ZACHARY LA ACTIVE 11/7/2016 None N/A EMERGENCY Q8519 JAUNG, MICHAEL SENYU, MD 6/1/2016 6/1/2021 MEDICINE HOUSTON TX ACTIVE 6/2/2016 None N/A S6217 JAVADI, JASMINE , MD 4/17/2020 4/17/2025 FAMILY MEDICINE GERIATRICS ACTIVE 4/21/2020 None N/A BROWNSVILL R6026 JAVAID, SHAHID, MD 2/16/2018 2/16/2023 PEDIATRICS E TX ACTIVE 2/26/2018 None N/A URGENT CARE Q6208 JAVAID, SIMRA, DO 10/1/2015 10/1/2020 MEDICINE ACTIVE 10/19/2015 None N/A GASTROENTEROLOG S5667 JAVED, FAIZ , DO 3/20/2020 3/20/2025 Y WEBSTER TX ACTIVE 6/8/2020 None N/A CRITICAL CARE S4322 JAVED, JEFFREY, MD 12/6/2019 12/6/2024 MEDICINE INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 12/12/2019 None N/A CRITICAL CARE S4322 JAVED, JEFFREY, MD 12/6/2019 12/6/2024 MEDICINE INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 12/12/2019 None N/A Q9833 JAVED, SAIMA, MD 8/26/2016 8/26/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 9/7/2016 None N/A NEUROLOGICAL S5192 JAVEDAN, SAMAN P, MD 2/21/2020 2/21/2025 SURGERY SHENANDOAH TX ACTIVE 3/2/2020 None N/A

Page 131 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date DERMATOLOGIC R3351 JAVVAJI, SRIMANASI, MD 6/2/2017 6/2/2022 SURGERY DERMATOLOGY PLANO TX ACTIVE 6/13/2017 None N/A

R2634 JAYAKUMAR, LALITHAPRIYA, MD 4/20/2017 4/20/2022 VASCULAR SURGERY GENERAL SURGERY SAN ANTONIO TX ACTIVE 4/26/2017 None N/A JAYARAMASWAMY SULOCHANA, S5193 SHILPA, MD 2/21/2020 2/21/2025 PEDIATRICS PEDIATRICS ACTIVE 2/25/2020 None N/A R0030 JAZAYERLI, ROUKAN, MD 9/15/2016 9/15/2021 PSYCHIATRY SLEEP MEDICINE EVANSTON IL ACTIVE 9/20/2016 None N/A EMERGENCY LICENSE S7075 JEANISE, SELINA ANN, DO 6/12/2020 6/12/2025 MEDICINE ISSUED 6/12/2020 None N/A

NEUROLOGICAL PEDIATRIC SURGERY Q6519 JEEVAN, DHRUVE SATISH, MD 11/16/2015 11/16/2020 SURGERY (NEUROLOGY) TEMPLE TX ACTIVE 12/7/2015 None N/A R2889 JEFFREY, DOUGLAS PAUL, MD 5/5/2017 5/5/2022 FAMILY MEDICINE EUGENE OR ACTIVE 5/24/2017 None N/A R1226 JENG, CHRISTINA LI-HONG, MD 1/6/2017 1/6/2022 ANESTHESIOLOGY NEW YORK NY ACTIVE 1/17/2017 None N/A ANESTHESIOLOGY - S6218 JENG, JEFFREY, MD 4/17/2020 4/17/2025 ANESTHESIOLOGY PAIN MANAGEMENT AUSTIN TX ACTIVE 4/20/2020 None N/A OBSTETRICS AND R0592 JENKINS, ANN, MD 10/31/2016 10/31/2021 GYNECOLOGY ACTIVE 3/28/2017 None N/A RADIATION S5194 JENKINS, DAVID KIRK, MD 2/21/2020 2/21/2025 ONCOLOGY TEMPLE TX ACTIVE 2/25/2020 None N/A JENKINS, RICHARD BEAUREGARD, Q8729 MD 6/10/2016 6/10/2021 OPHTHALMOLOGY HOUSTON TX ACTIVE 6/14/2016 None N/A HEMATOLOGY/ONCOL Q7565 JENKS, CAROLYN GERHARDT, DO 3/15/2016 3/15/2021 OGY INTERNAL MEDICINE ACTIVE 3/17/2016 None N/A Q6209 JENNINGS, AMY KIRSTEN, DO 10/1/2015 10/1/2020 ANESTHESIOLOGY DALLAS TX ACTIVE 10/12/2015 None N/A UNDERSEA EMERGENCY HYPERBARIC MED R0031 JENNINGS, M SHANE, MD 9/15/2016 9/15/2021 MEDICINE (EMER MED) SAN ANTONIO TX ACTIVE 9/19/2016 None N/A Q5200 JENNINGS, MARISA LEIGH, MD 7/15/2015 7/15/2020 PSYCHIATRY SAN ANTONIO TX ACTIVE 7/28/2015 None N/A R0732 JENQ, ROBERT, MD 11/15/2016 11/15/2021 ONCOLOGY INTERNAL MEDICINE HOUSTON TX ACTIVE 11/24/2016 None N/A EMERGENCY Q6430 JENSEN, JAMES II, MD 11/2/2015 11/2/2020 MEDICINE PEDIATRICS ACTIVE 12/1/2015 None N/A SEE ANESTHESIOLOGY - ADDICTION PREVIOUS R4066 JENSEN, JASON RICHARD, MD 8/1/2017 8/1/2022 PAIN MANAGEMENT MEDICINE SAN ANTONIO TX ACTIVE 8/10/2017 ORDER 11/28/2017

Q4994 JENSEN, SHANE, MD 7/1/2015 7/1/2020 TRAUMATIC SURGERY GENERAL SURGERY HOUSTON TX ACTIVE 7/8/2015 None N/A JEROME-KON, SCARLINE MARIE, CHICAGO S5195 MD 2/21/2020 2/21/2025 PSYCHIATRY HEIGHTS IL ACTIVE 3/2/2020 None N/A LICENSE S6418 JEYAKUMAR, NIKESHAN , MD 5/1/2020 5/1/2025 INTERNAL MEDICINE ISSUED 5/1/2020 None N/A Page 132 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date Q9644 JHAVAR, RAAGSUDHA, MD 8/15/2016 8/15/2021 INTERNAL MEDICINE ACTIVE 8/17/2016 None N/A DELINQUEN T-NON R0880 JIA, XIAOLIN, MD 12/2/2016 12/2/2021 INTERNAL MEDICINE PAYMENT 3/2/2017 None N/A DELINQUEN HEMATOLOGY/ONCOL T-NON R0593 JIA, YUXIA, MD 10/31/2016 10/31/2021 OGY GERIATRICS DALLAS TX PAYMENT 12/30/2017 None N/A Q9389 JIANG, LI , MD 8/1/2016 8/1/2021 RHEUMATOLOGY INTERNAL MEDICINE DALLAS TX ACTIVE 9/6/2016 None N/A

S5937 JIANG, RUIYANG, MD 4/3/2020 4/3/2025 UROLOGY UROLOGIC SURGERY AMARILLO TX ACTIVE 5/4/2020 None N/A GASTROENTEROLOG THE S5938 JILANI, OMAR KHAN, MD 4/3/2020 4/3/2025 Y INTERNAL MEDICINE WOODLANDS TX ACTIVE 4/17/2020 None N/A S5196 JILANI, USMAN KHAN, DO 2/21/2020 2/21/2025 INTERNAL MEDICINE CLEVELAND TX ACTIVE 3/9/2020 None N/A JILES, ELISICIA LOUISE TAYLOR, R4725 MD 9/22/2017 9/22/2022 FAMILY MEDICINE ACTIVE 9/29/2017 None N/A LICENSE Q5825 JIMENEZ RAMOS, FARRAH, MD 8/28/2015 8/28/2020 PEDIATRICS ISSUED 8/28/2015 None N/A ADULT JIMENEZ, CHRISTOPHER LOUIS, ORTHOPEDIC RECONSTRUCTIVE Q8267 MD 5/16/2016 5/16/2021 SURGERY ORTHOPEDICS ACTIVE 5/20/2016 None N/A GASTROENTEROLOG R4567 JINDAL, MOHIT, MD 9/8/2017 9/8/2022 Y TERRE HAUTE IN ACTIVE 9/27/2017 None N/A R2366 JINDAL, PARUL , MD 4/4/2017 4/4/2022 NEUROLOGY MODESTO CA ACTIVE 6/8/2017 None N/A PULMONARY CRITICAL CARE R0032 JIWANI, ALI ZUL, MD 9/15/2016 9/15/2021 MEDICINE MEDICINE HOUSTON TX ACTIVE 9/23/2016 None N/A EMERGENCY Q6211 JOH, JAE WON , MD 10/1/2015 10/1/2020 MEDICINE HOUSTON TX ACTIVE 10/7/2015 None N/A

R4568 JOHANNESEN, ELISE MARISA, MD 9/8/2017 9/8/2022 INTERNAL MED - PEDS DALLAS TX ACTIVE 9/22/2017 None N/A MUSCULOSKELETAL R0258 JOHN, JOSEPH MULLASSERIL, DO 9/30/2016 9/30/2021 RADIOLOGY RADIOLOGY NEWARK DE ACTIVE 10/11/2016 None N/A R2638 JOHN, STEEVEN , MD 4/20/2017 4/20/2022 INTERNAL MEDICINE HOSPITALIST AUSTIN TX ACTIVE 4/25/2017 None N/A INFECTIOUS S4645 JOHN, TENY MATHEW, MD 1/10/2020 1/10/2025 INTERNAL MEDICINE DISEASES HOUSTON TX ACTIVE 2/19/2020 None N/A JOHNS, MONTGOMERY NEWMAN, OBSTETRICS AND Q7396 MD 3/4/2016 3/4/2021 GYNECOLOGY ACTIVE 3/14/2016 None N/A PEDIATRIC EMERGENCY R2369 JOHNSON FUSCO, IREAL, MD 4/4/2017 4/4/2022 PEDIATRICS MEDICINE (PEDS) AUSTIN TX ACTIVE 4/20/2017 None N/A

Q6330 JOHNSON, ANDREW KESSLER, MD 10/15/2015 10/15/2020 OTOLARYNGOLOGY DALLAS TX ACTIVE 10/19/2015 None N/A Page 133 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date GERIATRIC R1969 JOHNSON, ANNE ELIZABETH , MD 3/3/2017 3/3/2022 PSYCHIATRY PSYCHIATRY DALLAS TX ACTIVE 3/24/2017 None N/A R4067 JOHNSON, BENNY, DO 8/1/2017 8/1/2022 ONCOLOGY HOUSTON TX ACTIVE 9/28/2017 None N/A PLASTIC & RECONSTRUCTIVE R2367 JOHNSON, BRET ANDREW, MD 4/4/2017 4/4/2022 GENERAL SURGERY SURGERY DALLAS TX ACTIVE 4/5/2017 None N/A ANESTHESIOLOGY - R3688 JOHNSON, CALVIN, MD 6/30/2017 6/30/2022 ANESTHESIOLOGY PAIN MANAGEMENT LOS ANGELES CA ACTIVE 7/7/2017 None N/A R4403 JOHNSON, CAROLINE, MD 8/25/2017 8/25/2022 NEPHROLOGY TEMPLE TX ACTIVE 9/19/2017 None N/A WICHITA R4246 JOHNSON, DANIELA , MD 8/15/2017 8/15/2022 FAMILY MEDICINE FALLS TX ACTIVE 8/28/2017 None N/A

Q6854 JOHNSON, DOUGLAS ROBERT, DO 1/6/2016 1/6/2021 INTERNAL MEDICINE FORT WORTH TX ACTIVE 1/8/2016 None N/A PALLIATIVE ALBUQUERQU R0423 JOHNSON, JAIRON MICHAEL , DO 10/14/2016 10/14/2021 INTERNAL MEDICINE MEDICINE E NM ACTIVE 11/30/2016 None N/A DIAGNOSTIC R4248 JOHNSON, JASON MICHAEL, MD 8/15/2017 8/15/2022 NEURO-RADIOLOGY RADIOLOGY HOUSTON TX ACTIVE 8/17/2017 None N/A EMERGENCY Q6035 JOHNSON, JENNA LYNN, MD 9/15/2015 9/15/2020 MEDICINE BIRMINGHAM AL ACTIVE 9/29/2015 None N/A Q4996 JOHNSON, KATHRYN ANN, MD 7/1/2015 7/1/2020 PEDIATRICS DALLAS TX ACTIVE 7/3/2015 None N/A JOHNSON, MARIANA MURGUIA, PHYSICAL MED. & R1394 MD 1/20/2017 1/20/2022 REHABILITATION DALLAS TX ACTIVE 2/7/2017 None N/A LICENSE Q4777 JOHNSON, PAUL, MD 6/12/2015 6/12/2020 GENERAL SURGERY ISSUED 6/12/2015 None N/A JOHNSON, RAPHNY ALEXANDRE, OBSTETRICS AND Q8520 MD 6/1/2016 6/1/2021 GYNECOLOGY WEBSTER TX ACTIVE 6/8/2016 None N/A EMERGENCY R2368 JOHNSON, RENEE CYNTHIA, MD 4/4/2017 4/4/2022 MEDICINE HOUSTON TX ACTIVE 6/23/2017 None N/A JOHNSON, VERNON NATHANIEL, Q6036 MD 9/15/2015 9/15/2020 FAMILY MEDICINE BIG SPRING TX ACTIVE 9/18/2015 None N/A Q6755 JOHNSTON, NATHAN SCOTT, DO 12/15/2015 12/15/2020 PSYCHIATRY SAN ANTONIO TX ACTIVE 12/16/2015 None N/A JOHNSTON, RACHAEL CELESTE, Q8916 MD 7/1/2016 7/1/2021 PEDIATRICS MCKINNEY TX ACTIVE 7/15/2016 None N/A CRITICAL CARE S5939 JO-HOY, FRANCOIS, MD 4/3/2020 4/3/2025 NEPHROLOGY MEDICINE (IM) ACTIVE 4/13/2020 None N/A S5398 JOICE, GREGORY ALAN, MD 3/6/2020 3/6/2025 UROLOGY DALLAS TX ACTIVE 3/12/2020 None N/A EMERGENCY R1786 JOLLY, SCOTT DAVID, DO 2/22/2017 2/22/2022 MEDICINE HOUSTON TX ACTIVE 1/18/2018 None N/A HEMATOLOGY/ONCO R4068 JONES, AMY LITTLE, MD 8/1/2017 8/1/2022 INTERNAL MEDICINE LOGY HOUSTON TX ACTIVE 8/4/2017 None N/A

Page 134 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date ANATOMIC/CLINICAL R1787 JONES, ANDREA, MD 2/22/2017 2/22/2022 PATHOLOGY ACTIVE 3/13/2017 None N/A OBSTETRICS AND Q5826 JONES, ANGELA, DO 8/28/2015 8/28/2020 GYNECOLOGY ACTIVE 9/9/2015 None N/A TEXAS LICENSE P3903 JONES, CHRISTINA , MD 11/16/2015 11/16/2020 HOSPITALIST DALLAS TX ISSUED 11/16/2015 None N/A OBSTETRICS & OBSTETRICS AND GYNECOLOGICAL COLLEGE R3353 JONES, DANIELLE NICOLE, MD 6/2/2017 6/2/2022 GYNECOLOGY SURGERY STATION TX ACTIVE 6/7/2017 None N/A S6219 JONES, JACOB CREED, MD 4/17/2020 4/17/2025 PEDIATRICS SPORTS MEDICINE FRISCO TX ACTIVE 5/26/2020 None N/A PHYSICAL MED. & Q7397 JONES, JEREMY RYAN, MD 3/4/2016 3/4/2021 REHABILITATION PAIN MANAGEMENT LUBBOCK TX ACTIVE 3/16/2016 None N/A HEMATOLOGY/ONCO R2136 JONES, JESSICA TREVINO, MD 3/20/2017 3/20/2022 INTERNAL MEDICINE LOGY ACTIVE 3/23/2017 None N/A EMERGENCY R2639 JONES, RANDY EUGENE, MD 4/20/2017 4/20/2022 MEDICINE AUSTIN TX ACTIVE 5/1/2017 None N/A UNDER EMERGENCY BOARD Q5827 JONES, ROGER STARNER JR, MD 8/28/2015 8/28/2020 MEDICINE ACTIVE 9/1/2015 ORDER 8/28/2015 REPRODUCTIVE OBSTETRICS AND ENDOCRINOLOGY R5573 JONES, TIFFANNY LATRICE, MD 1/5/2018 1/5/2023 GYNECOLOGY AND INFERTILITY MCKINNEY TX ACTIVE 1/15/2018 None N/A NEUROLOGICAL R2640 JONES, WESLEY HARRIS, MD 4/20/2017 4/20/2022 SURGERY HOUSTON TX ACTIVE 5/4/2017 None N/A OPHTHALMOLOGY - R1552 JONNA, GOWTHAM, MD 2/6/2017 2/6/2022 VITREOUS SURGERY OPHTHALMOLOGY AUSTIN TX ACTIVE 2/23/2017 None N/A JOOLUKUNTLA, ADITHYA REDDY, S5942 MD 4/3/2020 4/3/2025 ANESTHESIOLOGY HOUSTON TX ACTIVE 5/4/2020 None N/A OBSTETRICS AND Q9392 JORGENSEN, ERIN NICOLE, MD 8/1/2016 8/1/2021 GYNECOLOGY LEAGUE CITY TX ACTIVE 9/13/2016 None N/A Q9393 JOSE, ALAN, MD 8/1/2016 8/1/2021 INTERNAL MEDICINE SLIDELL LA ACTIVE 8/19/2016 None N/A R4569 JOSEPH, ASHLEY MERRIN, MD 9/8/2017 9/8/2022 ANESTHESIOLOGY PEDIATRICS DALLAS TX ACTIVE 11/9/2017 None N/A PEDIATRIC R2892 JOSEPH, CATHERINE , MD 5/5/2017 5/5/2022 PEDIATRICS NEPHROLOGY HOUSTON TX ACTIVE 5/10/2017 None N/A S6220 JOSEPH, DANNY T, MD 4/17/2020 4/17/2025 FAMILY MEDICINE HOUSTON TX ACTIVE 4/30/2020 None N/A

Q7214 JOSEPH, GEORGE MALIAKKAL, MD 2/16/2016 2/16/2021 OPHTHALMOLOGY BIG SPRING TX ACTIVE 3/8/2016 None N/A OPHTHALMOLOGY - R5748 JOSEPH, JAY ARUN RAJIV, MD 1/19/2018 1/19/2023 GLAUCOMA OPHTHALMOLOGY FOREST HILLS NY ACTIVE 1/25/2018 None N/A Q6950 JOSEPH, JEAN MANASSE, MD 1/15/2016 1/15/2021 FAMILY MEDICINE FAMILY PRACTICE ACTIVE 1/18/2016 None N/A Page 135 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date JOSEPH, RACHAEL ANN MELISSA, R1228 MD 1/6/2017 1/6/2022 INTERNAL MEDICINE HOSPITALIST BIDDESFORD ME ACTIVE 1/9/2017 None N/A EMERGENCY Q6331 JOSEPH, ROMEO JEAN, MD 10/15/2015 10/15/2020 MEDICINE HOUSTON TX ACTIVE 11/5/2015 None N/A EMERGENCY R5413 JOSEPH, ROYCE MATHEW, MD 12/8/2017 12/8/2022 MEDICINE FAMILY MEDICINE ODESSA TX ACTIVE 12/12/2017 None N/A DIAGNOSTIC MUSCULOSKELETAL Q6212 JOSEPH, SANTHOSH PAUL, MD 10/1/2015 10/1/2020 RADIOLOGY RADIOLOGY HOUSTON TX ACTIVE 10/21/2015 None N/A CARDIOVASCULAR Q5828 JOSEPH, SUSAN M, MD 8/28/2015 8/28/2020 CARDIOLOGY DISEASES DALLAS TX ACTIVE 9/11/2015 None N/A

R4570 JOSEPHS, MEREDITH SUSAN, MD 9/8/2017 9/8/2022 FAMILY MEDICINE HOUSTON TX ACTIVE 9/18/2017 None N/A HEMATOLOGY/ONCO R2371 JOSHI, JITESH, MD 4/4/2017 4/4/2022 INTERNAL MEDICINE LOGY NASSAU BAY TX ACTIVE 4/12/2017 None N/A PEDIATRIC CRITICAL MEDICAL R0035 JOSHI, PRASHANT, MD 9/15/2016 9/15/2021 CARE MEDICINE TOXICOLOGY EL PASO TX ACTIVE 9/21/2016 None N/A R2372 JOSHI, SHYAM , MD 4/4/2017 4/4/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 4/14/2017 None N/A OBSTETRICS AND R4726 JOSHIPURA, SWATI BUCH, DO 9/22/2017 9/22/2022 GYNECOLOGY DALLAS TX ACTIVE 10/2/2017 None N/A GERIATRIC R0259 JOY, CHRISTINE ELIZABETH, MD 9/30/2016 9/30/2021 PSYCHIATRY PSYCHIATRY SAN ANTONIO TX ACTIVE 10/6/2016 None N/A R1553 JOZWIK, BARTOSZ PAWEL, MD 2/6/2017 2/6/2022 CARDIOLOGY INTERNAL MEDICINE HOUSTON TX ACTIVE 2/8/2017 None N/A ORTHOPEDIC SURGERY OF THE Q8268 JU, KEVIN LEE, MD 5/16/2016 5/16/2021 SPINE ROCKWALL TX ACTIVE 5/18/2016 None N/A

Q7398 JUAN-RAMIREZ, JUAN PABLO, MD 3/4/2016 3/4/2021 RADIOLOGY ACTIVE 3/14/2016 None N/A

R3878 JUAREZ, HERIBERTO , MD 7/17/2017 7/17/2022 ANESTHESIOLOGY GENERAL SURGERY GALVESTON TX ACTIVE 8/15/2017 None N/A R0260 JUAREZ, JOCELYN CAMPOS, MD 9/30/2016 9/30/2021 INTERNAL MEDICINE HARLINGEN TX ACTIVE 11/16/2016 None N/A PEDIATRIC EMERGENCY N4877 JUDD, SARAH AMANDA, MD 4/20/2017 4/20/2022 PEDIATRICS MEDICINE (PEDS) HOUSTON TX ACTIVE 7/6/2017 None N/A EMERGENCY R4069 JULIEN, RYAN, MD 8/1/2017 8/1/2022 MEDICINE SAN ANTONIO TX ACTIVE 11/21/2017 None N/A DIAGNOSTIC R3115 JUMPER, HOLLY JO, MD 5/22/2017 5/22/2022 RADIOLOGY BREAST IMAGING DALLAS TX ACTIVE 5/25/2017 None N/A ORAL & MAXILLOFACIAL Q9394 JUNDT, JONATHON S, MD 8/1/2016 8/1/2021 SURGERY HOUSTON TX ACTIVE 8/19/2016 None N/A R4405 JUNG, JENNIFER KO, MD 8/25/2017 8/25/2022 FAMILY MEDICINE ACTIVE 9/26/2017 None N/A Page 136 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date S5668 JUNG, YOUNGSIN , MD 3/20/2020 3/20/2025 NEUROLOGY SLEEP MEDICINE SAN ANTONIO TX ACTIVE 6/4/2020 None N/A S5669 JURAK, JADE , MD 3/20/2020 3/20/2025 PEDIATRICS ACTIVE 4/14/2020 None N/A LICENSE Q4780 JYOTHINAGARAM, PRAVEENA, MD 6/12/2015 6/12/2020 INTERNAL MEDICINE NEPHROLOGY ISSUED 6/12/2015 None N/A EMERGENCY Q4608 JYOTHINDRAN, REVATHI, MD 6/1/2015 6/1/2020 MEDICINE ACTIVE 6/5/2015 None N/A EMERGENCY S4788 KABBA, CHIDINMA DAWN, MD 1/24/2020 1/24/2025 MEDICINE ATLANTA GA ACTIVE 2/7/2020 None N/A NEONATAL- KABBUR, PRAKASH MUTTANNA, NEONATAL- PERINATAL Q4781 MD 6/12/2015 6/12/2020 PERINATAL MEDICINE MEDICINE ARLINGTON TX ACTIVE 6/17/2015 None N/A

Q6037 KABIR, MOHAMMAD HUMAYUN, MD 9/15/2015 9/15/2020 INTERNAL MEDICINE NEPHROLOGY FORT WORTH tx ACTIVE 9/30/2015 None N/A ORTHOPEDIC PEDIATRIC S5671 KADADO, ALLEN ADIB, MD 3/20/2020 3/20/2025 SURGERY ORTHOPEDICS DALLAS TX ACTIVE 3/24/2020 None N/A HEAD AND NECK R0595 KADAKIA, SAMEEP, MD 10/31/2016 10/31/2021 SURGERY FORT WORTH TX ACTIVE 11/11/2016 None N/A S5672 KADAPURAM, BETSY MARY, DO 3/20/2020 3/20/2025 PEDIATRICS ACTIVE 4/1/2020 None N/A R3879 KAESBERG, JULIE LOUISE, MD 7/17/2017 7/17/2022 ANESTHESIOLOGY DALLAS TX ACTIVE 9/1/2017 None N/A ORTHOPEDIC Q9648 KAFCHINSKI, LISA ANN, MD 8/15/2016 8/15/2021 SURGERY ONCOLOGY EL PASO TX ACTIVE 9/1/2016 None N/A HEMATOLOGY/ONCO R5750 KAFEEL, MUHAMMAD IMRAN, MD 1/19/2018 1/19/2023 INTERNAL MEDICINE LOGY FLUSHING NY ACTIVE 3/19/2018 None N/A R5575 KAGWIMA, RUTH, MD 1/5/2018 1/5/2023 FAMILY MEDICINE COLLEYVILLE TX ACTIVE 2/6/2018 None N/A R0424 KAHN, ERNEST JAMES, DO 10/14/2016 10/14/2021 INTERNAL MEDICINE AUSTIN TX ACTIVE 10/17/2016 None N/A EMERGENCY R5276 KAHN, PATRICIA, DO 11/17/2017 11/17/2022 MEDICINE ACTIVE 11/29/2017 None N/A PHYSICAL MED. & R4071 KAISER, CASSANDRA JUANITA, DO 8/1/2017 8/1/2022 REHABILITATION DALLAS TX ACTIVE 8/30/2017 None N/A OTORHINOLARYNGOL Q5445 KAISER, TIMOTHY N, MD 8/3/2015 8/3/2020 OGY SLEEP MEDICINE LAWTON OK ACTIVE 8/4/2015 None N/A GASTROENTEROLOG OKLAHOMA Q7215 KAITHA, SINDHU REDDY, MD 2/16/2016 2/16/2021 Y INTERNAL MEDICINE CITY OK ACTIVE 5/16/2016 None N/A R3691 KAKKAR, EKTA , MD 6/30/2017 6/30/2022 INTERNAL MEDICINE HOUSTON TX ACTIVE 7/3/2017 None N/A R0596 KALAIR, MISBAH ASLAM, MD 10/31/2016 10/31/2021 FAMILY MEDICINE SPRINGFIELD IL ACTIVE 11/3/2016 None N/A PLASTIC & RECONSTRUCTIVE S4982 KALARIA, SHANA SUBODH, MD 2/7/2020 2/7/2025 SURGERY ACTIVE 5/1/2020 None N/A

R0426 KALDIS, PETER DENTON, MD 10/14/2016 10/14/2021 INTERNAL MED - PEDS HOUSTON TX ACTIVE 10/18/2016 None N/A

Page 137 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date KALEN, CHEMANTHI ROCHELLE, R4727 MD 9/22/2017 9/22/2022 FAMILY PRACTICE KELOWNA, BC ACTIVE 9/26/2017 None N/A CRITICAL CARE Q7900 KALKWARF, KYLE JEFFREY, MD 4/15/2016 4/15/2021 GENERAL SURGERY (SURGERY) HOUSTON TX ACTIVE 4/18/2016 None N/A

Q6432 KALLAM, AJAY SHUBHADEEP, MD 11/2/2015 11/2/2020 INTERNAL MEDICINE NEPHROLOGY EL PASO TX ACTIVE 11/11/2015 None N/A PEDIATRIC CRITICAL Q9838 KALLUR, SOWMYA, MD 8/26/2016 8/26/2021 CARE MEDICINE PEDIATRICS TEMPLE TX ACTIVE 8/29/2016 None N/A R2641 KALOLWALA, FAKHRI H, MD 4/20/2017 4/20/2022 INTERNAL MEDICINE HOSPITALIST HOUSTON TX ACTIVE 4/24/2017 None N/A ORTHOPEDIC SPORTS MEDICINE - S4983 KALRA, KUNAL, MD 2/7/2020 2/7/2025 SURGERY ORTHOPEDICS VICTORVILLE CA ACTIVE 2/25/2020 None N/A Q7216 KALRA, NEERAJ KUMAR, MD 2/16/2016 2/16/2021 HOSPITALIST DALLAS TX ACTIVE 2/26/2016 None N/A CARDIOVASCULAR GRAND Q9649 KALRA, NISHANT, MD 8/15/2016 8/15/2021 INTERNAL MEDICINE DISEASES RAPIDS MI ACTIVE 8/25/2016 None N/A NEUROLOGICAL SALT LAKE Q7720 KALRA, RICKY RAJ SINGH, MD 4/1/2016 4/1/2021 SURGERY CITY UT ACTIVE 4/5/2016 None N/A EMERGENCY LICENSE Q4782 KALSTED, CHARLES L, MD 6/12/2015 6/12/2020 MEDICINE ISSUED 6/12/2015 None N/A S4984 KALVA, GAYATHRI DEVI, MD 2/7/2020 2/7/2025 INTERNAL MEDICINE INTERNAL MEDICINE ACTIVE 5/5/2020 None N/A VASCULAR AND INTERVENTIONAL Q6433 KALVA, SANJEEVA PRASAD, MD 11/2/2015 11/2/2020 RADIOLOGY RADIOLOGY DALLAS TX ACTIVE 11/3/2015 None N/A R1054 KAMAL, ABUL KAWSAR, MD 12/16/2016 12/16/2021 HOSPITALIST HOSPITALIST LITTLE ROCK AR ACTIVE 2/8/2017 None N/A DIAGNOSTIC RADIOLOGY Q7399 KAMALI, ARASH, MD 3/4/2016 3/4/2021 RADIOLOGY NEURO-RADIOLOGY DEPARTMENT TX ACTIVE 4/1/2016 None N/A GYNECOLOGIC OBSTETRICS AND S6652 KAMATH, PRIYANKA , MD 5/15/2020 5/15/2025 ONCOLOGY GYNECOLOGY AUSTIN TX ACTIVE 5/19/2020 None N/A PULMONARY CRITICAL CARE Q7400 KAMATHAM, MADHURI, MD 3/4/2016 3/4/2021 MEDICINE SLEEP MEDICINE ACTIVE 3/9/2016 None N/A EMERGENCY R4988 KAMINSKY, ROBIN E, MD 10/20/2017 10/20/2022 MEDICINE SAN ANTONIO TX ACTIVE 11/20/2017 None N/A Q7401 KAMPE, DORIS, MD 3/4/2016 3/4/2021 INTERNAL MEDICINE BOLIVIA NC ACTIVE 4/20/2016 None N/A HEMATOLOGY/ONCOL R0037 KANAAN, ZEYAD, MD 9/15/2016 9/15/2021 OGY INTERNAL MEDICINE HOUSTON TX ACTIVE 9/21/2016 None N/A Q4611 KANDATHIL, ASHA, MD 6/1/2015 6/1/2020 RADIOLOGY NUCLEAR MEDICINE DALLAS TX ACTIVE 6/5/2015 None N/A

R6027 KANDIKATLA, RAMCHARITHA , MD 2/16/2018 2/16/2023 INTERNAL MEDICINE ODESSA TX ACTIVE 2/19/2018 None N/A KANDOTH, EUGIENEO GLIASTO, S6654 MD 5/15/2020 5/15/2025 INTERNAL MEDICINE HOSPITALIST PLANO TX ACTIVE 5/19/2020 None N/A

Page 138 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date EMERGENCY CORPUS Q4998 KANE, EVAN DANIEL, MD 7/1/2015 7/1/2020 MEDICINE CHRISTI TX ACTIVE 7/6/2015 None N/A R0427 KANESAN, KRISHNAKUMARI, MD 10/14/2016 10/14/2021 PEDIATRICS KATY TX ACTIVE 11/3/2016 None N/A SURGICAL CRITICAL WICHITA Q9839 KANG, CHRISTOPHER YOUNG, MD 8/26/2016 8/26/2021 GENERAL SURGERY CARE FALLS TX ACTIVE 9/12/2016 None N/A ADDICTION R1790 KANG, DAVID E, MD 2/22/2017 2/22/2022 PSYCHIATRY MEDICINE - AN SYRACUSE NY ACTIVE 2/28/2017 None N/A HEMATOLOGY/ONCOL LICENSE Q8269 KANG, GHANA , MD 5/16/2016 5/16/2021 OGY RICHARDSON TX ISSUED 5/16/2016 None N/A PEDIATRIC INTERVENTIONAL Q5829 KANG, LISA, MD 8/28/2015 8/28/2020 RADIOLOGY RADIOLOGY DALLAS TX ACTIVE 8/31/2015 None N/A PEDIATRIC HEMATOLOGY/ONCOL PALLIATIVE Q9395 KANG, TAMMY, MD 8/1/2016 8/1/2021 OGY MEDICINE HOUSTON TX ACTIVE 8/11/2016 None N/A ANESTHESIOLOGY - Q4612 KANJIA, MAYUR BHAGVANJI, MD 6/1/2015 6/1/2020 PAIN MANAGEMENT PAIN MEDICINE HOUSTON TX ACTIVE 6/11/2015 None N/A PEDIATRIC ANESTHESIOLOGY LICENSE Q4783 KANJIA, MEGHA KARKERA, MD 6/12/2015 6/12/2020 ANESTHESIOLOGY (PEDS) ISSUED 6/12/2015 None N/A KANNAMPUZHA, JERIL ANTHONY, Q9840 MD 8/26/2016 8/26/2021 PEDIATRICS TEXARKANA TX ACTIVE 9/15/2016 None N/A Q5674 KANSAL, RISHAV, MD 8/14/2015 8/14/2020 OPHTHALMOLOGY RICHARDSON TX ACTIVE 8/31/2015 None N/A PLASTIC & RECONSTRUCTIVE S5676 KANTH, ADITI MADISETTY, MD 3/20/2020 3/20/2025 SURGERY OTHER SPECIALTY ACTIVE 6/16/2020 None N/A S6222 KANU, OBIAJULU UBAWIKE, MD 4/17/2020 4/17/2025 INTERNAL MEDICINE NEPHROLOGY FORT WORTH TX ACTIVE 4/24/2020 None N/A MUSCULOSKELETAL S4985 KANU, OKEZIKA CHIJIOKE, MD 2/7/2020 2/7/2025 RADIOLOGY RADIOLOGY HOUSTON TX ACTIVE 3/6/2020 None N/A GASTROENTEROLOG Q6522 KANURI, NAVYA DEEPTHI, MD 11/16/2015 11/16/2020 Y INTERNAL MEDICINE TYLER TX ACTIVE 11/17/2015 None N/A OBSTETRICS AND R3882 KAO, LYDIA, MD 7/17/2017 7/17/2022 GYNECOLOGY HOUSTON TX ACTIVE 7/24/2017 None N/A Q5830 KAOUS, SHAHID MEHMOOD, MD 8/28/2015 8/28/2020 PSYCHIATRY SAN ANTONIO TX ACTIVE 9/2/2015 None N/A CRITICAL CARE S6655 KAPADIA, AVNI , MD 5/15/2020 5/15/2025 NEUROLOGY MEDICINE SHENANDOAH TX ACTIVE 5/19/2020 None N/A TRANSPLANT K0855 KAPLAN, BRUCE, MD 6/2/2017 6/2/2022 NEPHROLOGY SURGERY TEMPLE TX ACTIVE 6/22/2017 None N/A PEDIATRIC Q8525 KAPLAN, KEVIN ALAN, MD 6/1/2016 6/1/2021 PULMONOLOGY SLEEP MEDICINE HOUSTON TX ACTIVE 6/3/2016 None N/A EMERGENCY Q8526 KARANJA, JASON M, MD 6/1/2016 6/1/2021 MEDICINE WEBSTER TX ACTIVE 6/10/2016 None N/A Page 139 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date HAND SURGERY - ORTHOPEDIC ORTHOPEDIC S6223 KARBACH, LAUREN EMMA, MD 4/17/2020 4/17/2025 SURGERY SURGERY SAN ANTONIO TX ACTIVE 4/20/2020 None N/A KARFUNKLE, BENJAMIN LEWIS, EMERGENCY R3883 MD 7/17/2017 7/17/2022 MEDICINE HOUSTON TX ACTIVE 7/24/2017 None N/A KARIM-UD-DIN, SHEIKH RIZWAN, Q6333 MD 10/15/2015 10/15/2020 FAMILY MEDICINE LUBBOCK TX ACTIVE 10/20/2015 None N/A R3694 KARMEGAM, SATHISH , MD 6/30/2017 6/30/2022 INTERNAL MEDICINE HOSPITALIST DALLAS TX ACTIVE 7/11/2017 None N/A KARMOUT, CHRISTOPHER IVAN, R4408 MD 8/25/2017 8/25/2022 FAMILY MEDICINE CONROE TX ACTIVE 10/11/2017 None N/A GASTROENTEROLOG Q6215 KARNATI, DEEPTI, MD 10/1/2015 10/1/2020 Y RICHLANDS VA ACTIVE 10/5/2015 None N/A CARDIOVASCULAR INTERVENTIONAL Q6041 KARNATI, PAVAN KUMAR, MD 9/15/2015 9/15/2020 DISEASES CARDIOLOGY RICHLANDS VA ACTIVE 9/17/2015 None N/A

KARNIK, KAVITHA TIRUMALASETTI CLINICAL R4409 , MD 8/25/2017 8/25/2022 CHILD NEUROLOGY NEUROPHYSIOLOGY HOUSTON TX ACTIVE 8/28/2017 None N/A

OPHTHALMOLOGY - R1055 KARTH, PETER, MD 12/16/2016 12/16/2021 OPHTHALMOLOGY VITREOUS SURGERY EUGENE OR ACTIVE 12/20/2016 None N/A

R4252 KASINDI, DOMINIQUE ALBERT, MD 8/15/2017 8/15/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 8/17/2017 None N/A Q4999 KASSEM, HANIA , MD 7/1/2015 7/1/2020 INTERNAL MEDICINE NEPHROLOGY GALVESTON TX ACTIVE 9/4/2015 None N/A VASCULAR Q6855 KASS-HOUT, OMAR, MD 1/6/2016 1/6/2021 NEUROLOGY NEUROLOGY AMHERST NY ACTIVE 2/22/2016 None N/A OPHTHALMOLOGY - Q8731 KASUGA, DANIEL TAKEO, MD 6/10/2016 6/10/2021 VITREOUS SURGERY EL PASO TX ACTIVE 6/16/2016 None N/A Q8527 KATARIA, JASMEET KAUR, MD 6/1/2016 6/1/2021 PEDIATRICS HOUSTON TX ACTIVE 6/3/2016 None N/A Q5450 KATARIA, RAHUL , MD 8/3/2015 8/3/2020 PEDIATRICS EL PASO TX ACTIVE 8/5/2015 None N/A EMERGENCY Q8082 KATHURIA, NEIL, MD 5/2/2016 5/2/2021 MEDICINE WHITE PLAINS NY ACTIVE 5/9/2016 None N/A R0428 KATIKANENI, MADHAVI, MD 10/14/2016 10/14/2021 INTERNAL MEDICINE NEPHROLOGY BRONX NY ACTIVE 12/15/2016 None N/A KATIKANENI, RAO Q6756 MURALIKRISHNA, MD 12/15/2015 12/15/2020 PEDIATRICS ACTIVE 12/28/2015 None N/A EMERGENCY GARFIELD Q8919 KATIRAI, ANIS BORRAH, MD 7/1/2016 7/1/2021 MEDICINE HEIGHTS OH ACTIVE 9/16/2016 None N/A ABDOMINAL Q5675 KATKAR, AMOL SURYAKANT, MD 8/14/2015 8/14/2020 RADIOLOGY RADIOLOGY SAN ANTONIO TX ACTIVE 8/20/2015 None N/A

NEONATAL- S6224 KATO, HUGO KIYOSHI, MD 4/17/2020 4/17/2025 PERINATAL MEDICINE EL PASO TX ACTIVE 4/21/2020 None N/A Page 140 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date R4858 KATZ, NURIT SIMON, MD 10/6/2017 10/6/2022 INTERNAL MEDICINE HOUSTON TX ACTIVE 10/20/2017 None N/A Q5000 KATZ, ROBERT MICHAEL, MD 7/1/2015 7/1/2020 FAMILY PRACTICE OBSTETRICS COLUMBUS TX ACTIVE 7/3/2015 None N/A PEDIATRIC Q8528 KAUFMAN, BRIAN EDWARD, MD 6/1/2016 6/1/2021 ORTHOPEDICS AUSTIN TX ACTIVE 6/3/2016 None N/A Q6216 KAUL, BHAVIKA , MD 10/1/2015 10/1/2020 INTERNAL MEDICINE HOUSTON TX ACTIVE 10/26/2015 None N/A

R2375 KAUR, AMANDEEP , MD 4/4/2017 4/4/2022 FAMILY MEDICINE GERIATRICS INDIANAPOLIS IN ACTIVE 6/1/2017 None N/A Q9842 KAUR, NAVNIDHI, MD 8/26/2016 8/26/2021 FAMILY MEDICINE LAWTON OK ACTIVE 9/16/2016 None N/A LICENSE R6214 KAUR, RATINDER JIT, MD 3/2/2018 3/2/2023 INTERNAL MEDICINE RHEUMATOLOGY ISSUED 3/2/2018 None N/A GERIATRIC MEDICINE PALLIATIVE LICENSE S5678 KAUR, RUPINDER PAL, DO 3/20/2020 3/20/2025 (FAMILY PRACTICE) MEDICINE ISSUED 3/20/2020 None N/A LICENSE Q5833 KAURA, ABHIMANYU, MD 8/28/2015 8/28/2020 INTERNAL MEDICINE ISSUED 8/28/2015 None N/A Q5453 KAUSER, RICKY, MD 8/3/2015 8/3/2020 INTERNAL MEDICINE FORT WORTH TX ACTIVE 8/7/2015 None N/A Q8920 KAUSHAL, SHIVTEJ SINGH, MD 7/1/2016 7/1/2021 INTERNAL MEDICINE HOUSTON TX ACTIVE 7/28/2016 None N/A Q8529 KAUSHIK, PRAFUL, MD 6/1/2016 6/1/2021 INTERNAL MEDICINE HUMBLE TX ACTIVE 6/10/2016 None N/A INTERVENTIONAL R0039 KAVALI, PAVAN KUMAR, MD 9/15/2016 9/15/2021 RADIOLOGY RADIOLOGY ST. LOUIS MO ACTIVE 9/20/2016 None N/A EMERGENCY S4507 KAYE, ILAN , MD 12/20/2019 12/20/2024 MEDICINE FORT WOTH TX ACTIVE 1/13/2020 None N/A DIAGNOSTIC LICENSE Q6042 KAZEMI, SHOELEH, MD 9/15/2015 9/15/2020 RADIOLOGY BREAST IMAGING ISSUED 9/15/2015 None N/A Q4613 KAZI, HASEEB A, MD 6/1/2015 6/1/2020 HOSPITALIST INTERNAL MEDICINE DALLAS TX ACTIVE 6/2/2015 None N/A Q5454 KAZI, RUCHIKA, MD 8/3/2015 8/3/2020 HOSPITALIST FRISCO TX ACTIVE 8/4/2015 None N/A R5752 KAZIM, MOHAMMAD TALHA, DO 1/19/2018 1/19/2023 INTERNAL MEDICINE HOSPITALIST ACTIVE 2/8/2018 None N/A HEMATOLOGY/ONCOL R4072 KAZMI, SYED MOHAMMAD ALI, MD 8/1/2017 8/1/2022 OGY INTERNAL MEDICINE DALLAS TX ACTIVE 8/2/2017 None N/A EMERGENCY R4991 KEATON, RACHEL LEE, MD 10/20/2017 10/20/2022 MEDICINE SAN ANTONIO TX ACTIVE 11/17/2017 None N/A OBSTETRICS AND Q6337 KEEFE, KRISTIN ANN, MD 10/15/2015 10/15/2020 PALLIATIVE MEDICINE GYNECOLOGY AUSTIN TX ACTIVE 10/22/2015 None N/A KEFLEMARIAM, YENABI JOSEPH, CARDIOTHORACIC Q9650 MD 8/15/2016 8/15/2021 ANESTHESIOLOGY HARLINGEN TX ACTIVE 8/17/2016 None N/A URGENT CARE - LICENSE Q5835 KEHRES, DOUGLAS LUKE, MD 8/28/2015 8/28/2020 FAMILY MEDICINE FAMILY PRACTICE ISSUED 8/28/2015 None N/A SURGICAL CRITICAL TRAUMATIC LICENSE S7077 KEITH, STACEY LYN, MD 6/12/2020 6/12/2025 CARE SURGERY ISSUED 6/12/2020 None N/A PULMONARY CRITICAL CARE R3120 KELBE, JILALU ASMERA, MD 5/22/2017 5/22/2022 MEDICINE INTERNAL MEDICINE DALLAS TX ACTIVE 6/29/2017 None N/A Page 141 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date Q6436 KELLER, BRADLY J, MD 11/2/2015 11/2/2020 PSYCHIATRY ACTIVE 11/4/2015 None N/A Q5002 KELLER, DEBORAH SUSAN, MD 7/1/2015 7/1/2020 GENERAL SURGERY HOUSTON TX ACTIVE 7/2/2015 None N/A

S5200 KELLER, MICHAEL CHARLES, MD 2/21/2020 2/21/2025 GENERAL SURGERY CYPRESS TX ACTIVE 4/27/2020 None N/A S4991 KELLEY, JAMES JOSEPH IV, DO 2/7/2020 2/7/2025 UROLOGY FORT WORTH TX ACTIVE 2/10/2020 None N/A CARDIOVASCULAR S5401 KELLEY, MOSES III, MD 3/6/2020 3/6/2025 DISEASES ACTIVE 3/10/2020 None N/A R4992 KELLEY, RAYMOND SCOTT, MD 10/20/2017 10/20/2022 ANESTHESIOLOGY GAINESVILLE FL ACTIVE 10/26/2017 None N/A BROWNSVILL R0040 KELLEY, SALLY ANN, MD 9/15/2016 9/15/2021 PALLIATIVE MEDICINE E TX ACTIVE 10/11/2016 None N/A

OPHTHALMOLOGY - Q9396 KELLOGG, CLINT W, DO 8/1/2016 8/1/2021 OPHTHALMOLOGY VITREOUS SURGERY GALVESTON TX ACTIVE 8/3/2016 None N/A ORTHOPEDIC R2376 KELLY, DREW PATRICK, MD 4/4/2017 4/4/2022 TRAUMA DALLAS TX ACTIVE 4/5/2017 None N/A OBSTETRICS AND D8301 KELLY, JOHN BARRY, MD 10/14/2016 10/14/2021 GYNECOLOGY ACTIVE 10/26/2016 None N/A UNDER BOARD Q8083 KELLY, SARAH VAN EPP, MD 5/2/2016 5/2/2021 INTERNAL MEDICINE PATHOLOGY ACTIVE 5/9/2016 ORDER 4/4/2016 Q5003 KEMAL, NEJMUDIN RESHAD, MD 7/1/2015 7/1/2020 INTERNAL MEDICINE HOSPITALIST HOUSTON TX ACTIVE 9/7/2015 None N/A R0429 KEMP, JEFFREY RUSSELL, MD 10/14/2016 10/14/2021 INTERNAL MEDICINE HOSPITALIST LONGVIEW TX ACTIVE 10/25/2016 None N/A

R5414 KENFACK, EVE ESPERANCE, MD 12/8/2017 12/8/2022 INTERNAL MEDICINE HOSPITALIST HOUSTON TX ACTIVE 1/3/2018 None N/A S4508 KENNEDY, AUDRA NICOLE, MD 12/20/2019 12/20/2024 FAMILY MEDICINE GRAHAM TX ACTIVE 1/8/2020 None N/A EMERGENCY Q7722 KENNEDY, CHRISTOPHER, MD 4/1/2016 4/1/2021 MEDICINE DALLAS TX ACTIVE 4/11/2016 None N/A SURGICAL CRITICAL LICENSE Q4786 KENNEDY, RYAN OLIVER , MD 6/12/2015 6/12/2020 TRAUMATIC SURGERY CARE ISSUED 6/12/2015 None N/A OBSTETRICS & GYNECOLOGICAL WICHITA S5946 KENNER, JAMAAN, MD 4/3/2020 4/3/2025 SURGERY FALLS TX ACTIVE 4/14/2020 None N/A KENNETH-NWOSA, KENNETH S5402 OBIEFUNA, MD 3/6/2020 3/6/2025 FAMILY MEDICINE GALVESTON TX ACTIVE 3/9/2020 None N/A EMERGENCY R3885 KENNIS, JACK DAVID, MD 7/17/2017 7/17/2022 MEDICINE INTERNAL MEDICINE ACTIVE 9/4/2017 None N/A S5202 KENNIS, MICHAEL BRETT, MD 2/21/2020 2/21/2025 FAMILY MEDICINE NEW YORK NY ACTIVE 3/11/2020 None N/A EMERGENCY EMERGENCY Q5004 KENNY, COLIN MATTHEW, DO 7/1/2015 7/1/2020 MEDICINE MEDICINE ALICE TX ACTIVE 7/3/2015 None N/A Q6338 KENNY, JOHN MICHAEL, MD 10/15/2015 10/15/2020 PSYCHIATRY SCARSDALE NY ACTIVE 10/20/2015 None N/A

Page 142 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date DELINQUEN T-NON R4073 KENT, MICHAEL GRANT, MD 8/1/2017 8/1/2022 GENERAL SURGERY PAYMENT 12/4/2017 None N/A

R1057 KENWORTHY, JOHN ELIASON, DO 12/16/2016 12/16/2021 FAMILY MEDICINE DENISON TX ACTIVE 1/2/2017 None N/A

NEURO-PHYSIOLOGY R5878 KESARI, NAVIN KUMAR, MD 2/2/2018 2/2/2023 NEUROLOGY (NEUROLOGY) ACTIVE 2/19/2018 None N/A KESSINGER, THOMAS WILLIAM, CARDIOTHORACIC R5277 MD 11/17/2017 11/17/2022 ANESTHESIOLOGY ANESTHESIOLOGY ACTIVE 11/22/2017 None N/A INTERVENTIONAL CARDIOVASCULAR S6423 KETRON, LOWELL LANE, MD 5/1/2020 5/1/2025 CARDIOLOGY DISEASES CONROE TX ACTIVE 5/18/2020 None N/A KETWAROO, GYANPRAKASH GASTROENTEROLOG R1561 AVINASH, MD 2/6/2017 2/6/2022 Y HOUSTON TX ACTIVE 4/17/2017 None N/A KETWAROO, PAMELA MARIE PEDIATRIC CARDIOTHORACIC R0041 DEAVER, MD 9/15/2016 9/15/2021 RADIOLOGY RADIOLOGY HOUSTON TX ACTIVE 10/14/2016 None N/A SURGICAL Q7065 KEUNG, EMILY ZHI-YUN, MD 2/1/2016 2/1/2021 GENERAL SURGERY ONCOLOGY ACTIVE 2/4/2016 None N/A DIAGNOSTIC DIAGNOSTIC R1794 KEY, BRANDON MARTIN, MD 2/22/2017 2/22/2022 RADIOLOGY RADIOLOGY ACTIVE 3/20/2017 None N/A PSYCHOSOMATIC Q5201 KEY, RICHARD GARRETT, MD 7/15/2015 7/15/2020 PSYCHIATRY MEDICINE AUSTIN TX ACTIVE 7/17/2015 None N/A LICENSE R6028 KEYBURN, HANH, DO 2/16/2018 2/16/2023 PEDIATRICS ISSUED 2/16/2018 None N/A R1229 KEYES, KYLE , MD 1/6/2017 1/6/2022 UROLOGY SUGAR LAND TX ACTIVE 1/16/2017 None N/A WEATHERFOR Q6043 KHADBAI, ADAM , MD 9/15/2015 9/15/2020 FAMILY MEDICINE D TX ACTIVE 9/22/2015 None N/A OPHTHALMOLOGY - Q7402 KHALAF, HAMZAH, MD 3/4/2016 3/4/2021 VITREOUS SURGERY OPHTHALMOLOGY MCALLEN TX ACTIVE 3/10/2016 None N/A LICENSE Q5837 KHALID, MONA, MD 8/28/2015 8/28/2020 INTERNAL MEDICINE HOSPITALIST ISSUED 8/28/2015 None N/A HEMATOLOGY/ONCOL R5754 KHALIFE, MUSTAPHA, MD 1/19/2018 1/19/2023 OGY INTERNAL MEDICINE TYLER TX ACTIVE 3/6/2018 None N/A Q7901 KHALIL, ANDREW, DO 4/15/2016 4/15/2021 INTERNAL MEDICINE ACTIVE 5/4/2016 None N/A Q9651 KHALIL, MOHAMED, MD 8/15/2016 8/15/2021 INTERNAL MEDICINE INTERNAL MEDICINE HOUSTON TX ACTIVE 8/31/2016 None N/A R3886 KHALIL, SABRY, MD 7/17/2017 7/17/2022 ANESTHESIOLOGY LUBBOCK TX ACTIVE 7/24/2017 None N/A OTORHINOLARYNGOL S6225 KHALILI, SAMMY, MD 4/17/2020 4/17/2025 OGY RHINOLOGY MILWAUKEE WI ACTIVE 5/6/2020 None N/A OBSTETRICS AND R0598 KHAMSI, NAIMA , MD 10/31/2016 10/31/2021 GYNECOLOGY EL PASO TX ACTIVE 12/14/2016 None N/A R0430 KHAN, AASIA BASHIR, MD 10/14/2016 10/14/2021 HOSPITALIST ACTIVE 10/17/2016 None N/A Page 143 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date R5278 KHAN, ABDUL RAHIM, MD 11/17/2017 11/17/2022 CARDIOLOGY ACTIVE 1/8/2018 None N/A

PH00004 KHAN, ADNAN , MD 3/4/2016 3/4/2021 INTERNAL MEDICINE ACTIVE 3/14/2016 None N/A PEDIATRIC Q8921 KHAN, ADNAN I, MD 7/1/2016 7/1/2021 PSYCHIATRY PSYCHIATRY WYCKOFF NJ ACTIVE 8/29/2016 None N/A S5947 KHAN, AHMED SHEZAD ALI, MD 4/3/2020 4/3/2025 INTERNAL MEDICINE ACTIVE 5/29/2020 None N/A R0599 KHAN, ALI RAZA , MD 10/31/2016 10/31/2021 FAMILY MEDICINE HOSPITALIST MIDLAND TX ACTIVE 11/23/2016 None N/A ANESTHESIOLOGY - STROUDSBUR R3542 KHAN, ARIF AHMAD, MD 6/16/2017 6/16/2022 ANESTHESIOLOGY PAIN MANAGEMENT G PA ACTIVE 8/2/2017 None N/A CARDIOVASCULAR INTERVENTIONAL S5404 KHAN, ASHFAQ AHMAD, MD 3/6/2020 3/6/2025 DISEASES CARDIOLOGY ACTIVE 3/12/2020 None N/A KHAN, DURRESHAHWAR Q8922 KHURSHEED, MD 7/1/2016 7/1/2021 HOSPITALIST INTERNAL MEDICINE ACTIVE 7/4/2016 None N/A CHILD AND ADOLESCENT R4574 KHAN, EMAD AHMED, MD 9/8/2017 9/8/2022 PSYCHIATRY PSYCHIATRY DALLAS TX ACTIVE 9/11/2017 None N/A Q7066 KHAN, FAHAD, MD 2/1/2016 2/1/2021 NEPHROLOGY INTERNAL MEDICINE CLOVIS CA ACTIVE 4/19/2016 None N/A LICENSE Q6339 KHAN, FAISAL RASHID, MD 10/15/2015 10/15/2020 INTERNAL MEDICINE ISSUED 10/15/2015 None N/A PAIN PHYSICAL MED. & MANAGEMENT/REHA R5579 KHAN, FARHEEN ARSHIA, DO 1/5/2018 1/5/2023 REHABILITATION B MED ALEXANDRIA, LA ACTIVE 1/18/2018 None N/A WASHINGTON R5880 KHAN, FIZA, MD 2/2/2018 2/2/2023 PSYCHIATRY DC DC ACTIVE 2/26/2018 None N/A CARDIOVASCULAR INTERVENTIONAL Q5203 KHAN, HASHIM ALI, MD 7/15/2015 7/15/2020 DISEASES CARDIOLOGY AUSTIN TX ACTIVE 7/16/2015 None N/A PALLIATIVE Q6857 KHAN, HUMA, MD 1/6/2016 1/6/2021 INTERNAL MEDICINE MEDICINE SAN ANTONIO TX ACTIVE 1/7/2016 None N/A CORNEA REFRACTIVE R2139 KHAN, HUMAIR , MD 3/20/2017 3/20/2022 OPHTHALMOLOGY SURGERY GALVESTON TX ACTIVE 6/2/2017 None N/A NEONATAL- PERINATAL NEW S4510 KHAN, IMTEYAZ AHMAD, MD 12/20/2019 12/20/2024 PEDIATRICS MEDICINE BRUNSWICK NJ ACTIVE 1/15/2020 None N/A Q5005 KHAN, MADIHA AHMED, MD 7/1/2015 7/1/2020 FAMILY MEDICINE GALVESTON TX ACTIVE 7/3/2015 None N/A EMERGENCY R5881 KHAN, MANSOOR ALI, MD 2/2/2018 2/2/2023 MEDICINE JERSEY CITY NJ ACTIVE 2/6/2018 None N/A R0888 KHAN, MARIAM MAHMOOD, MD 12/2/2016 12/2/2021 FAMILY MEDICINE MIDLAND TX ACTIVE 2/27/2017 None N/A Q4614 KHAN, MAZHAR AHMED, MD 6/1/2015 6/1/2020 FAMILY MEDICINE FAMILY PRACTICE ACTIVE 6/2/2015 None N/A

Page 144 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date CHILD AND ADOLESCENT R4414 KHAN, MEHNAZ ALI, MD 8/25/2017 8/25/2022 PSYCHIATRY PSYCHIATRY ST.JOSEPH MO ACTIVE 11/30/2017 None N/A GERIATRIC KHAN, MOHAMMAD ABUL KALAM, MEDICINE (INTERNAL WAKE R0431 MD 10/14/2016 10/14/2021 INTERNAL MEDICINE MED) FOREST NC ACTIVE 10/24/2016 None N/A HEMATOLOGY/ONCO N5771 KHAN, MOHAMMAD M, MD 6/16/2017 6/16/2022 INTERNAL MEDICINE LOGY LEBANON PA ACTIVE 11/1/2017 None N/A R1060 KHAN, MOHAMMED FAIZ, MD 12/16/2016 12/16/2021 INTERNAL MEDICINE HOSPITALIST HOUSTON TX ACTIVE 12/26/2016 None N/A R3543 KHAN, MUBEEN, MD 6/16/2017 6/16/2022 INTERNAL MEDICINE NEPHROLOGY HOUSTON TX ACTIVE 6/26/2017 None N/A EMERGENCY Q9653 KHAN, MUDASSIR, MD 8/15/2016 8/15/2021 MEDICINE TOMBALL TX ACTIVE 8/17/2016 None N/A CAMPBELLSVI Q6757 KHAN, MUHAMMAD A, MD 12/15/2015 12/15/2020 PEDIATRICS LLE KY ACTIVE 12/21/2015 None N/A LICENSE Q6524 KHAN, MUHAMMAD ALI NIAZ, MD 11/16/2015 11/16/2020 INTERNAL MEDICINE ISSUED 11/16/2015 None N/A R0889 KHAN, MUHAMMAD USMAN, MD 12/2/2016 12/2/2021 CARDIOLOGY INTERNAL MEDICINE ROCHESTER NY ACTIVE 12/7/2016 None N/A INFECTIOUS Q5204 KHAN, NABEELA, DO 7/15/2015 7/15/2020 DISEASES INTERNAL MEDICINE HOUSTON TX ACTIVE 7/22/2015 None N/A R0600 KHAN, NAVAID MUNEER, MD 10/31/2016 10/31/2021 FAMILY MEDICINE HOSPITALIST SAN ANTONIO TX ACTIVE 11/28/2016 None N/A OPHTHALMOLOGY - R2377 KHAN, RABEEA, MD 4/4/2017 4/4/2022 OPHTHALMOLOGY CORNEA DALLAS TX ACTIVE 4/12/2017 None N/A Q6045 KHAN, RAO ALI HASHIM, MD 9/15/2015 9/15/2020 NEPHROLOGY INTERNAL MEDICINE BLUEFIELD WV ACTIVE 11/16/2015 None N/A LICENSE Q5840 KHAN, SADAF SANA, MD 8/28/2015 8/28/2020 NEPHROLOGY INTERNAL MEDICINE ISSUED 8/28/2015 None N/A Q8530 KHAN, SAFIA SAMEEM, MD 6/1/2016 6/1/2021 FAMILY MEDICINE SLEEP MEDICINE PLANO TX ACTIVE 6/7/2016 None N/A EMERGENCY R3699 KHAN, SAJID, MD 6/30/2017 6/30/2022 MEDICINE PEARLAND TX ACTIVE 7/6/2017 None N/A Q6046 KHAN, SAMAD HASSAN, MD 9/15/2015 9/15/2020 FAMILY PRACTICE ACTIVE 9/16/2015 None N/A PHYSICAL MED. & R1563 KHAN, SAMAIRA, DO 2/6/2017 2/6/2022 REHABILITATION ACTIVE 3/13/2017 None N/A R6215 KHAN, SAMIRA, MD 3/2/2018 3/2/2023 INTERNAL MEDICINE ACTIVE 3/13/2018 None N/A Q8085 KHAN, SANA IMTIAZ, DO 5/2/2016 5/2/2021 FAMILY MEDICINE HOUSTON TX ACTIVE 5/23/2016 None N/A R0042 KHAN, SARAH, MD 9/15/2016 9/15/2021 INTERNAL MEDICINE ACTIVE 9/27/2016 None N/A CHILD AND ADOLESCENT Q8923 KHAN, SHAHZAD A, MD 7/1/2016 7/1/2021 PSYCHIATRY PSYCHIATRY SAN DIEGO CA ACTIVE 7/11/2016 None N/A NEUROMUSCULAR Q9399 KHAN, SHAIDA , DO 8/1/2016 8/1/2021 NEUROLOGY DISEASE DALLAS TX ACTIVE 8/3/2016 None N/A INFECTIOUS R2893 KHAN, SIDRAH, MD 5/5/2017 5/5/2022 INTERNAL MEDICINE DISEASES AUSTIN TX ACTIVE 5/16/2017 None N/A Page 145 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date OPHTHALMOLOGY - R0432 KHAN, TANYA TABASSUM, MD 10/14/2016 10/14/2021 RECONST SURGERY OPHTHALMOLOGY AUSTIN TX ACTIVE 10/19/2016 None N/A SPORTS MEDICINE - Q8086 KHAN, UMAR, MD 5/2/2016 5/2/2021 INTERNAL MEDICINE IM SAN ANTONIO TX ACTIVE 5/9/2016 None N/A FAMILY PRACTICE - LICENSE S6868 KHAN, VAKAR ALI, MD 5/29/2020 5/29/2025 FAMILY MEDICINE EMERGENCY MED ISSUED 5/29/2020 None N/A DELINQUEN ABDOMINAL T-NON R0737 KHAN, YASIR, DO 11/15/2016 11/15/2021 GENERAL SURGERY SURGERY CINCINNATI OH PAYMENT 12/30/2017 None N/A CARDIAC ELECTROPHYSIOLO R2378 KHAN, ZAKA ULLAH, MD 4/4/2017 4/4/2022 CARDIOLOGY GY HOUSTON TX ACTIVE 5/19/2017 None N/A MEDICAL TOXICOLOGY (EMERGENCY LICENSE Q6639 KHAN, ZEESHAN MOHAMMAD, MD 12/4/2015 12/4/2020 MEDICINE) ISSUED 12/4/2015 None N/A

Q6639 KHAN, ZEESHAN MOHAMMAD, MD 12/4/2015 12/4/2020 FAMILY MEDICINE FAMILY MEDICINE ACTIVE 12/14/2015 None N/A

Q6639 KHAN, ZEESHAN MOHAMMAD, MD 12/4/2015 12/4/2020 FAMILY MEDICINE FAMILY MEDICINE ACTIVE 12/14/2015 None N/A R2894 KHAN, ZESHAN MALIK, DO 5/5/2017 5/5/2022 ANESTHESIOLOGY ACTIVE 5/22/2017 None N/A OBSTETRICS AND R4258 KHANDAKER, SADIA AYESHA, MD 8/15/2017 8/15/2022 GYNECOLOGY MIDDLETOWN NY ACTIVE 8/31/2017 None N/A LICENSE S7079 KHANDELWAL, NUVNEET , MD 6/12/2020 6/12/2025 INTERNAL MEDICINE HOSPITALIST ISSUED 6/12/2020 None N/A VASCULAR R0601 KHANDELWAL, PRIYANK, MD 10/31/2016 10/31/2021 NEUROLOGY NEUROLOGY ACTIVE 1/16/2017 None N/A COLON AND RECTAL R0433 KHANI, MOHUMMED RADWAN, MD 10/14/2016 10/14/2021 SURGERY GENERAL SURGERY PEARLAND TX ACTIVE 11/11/2016 None N/A S5948 KHANJEE, NAVEED KARIM, MD 4/3/2020 4/3/2025 INTERNAL MEDICINE HOUSTON TX ACTIVE 4/9/2020 None N/A EMERGENCY Q5006 KHARBANDA, BRYAN SINGH, MD 7/1/2015 7/1/2020 MEDICINE ACTIVE 7/2/2015 None N/A R0738 KHAREL NEPAL, BINITA, MD 11/15/2016 11/15/2021 INTERNAL MEDICINE LINDALE TX ACTIVE 11/16/2016 None N/A PEDIATRICS, S5205 KHAROUF, RAMI M, MD 2/21/2020 2/21/2025 CARDIOLOGY WILMINGTON DE ACTIVE 3/16/2020 None N/A VASCULAR R0043 KHATRI, RAKESH, MD 9/15/2016 9/15/2021 NEUROLOGY NEUROLOGY EL PASO TX ACTIVE 9/20/2016 None N/A Q9654 KHATTAK, AISHA, MD 8/15/2016 8/15/2021 NEPHROLOGY INTERNAL MEDICINE HOUSTON TX ACTIVE 8/17/2016 None N/A R1564 KHAWAJA, ASIM, MD 2/6/2017 2/6/2022 INTERNAL MEDICINE HOUSTON TX ACTIVE 2/7/2017 None N/A KHAWAJA, MUHAMMAD RIZWAN HEMATOLOGY/ONCO R1795 UL HAQ, MD 2/22/2017 2/22/2022 INTERNAL MEDICINE LOGY LOVINGTON NM ACTIVE 3/1/2017 None N/A Page 146 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date INTERVENTIONAL CARDIOVASCULAR S5950 KHAWAJA, OWAIS AJAZ, MD 4/3/2020 4/3/2025 CARDIOLOGY DISEASES STOCKTON CA ACTIVE 4/27/2020 None N/A PEDIATRIC HEMATOLOGY/ONCOL R1796 KHAZAL, SAJAD JAWAD, MD 2/22/2017 2/22/2022 OGY OTHER SPECIALTY HOUSTON TX ACTIVE 3/31/2017 None N/A R0045 KHERA, ROHAN, MD 9/15/2016 9/15/2021 INTERNAL MEDICINE CARDIOLOGY DALLAS TX ACTIVE 9/21/2016 None N/A ANESTHESIOLOGY - S5406 KHIMANI, NAMRATA B, MD 3/6/2020 3/6/2025 ANESTHESIOLOGY PAIN MANAGEMENT NEW YORK NY ACTIVE 4/21/2020 None N/A DIAGNOSTIC TM00864 KHIMJI, TASNEEM NAUSHAD, MD 2/7/2020 2/7/2025 RADIOLOGY EDEN PRAIRIE MN ACTIVE 2/10/2020 None N/A PEDIATRIC R3358 KHIN, EI EI, MD 6/2/2017 6/2/2022 PEDIATRICS NEPHROLOGY EL PASO TX ACTIVE 6/5/2017 None N/A CRITICAL CARE R3888 KHORSAND, SARAH MICHELLE, MD 7/17/2017 7/17/2022 ANESTHESIOLOGY ANESTHESIOLOGY DALLAS TX ACTIVE 7/24/2017 None N/A KHOURY, GHASSAN HANI NICOLA, Q6858 MD 1/6/2016 1/6/2021 INTERNAL MEDICINE AMARILLO TX ACTIVE 1/18/2016 None N/A PEDIATRIC ANESTHESIOLOGY R4416 KHOURY, RONNIE, MD 8/25/2017 8/25/2022 ANESTHESIOLOGY (PEDS) EFFINGHAM IL ACTIVE 10/3/2017 None N/A ANESTHESIOLOGY - Q7220 KHOURY, SPIRO ADEL, MD 2/16/2016 2/16/2021 ANESTHESIOLOGY PAIN MANAGEMENT ACTIVE 2/29/2016 None N/A Q9173 KHUC, DANIEL MINH, MD 7/15/2016 7/15/2021 FAMILY MEDICINE SPRING TX ACTIVE 7/22/2016 None N/A

R0265 KHURRAM, FARZEEN AHMED, MD 9/30/2016 9/30/2021 FAMILY MEDICINE JOHNS CREEK GA ACTIVE 3/1/2018 None N/A Q6525 KHURRAM, SOBIA K, MD 11/16/2015 11/16/2020 PSYCHIATRY EL PASO TX ACTIVE 11/18/2015 None N/A DELINQUEN INFECTIOUS T-NON R4861 KHURSHID, KHAWAR, MD 10/6/2017 10/6/2022 DISEASES INTERNAL MEDICINE PAYMENT 1/4/2018 None N/A LICENSE S4996 KHURSHID, MADIHA, MD 2/7/2020 2/7/2025 HOSPITALIST ISSUED 2/7/2020 None N/A S5952 KHUWAJA, SAMREEN, MD 4/3/2020 4/3/2025 INTERNAL MEDICINE ACTIVE 4/6/2020 None N/A RADIATION Q8087 KHWAJA, SHARIQ , MD 5/2/2016 5/2/2021 ONCOLOGY HOUSTON TX ACTIVE 5/9/2016 None N/A R1974 KIANI, SHAMAS CHUNGEZ, MD 3/3/2017 3/3/2022 ANESTHESIOLOGY ALBERT LEA MN ACTIVE 4/3/2017 None N/A R4575 KIANMAJD, MAJID, DO 9/8/2017 9/8/2022 GENERAL SURGERY HOUSTON TX ACTIVE 10/9/2017 None N/A R4728 KIEFFER, HILARY JANE, MD 9/22/2017 9/22/2022 FAMILY MEDICINE CONROE TX ACTIVE 9/27/2017 None N/A EMERGENCY CRITICAL CARE THE R3889 KIEVLAN, DANIEL RHODES, MD 7/17/2017 7/17/2022 MEDICINE MEDICINE WOODLANDS TX ACTIVE 7/25/2017 None N/A R2897 KILARI, RAKESH, MD 5/5/2017 5/5/2022 NEPHROLOGY INTERNAL MEDICINE PLANO TX ACTIVE 5/15/2017 None N/A PEDIATRICS, Q6341 KILGORE, ADRIENNE LATRICE, MD 10/15/2015 10/15/2020 CARDIOLOGY HOUSTON TX ACTIVE 11/2/2015 None N/A Page 147 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date EMERGENCY R1063 KIM, ANGELO, MD 12/16/2016 12/16/2021 MEDICINE DALLAS TX ACTIVE 1/2/2017 None N/A INTERVENTIONAL R6030 KIM, CARL, MD 2/16/2018 2/16/2023 RADIOLOGY RADIOLOGY ROUND ROCK TX ACTIVE 2/26/2018 None N/A URGENT CARE - Q8088 KIM, CLAIRE HYAEKYONG, DO 5/2/2016 5/2/2021 FAMILY MEDICINE FAMILY PRACTICE ACTIVE 5/3/2016 None N/A EMERGENCY Q6220 KIM, DANIEL DAEUN, MD 10/1/2015 10/1/2020 MEDICINE HOUSTON TX ACTIVE 10/5/2015 None N/A

Q9400 KIM, DAVID YOUNG, MD 8/1/2016 8/1/2021 NEURO-RADIOLOGY EDEN PRAIRIE MN ACTIVE 8/3/2016 None N/A SURGICAL CRITICAL R4576 KIM, DAVID, MD 9/8/2017 9/8/2022 TRAUMATIC SURGERY CARE HOUSTON TX ACTIVE 9/18/2017 None N/A EMERGENCY Q8090 KIM, EDWARD HYONGCHOL, MD 5/2/2016 5/2/2021 MEDICINE CEDAR PARK TX ACTIVE 5/9/2016 None N/A PEDIATRIC R4259 KIM, ERIN D, MD 8/15/2017 8/15/2022 NEPHROLOGY DALLAS TX ACTIVE 9/4/2017 None N/A ORTHOPEDIC R4260 KIM, HANNAH HYUNHEE, MD 8/15/2017 8/15/2022 SURGERY FORT WORTH TX ACTIVE 8/28/2017 None N/A S5408 KIM, HEIDI , MD 3/6/2020 3/6/2025 PEDIATRICS DALLAS TX ACTIVE 3/16/2020 None N/A CARDIOVASCULAR R3545 KIM, JU HYUN, MD 6/16/2017 6/16/2022 CARDIOLOGY DISEASES HOUSTON TX ACTIVE 7/7/2017 None N/A PHYSICAL MED. & OCCUPATIONAL R3891 KIM, STEVE DAE, DO 7/17/2017 7/17/2022 REHABILITATION MEDICINE HOUSTON TX ACTIVE 7/18/2017 None N/A PREVENTIVE S5409 KIM, YOON HANG, MD 3/6/2020 3/6/2025 MEDICINE UNSPECIFIED SAN ANTONIO TX ACTIVE 3/10/2020 None N/A Q9844 KIMANI, MAUREEN WANGUI, MD 8/26/2016 8/26/2021 INTERNAL MEDICINE HOUSTON TX ACTIVE 8/29/2016 None N/A PEDIATRIC ANESTHESIOLOGY R3700 KIMATIAN, STEPHEN JOHN, MD 6/30/2017 6/30/2022 ANESTHESIOLOGY (PEDS) DALLAS TX ACTIVE 7/7/2017 None N/A CRITICAL CARE R4729 KIMBAL, KYLE CLARK, MD 9/22/2017 9/22/2022 GENERAL SURGERY (SURGERY) TEMPLE TX ACTIVE 10/2/2017 None N/A SURGICAL R4261 KIMBALL, SARAH CARISSA, MD 8/15/2017 8/15/2022 ONCOLOGY TEMPLE TX ACTIVE 8/31/2017 None N/A R4993 KIMELHEIM, ROBERT ALAN, DO 10/20/2017 10/20/2022 RHEUMATOLOGY INTERNAL MEDICINE TEMPLE TX ACTIVE 10/26/2017 None N/A OBSTETRICS AND S4796 KINCAID, GEOFFREY C, MD 1/24/2020 1/24/2025 GYNECOLOGY KNOXVILLE TN ACTIVE 2/3/2020 None N/A OBSTETRICS AND LICENSE Q5680 KINDRED, ROBIN, MD 8/14/2015 8/14/2020 GYNECOLOGY ISSUED 8/14/2015 None N/A PHYSICAL MED. & Q6048 KING, AARON MATTHEW, MD 9/15/2015 9/15/2020 REHABILITATION VICTORIA TX ACTIVE 11/16/2015 None N/A R5755 KING, ALICE , MD 1/19/2018 1/19/2023 PEDIATRIC SURGERY ST LOUIS MO ACTIVE 2/21/2018 None N/A Page 148 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date S6426 KING, DARLENE RAE, MD 5/1/2020 5/1/2025 PSYCHIATRY DALLAS TX ACTIVE 5/5/2020 None N/A THE Q8272 KING, STACI DENISE, MD 5/16/2016 5/16/2021 CHILD NEUROLOGY WOODLANDS TX ACTIVE 5/24/2016 None N/A ADDICTION Q8531 KING, VAN LEWIS JR, MD 6/1/2016 6/1/2021 PSYCHIATRY PSYCHIATRY SAN ANTONIO TX ACTIVE 6/2/2016 None N/A EMERGENCY EMERGENCY CORPUS R4577 KINGSLEY, BENJAMIN KEITH, MD 9/8/2017 9/8/2022 MEDICINE MEDICINE CHRISTI TX ACTIVE 10/2/2017 None N/A R0890 KINMAN, CASEY LYNN, MD 12/2/2016 12/2/2021 UROGYNECOLOGY GYNECOLOGY IRVING TX ACTIVE 1/31/2017 None N/A PEDIATRIC CRITICAL LICENSE Q8532 KIOKO, MARILYN MUTHEU, MD 6/1/2016 6/1/2021 PEDIATRICS CARE MEDICINE ISSUED 6/1/2016 None N/A EMERGENCY R0740 KIRBY, JESSICA JEWART, DO 11/15/2016 11/15/2021 MEDICINE FORT WORTH TX ACTIVE 11/17/2016 None N/A EMERGENCY R0741 KIRBY, RYAN PATRICK, MD 11/15/2016 11/15/2021 MEDICINE FORT WORTH TX ACTIVE 11/17/2016 None N/A GERIATRIC MEDICINE (FAMILY WINDSOR R1397 KIRCHER, KYLE JOHN, MD 1/20/2017 1/20/2022 FAMILY MEDICINE PRACTICE) HEIGHTS IA ACTIVE 1/30/2017 None N/A PAIN MANAGEMENT/REHAB PHYSICAL MED. & Q9403 KIRKLAND, ARRASH, MD 8/1/2016 8/1/2021 MED REHABILITATION ALLEN TX ACTIVE 9/2/2016 None N/A

Q8927 KIRKLAND, CRYSTAL COLLIN, MD 7/1/2016 7/1/2021 INTERNAL MEDICINE HOSPITALIST SAN ANGELO TX ACTIVE 7/5/2016 None N/A KIRKSEY, KATHLEEN THERESA, R2144 MD 3/20/2017 3/20/2022 PEDIATRICS KILLEEN TX ACTIVE 5/17/2017 None N/A EMERGENCY S4650 KIRSCHNER, MICHAEL NEIL, DO 1/10/2020 1/10/2025 MEDICINE EL PASO TX ACTIVE 1/15/2020 None N/A ORTHOPEDIC PEDIATRIC R1799 KISHAN, SHYAM, MD 2/22/2017 2/22/2022 SURGERY ORTHOPEDICS PLANO TX ACTIVE 3/6/2017 None N/A SURGICAL Q9655 KITANO, MIO, MD 8/15/2016 8/15/2021 ONCOLOGY SAN ANTONIO TX ACTIVE 8/29/2016 None N/A Q9404 KITCHENS, BENJAMIN LEE, MD 8/1/2016 8/1/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 8/3/2016 None N/A S6661 KITIASHVILI, VLADIMER, MD 5/15/2020 5/15/2025 INTERNAL MEDICINE ACTIVE 5/18/2020 None N/A CRITICAL CARE PULMONARY Q6527 KITZIS, VANESSA, MD 11/16/2015 11/16/2020 MEDICINE (IM) DISEASES SAINT LOUIS MO ACTIVE 11/24/2015 None N/A TRANSPLANT Q8928 KLAIR, TARUNJEET SINGH, MD 7/1/2016 7/1/2021 SURGERY SAN ANTONIO TX ACTIVE 9/14/2016 None N/A R4578 KLAPPROTH, RIESA ANN, MD 9/8/2017 9/8/2022 FAMILY MEDICINE TEMPLE TN ACTIVE 9/12/2017 None N/A R4579 KLAPPROTH, SHAWN , MD 9/8/2017 9/8/2022 FAMILY MEDICINE TEMPLE TX ACTIVE 9/11/2017 None N/A KLEUSER, LAWRENCE PETER III, EMERGENCY Q9845 MD 8/26/2016 8/26/2021 MEDICINE NASHVILLE TN ACTIVE 9/12/2016 None N/A Q8930 KLOEFKORN, CHAD ALAN, MD 7/1/2016 7/1/2021 INTERNAL MEDICINE HOUSTON TX ACTIVE 7/11/2016 None N/A Page 149 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date KLOVENSKI, VICTORIA EMERGENCY Q5842 SCHNEIDER, MD 8/28/2015 8/28/2020 MEDICINE TEMPLE TX ACTIVE 9/14/2015 None N/A FREDERICKSB Q9405 KLUMP, SHANNON FAITH, DO 8/1/2016 8/1/2021 FAMILY MEDICINE URG TX ACTIVE 9/27/2016 None N/A EMERGENCY R2381 KLYUY, DMITRY, MD 4/4/2017 4/4/2022 MEDICINE GENEVA OH ACTIVE 7/4/2017 None N/A Q6049 KNAPP, ERIC FARQUIS, MD 9/15/2015 9/15/2020 FAMILY MEDICINE BRYAN TX ACTIVE 9/17/2015 None N/A COLON AND RECTAL Q9176 KNAPPS, JEAN ALEXANDER, MD 7/15/2016 7/15/2021 SURGERY GENERAL SURGERY HOUSTON TX ACTIVE 7/22/2016 None N/A Q4791 KNIGHT, CHERYL LOGSDON, MD 6/12/2015 6/12/2020 FAMILY PRACTICE HOUSTON TX ACTIVE 6/18/2015 None N/A R2644 KNOD, JENNIFER LESLIE, MD 4/20/2017 4/20/2022 PEDIATRIC SURGERY DALLAS TX ACTIVE 5/18/2017 None N/A LICENSE Q6640 KNOTT, EROL MARTIN JR, DO 12/4/2015 12/4/2020 PEDIATRIC SURGERY ISSUED 12/4/2015 None N/A Q6640 KNOTT, EROL MARTIN JR, DO 12/4/2015 12/4/2020 PEDIATRIC SURGERY FORT WORTH TX ACTIVE 2/29/2016 None N/A Q6640 KNOTT, EROL MARTIN JR, DO 12/4/2015 12/4/2020 PEDIATRIC SURGERY FORT WORTH TX ACTIVE 2/29/2016 None N/A PEDIATRIC EMERGENCY Q7222 KNOX, CHARLES G, MD 2/16/2016 2/16/2021 PEDIATRICS MEDICINE (PEDS) DALLAS TX ACTIVE 3/7/2016 None N/A DIAGNOSTIC Q8093 KNUDTSON, JOHN DAVID , MD 5/2/2016 5/2/2021 RADIOLOGY HOUSTON TX ACTIVE 5/4/2016 None N/A LICENSE Q8274 KOBRIN, JONATHAN ALLEN, MD 5/16/2016 5/16/2021 INTERNAL MEDICINE ISSUED 5/16/2016 None N/A CRITICAL CARE Q5457 KOCIK, JUREK FRANCISCO, MD 8/3/2015 8/3/2020 GENERAL SURGERY (SURGERY) TYLER TX ACTIVE 8/20/2015 None N/A CORPUS Q9656 KODAK, PAVLO, MD 8/15/2016 8/15/2021 HOSPITALIST CHRISTI TX ACTIVE 8/25/2016 None N/A GERIATRICS - Q9178 KODALI, LEENA RAO, MD 7/15/2016 7/15/2021 INTERNAL MEDICINE INTERNAL MEDICINE BRYAN TX ACTIVE 9/27/2016 None N/A R3546 KODATI, SHILPA M , MD 6/16/2017 6/16/2022 OPHTHALMOLOGY HOUSTON TX ACTIVE 6/21/2017 None N/A OBSTETRICS AND LICENSE S7080 KODEIH, HANNA RAE, DO 6/12/2020 6/12/2025 GYNECOLOGY ISSUED 6/12/2020 None N/A R0436 KODURU, SRILATHA, MD 10/14/2016 10/14/2021 INTERNAL MEDICINE ALEXANDIRA LA ACTIVE 10/26/2016 None N/A Q5681 KOEHLER, BRUCE ERIC II, MD 8/14/2015 8/14/2020 PEDIATRICS ACTIVE 8/18/2015 None N/A HAND SURGERY - ORTHOPEDIC ORTHOPEDIC R6218 KOEHLER, DANIEL, MD 3/2/2018 3/2/2023 SURGERY SURGERY DALLAS TX ACTIVE 3/12/2018 None N/A ADULT ORTHOPEDIC RECONSTRUCTIVE Q6953 KOENIG, KARL MARC, MD 1/15/2016 1/15/2021 SURGERY ORTHOPEDICS AUSTIN TX ACTIVE 1/20/2016 None N/A INTERNAL MED - R0047 KOENIG, SARA MITTASCH, MD 9/15/2016 9/15/2021 RADIOLOGY EMERGENCY MED SAN ANTONIO TX ACTIVE 9/26/2016 None N/A Page 150 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date S4512 KOERPER, KARL PHILIP, MD 12/20/2019 12/20/2024 ANESTHESIOLOGY ACTIVE 1/15/2020 None N/A EMERGENCY LICENSE Q6642 KOH, HEAJEOUNG ELIZABETH, MD 12/4/2015 12/4/2020 MEDICINE ISSUED 12/4/2015 None N/A EMERGENCY Q6642 KOH, HEAJEOUNG ELIZABETH, MD 12/4/2015 12/4/2020 MEDICINE SALEM OR ACTIVE 12/16/2015 None N/A EMERGENCY Q6642 KOH, HEAJEOUNG ELIZABETH, MD 12/4/2015 12/4/2020 MEDICINE SALEM OR ACTIVE 12/16/2015 None N/A SURGICAL CRITICAL S6871 KOHLER, CASEY , MD 5/29/2020 5/29/2025 TRAUMATIC SURGERY CARE DALLAS TX ACTIVE 6/1/2020 None N/A MUSCULOSKELETAL S7081 KOHLI, AJAY, MD 6/12/2020 6/12/2025 RADIOLOGY RADIOLOGY DALLAS TX ACTIVE 6/15/2020 None N/A R4418 KOKA, SAGARIKA, MD 8/25/2017 8/25/2022 INTERNAL MEDICINE HOUSTON TX ACTIVE 8/31/2017 None N/A R1567 KOKORICHA, TOBORE, MD 2/6/2017 2/6/2022 INTERNAL MEDICINE HOSPITALIST CLOVIS NM ACTIVE 3/2/2017 None N/A N7294 KOLI, ABHIJEET VIJAY, MD 1/5/2018 1/5/2023 CARDIOLOGY INTERNAL MEDICINE AIEA HI ACTIVE 1/19/2018 None N/A CHILD AND ADOLESCENT LICENSE R5757 KOLI, ROSHNI LANI, MD 1/19/2018 1/19/2023 PSYCHIATRY PSYCHIATRY ISSUED 1/19/2018 None N/A NEUROLOGICAL Q7067 KOLTZ, MICHAEL THOMAS, MD 2/1/2016 2/1/2021 SURGERY ROUND ROCK TX ACTIVE 2/10/2016 None N/A ADULT SPORTS MEDICINE - RECONSTRUCTIVE R4862 KOLWADKAR, YOGESH VINOD, MD 10/6/2017 10/6/2022 ORTHOPEDICS ORTHOPEDICS SPENCER IA ACTIVE 10/9/2017 None N/A

NEONATAL- LICENSE R6219 KONA, SASHI KUMAR, MD 3/2/2018 3/2/2023 PERINATAL MEDICINE PEDIATRICS ISSUED 3/2/2018 None N/A GERIATRIC MEDICINE (FAMILY S5681 KONDAMUDI, VASANTHA, MD 3/20/2020 3/20/2025 FAMILY MEDICINE PRACTICE) ACTIVE 4/13/2020 None N/A R1065 KONERU, SUSHMA, MD 12/16/2016 12/16/2021 CARDIOLOGY DES MOINES IA ACTIVE 12/19/2016 None N/A CARDIAC ELECTROPHYSIOLOG CARDIOVASCULAR S6872 KONG, MELISSA H, MD 5/29/2020 5/29/2025 Y DISEASES ACTIVE 6/5/2020 None N/A KONOPKA, GEOFFREY ORTHOPEDIC R3360 NEWCOMER, MD 6/2/2017 6/2/2022 SURGERY HAND SURGERY ACTIVE 6/7/2017 None N/A INTERVENTIONAL CARDIOVASCULAR Q6439 KOO, MICHAEL HOSUNG, MD 11/2/2015 11/2/2020 CARDIOLOGY DISEASES SUGAR LAND TX ACTIVE 11/24/2015 None N/A PHYSICAL MED. & Q5683 KOPP, FABIOLLA SIQUEIRA, MD 8/14/2015 8/14/2020 REHABILITATION HOUSTON TX ACTIVE 8/18/2015 None N/A PULMONARY R4262 KORAH, JOSEPH MANI, MD 8/15/2017 8/15/2022 MEDICINE INTERNAL MEDICINE ACTIVE 10/11/2017 None N/A

Page 151 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date CARDIAC ELECTROPHYSIOLOG R2145 KORANNE, KETAN PRAKASH, MD 3/20/2017 3/20/2022 Y CARDIOLOGY HOUSTON TX ACTIVE 4/3/2017 None N/A EMERGENCY R2901 KORNHAUSER, AARON, MD 5/5/2017 5/5/2022 MEDICINE KINGWOOD TX ACTIVE 5/16/2017 None N/A OPHTHALMOLOGY - Q9406 KORNMANN, HELEN LEE, MD 8/1/2016 8/1/2021 GLAUCOMA DALLAS TX ACTIVE 8/10/2016 None N/A KORRAPATI, VAMSI KIRAN R2384 CHOWDARY, MD 4/4/2017 4/4/2022 INTERNAL MEDICINE TYLER TX ACTIVE 4/25/2017 None N/A EMERGENCY R0048 KOSCIUK, MARTIN, MD 9/15/2016 9/15/2021 MEDICINE FAMILY MEDICINE LUFKIN TX ACTIVE 9/20/2016 None N/A S5682 KOSKEY, GLORIA , MD 3/20/2020 3/20/2025 PEDIATRICS DALLAS TX ACTIVE 3/27/2020 None N/A INTERNAL MED - R4077 KOSTURAKIS, DAVID, MD 8/1/2017 8/1/2022 EMERGENCY MED ACTIVE 8/4/2017 None N/A CRITICAL CARE S5957 KOSZEWSKI, AMANDA LYNN, DO 4/3/2020 4/3/2025 ANESTHESIOLOGY MEDICINE HOUSTON TX ACTIVE 4/16/2020 None N/A R2385 KOTAPATI, SESHA KRISHNA, MD 4/4/2017 4/4/2022 PSYCHIATRY MIDLAND TX ACTIVE 4/11/2017 None N/A LICENSE Q4792 KOTHANDARAMAN, SRILATHA, MD 6/12/2015 6/12/2020 INTERNAL MEDICINE RHEUMATOLOGY ISSUED 6/12/2015 None N/A R1400 KOTLA, SUMAN KRISHNA , MD 1/20/2017 1/20/2022 INTERNAL MEDICINE INTERNAL MEDICINE DALLAS TX ACTIVE 4/13/2017 None N/A Q7904 KOTRA, HARIKRISHNA, MD 4/15/2016 4/15/2021 INTERNAL MEDICINE SPRINGFIELD MA ACTIVE 4/19/2016 None N/A Q8932 KOTTEWAR, SAKET, MD 7/1/2016 7/1/2021 INTERNAL MEDICINE HOSPITALIST SAN ANTONIO TX ACTIVE 7/15/2016 None N/A EMERGENCY CRITICAL CARE R1232 KOUCH, MICHAEL, MD 1/6/2017 1/6/2022 MEDICINE MEDICINE ABILENE TX ACTIVE 1/18/2017 None N/A CARDIAC ELECTROPHYSIOLOG CARDIOVASCULAR Q7223 KOUL, ASHOK KUMAR, MD 2/16/2016 2/16/2021 Y DISEASES SAN ANGELO TX ACTIVE 2/17/2016 None N/A R1401 KOVACS, ADRIENN , DO 1/20/2017 1/20/2022 INTERNAL MEDICINE ACTIVE 2/13/2017 None N/A NEUROLOGY/DIAGN OSTIC KOVOOR, JERRY MATHEW ELIAS , RAD/NEURORADIOLO Q9657 MD 8/15/2016 8/15/2021 RADIOLOGY GY ACTIVE 11/11/2016 None N/A ORTHOPEDIC FOOT AND ANKLE, Q8275 KOZANEK, MICHAL, MD 5/16/2016 5/16/2021 SURGERY ORTHOPEDICS ACTIVE 5/23/2016 None N/A GEORGETOW S7082 KRAMER, AARON S, DO 6/12/2020 6/12/2025 PSYCHIATRY N TX ACTIVE 6/16/2020 None N/A ANATOMIC KRAUS, MADELEINE DE REDING, HEMATOLOGY PATHOLOGY & LAB LICENSE S6873 MD 5/29/2020 5/29/2025 (PATHOLOGY) MEDICINE ISSUED 5/29/2020 None N/A LICENSE Q5844 KRAUSE, ROBERT WILLIAM, MD 8/28/2015 8/28/2020 RADIOLOGY ISSUED 8/28/2015 None N/A Page 152 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date KRAUSE-CASTANEDA, JULIA R0050 SHAE, MD 9/15/2016 9/15/2021 FAMILY MEDICINE OBSTETRICS BRYAN TX ACTIVE 9/28/2016 None N/A ANESTHESIOLOGY - R4079 KRAZIT, STEPHEN TAYLOR, MD 8/1/2017 8/1/2022 PAIN MANAGEMENT ANESTHESIOLOGY ACTIVE 8/2/2017 None N/A PEDIATRIC ANESTHESIOLOGY R0051 KREIDEL, KERRY LYNNE, MD 9/15/2016 9/15/2021 ANESTHESIOLOGY (PEDS) SAN ANTONIO TX ACTIVE 11/22/2016 None N/A LICENSE Q7906 KREIN, STUART, MD 4/15/2016 4/15/2021 PSYCHIATRY ISSUED 4/15/2016 None N/A OTORHINOLARYNGOL R3124 KREITMAN, YAEL , MD 5/22/2017 5/22/2022 OGY TEMPLE TX ACTIVE 6/14/2017 None N/A OBSTETRICS & GYNECOLOGICAL GYNECOLOGIC R5885 KREMER, KEVIN, MD 2/2/2018 2/2/2023 SURGERY ONCOLOGY DALLAS TX ACTIVE 2/6/2018 None N/A KRESTA, ALEXANDER MICHAEL, EMERGENCY S6663 MD 5/15/2020 5/15/2025 MEDICINE EL PASO TX ACTIVE 5/18/2020 None N/A OBSTETRICS AND Q5686 KRIG, MARIE, MD 8/14/2015 8/14/2020 GYNECOLOGY CLINTON MD ACTIVE 8/28/2015 None N/A DIAGNOSTIC R5149 KRISHNAN, ARUN RADHA, MD 11/3/2017 11/3/2022 RADIOLOGY RADIOLOGY SACRAMENTO CA ACTIVE 11/22/2017 None N/A PREVENTIVE Q8933 KRISHNASWAMI, JANANI, MD 7/1/2016 7/1/2021 MEDICINE INTERNAL MEDICINE MCALLEN TX ACTIVE 8/8/2016 None N/A EMERGENCY Q6759 KROES, JEREMY SCOTT, MD 12/15/2015 12/15/2020 MEDICINE MIDLAND TX ACTIVE 12/17/2015 None N/A COLON AND RECTAL LICENSE Q5845 KRONFOL, ZIAD NABIL, MD 8/28/2015 8/28/2020 SURGERY GENERAL SURGERY ISSUED 8/28/2015 None N/A PEDIATRIC R0052 KROPP, BRADLEY PETER, MD 9/15/2016 9/15/2021 UROLOGY UROLOGY FORT WORTH TX ACTIVE 9/19/2016 None N/A KROW-RODNEY, ABENA R1803 APPEADUA, MD 2/22/2017 2/22/2022 FAMILY MEDICINE MUENSTER TX ACTIVE 3/8/2017 None N/A FAMILY PRACTICE - M1189 KRUCKNER, DOUGLAS LEE, MD 10/15/2015 10/15/2020 FAMILY MEDICINE EMERGENCY MED STAMFORD TX ACTIVE 10/29/2015 None N/A HAND SURGERY - ORTHOPEDIC Q5687 KRUSE, KEVIN KARL II, MD 8/14/2015 8/14/2020 ORTHOPEDICS SURGERY DALLAS TX ACTIVE 8/17/2015 None N/A R1804 KSHIRSAGAR, RAVI KUMAR, MD 2/22/2017 2/22/2022 INTERNAL MEDICINE HOSPITALIST 500033, INDIA ACTIVE 3/2/2017 None N/A BROWNSVILL R4080 KU, CHRISTINE W, DO 8/1/2017 8/1/2022 DERMATOLOGY E TX ACTIVE 8/3/2017 None N/A R0745 KUANG, AUDREY, MD 11/15/2016 11/15/2021 INTERNAL MEDICINE AUSTIN TX ACTIVE 12/22/2016 None N/A GYNECOLOGIC Q7907 KUECK, ANGELA, MD 4/15/2016 4/15/2021 ONCOLOGY AUSTIN TX ACTIVE 4/19/2016 None N/A Page 153 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date OBSTETRICS & GYNECOLOGICAL Q7729 KUECK, KATHLEEN DEAN, MD 4/1/2016 4/1/2021 SURGERY AUSTIN TX ACTIVE 4/5/2016 None N/A R0604 KUEHT, MICHAEL , MD 10/31/2016 10/31/2021 GENERAL SURGERY HOUSTON TX ACTIVE 11/8/2016 None N/A EMERGENCY S5683 KUHL, EVAN, MD 3/20/2020 3/20/2025 MEDICINE HOUSTON TX ACTIVE 3/27/2020 None N/A KUHLMANN-CAPEK, MAGGIE JO, MATERNAL AND R1402 MD 1/20/2017 1/20/2022 FETAL MEDICINE OBSTETRICS GALVESTON TX ACTIVE 2/2/2017 None N/A Q8277 KUHRT, MAUREEN PONS, MD 5/16/2016 5/16/2021 GENERAL SURGERY OTHER SPECIALTY EVANSVILLE IN ACTIVE 5/23/2016 None N/A ORTHOPEDIC ORTHOPEDIC SURGERY OF THE Q7908 KUKKAR, NITIN, MD 4/15/2016 4/15/2021 SURGERY SPINE QUINCY IL ACTIVE 4/18/2016 None N/A KUKREJA, JANET ELYSE BAACK, Q7909 MD 4/15/2016 4/15/2021 UROLOGIC SURGERY HOUSTON TX ACTIVE 4/20/2016 None N/A PEDIATRIC Q6760 KUKREJA, MARCIA KOMLOS, MD 12/15/2015 12/15/2020 RADIOLOGY NEURO-RADIOLOGY HOUSTON TX ACTIVE 1/11/2016 None N/A PEDIATRIC EMERGENCY R2645 KULKARNI, ABHAY KRISHNAJI, MD 4/20/2017 4/20/2022 MEDICINE (PEDS) HOUSTON TX ACTIVE 5/1/2017 None N/A OBSTETRICS AND Q6862 KULKARNI, ANUBHI , MD 1/6/2016 1/6/2021 GYNECOLOGY LUBBOCK TX ACTIVE 2/4/2016 None N/A EMERGENCY Q5010 KULP, KARI ANN, MD 7/1/2015 7/1/2020 MEDICINE AUSTIN TX ACTIVE 7/6/2015 None N/A EMERGENCY Q9407 KULSTAD, CHRISTINE E, MD 8/1/2016 8/1/2021 MEDICINE DALLAS TX ACTIVE 8/5/2016 None N/A EMERGENCY Q8934 KULSTAD, ERIK, MD 7/1/2016 7/1/2021 MEDICINE OAK LAWN IL ACTIVE 7/26/2016 None N/A R4580 KUMAR, AKSHITA , MD 9/8/2017 9/8/2022 GENERAL SURGERY HOUSTON TX ACTIVE 9/11/2017 None N/A R5585 KUMAR, ANEEL, MD 1/5/2018 1/5/2023 INTERNAL MEDICINE ACTIVE 1/10/2018 None N/A R4994 KUMAR, BALVINDER, MD 10/20/2017 10/20/2022 INTERNAL MEDICINE OXFORD NC ACTIVE 12/25/2017 None N/A R0893 KUMAR, BOBBIE VINILA, MD 12/2/2016 12/2/2021 FAMILY MEDICINE SHORELINE WA ACTIVE 12/12/2016 None N/A Q6052 KUMAR, DAVID VIJAY, MD 9/15/2015 9/15/2020 INTERNAL MEDICINE NEWMARKET ACTIVE 11/9/2015 None N/A Q5846 KUMAR, DEEPAK, MD 8/28/2015 8/28/2020 PSYCHIATRY COALINGA CA ACTIVE 9/1/2015 None N/A HEMATOLOGY/ONCO R3702 KUMAR, MONIKA, MD 6/30/2017 6/30/2022 INTERNAL MEDICINE LOGY DALLAS TX ACTIVE 7/17/2017 None N/A LICENSE TM00885 KUMAR, PRASANNA G, MD 6/12/2020 6/12/2025 RADIOLOGY MAMMOGRAPHY ISSUED 6/12/2020 None N/A INTERVENTIONAL LICENSE Q5011 KUMAR, SACHIN, MD 7/1/2015 7/1/2020 CARDIOLOGY CARDIOLOGY ISSUED 7/1/2015 None N/A

Page 154 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date GERIATRIC MEDICINE (INTERNAL R1066 KUMAR, SAMUDYATHA ANUP, MD 12/16/2016 12/16/2021 INTERNAL MEDICINE MED) BEAVERTON OR ACTIVE 3/7/2017 None N/A

S5411 KUMAR, VINEETH NARAYANA, MD 3/6/2020 3/6/2025 FAMILY MEDICINE ACTIVE 3/24/2020 None N/A GASTROENTEROLOG Q7571 KUMARAVEL, VEENA, MD 3/15/2016 3/15/2021 Y RICHARDSON TX ACTIVE 4/11/2016 None N/A INTERVENTIONAL R4081 KUMFA, PAUL N, MD 8/1/2017 8/1/2022 CARDIOLOGY GALVESTON TX ACTIVE 9/13/2017 None N/A RADIATION R6221 KUN, LARRY E, MD 3/2/2018 3/2/2023 ONCOLOGY DALLAS TX ACTIVE 3/14/2018 None N/A PHYSICAL MED. & LICENSE S7083 KUPPERMAN, WYATT, DO 6/12/2020 6/12/2025 REHABILITATION SPINE MEDICINE ISSUED 6/12/2020 None N/A PLASTIC & RECONSTRUCTIVE Q8935 KURAPATI, SRIKANTH, MD 7/1/2016 7/1/2021 SURGERY GENERAL SURGERY BIRMINGHAM AL ACTIVE 7/6/2016 None N/A TRAUMATIC R0439 KUREK, STANLEY JR, DO 10/14/2016 10/14/2021 GENERAL SURGERY SURGERY TEMPLE TX ACTIVE 11/10/2016 None N/A Q8936 KURIAN, JOSEPH KALATHIL, MD 7/1/2016 7/1/2021 ANESTHESIOLOGY TYLER TX ACTIVE 7/4/2016 None N/A CARDIAC KURIAN, THOMAS KANJAPALLIL, ELECTROPHYSIOLOG R0440 MD 10/14/2016 10/14/2021 Y CARDIOLOGY AUSTIN TX ACTIVE 12/13/2016 None N/A S6430 KURTH, CHRISTIAN DANIEL, DO 5/1/2020 5/1/2025 ANESTHESIOLOGY IRVING TX ACTIVE 5/13/2020 None N/A SPORTS MEDICINE URGENT CARE Q6440 KURUP, SUNIL , MD 11/2/2015 11/2/2020 (FAMILY PRACTICE) MEDICINE GRAPEVINE TX ACTIVE 11/4/2015 None N/A PEDIATRIC ORTHOPEDIC Q7407 KUSHARE, INDRANIL, MD 3/4/2016 3/4/2021 ORTHOPEDICS SURGERY HOUSTON TX ACTIVE 3/30/2016 None N/A R6222 KWAK, MIN JI , MD 3/2/2018 3/2/2023 INTERNAL MEDICINE HOUSTON TX ACTIVE 3/13/2018 None N/A DERMATOLOGIC R2646 KWAK, YOUNG JIN, MD 4/20/2017 4/20/2022 DERMATOLOGY SURGERY HOUSTON TX ACTIVE 5/16/2017 None N/A CARDIOVASCULAR R6223 KWON, CHRISTOPHER C, MD 3/2/2018 3/2/2023 SURGERY BALTIMORE MD ACTIVE 3/9/2018 None N/A ADDICTION Q7732 KWON, JOE YOSUP, MD 4/1/2016 4/1/2021 PSYCHIATRY PSYCHIATRY DALLAS TX ACTIVE 4/11/2016 None N/A KYATHANAHALLI PUTTALINGAPPA, Q5014 LOKESH, MD 7/1/2015 7/1/2020 FAMILY MEDICINE ACTIVE 8/18/2015 None N/A EMERGENCY Q9660 KYRELLOS, MICHAEL, MD 8/15/2016 8/15/2021 FAMILY MEDICINE MEDICINE LONGVIEW TX ACTIVE 9/2/2016 None N/A R4419 LA ROCCA, JULIETA GARCIA, MD 8/25/2017 8/25/2022 FAMILY MEDICINE ACTIVE 8/28/2017 None N/A VASCULAR R3126 LAALI, SAM JAMSHID, MD 5/22/2017 5/22/2022 NEUROLOGY NEUROLOGY GRAPEVINE TX ACTIVE 5/25/2017 None N/A Page 155 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PEDIATRIC R3703 LABINER, KATHERINE STACY , MD 6/30/2017 6/30/2022 CHILD NEUROLOGY NEUROLOGY DALLAS TX ACTIVE 7/26/2017 None N/A PEDIATRIC HEMATOLOGY/ONCOL N2613 LABORDE, CARRIE ELIZABETH, MD 12/6/2019 12/6/2024 OGY TEMPLE TX ACTIVE 12/10/2019 None N/A PEDIATRIC HEMATOLOGY/ONCOL N2613 LABORDE, CARRIE ELIZABETH, MD 12/6/2019 12/6/2024 OGY TEMPLE TX ACTIVE 12/10/2019 None N/A COLLEGE Q7572 LACEFIELD, EVAN, MD 3/15/2016 3/15/2021 UROLOGY UROLOGIC SURGERY STATION TX ACTIVE 3/17/2016 None N/A LACHOWIEZ, CURTIS ANDREW, HEMATOLOGY/ONCOL S5208 MD 2/21/2020 2/21/2025 OGY HOUSTON TX ACTIVE 3/4/2020 None N/A PALLIATIVE Q8278 LACOSS, JENNIFER JOY, MD 5/16/2016 5/16/2021 INTERNAL MEDICINE MEDICINE SAN ANTONIO TX ACTIVE 5/25/2016 None N/A DELINQUEN EMERGENCY T-NON Q6956 LAFREE, ANDREW THOMAS, MD 1/15/2016 1/15/2021 MEDICINE PAYMENT 4/14/2016 None N/A ORTHOPEDIC PEDIATRIC SURGERY OF THE R5421 LAGO, MICHAEL TIMOTHY, MD 12/8/2017 12/8/2022 ORTHOPEDICS SPINE EDINBURG TX ACTIVE 12/13/2017 None N/A R2902 LAHIRI, SUBHRAJIT, MD 5/5/2017 5/5/2022 PEDIATRICS UNSPECIFIED HOUSTON TX ACTIVE 5/10/2017 None N/A LICENSE Q6644 LAHOURCADE, JOHN AUSTIN, MD 12/4/2015 12/4/2020 GENERAL SURGERY ISSUED 12/4/2015 None N/A

Q6644 LAHOURCADE, JOHN AUSTIN, MD 12/4/2015 12/4/2020 GENERAL SURGERY SAN ANTONIO TX ACTIVE 12/10/2015 None N/A

Q6644 LAHOURCADE, JOHN AUSTIN, MD 12/4/2015 12/4/2020 GENERAL SURGERY SAN ANTONIO TX ACTIVE 12/10/2015 None N/A CRITICAL CARE R3127 LAHSAEI, PEIMAN, MD 5/22/2017 5/22/2022 ANESTHESIOLOGY ANESTHESIOLOGY DALLAS TX ACTIVE 5/24/2017 None N/A EMERGENCY CORAL Q9408 LAI, GARY, DO 8/1/2016 8/1/2021 MEDICINE SPRINGS FL ACTIVE 9/21/2016 None N/A PULMONARY CRITICAL CARE S5961 LAI, KATHRYN , MD 4/3/2020 4/3/2025 MEDICINE INTERNAL MEDICINE HOUSTON TX ACTIVE 4/7/2020 None N/A RADIATION Q5015 LAINE, AARON MICHAEL, MD 7/1/2015 7/1/2020 ONCOLOGY DALLAS TX ACTIVE 7/3/2015 None N/A EMERGENCY R4582 LAITINEN, BRADLEY, MD 9/8/2017 9/8/2022 MEDICINE ACTIVE 9/18/2017 None N/A R1233 LAKHANI, ADNAN, MD 1/6/2017 1/6/2022 INTERNAL MEDICINE HOSPITALIST ANGLETON TX ACTIVE 1/11/2017 None N/A DIAGNOSTIC S6431 LALAJI, ANAND PANKAJ, MD 5/1/2020 5/1/2025 RADIOLOGY ATLANTA GA ACTIVE 5/14/2020 None N/A Page 156 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date Q8095 LALANI, TANIA, MD 5/2/2016 5/2/2021 INTERNAL MEDICINE PANAMA CITY FL ACTIVE 5/13/2016 None N/A DELINQUEN T-NON R5153 LALEZARI, SEPEHR, MD 11/3/2017 11/3/2022 GENERAL SURGERY PAYMENT 2/1/2018 None N/A FOOT AND ANKLE, ORTHOPEDIC Q9661 LALLI, TRAPPER, MD 8/15/2016 8/15/2021 ORTHOPEDICS SURGERY DALLAS TX ACTIVE 8/18/2016 None N/A R3547 LAM, AIMEE NGUYEN, MD 6/16/2017 6/16/2022 OPHTHALMOLOGY SAN ANTONIO TX ACTIVE 6/29/2017 None N/A R2903 LAM, HAMILTON VO, MD 5/5/2017 5/5/2022 HOSPITALIST INTERNAL MEDICINE ATLANTA GA ACTIVE 7/12/2017 None N/A S6665 LAM, KHOA VU DANG, MD 5/15/2020 5/15/2025 RADIOLOGY NEURO-RADIOLOGY DALLAS TX ACTIVE 5/21/2020 None N/A Q9180 LAM, MAI TRUC, MD 7/15/2016 7/15/2021 FAMILY MEDICINE WACO TX ACTIVE 8/1/2016 None N/A OBSTETRICS AND Q5016 LAM, VIEN CAM, MD 7/1/2015 7/1/2020 GYNECOLOGY ANGLETON TX ACTIVE 7/3/2015 None N/A Q9410 LAM, VINCENT K, MD 8/1/2016 8/1/2021 ONCOLOGY HOUSTON TX ACTIVE 9/2/2016 None N/A LAMARTINE, NORA ELIZABETH , CORPUS R5761 MD 1/19/2018 1/19/2023 FAMILY MEDICINE OBSTETRICS CHRISTI TX ACTIVE 1/22/2018 None N/A INFECTIOUS Q8538 LAMB, GABRIELLA SOPHIA, MD 6/1/2016 6/1/2021 PEDIATRICS DISEASES HOUSTON TX ACTIVE 6/3/2016 None N/A THORACIC CARDIOVASCULAR R4082 LAMELAS, JOSEPH, MD 8/1/2017 8/1/2022 SURGERY THORACIC SURGERY HOUSTON TX ACTIVE 8/3/2017 None N/A S6229 LANDAU, BARCLEIGH PAIGE, MD 4/17/2020 4/17/2025 OTOLARYNGOLOGY SAN ANGELO TX ACTIVE 6/11/2020 None N/A Q9181 LANDERO, MARIA EDNA, MD 7/15/2016 7/15/2021 FAMILY MEDICINE GRANBURY TX ACTIVE 7/18/2016 None N/A PEDIATRIC HEMATOLOGY/ONCOL LICENSE Q8736 LANDI, DANIEL BRYCE, MD 6/10/2016 6/10/2021 OGY ISSUED 6/10/2016 None N/A LANDRY, DANA MARIE CHANEY, EMERGENCY Q7068 MD 2/1/2016 2/1/2021 MEDICINE ACTIVE 2/8/2016 None N/A R3364 LANDRY, JESSICA BOAT, MD 6/2/2017 6/2/2022 PEDIATRICS DALLAS TX ACTIVE 6/19/2017 None N/A EMERGENCY Q5847 LANE, NATHANIEL GRAHAM, MD 8/28/2015 8/28/2020 MEDICINE FORT WORTH TX ACTIVE 9/4/2015 None N/A LICENSE Q6530 LANERIE, JESSICA ANN, MD 11/16/2015 11/16/2020 PEDIATRICS ISSUED 11/16/2015 None N/A PEDIATRIC EMERGENCY LICENSE S6668 LANG, BENJAMIN ANDREW, MD 5/15/2020 5/15/2025 MEDICINE (PEDS) ISSUED 5/15/2020 None N/A S4802 LANG, BENJAMIN JOSEPH, MD 1/24/2020 1/24/2025 PATHOLOGY DALLAS TX ACTIVE 1/28/2020 None N/A

Q6057 LANGMADE, LAURA LAWSON, MD 9/15/2015 9/15/2020 ANESTHESIOLOGY ACTIVE 12/7/2015 None N/A OBSTETRICS AND S5962 LANGSJOEN, LAUREN ALENA, MD 4/3/2020 4/3/2025 GYNECOLOGY HOUSTON TX ACTIVE 4/9/2020 None N/A

Page 157 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PHYSICAL MED. & SPINAL CORD G8233 LANIG, INDIRA S, MD 2/22/2017 2/22/2022 REHABILITATION INJURY MEDICINE JOHNSTON CO ACTIVE 3/20/2017 None N/A R4420 LANZA DI SCALEA, TERESA, MD 8/25/2017 8/25/2022 PSYCHIATRY AUSTIN TX ACTIVE 9/1/2017 None N/A EMERGENCY Q6865 LANZILLO, CHARLES F III, MD 1/6/2016 1/6/2021 MEDICINE VICTORIA TX ACTIVE 3/23/2016 None N/A MATERNAL AND Q8939 LAORDEN, JESSICA LYN, MD 7/1/2016 7/1/2021 FAMILY MEDICINE FETAL MEDICINE FORT WORTH TX ACTIVE 7/11/2016 None N/A LABORATORY Q8737 LAPOSATA, MICHAEL , MD 6/10/2016 6/10/2021 PATHOLOGY MEDICINE GALVESTON TX ACTIVE 6/21/2016 None N/A CRITICAL CARE Q8096 LAPSIA, MUNISH HARISH, MD 5/2/2016 5/2/2021 INTERNAL MEDICINE MEDICINE (IM) ACTIVE 5/10/2016 None N/A EMERGENCY R0606 LARA, MICHAEL, MD 10/31/2016 10/31/2021 MEDICINE ACTIVE 1/22/2018 None N/A OBSTETRICS AND Q6223 LARAWAY, JOHN DAVID, MD 10/1/2015 10/1/2020 GYNECOLOGY BRENHAM TX ACTIVE 10/6/2015 None N/A Q5208 LARGE, RANDY SIMPSON, DO 7/15/2015 7/15/2020 ANESTHESIOLOGY FAMILY MEDICINE SCOTTSDALE AZ ACTIVE 7/29/2015 None N/A CHILD AND ADOLESCENT Q9411 LARKINS, DAMIEN MICHAEL, MD 8/1/2016 8/1/2021 PSYCHIATRY PSYCHIATRY HOUSTON TX ACTIVE 8/3/2016 None N/A Q9412 LAROCHE, CYNTHIA, MD 8/1/2016 8/1/2021 PEDIATRICS PASADENA TX ACTIVE 8/3/2016 None N/A OBSTETRICS AND Q5209 LARRAZALETA, MARIA ELENA, MD 7/15/2015 7/15/2020 GYNECOLOGY EL PASO TX ACTIVE 7/27/2015 None N/A LARSON, CHRISTOPHER DAVID CARDIOTHORACIC Q7573 DAVIS, DO 3/15/2016 3/15/2021 ANESTHESIOLOGY ANESTHESIOLOGY TEMPLE TX ACTIVE 3/21/2016 None N/A R0442 LARSON, NICHOLAS, MD 10/14/2016 10/14/2021 UNSPECIFIED ACTIVE 10/19/2016 None N/A EMERGENCY S7085 LARY, SARA, DO 6/12/2020 6/12/2025 MEDICINE EL PASO TX ACTIVE 6/16/2020 None N/A LASHER, STEPHEN ANDREW JR, PALLIATIVE Q6866 MD 1/6/2016 1/6/2021 INTERNAL MEDICINE MEDICINE HOUSTON TX ACTIVE 3/22/2016 None N/A

Q8940 LASTOVICA, BRYNN LENANN, MD 7/1/2016 7/1/2021 FAMILY MEDICINE ACTIVE 7/6/2016 None N/A R2388 LAT, TASNIM , DO 4/4/2017 4/4/2022 INTERNAL MEDICINE TEMPLE TX ACTIVE 4/12/2017 None N/A EMERGENCY FORT R0269 LATHER, ROBERT KEITH, MD 9/30/2016 9/30/2021 MEDICINE BELVOIR VA ACTIVE 10/3/2016 None N/A R3128 LATIF, RAFAY, MD 5/22/2017 5/22/2022 HOSPITALIST INTERNAL MEDICINE NEW YORK NY ACTIVE 5/30/2017 None N/A INFECTIOUS Q5210 LAU, ABBY, MD 7/15/2015 7/15/2020 DISEASES INTERNAL MEDICINE DALLAS TX ACTIVE 7/23/2015 None N/A

S4517 LAURITSEN, JONATHAN MARK, DO 12/20/2019 12/20/2024 NEUROLOGY DALLAS TX ACTIVE 2/7/2020 None N/A

J7550 LAVERGNE, BLAINE EDWARD, MD 11/3/2017 11/3/2022 FAMILY PRACTICE LAFAYETTE LA ACTIVE 11/21/2017 None N/A Page 158 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date ANATOMIC S6875 LAVEZO, JONATHAN LYNN, MD 5/29/2020 5/29/2025 PATHOLOGY NEURO-PATHOLOGY EL PASO TX ACTIVE 6/3/2020 None N/A UROLOGIC S6669 LAVIANA, AARON ALAN, MD 5/15/2020 5/15/2025 UROLOGIC SURGERY ONCOLOGY AUSTIN TX ACTIVE 5/18/2020 None N/A R0054 LAVOY, ERIC JEFFREY, MD 9/15/2016 9/15/2021 FAMILY MEDICINE TYLER TX ACTIVE 9/23/2016 None N/A PLASTIC & RECONSTRUCTIVE Q6763 LAW, HUAY-ZONG , MD 12/15/2015 12/15/2020 SURGERY DALLAS TX ACTIVE 12/17/2015 None N/A LICENSE Q5849 LAWAL, NURUDEEN AKANBI, MD 8/28/2015 8/28/2020 INTERNAL MEDICINE ISSUED 8/28/2015 None N/A PULMONARY CRITICAL CARE R3899 LAWAL, OLUFEMI AYOOLA, MD 7/17/2017 7/17/2022 INTERNAL MEDICINE MEDICINE ABERDEEN SD ACTIVE 7/26/2017 None N/A EMERGENCY S5414 LAWAL, OLUFOLAHAN, MD 3/6/2020 3/6/2025 MEDICINE KATY TX ACTIVE 3/23/2020 None N/A CARDIOVASCULAR S4803 LAWLESS, SEAN MICHAEL, MD 1/24/2020 1/24/2025 INTERNAL MEDICINE DISEASES HOUSTON TX ACTIVE 2/19/2020 None N/A OBSTETRICS AND R4584 LAWSON, ASHLI ALYSSA, MD 9/8/2017 9/8/2022 GYNECOLOGY DALLAS TX ACTIVE 9/18/2017 None N/A LAWSON, WILLIAM BRADFORD, ADDICTION Q9183 MD 7/15/2016 7/15/2021 PSYCHIATRY PSYCHIATRY AUSTIN TX ACTIVE 7/28/2016 None N/A R3367 LAYBA, CATHLINE JO, MD 6/2/2017 6/2/2022 GENERAL SURGERY GALVESTON TX ACTIVE 6/9/2017 None N/A

Q7912 LAYMAN, RACHEL MICHELLE, MD 4/15/2016 4/15/2021 ONCOLOGY INTERNAL MEDICINE ACTIVE 5/30/2016 None N/A R2151 LAZAR, LAUREN KYLIE, MD 3/20/2017 3/20/2022 PEDIATRICS DALLAS TX ACTIVE 4/3/2017 None N/A LAZZARESCHI, GERALD VASCO, EMERGENCY R1569 MD 2/6/2017 2/6/2022 MEDICINE UKIAH CA ACTIVE 2/7/2017 None N/A S5211 LE, CAROL KIM, DO 2/21/2020 2/21/2025 GENERAL SURGERY ACTIVE 5/29/2020 None N/A LICENSE Q5465 LE, LINDA , MD 8/3/2015 8/3/2020 VASCULAR SURGERY GENERAL SURGERY HOUSTON TX ISSUED 8/3/2015 None N/A Q5017 LE, MY DUYEN, MD 7/1/2015 7/1/2020 INTERNAL MEDICINE ACTIVE 7/8/2015 None N/A

R5155 LE, TERRY NGOC, MD 11/3/2017 11/3/2022 NEPHROLOGY INTERNAL MEDICINE SHREVEPORT LA ACTIVE 2/13/2018 None N/A HANSCOM Q7408 LE, THANH-THAO T, MD 3/4/2016 3/4/2021 FAMILY MEDICINE AFB MA ACTIVE 3/14/2016 None N/A R1069 LE, TRI CAO, MD 12/16/2016 12/16/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 12/20/2016 None N/A DIAGNOSTIC R4084 LE, VIET THIEN, MD 8/1/2017 8/1/2022 RADIOLOGY HOUSTON TX ACTIVE 9/1/2017 None N/A R3900 LE, XIUNING , MD 7/17/2017 7/17/2022 ONCOLOGY INTERNAL MEDICINE HOUSTON TX ACTIVE 8/18/2017 None N/A LEACH, CHRISTOPHER MARKS, FAMILY PRACTICE - R4998 MD 10/20/2017 10/20/2022 FAMILY MEDICINE EMERGENCY MED LUBBOCK TX ACTIVE 10/24/2017 None N/A Page 159 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date R1810 LEACH, ROBERT JAMES, MD 2/22/2017 2/22/2022 NEPHROLOGY INTERNAL MEDICINE TEXARKANA TX ACTIVE 3/1/2017 None N/A MOVEMENT S6877 LEAL BAILEY, HUMBERTO , MD 5/29/2020 5/29/2025 NEUROLOGY DISORDERS HOUSTON TX ACTIVE 6/1/2020 None N/A S4332 LEAMON, CASEY ALLEN, MD 12/6/2019 12/6/2024 FAMILY MEDICINE WACO TX ACTIVE 1/27/2020 None N/A S4332 LEAMON, CASEY ALLEN, MD 12/6/2019 12/6/2024 FAMILY MEDICINE WACO TX ACTIVE 1/27/2020 None N/A EMERGENCY R1811 LEBAS, PHILLIP LUKE, MD 2/22/2017 2/22/2022 MEDICINE ROCKPORT TX ACTIVE 3/3/2017 None N/A R6035 LEBOEUF, BRITNI CENE, MD 2/16/2018 2/16/2023 PEDIATRICS AUSTIN TX ACTIVE 2/19/2018 None N/A

Q7224 LEDESMA, RUDRICK VILLOSO, MD 2/16/2016 2/16/2021 INTERNAL MEDICINE NEPHROLOGY VALHALLA NY ACTIVE 3/7/2016 None N/A LEDEZMA ALVAREZ, JOSE LUIS, R1405 MD 1/20/2017 1/20/2022 FAMILY PRACTICE ACTIVE 3/8/2017 None N/A LICENSE Q6531 LEDFORD, JAMIE R, MD 11/16/2015 11/16/2020 RADIOLOGY ISSUED 11/16/2015 None N/A R2653 LEE, ALICE MORAN, MD 4/20/2017 4/20/2022 PEDIATRICS HOUSTON TX ACTIVE 4/24/2017 None N/A PEDIATRIC CRITICAL Q7913 LEE, AMY ELIZABETH, MD 4/15/2016 4/15/2021 CARE MEDICINE DALLAS TX ACTIVE 4/29/2016 None N/A CARDIOVASCULAR Q8098 LEE, ANDY YEN-TANG, MD 5/2/2016 5/2/2021 DISEASES INTERNAL MEDICINE DALLAS TX ACTIVE 5/3/2016 None N/A R6224 LEE, BENJAMIN JIAWEI, MD 3/2/2018 3/2/2023 NEPHROLOGY INTERNAL MEDICINE HOUSTON TX ACTIVE 3/5/2018 None N/A Q6224 LEE, CHIAO, MD 10/1/2015 10/1/2020 PSYCHIATRY PSYCHIATRY FORT WORTH TX ACTIVE 10/12/2015 None N/A Q8541 LEE, CHRISTOPHER , MD 6/1/2016 6/1/2021 OPHTHALMOLOGY DALLAS TX ACTIVE 6/13/2016 None N/A THORACIC CARDIOVASCULAR Q6765 LEE, DANIEL C, MD 12/15/2015 12/15/2020 SURGERY GENERAL SURGERY TEMPLE TX ACTIVE 1/6/2016 None N/A Q5688 LEE, DAVID , MD 8/14/2015 8/14/2020 INTERNAL MEDICINE PLANO TX ACTIVE 8/17/2015 None N/A Q7574 LEE, DAVID WEE, DO 3/15/2016 3/15/2021 FAMILY MEDICINE FAMILY PRACTICE TALIHINA OK ACTIVE 3/31/2016 None N/A OBSTETRICS AND Q7226 LEE, EUNICE, MD 2/16/2016 2/16/2021 GYNECOLOGY ALLENTOWN PA ACTIVE 4/7/2016 None N/A LICENSE Q4796 LEE, HELEN HEEYOUNG, MD 6/12/2015 6/12/2020 ANESTHESIOLOGY ISSUED 6/12/2015 None N/A S5965 LEE, ISAAC LEONGKIT, MD 4/3/2020 4/3/2025 GENERAL SURGERY ACTIVE 4/7/2020 None N/A R1812 LEE, JAMES , MD 2/22/2017 2/22/2022 OPHTHALMOLOGY LUBBOCK TX ACTIVE 3/28/2017 None N/A SURGICAL BREAST R2152 LEE, JOANNA SONG, MD 3/20/2017 3/20/2022 ONCOLOGY GENERAL SURGERY HOUSTON TX ACTIVE 3/27/2017 None N/A ADMINISTRATIVE R3548 LEE, KENYATTA YORUBA, MD 6/16/2017 6/16/2022 FAMILY MEDICINE MEDICINE SAN ANTONIO TX ACTIVE 9/5/2017 None N/A EMERGENCY Q7575 LEE, KIE YUNG, MD 3/15/2016 3/15/2021 MEDICINE ARLINGTON TX ACTIVE 4/1/2016 None N/A PEDIATRIC INTENSIVE PEDIATRIC R5589 LEE, LUIS PABLO, MD 1/5/2018 1/5/2023 CARE INTENSIVE CARE HARLINGEN TX ACTIVE 1/12/2018 None N/A Page 160 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date ENDOCRINOLOGY, DIABETES AND Q7576 LEE, MARIA NIEN-FENG, MD 3/15/2016 3/15/2021 METABOLISM ACTIVE 4/14/2016 None N/A PEDIATRICS, ALLERGY & ALLERGY AND Q8941 LEE, MIN JUNG, MD 7/1/2016 7/1/2021 IMMUNOLOGY IMMUNOLOGY DALLAS TX ACTIVE 7/11/2016 None N/A EMERGENCY R5886 LEE, PHOEBE, MD 2/2/2018 2/2/2023 MEDICINE BELLAIRE TX ACTIVE 2/6/2018 None N/A R6225 LEE, SAMUEL , MD 3/2/2018 3/2/2023 ANESTHESIOLOGY HOUSTON TX ACTIVE 3/13/2018 None N/A EMERGENCY R5282 LEE, SAMUEL SIWON, MD 11/17/2017 11/17/2022 MEDICINE DALLAS TX ACTIVE 11/23/2017 None N/A DRIPPING R4733 LEE, SHELLY , MD 9/22/2017 9/22/2022 OPHTHALMOLOGY SPRINGS TX ACTIVE 10/10/2017 None N/A SPORTS MEDICINE - NEUROMUSCULOSK PHYSICAL MEDICINE & ELETAL Q9184 LEE, YEIN, DO 7/15/2016 7/15/2021 REHABILITATION MEDICINE/OMT FORT WORTH TX ACTIVE 7/18/2016 None N/A Q9414 LEE, YVONNE, MD 8/1/2016 8/1/2021 OTOLARYNGOLOGY BEDFORD TX ACTIVE 8/11/2016 None N/A PHYSICAL MED. & R3129 LEEK, DUSTIN RYAN, MD 5/22/2017 5/22/2022 REHABILITATION DALLAS TX ACTIVE 5/30/2017 None N/A LEE-OSTERMAYER, KATHY OBSTETRICS AND LICENSE Q8739 KAISEE, MD 6/10/2016 6/10/2021 GYNECOLOGY ISSUED 6/10/2016 None N/A

R2905 LEFEVRE, NICHOLAS MICHAEL, MD 5/5/2017 5/5/2022 FAMILY MEDICINE FORT WORTH TX ACTIVE 6/8/2017 None N/A R2906 LEFEVRE, WHITNEY BECK, MD 5/5/2017 5/5/2022 FAMILY MEDICINE FORT WORTH TX ACTIVE 6/8/2017 None N/A S6670 LEGHA, SAPNA, MD 5/15/2020 5/15/2025 INTERNAL MEDICINE CARDIOLOGY DALLAS TX ACTIVE 5/21/2020 None N/A R1406 LEHMAN, TRAVIS EDWARD, DO 1/20/2017 1/20/2022 INTERNAL MEDICINE VERNON TX ACTIVE 1/23/2017 None N/A PFLUGERVILL R4999 LEICHT, KATHERINE M, DO 10/20/2017 10/20/2022 FAMILY MEDICINE E TX ACTIVE 1/5/2018 None N/A ANATOMIC/CLINICAL DERMATOPATHOLO Q6059 LELEUX, TODD M, MD 9/15/2015 9/15/2020 PATHOLOGY GY CROWLEY LA ACTIVE 9/22/2015 None N/A

R1071 LEMASTER, AUSTIN THOMAS, MD 12/16/2016 12/16/2021 INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 12/21/2016 None N/A LEMERANDE, ALAN ROBERT JR, R0607 MD 10/31/2016 10/31/2021 FAMILY MEDICINE MALVERN PA ACTIVE 1/20/2017 None N/A

PEDIATRIC S4335 LEMON, KATHERINE PAIGE, MD 12/6/2019 12/6/2024 INFECTIOUS DISEASE PEDIATRICS HOUSTON TX ACTIVE 12/10/2019 None N/A

PEDIATRIC S4335 LEMON, KATHERINE PAIGE, MD 12/6/2019 12/6/2024 INFECTIOUS DISEASE PEDIATRICS HOUSTON TX ACTIVE 12/10/2019 None N/A R0445 LENG, BING , MD 10/14/2016 10/14/2021 PATHOLOGY TEMPLE TX ACTIVE 10/25/2016 None N/A Page 161 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date

OPHTHALMOLOGY - LICENSE TM00608 LENG, THEODORE, MD 7/15/2015 7/15/2020 OPHTHALMOLOGY VITREOUS SURGERY ISSUED 7/15/2015 None N/A OBSTETRICS AND R0271 LENHART, MEGAN , MD 9/30/2016 9/30/2021 GYNECOLOGY SAN ANTONIO TX ACTIVE 10/4/2016 None N/A

OPHTHALMOLOGY - R3368 LEON ALVARADO, LUIS G, MD 6/2/2017 6/2/2022 OPHTHALMOLOGY VITREOUS SURGERY SAN ANGELO TX ACTIVE 6/5/2017 None N/A Q8283 LEON, PHILLIP JOSEPH, MD 5/16/2016 5/16/2021 PSYCHIATRY KILLEEN TX ACTIVE 6/3/2016 None N/A EMERGENCY R3706 LEONARD, JOHN HENRY, MD 6/30/2017 6/30/2022 MEDICINE ACTIVE 7/11/2017 None N/A EMERGENCY R5590 LEONARD, THOMAS KELLER, MD 1/5/2018 1/5/2023 MEDICINE GAINESVILLE FL ACTIVE 1/18/2018 None N/A LEONE, CHRISTOPHER AUSTIN, R5423 MD 12/8/2017 12/8/2022 HOSPITALIST PLANP TX ACTIVE 12/15/2017 None N/A LEONG, AMELIA WIKE FREEMAN, LICENSE Q6532 MD 11/16/2015 11/16/2020 INTERNAL MEDICINE ISSUED 11/16/2015 None N/A R4087 LEONHARDT, LORI ROSE, MD 8/1/2017 8/1/2022 FAMILY MEDICINE KEY WEST FL ACTIVE 10/24/2017 None N/A R3369 LERMAN, MARSHALL JASON, MD 6/2/2017 6/2/2022 PEDIATRICS HOUSTON TX ACTIVE 6/13/2017 None N/A EMERGENCY PLATTSBURG Q6868 LESAGE, FRANCOIS DANIEL, MD 1/6/2016 1/6/2021 MEDICINE FAMILY MEDICINE H NY ACTIVE 1/25/2016 None N/A

Q8284 LESTER, SHAYLA, MD 5/16/2016 5/16/2021 INTERNAL MED - PEDS ACTIVE 6/7/2016 None N/A R1234 LEUNG, CERENA KEI YAN, MD 1/6/2017 1/6/2022 INTERNAL MEDICINE HOUSTON TX ACTIVE 1/12/2017 None N/A OPHTHALMOLOGY - Q9415 LEUNG, ELLA, MD 8/1/2016 8/1/2021 VITREOUS SURGERY OPHTHALMOLOGY HOUSTON TX ACTIVE 8/10/2016 None N/A DIAGNOSTIC R3130 LEUNG, JESSICA WAI TING, MD 5/22/2017 5/22/2022 RADIOLOGY BREAST IMAGING HOUSTON TX ACTIVE 6/14/2017 None N/A Q7577 LEUNG, SAMSON, MD 3/15/2016 3/15/2021 ANESTHESIOLOGY CLAREMONT CA ACTIVE 3/21/2016 None N/A R4867 LEVACIC, DANIJELA, MD 10/6/2017 10/6/2022 NEUROLOGY NEURO-ONCOLOGY TEMPLE TX ACTIVE 11/1/2017 None N/A INTERVENTIONAL DIAGNOSTIC S6231 LEVEY, ALEXA OLSZEWSKI, MD 4/17/2020 4/17/2025 RADIOLOGY RADIOLOGY HOUSTON TX ACTIVE 4/20/2020 None N/A Q8544 LEVEY, RICHARD MICHAEL, MD 6/1/2016 6/1/2021 RADIOLOGY OROVILLE CA ACTIVE 6/15/2016 None N/A S7087 LEVEY, RYAN S, MD 6/12/2020 6/12/2025 UROLOGY HOUSTON TX ACTIVE 6/15/2020 None N/A PLASTIC & CRITICAL CARE RECONSTRUCTIVE S6435 LEVI, BENJAMIN, MD 5/1/2020 5/1/2025 (SURGERY) SURGERY DALLAS TX ACTIVE 5/7/2020 None N/A EMERGENCY Q7409 LEVIN, DANA REED, MD 3/4/2016 3/4/2021 MEDICINE WEBSTER TX ACTIVE 3/16/2016 None N/A

Page 162 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PEDIATRIC EMERGENCY LICENSE Q8740 LEVINE, MARLA CASEY, MD 6/10/2016 6/10/2021 MEDICINE (PEDS) ISSUED 6/10/2016 None N/A Q5214 LEVINE, MICHAEL HOWARD, MD 7/15/2015 7/15/2020 NEUROLOGY SLEEP MEDICINE ACTIVE 7/21/2015 None N/A LICENSE S6232 LEVY, JAY BERRY, MD 4/17/2020 4/17/2025 PEDIATRIC UROLOGY ISSUED 4/17/2020 None N/A ANATOMIC/CLINICAL R1571 LEWIS, GLORIA HUANG, MD 2/6/2017 2/6/2022 PATHOLOGY CYTOPATHOLOGY SAN ANTONIO TX ACTIVE 4/6/2017 None N/A PEDIATRIC EMERGENCY Q5215 LEWIS, JONATHAN DANIEL, MD 7/15/2015 7/15/2020 PEDIATRICS MEDICINE (PEDS) HOUSTON TX ACTIVE 8/4/2015 None N/A LICENSE Q5471 LEWIS, SPENCER RYAN, MD 8/3/2015 8/3/2020 FAMILY MEDICINE ISSUED 8/3/2015 None N/A EMERGENCY LICENSE Q4623 LEWIS, WHITNEY KRISTINA, DO 6/1/2015 6/1/2020 MEDICINE ISSUED 6/1/2015 None N/A EMERGENCY BALCH S4336 LI, ANDREA, MD 12/6/2019 12/6/2024 MEDICINE SPRINGS TX ACTIVE 1/24/2020 None N/A EMERGENCY BALCH S4336 LI, ANDREA, MD 12/6/2019 12/6/2024 MEDICINE SPRINGS TX ACTIVE 1/24/2020 None N/A HEMATOLOGY/ONCOL S4337 LI, ANG, MD 12/6/2019 12/6/2024 OGY INTERNAL MEDICINE HOUSTON TX ACTIVE 12/11/2019 None N/A HEMATOLOGY/ONCOL S4337 LI, ANG, MD 12/6/2019 12/6/2024 OGY INTERNAL MEDICINE HOUSTON TX ACTIVE 12/11/2019 None N/A PHYSICAL MED. & R2907 LI, CAROL , MD 5/5/2017 5/5/2022 REHABILITATION SAN ANTONIO TX ACTIVE 5/15/2017 None N/A OBSTETRICS AND MATERNAL AND CORPUS Q8285 LI, CHAO, MD 5/16/2016 5/16/2021 GYNECOLOGY FETAL MEDICINE CHRISTI TX ACTIVE 5/17/2016 None N/A S5967 LI, DENISE JING, MD 4/3/2020 4/3/2025 NEUROLOGY DALLAS TX ACTIVE 4/6/2020 None N/A R5591 LI, DONGMING , MD 1/5/2018 1/5/2023 INTERNAL MEDICINE ACTIVE 1/19/2018 None N/A R3901 LI, HANHAN , MD 7/17/2017 7/17/2022 UROLOGIC SURGERY HOUSTON TX ACTIVE 7/24/2017 None N/A Q6869 LI, JINGYI, MD 1/6/2016 1/6/2021 ANESTHESIOLOGY ACTIVE 3/9/2016 None N/A R2391 LI, LI, MD 4/4/2017 4/4/2022 PSYCHIATRY HOUSTON TX ACTIVE 5/16/2017 None N/A R5000 LI, LIN, MD 10/20/2017 10/20/2022 FAMILY MEDICINE FAMILY PRACTICE DALLAS TX ACTIVE 10/31/2017 None N/A R2156 LIANG, BUQING, MD 3/20/2017 3/20/2022 GENERAL SURGERY ACTIVE 3/30/2017 None N/A S4338 LIANG, IRENA, DO 12/6/2019 12/6/2024 FAMILY MEDICINE ACTIVE 3/3/2020 None N/A S4338 LIANG, IRENA, DO 12/6/2019 12/6/2024 FAMILY MEDICINE ACTIVE 3/3/2020 None N/A NEUROMUSCULAR Q7410 LIAO, BING , MD 3/4/2016 3/4/2021 NEUROLOGY DISEASE ROCHESTER MN ACTIVE 4/7/2016 None N/A THORACIC CARDIOVASCULAR S6233 LIAO, KENNETH KANGXIONG, MD 4/17/2020 4/17/2025 SURGERY HOUSTON TX ACTIVE 4/21/2020 None N/A Page 163 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date R2908 LIAW, WINSTON, MD 5/5/2017 5/5/2022 FAMILY MEDICINE FAIRFAX VA ACTIVE 5/12/2017 None N/A EMERGENCY R1073 LIBERATORE, ANNA, MD 12/16/2016 12/16/2021 MEDICINE N/A FL ACTIVE 1/26/2017 None N/A DIAGNOSTIC Q8099 LICHLITER, ANDREW H, MD 5/2/2016 5/2/2021 RADIOLOGY DALLAS TX ACTIVE 5/4/2016 None N/A HAND SURGERY - ORTHOPEDIC ORTHOPEDIC R3370 LICHT, HEATHER LEIGH, MD 6/2/2017 6/2/2022 SURGERY SURGERY ACTIVE 6/9/2017 None N/A LICHTERMAN, JAKE NATHANIEL, HEMATOLOGY/ONCOL S5686 DO 3/20/2020 3/20/2025 OGY INTERNAL MEDICINE DALLAS TX ACTIVE 4/8/2020 None N/A R5764 LIEBLER, HILLARY COWLEY, MD 1/19/2018 1/19/2023 INTERNAL MEDICINE HOUSTON TX ACTIVE 1/23/2018 None N/A

P3029 LIECHTY, JOSEPH MATTHEW, MD 5/15/2020 5/15/2025 VASCULAR SURGERY LOUISVILLE KY ACTIVE 5/19/2020 None N/A OPHTHALMOLOGY - S4807 LIEU, PHILIP , MD 1/24/2020 1/24/2025 VITREOUS SURGERY OPHTHALMOLOGY DALLAS TX ACTIVE 2/4/2020 None N/A EMERGENCY R2392 LIEVANO, KANG MEI NANCY, DO 4/4/2017 4/4/2022 MEDICINE EL PASO TX ACTIVE 4/7/2017 None N/A PEDIATRIC HEMATOLOGY/ONCOL S6436 LIGON, JOHN ALLEN, MD 5/1/2020 5/1/2025 OGY PEDIATRICS HOUSTON TX ACTIVE 5/4/2020 None N/A R5156 LIM, GRACE EUNA, MD 11/3/2017 11/3/2022 FAMILY MEDICINE FAMILY PRACTICE FAIRFAX VA ACTIVE 12/13/2017 None N/A EMERGENCY LICENSE S5688 LIM, JOSHUA TIMOTHY, MD 3/20/2020 3/20/2025 MEDICINE ISSUED 3/20/2020 None N/A RADIATION JBSA FT SAM R4265 LIM, TREVOR, MD 8/15/2017 8/15/2022 ONCOLOGY HOUSTON TX ACTIVE 8/22/2017 None N/A R2909 LIMA, DANIEL SAMPAIO, MD 5/5/2017 5/5/2022 ANESTHESIOLOGY HOUSTON TX ACTIVE 5/10/2017 None N/A OBSTETRICS & GYNECOLOGICAL LAKE Q6060 LIMA, SHIRLEY, MD 9/15/2015 9/15/2020 SURGERY JACKSON TX ACTIVE 9/28/2015 None N/A DIAGNOSTIC LICENSE Q6647 LIN, CAROL, MD 12/4/2015 12/4/2020 RADIOLOGY ISSUED 12/4/2015 None N/A DIAGNOSTIC MORTON Q6647 LIN, CAROL, MD 12/4/2015 12/4/2020 RADIOLOGY GROVE IL ACTIVE 12/9/2015 None N/A DIAGNOSTIC MORTON Q6647 LIN, CAROL, MD 12/4/2015 12/4/2020 RADIOLOGY GROVE IL ACTIVE 12/9/2015 None N/A S6673 LIN, HAW YU, MD 5/15/2020 5/15/2025 ANESTHESIOLOGY HOUSTON TX ACTIVE 5/21/2020 None N/A OTOLARYNGOLOGY S7089 LIN, KENNY FEI, MD 6/12/2020 6/12/2025 (NEUROTOLOGY) HOUSTON TX ACTIVE 6/15/2020 None N/A RADIATION R1573 LIN, LILIE LEMING, MD 2/6/2017 2/6/2022 ONCOLOGY HOUSTON TX ACTIVE 2/27/2017 None N/A Q9664 LIN, MITCHELL, MD 8/15/2016 8/15/2021 ANESTHESIOLOGY DALLAS TX ACTIVE 8/25/2016 None N/A Page 164 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date LICENSE Q6648 LIN, PETER CHARLIE, MD 12/4/2015 12/4/2020 ANESTHESIOLOGY ISSUED 12/4/2015 None N/A Q6648 LIN, PETER CHARLIE, MD 12/4/2015 12/4/2020 ANESTHESIOLOGY DALLAS TX ACTIVE 2/3/2016 None N/A Q6648 LIN, PETER CHARLIE, MD 12/4/2015 12/4/2020 ANESTHESIOLOGY DALLAS TX ACTIVE 2/3/2016 None N/A LICENSE S7090 LIN, WILLIAM I, MD 6/12/2020 6/12/2025 FAMILY MEDICINE OBSTETRICS ISSUED 6/12/2020 None N/A R2157 LINARES-CANO, GLENDA , MD 3/20/2017 3/20/2022 FAMILY MEDICINE SAN ANOTIO TX ACTIVE 3/28/2017 None N/A Q6957 LINDEMAN, TRACEY EINEM, MD 1/15/2016 1/15/2021 INTERNAL MEDICINE ACTIVE 1/22/2016 None N/A LICENSE S6674 LINDGREN, DAVID A, MD 5/15/2020 5/15/2025 FAMILY MEDICINE ISSUED 5/15/2020 None N/A R2393 LINDO, ROLANDO J JR, MD 4/4/2017 4/4/2022 FAMILY MEDICINE ACTIVE 6/9/2017 None N/A R0272 LINDO, ROLANDO JOSÉ SR, MD 9/30/2016 9/30/2021 FAMILY MEDICINE CLOVIS NM ACTIVE 10/5/2016 None N/A LICENSE S6879 LINDQUIST, JUSTIN KYLE, MD 5/29/2020 5/29/2025 NEUROLOGY ISSUED 5/29/2020 None N/A COLLEGE S5969 LINDSEY, CODY CLAYTON, MD 4/3/2020 4/3/2025 PSYCHIATRY STATION TX ACTIVE 4/20/2020 None N/A EMERGENCY Q7411 LINDSEY, JAMES YORK, MD 3/4/2016 3/4/2021 MEDICINE CARROLLTON TX ACTIVE 3/25/2016 None N/A R3902 LINDSEY, TYANNE FRIES, MD 7/17/2017 7/17/2022 PEDIATRICS HOUSTON TX ACTIVE 7/24/2017 None N/A LICENSE Q6533 LING, CARL H, MD 11/16/2015 11/16/2020 DERMATOLOGY ISSUED 11/16/2015 None N/A CARDIAC ELECTROPHYSIOLOG Q8743 LINK, MARK STEVEN, MD 6/10/2016 6/10/2021 Y CARDIOLOGY DALLAS TX ACTIVE 6/21/2016 None N/A R6228 LINZAY, CATHERINE DOWNS, MD 3/2/2018 3/2/2023 INTERNAL MEDICINE DALLAS TX ACTIVE 3/19/2018 None N/A R6038 LIPSITT, ADAM SAMUEL, MD 2/16/2018 2/16/2023 PSYCHIATRY TEMPLE TX ACTIVE 2/20/2018 None N/A PEDIATRIC HEMATOLOGY/ONCO R4089 LIPSITT, AMANDA , MD 8/1/2017 8/1/2022 PEDIATRICS LOGY SAN ANTONIO TX ACTIVE 8/11/2017 None N/A R1813 LIRO, CHRISTINA MARIE, DO 2/22/2017 2/22/2022 INTERNAL MEDICINE HOSPITALIST DALLAS TX ACTIVE 3/27/2017 None N/A ENDOCRINOLOGY, DIABETES AND R3371 LIROV, ROY, MD 6/2/2017 6/2/2022 GENERAL SURGERY METABOLISM AUSTIN TX ACTIVE 6/8/2017 None N/A R3903 LITTLE, LANNA , MD 7/17/2017 7/17/2022 INTERNAL MEDICINE INTERNAL MEDICINE DALLAS TX ACTIVE 7/24/2017 None N/A PEDIATRIC R0898 LITTLE, RHIANNA MELISSA, MD 12/2/2016 12/2/2021 ORTHOPEDICS SAN ANTONIO TX ACTIVE 12/26/2016 None N/A LITTLEJOHN, CHRISTOPHER LAKE, R5425 MD 12/8/2017 12/8/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 1/2/2018 None N/A INTERVENTIONAL R4266 LITTMAN, NOAM TZVI, MD 8/15/2017 8/15/2022 RADIOLOGY RADIOLOGY HUSTON TX ACTIVE 8/16/2017 None N/A R2910 LITVAK, PAUL , MD 5/5/2017 5/5/2022 NEUROLOGY HOUSTON TX ACTIVE 5/8/2017 None N/A Page 165 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date R5889 LIU, HUIFEI , MD 2/2/2018 2/2/2023 PATHOLOGY SEATTLE WA ACTIVE 2/21/2018 None N/A EMERGENCY Q9852 LIU, JENNY AIHONG, MD 8/26/2016 8/26/2021 FAMILY MEDICINE MEDICINE KINGSVILLE TX ACTIVE 8/31/2016 None N/A PHYSICAL MED. & S4520 LIU, TONY TONGYU, DO 12/20/2019 12/20/2024 PAIN MEDICINE REHABILITATION SHREVEPORT LA ACTIVE 1/21/2020 None N/A R5283 LIU, XIAOZHOU, MD 11/17/2017 11/17/2022 RADIOLOGY DALLAS TX ACTIVE 11/21/2017 None N/A LICENSE Q6534 LIU, YAN , MD 11/16/2015 11/16/2020 CARDIOLOGY INTERNAL MEDICINE ISSUED 11/16/2015 None N/A EMERGENCY Q7914 LIVINGSTON, COLE JOSEPH, MD 4/15/2016 4/15/2021 MEDICINE EL PASO TX ACTIVE 5/4/2016 None N/A LLUBERES GORDO, KARLA R6229 MICHELLE, MD 3/2/2018 3/2/2023 PEDIATRICS ACTIVE 3/9/2018 None N/A PHYSICAL MED. & SPINE AND SPORTS R3551 LLULL VERA, MILAGROS M, MD 6/16/2017 6/16/2022 REHABILITATION MEDICINE SAN ANGELO TX ACTIVE 6/19/2017 None N/A NORTH R1075 LO, ABRAHAM, DO 12/16/2016 12/16/2021 INTERNAL MEDICINE BERGEN NJ ACTIVE 1/2/2017 None N/A S6235 LOCKE, TRAN, MD 4/17/2020 4/17/2025 RHINOLOGY OTOLARYNGOLOGY HOUSTON TX ACTIVE 4/27/2020 None N/A EMERGENCY R5284 LOERA, FELIPE ERNESTO, MD 11/17/2017 11/17/2022 MEDICAL SERVICES PEARLAND TX ACTIVE 11/20/2017 None N/A EMERGENCY R2911 LOEWEN, JOHN WILLIAM, MD 5/5/2017 5/5/2022 MEDICINE SANTA ROSA CA ACTIVE 8/2/2017 None N/A R5158 LONDON, DAVID , MD 11/3/2017 11/3/2022 INTERNAL MEDICINE HOUSTON TX ACTIVE 2/13/2018 None N/A DIAGNOSTIC MUSCULOSKELETAL R1814 LONG, JAMES ANTHONY, MD 2/22/2017 2/22/2022 RADIOLOGY RADIOLOGY SAVANNAH GA ACTIVE 3/1/2017 None N/A R2658 LONG, MEGAN, MD 4/20/2017 4/20/2022 PEDIATRICS HOUSTON TX ACTIVE 5/8/2017 None N/A PEDIATRIC EMERGENCY Q7228 LONG, RACHEL ANNA, DO 2/16/2016 2/16/2021 PEDIATRICS MEDICINE (PEDS) DALLAS TX ACTIVE 2/18/2016 None N/A DELINQUEN T-NON Q9853 LONG, SAMUEL EVERETTE III, MD 8/26/2016 8/26/2021 GENERAL SURGERY AUSTIN TX PAYMENT 12/30/2017 None N/A HARKER R3553 LONGFIELD, EVAN, MD 6/16/2017 6/16/2022 OTOLARYNGOLOGY HEIGHTS TX ACTIVE 8/25/2017 None N/A LONGORIA, LEONARDO ARTURO, OBSTETRICS AND R1407 MD 1/20/2017 1/20/2022 FAMILY MEDICINE GYNECOLOGY MOBILE AL ACTIVE 2/6/2017 None N/A GASTROENTEROLOG Q9419 LOO, NICOLE MING-MING, MD 8/1/2016 8/1/2021 HEPATOLOGY Y SAN ANTONIO TX ACTIVE 9/16/2016 None N/A Q7734 LOOCHTAN, MICHAEL, MD 4/1/2016 4/1/2021 OTOLARYNGOLOGY OTHER SPECIALTY SAN ANTONIO TX ACTIVE 4/4/2016 None N/A THORACIC CARDIOVASCULAR CARDIOVASCULAR R3131 LOOR, GABRIEL , MD 5/22/2017 5/22/2022 SURGERY SURGERY HOUSTON TX ACTIVE 6/8/2017 None N/A Page 166 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date CRITICAL CARE R4869 LOOR, MICHELE M, MD 10/6/2017 10/6/2022 GENERAL SURGERY (SURGERY) HOUSTON TX ACTIVE 11/2/2017 None N/A LOPEZ CALDERON, KARLA R3372 RAQUEL, MD 6/2/2017 6/2/2022 PSYCHIATRY FORT WORTH TX ACTIVE 6/12/2017 None N/A LOPEZ PAYARES, GISELA MARIA, Q5217 MD 7/15/2015 7/15/2020 FAMILY PRACTICE RICHMOND VA ACTIVE 8/28/2015 None N/A LICENSE Q5020 LOPEZ SEPULVEDA, JAXEL, MD 7/1/2015 7/1/2020 FAMILY MEDICINE ISSUED 7/1/2015 None N/A GERIATRICS - INFECTIOUS Q7412 LOPEZ VAZQUEZ, MANUEL , MD 3/4/2016 3/4/2021 INTERNAL MEDICINE DISEASES SAN ANTONIO TX ACTIVE 5/30/2016 None N/A Q6767 LOPEZ, ANDREA DEL PILAR, MD 12/15/2015 12/15/2020 PEDIATRICS KYLE TX ACTIVE 2/8/2016 None N/A CORPUS R2160 LOPEZ, EVITA F, DO 3/20/2017 3/20/2022 INTERNAL MEDICINE CHRISTI TX ACTIVE 4/12/2017 None N/A PHYSICAL MED. & Q9854 LOPEZ, MARIELISA, MD 8/26/2016 8/26/2021 REHABILITATION FRISCO TX ACTIVE 8/29/2016 None N/A PEDIATRIC Q8289 LOPEZ, MICHAEL ANTHONY, MD 5/16/2016 5/16/2021 OPHTHALMOLOGY HOUSTON TX ACTIVE 5/17/2016 None N/A R3132 LOPEZ, PAMELA ANN, MD 5/22/2017 5/22/2022 PSYCHIATRY AUSTIN TX ACTIVE 6/7/2017 None N/A Q8290 LOPEZ, ROSALIND , MD 5/16/2016 5/16/2021 PEDIATRICS MESQUITE TX ACTIVE 5/24/2016 None N/A R5160 LOPEZ-LOPEZ, IVONNE , MD 11/3/2017 11/3/2022 FAMILY MEDICINE MCALLEN TX ACTIVE 11/13/2017 None N/A OBSTETRICS AND OBSTETRICS AND R0060 LORA ALCANTARA, ISAMARIE, MD 9/15/2016 9/15/2021 GYNECOLOGY GYNECOLOGY ROWLETT TX ACTIVE 10/7/2016 None N/A Q9855 LORD, JOSHUA , MD 8/26/2016 8/26/2021 PSYCHIATRY DALLAS TX ACTIVE 8/29/2016 None N/A INTERVENTIONAL Q5689 LOREE, ROBERT THOMAS, MD 8/14/2015 8/14/2020 RADIOLOGY RADIOLOGY EL PASO TX ACTIVE 8/21/2015 None N/A LORENZ, LANDON BERNHARDT, OBSTETRICS AND R3555 MD 6/16/2017 6/16/2022 GYNECOLOGY CLEBURNE TX ACTIVE 6/20/2017 None N/A LORENZANA, JESSICA ASHLEY, URGENT CARE R4587 MD 9/8/2017 9/8/2022 HOSPITALIST MEDICINE ACTIVE 12/4/2017 None N/A

Q7736 LOTT, BRITTON BENNETT, MD 4/1/2016 4/1/2021 RADIOLOGY BREAST IMAGING FAYETTEVILLE AR ACTIVE 4/11/2016 None N/A EMERGENCY Q9666 LOVETT, PARIS BRETT, MD 8/15/2016 8/15/2021 MEDICINE HOLLYWOOD FL ACTIVE 10/24/2016 None N/A PULMONARY CRITICAL CARE R2395 LOVIN, DYLAN, MD 4/4/2017 4/4/2022 MEDICINE INTERNAL MEDICINE DALLAS TX ACTIVE 4/10/2017 None N/A

Q9421 LOWDEN, ANDREA RAPHIELA, MD 8/1/2016 8/1/2021 CHILD NEUROLOGY DALLAS TX ACTIVE 8/3/2016 None N/A R1816 LOWE, ALISON CYR, MD 2/22/2017 2/22/2022 DERMATOLOGY LAKEWAY TX ACTIVE 3/1/2017 None N/A

Page 167 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PEDIATRIC ANESTHESIOLOGY Q9856 LOWERY, JAMEL EDWARD, MD 8/26/2016 8/26/2021 ANESTHESIOLOGY (PEDS) HOUSTON TX ACTIVE 8/31/2016 None N/A EMERGENCY R5769 LOZANO, SERGIO JR, MD 1/19/2018 1/19/2023 MEDICINE TEMPLE TX ACTIVE 2/5/2018 None N/A OBSTETRICS AND MATERNAL AND R4267 LOZOVYY, VIOLETTA , MD 8/15/2017 8/15/2022 GYNECOLOGY FETAL MEDICINE GALVESTON TX ACTIVE 8/30/2017 None N/A

R4735 LU, TONY , MD 9/22/2017 9/22/2022 VASCULAR SURGERY HOUSTON TX ACTIVE 11/20/2017 None N/A R1983 LU, WEIXIN, MD 3/3/2017 3/3/2022 PSYCHIATRY HOUSTON TX ACTIVE 5/15/2017 None N/A NUCLEAR IMAGING R1575 LU, YANG, MD 2/6/2017 2/6/2022 NUCLEAR MEDICINE AND THERAPY HOUSTON TX ACTIVE 2/10/2017 None N/A EMERGENCY Q5476 LUCK, JOHN BENJAMIN, MD 8/3/2015 8/3/2020 MEDICINE ACTIVE 8/28/2015 None N/A TEXAS EMERGENCY W LICENSE CANCELLED K0911 LUCZKOW, DANIEL, MD 6/12/2020 6/12/2025 MEDICINE BARNSTABLE MA ISSUED 6/12/2020 BY BOARD 6/4/2010 RADIATION LICENSE S6679 LUDMIR, ETHAN BERNARD, MD 5/15/2020 5/15/2025 ONCOLOGY ISSUED 5/15/2020 None N/A R2912 LUDT, CAMERON, DO 5/5/2017 5/5/2022 NEUROLOGY AUSTIN TX ACTIVE 5/10/2017 None N/A OBSTETRICS & GYNECOLOGICAL R5161 LUGO, JONATHAN MATTHEW, MD 11/3/2017 11/3/2022 SURGERY EDINBURG TX ACTIVE 1/3/2018 None N/A EMERGENCY URGENT CARE R3556 LUHM VIGOR, MICHELE A, MD 6/16/2017 6/16/2022 MEDICINE MEDICINE KILLEEN TX ACTIVE 6/20/2017 None N/A EMERGENCY R2660 LUI, EDWIN, DO 4/20/2017 4/20/2022 MEDICINE SAN ANTONIO TX ACTIVE 4/24/2017 None N/A LUKASZCZYK, THOMAS ANDREW EMERGENCY R5162 JR, MD 11/3/2017 11/3/2022 MEDICINE BAKERSFIELD CA ACTIVE 12/22/2017 None N/A R5005 LUKE, SUZETTE , MD 10/20/2017 10/20/2022 OPHTHALMOLOGY LUBBOCK TX ACTIVE 12/5/2017 None N/A EMERGENCY S5217 LULLA, ADITYA, MD 2/21/2020 2/21/2025 MEDICINE DALLAS TX ACTIVE 5/13/2020 None N/A LUNDY, JONATHAN BERGENDAHL, Q8101 MD 5/2/2016 5/2/2021 TRAUMATIC SURGERY GENERAL SURGERY FORT HOOD TX ACTIVE 5/16/2016 None N/A TRANSPLANT Q6958 LUNSFORD, KERI ELIZABETH, MD 1/15/2016 1/15/2021 GENERAL SURGERY SURGERY HOUSTON TX ACTIVE 1/19/2016 None N/A HAND SURGERY - ORTHOPEDIC R2401 LUO, RANDY YU, MD 4/4/2017 4/4/2022 ORTHOPEDICS SURGERY HOUSTON TX ACTIVE 4/28/2017 None N/A INFECTIOUS R1409 LUQUE, AMNERIS ESTHER, MD 1/20/2017 1/20/2022 DISEASES INTERNAL MEDICINE DALLAS TX ACTIVE 1/30/2017 None N/A Page 168 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date Q5022 LUSK, KATHERINE M, MD 7/1/2015 7/1/2020 PEDIATRICS HOUSTON TX ACTIVE 7/13/2015 None N/A HEMATOLOGY/ONCOL Q7916 LUU, DAI CHU NGUYEN, MD 4/15/2016 4/15/2021 OGY INTERNAL MEDICINE DALLAS TX ACTIVE 4/19/2016 None N/A R6230 LUU, HIEU, MD 3/2/2018 3/2/2023 HOSPITALIST TUCSON AZ ACTIVE 3/14/2018 None N/A LICENSE S6441 LWANGA, JULIET, MD 5/1/2020 5/1/2025 INTERNAL MEDICINE ISSUED 5/1/2020 None N/A THORACIC CARDIOVASCULAR R1238 LY, TRUC TRUNG, MD 1/6/2017 1/6/2022 SURGERY GENERAL SURGERY SAN ANTONIO TX ACTIVE 1/25/2017 None N/A R5890 LYN, RAQUEL LEANNE, MD 2/2/2018 2/2/2023 INTERNAL MEDICINE AUSTIN TX ACTIVE 2/5/2018 None N/A OBSTETRICS AND Q5023 LYNCH, BERNARD ANDREW, MD 7/1/2015 7/1/2020 GYNECOLOGY ACTIVE 7/10/2015 None N/A R0062 LYNCH, JANEL MARIE, MD 9/15/2016 9/15/2021 PEDIATRICS EL PASO TX ACTIVE 9/22/2016 None N/A OPHTHALMOLOGY - LICENSE Q4799 LYNDS, ROSS TUCKER, MD 6/12/2015 6/12/2020 VITREOUS SURGERY ISSUED 6/12/2015 None N/A EMERGENCY EMERGENCY Q7917 LYON, STEPHEN MICHAEL, DO 4/15/2016 4/15/2021 MEDICINE MEDICINE ABILENE TX ACTIVE 4/26/2016 None N/A COLLEGE Q8292 LYONS, CARLY ELIZABETH, MD 5/16/2016 5/16/2021 PEDIATRICS STATION TX ACTIVE 5/18/2016 None N/A PEDIATRIC Q5858 LYONS, KAREN , MD 8/28/2015 8/28/2020 RADIOLOGY RADIOLOGY LITTLE ROCK AR ACTIVE 8/31/2015 None N/A THORACIC CARDIOVASCULAR CARDIOVASCULAR LICENSE Q4628 LYTLE, BRUCE WHITNEY, MD 6/1/2015 6/1/2020 SURGERY SURGERY ISSUED 6/1/2015 None N/A R2162 MA, LIQIAO , MD 3/20/2017 3/20/2022 DERMATOLOGY DALLAS TX ACTIVE 3/28/2017 None N/A EMERGENCY LICENSE S7092 MA, ZHENG BEN, MD 6/12/2020 6/12/2025 MEDICINE ISSUED 6/12/2020 None N/A GRAND R0063 MAAN, WAJIHA, MD 9/15/2016 9/15/2021 PEDIATRICS SALINE TX ACTIVE 9/23/2016 None N/A R1817 MABRY CANTU, CARLYE, MD 2/22/2017 2/22/2022 INTERNAL MEDICINE INTERNAL MEDICINE AUSTIN TX ACTIVE 3/13/2017 None N/A THORACIC MACGILLIVRAY, THOMAS CARDIOVASCULAR R0065 EDWARD, MD 9/15/2016 9/15/2021 SURGERY HOUSTON TX ACTIVE 9/21/2016 None N/A LICENSE R6231 MACHADO, GASTON JR, MD 3/2/2018 3/2/2023 FAMILY PRACTICE GENERAL PRACTICE ISSUED 3/2/2018 None N/A EMERGENCY R5006 MACKIE, EMILY LOUISE, MD 10/20/2017 10/20/2022 MEDICINE PORTSMOUTH VA ACTIVE 11/20/2017 None N/A PEDIATRIC CRITICAL PEDIATRICS, R2913 MACKMAN, CHAD AARON, MD 5/5/2017 5/5/2022 CARE MEDICINE CARDIOLOGY FORT WORTH TX ACTIVE 5/8/2017 None N/A R6233 MACLEOD, ERIN CROWLEY, DO 3/2/2018 3/2/2023 PEDIATRICS AUSTIN TX ACTIVE 3/7/2018 None N/A

Page 169 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date CHILD AND ADOLESCENT CHARLOTTES R3557 MADAAN, VISHAL, MD 6/16/2017 6/16/2022 PSYCHIATRY PSYCHIATRY VILLE VA ACTIVE 7/10/2017 None N/A CARDIOVASCULAR Q6873 MADAN, PANKAJ, MD 1/6/2016 1/6/2021 INTERNAL MEDICINE DISEASES SAN ANTONIO TX ACTIVE 1/13/2016 None N/A EMERGENCY S4522 MADDEN, ERIC ANTHONY, MD 12/20/2019 12/20/2024 MEDICINE HOUSTON TX ACTIVE 12/24/2019 None N/A PEDIATRIC HEMATOLOGY/ONCOL Q9189 MADDEN, LISA MARIE, MD 7/15/2016 7/15/2021 OGY SAN ANTONIO TX ACTIVE 7/22/2016 None N/A R5163 MADEY, JASON , MD 11/3/2017 11/3/2022 NEUROLOGY ACTIVE 2/5/2018 None N/A Q8948 MADHAVAN, SRINIVASA R, MD 7/1/2016 7/1/2021 INTERNAL MEDICINE FRISCO TX ACTIVE 9/5/2016 None N/A MADHRIRA, MACHAIAH Q5219 MUTHANNA, MD 7/15/2015 7/15/2020 NEPHROLOGY FORT WORTH TX ACTIVE 8/26/2015 None N/A MADHUSUDANANNAIR- HEMATOLOGY/ONCOL PALLIATIVE SOUTH R5287 KUNNUPARAMPIL, VINU , MD 11/17/2017 11/17/2022 OGY MEDICINE CHARLESTON WV ACTIVE 12/11/2017 None N/A EMERGENCY Q7413 MADISON, ADRIENNE NICOLE, MD 3/4/2016 3/4/2021 MEDICINE KINGWOOD TX ACTIVE 3/8/2016 None N/A SURGICAL NORTHAMPTO R0750 MADUEKWE, UGWUJI N, MD 11/15/2016 11/15/2021 GENERAL SURGERY ONCOLOGY N MA ACTIVE 12/2/2016 None N/A MAGBEGOR, SAINT S5693 OGHENEWEMO, MD 3/20/2020 3/20/2025 ANESTHESIOLOGY ACTIVE 3/23/2020 None N/A SURGICAL CRITICAL R2661 MAGHAMI, NIMA, MD 4/20/2017 4/20/2022 GENERAL SURGERY CARE HOUSTON TX ACTIVE 5/4/2017 None N/A EMERGENCY GRAND R0900 MAGRO, FRANK MATTHEW, DO 12/2/2016 12/2/2021 MEDICINE PRAIRIE TX ACTIVE 12/12/2016 None N/A

Q6959 MAGUCHI ALDRETE, MEGUMI , MD 1/15/2016 1/15/2021 GERIATRICS HOSPITALIST PENSACOLA FL ACTIVE 1/18/2016 None N/A PEDIATRIC HEMATOLOGY/ONCO R1984 MAHADEO, KRIS MICHAEL, MD 3/3/2017 3/3/2022 PEDIATRICS LOGY HOUSTON TX ACTIVE 3/21/2017 None N/A HEMATOLOGY/ONCO S4811 MAHADEVAN, DARUKA , MD 1/24/2020 1/24/2025 ONCOLOGY LOGY SAN ANTONIO TX ACTIVE 1/28/2020 None N/A THE Q9424 MAHAPATRA, SMITA, MD 8/1/2016 8/1/2021 PEDIATRICS WOODLANDS TX ACTIVE 8/3/2016 None N/A LICENSE S6882 MAHAR, JAMAL HUSSAIN, MD 5/29/2020 5/29/2025 INTERNAL MEDICINE ISSUED 5/29/2020 None N/A Q9859 MAHARAJ MIKIEL, INDIRA C, MD 8/26/2016 8/26/2021 FAMILY MEDICINE ABILENE TX ACTIVE 9/12/2016 None N/A MAHASNEH, OMAR ALI Q6537 MOHAMMAD, MD 11/16/2015 11/16/2020 INTERNAL MEDICINE AMARILLLO TX ACTIVE 11/20/2015 None N/A R4090 MAHAVESH, AMTUL K, MD 8/1/2017 8/1/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 8/24/2017 None N/A Page 170 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date S5007 MAHDAWI, REEM TARIQ, MD 2/7/2020 2/7/2025 HOSPITALIST INTERNAL MEDICINE ST PAUL MN ACTIVE 3/23/2020 None N/A EMERGENCY Q7071 MAHER, STEVEN MICHAEL, DO 2/1/2016 2/1/2021 MEDICINE AUSTIN TX ACTIVE 3/3/2016 None N/A CHILD AND ADOLESCENT R6041 MAHESHWARI, RICHA, MD 2/16/2018 2/16/2023 PSYCHIATRY PSYCHIATRY DALLAS TX ACTIVE 2/26/2018 None N/A Q5691 MAHESHWARI, SURBHI, MD 8/14/2015 8/14/2020 PEDIATRICS ACTIVE 8/19/2015 None N/A PEDIATRIC Q9425 MAHMOOD, BRIAN KELLY, MD 8/1/2016 8/1/2021 PULMONOLOGY PEDIATRICS DALLAS TX ACTIVE 8/16/2016 None N/A PALLIATIVE IRONMOUNTAI TM00694 MAHMOOD, RUTH, MD 1/5/2018 1/5/2023 INTERNAL MEDICINE MEDICINE N MI ACTIVE 1/8/2018 None N/A PULMONARY CRITICAL CARE LICENSE R6235 MAHMOOD, SYED MINHAJ, MD 3/2/2018 3/2/2023 MEDICINE MEDICINE (IM) ISSUED 3/2/2018 None N/A Q8949 MAHMOODUDDIN, FAISAL , MD 7/1/2016 7/1/2021 FAMILY MEDICINE CYPRESS TX ACTIVE 7/18/2016 None N/A PHYSICAL MED. & Q8294 MAHMOUD, AHMED, MD 5/16/2016 5/16/2021 REHABILITATION PAIN & SPINE BRIDGEPORT WV ACTIVE 6/10/2016 None N/A MAHMOUD, ROLA ABDELRAHMAN Q5026 MOSTAFA , MD 7/1/2015 7/1/2020 NEUROLOGY HOUSTON TX ACTIVE 7/20/2015 None N/A Q9667 MAHNKE, NINA ERIN, MD 8/15/2016 8/15/2021 ANESTHESIOLOGY SAN ANTONIO TX ACTIVE 8/16/2016 None N/A S5977 MAI, TUNG DINH, DO 4/3/2020 4/3/2025 INTERNAL MEDICINE HOSPITALIST SPRINGFIELD MO ACTIVE 4/16/2020 None N/A MAIRURA, EDWARD MASENGO, ORTHOPEDIC LICENSE Q8744 MD 6/10/2016 6/10/2021 SURGERY ORTHOPEDICS DALLAS TX ISSUED 6/10/2016 None N/A HEMATOLOGY/ONCOL S6442 MAITI, ABHISHEK , MD 5/1/2020 5/1/2025 OGY INTERNAL MEDICINE HOUSTON TX ACTIVE 5/4/2020 None N/A S4523 MAI-TRAN, VIVIAN TUONG-VI, MD 12/20/2019 12/20/2024 BREAST IMAGING ACTIVE 1/2/2020 None N/A

Q8102 MAKABALI, REYNALDO LIMPIN, MD 5/2/2016 5/2/2021 PEDIATRICS GENERAL PRACTICE LOS ANGELES CA ACTIVE 5/4/2016 None N/A NEUROLOGICAL Q8745 MAKNOJIA, ASIF , MD 6/10/2016 6/10/2021 SURGERY SAN ANTONIO TX ACTIVE 6/20/2016 None N/A INTERVENTIONAL CRITICAL CARE LICENSE Q8550 MAKWANA, HEMRAJ R, MD 6/1/2016 6/1/2021 CARDIOLOGY MEDICINE (IM) ISSUED 6/1/2016 None N/A CRITICAL CARE - R1078 MALAIYANDI, DEEPA, MD 12/16/2016 12/16/2021 NEUROLOGY NEUROSURGERY GALVESTON TX ACTIVE 12/21/2016 None N/A GASTROENTEROLOG R1079 MALAKOUTI, MAZYAR , MD 12/16/2016 12/16/2021 INTERNAL MEDICINE Y SAN ANTONIO TX ACTIVE 1/9/2017 None N/A MALATESTA MUNCHER, ROSSANA, PEDIATRIC Q7415 MD 3/4/2016 3/4/2021 NEPHROLOGY HOUSTON TX ACTIVE 3/7/2016 None N/A R3906 MALBARI, FATEMA, MD 7/17/2017 7/17/2022 NEURO-ONCOLOGY CHILD NEUROLOGY HOUSTON TX ACTIVE 9/15/2017 None N/A EMERGENCY H8740 MALCOLM, DOUGLAS BARRY, MD 10/14/2016 10/14/2021 MEDICINE SHELL BEACH CA ACTIVE 10/21/2016 None N/A

Page 171 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date ENDOCRINOLOGY, MALDONADO CORCHADO, DIABETES AND Q8103 ENRIQUE R, MD 5/2/2016 5/2/2021 INTERNAL MEDICINE METABOLISM SAN ANTONIO TX ACTIVE 5/9/2016 None N/A GERIATRIC MALDONADO RODRIGUEZ, MEDICINE (FAMILY R0901 MIGUEL A, MD 12/2/2016 12/2/2021 FAMILY MEDICINE PRACTICE) HOUSTON TX ACTIVE 12/16/2016 None N/A OBSTETRICS AND LICENSE S5694 MALDONADO, VIOLET MARIE, MD 3/20/2020 3/20/2025 GYNECOLOGY ISSUED 3/20/2020 None N/A MALEK, MACKENZIE LEIGH OBSTETRICS AND S6237 WILSON, MD 4/17/2020 4/17/2025 GYNECOLOGY UROGYNECOLOGY TEMPLE TX ACTIVE 4/20/2020 None N/A MALEKPOUR GHORBANI, VASCULAR R0611 FATEMEH, MD 10/31/2016 10/31/2021 GENERAL SURGERY SURGERY DALLAS TX ACTIVE 11/14/2016 None N/A S7094 MALHOTRA, AEKTA, MD 6/12/2020 6/12/2025 PSYCHIATRY PLANO TX ACTIVE 6/15/2020 None N/A GERIATRIC MEDICINE (INTERNAL R6236 MALHOTRA, KEYA, MD 3/2/2018 3/2/2023 INTERNAL MEDICINE MED) LUBBOCK TX ACTIVE 3/7/2018 None N/A LICENSE Q6649 MALI, RAJESH, MD 12/4/2015 12/4/2020 INTERNAL MEDICINE ISSUED 12/4/2015 None N/A

NEW SMYRNA Q6649 MALI, RAJESH, MD 12/4/2015 12/4/2020 INTERNAL MEDICINE BEACH FL ACTIVE 2/11/2016 None N/A

NEW SMYRNA Q6649 MALI, RAJESH, MD 12/4/2015 12/4/2020 INTERNAL MEDICINE BEACH FL ACTIVE 2/11/2016 None N/A CORPUS Q7416 MALIE, PATRICK MICHAEL, DO 3/4/2016 3/4/2021 INTERNAL MEDICINE CHRISTI TX ACTIVE 3/23/2016 None N/A PALLIATIVE Q7738 MALIGI, COURTNEY B , MD 4/1/2016 4/1/2021 FAMILY MEDICINE MEDICINE HOUSTON TX ACTIVE 4/5/2016 None N/A Q7739 MALIK, FAHAD MUBARIK, MD 4/1/2016 4/1/2021 PEDIATRICS ACTIVE 4/6/2016 None N/A PEDIATRIC CRITICAL Q8951 MALIK, MOHAMMAD TARIQ, MD 7/1/2016 7/1/2021 CARE MEDICINE PEDIATRICS MESA AZ ACTIVE 7/12/2016 None N/A OBSTETRICS AND OBSTETRICS AND Q9669 MALIK, MOKERRUM FATIMA, MD 8/15/2016 8/15/2021 GYNECOLOGY GYNECOLOGY HOUSTON TX ACTIVE 8/17/2016 None N/A LICENSE S6443 MALIK, REHAN AHMED, MD 5/1/2020 5/1/2025 INTERNAL MEDICINE ISSUED 5/1/2020 None N/A R1080 MALIK, SADIA SHAUKAT, MD 12/16/2016 12/16/2021 FAMILY MEDICINE TYLER TX ACTIVE 12/26/2016 None N/A HEMATOLOGY/ONCO Q9670 MALIK, SHAHBAZ ASIF, MD 8/15/2016 8/15/2021 INTERNAL MEDICINE LOGY AUSTIN TX ACTIVE 8/17/2016 None N/A DELINQUEN TRANSPLANT T-NON Q6960 MALIK, TAMER AYAD, MD 1/15/2016 1/15/2021 GENERAL SURGERY SURGERY PAYMENT 4/14/2016 None N/A Page 172 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date GERIATRIC MEDICINE (INTERNAL R5429 MALLICK, ADNAN , MD 12/8/2017 12/8/2022 INTERNAL MEDICINE MED) DOTHAN AL ACTIVE 1/17/2018 None N/A LICENSE R5593 MALLU, SRILATHA, MD 1/5/2018 1/5/2023 ANESTHESIOLOGY ISSUED 1/5/2018 None N/A R3709 MALOUF, JEREMY CHIP , MD 6/30/2017 6/30/2022 FAMILY MEDICINE ODESSA TX ACTIVE 7/20/2017 None N/A CORNEA MAMALIS, CHRISTINA ANGELINE, REFRACTIVE S6444 MD 5/1/2020 5/1/2025 OPHTHALMOLOGY SURGERY HOUSTON TX ACTIVE 5/7/2020 None N/A R2662 MAMSA, KHADIJA AHMAD, MD 4/20/2017 4/20/2022 INTERNAL MEDICINE CARLSBAD NM ACTIVE 5/1/2017 None N/A DIAGNOSTIC R0068 MANASAWALA, MOHAMMED H, MD 9/15/2016 9/15/2021 RADIOLOGY BLUE BELL PA ACTIVE 9/21/2016 None N/A OBSTETRICS AND Q7920 MANCEAU-KHA, AMANDA RAE, DO 4/15/2016 4/15/2021 GYNECOLOGY AUTIN TX ACTIVE 4/18/2016 None N/A S5696 MANCERA, LUCIANO, MD 3/20/2020 3/20/2025 FAMILY MEDICINE HOUSTON TX ACTIVE 3/27/2020 None N/A MANCHEZHATHU RAJAGOPALAMENON, REJEESH S5427 MENON, MD 3/6/2020 3/6/2025 HOSPITALIST INTERNAL MEDICINE PASCO WA ACTIVE 3/20/2020 None N/A Q6062 MANCIA, EDUARDO , MD 9/15/2015 9/15/2020 PEDIATRICS ACTIVE 9/17/2015 None N/A INTERVENTIONAL Q8296 MANDA, YUGANDHAR REDDY, MD 5/16/2016 5/16/2021 CARDIOLOGY CARDIOLOGY LUFKIN TX ACTIVE 5/19/2016 None N/A UROLOGIC R6042 MANDALAPU, RAO S , MD 2/16/2018 2/16/2023 UROLOGIC SURGERY ONCOLOGY HOUSTON TX ACTIVE 2/19/2018 None N/A ELECTROPHYSIOLO LICENSE Q5481 MANDELL, RYAN SCOTT, DO 8/3/2015 8/3/2020 CARDIOLOGY GY PLANO TX ISSUED 8/3/2015 None N/A OPHTHALMOLOGY - R2663 MANDO, JOSEPH THOMAS, MD 4/20/2017 4/20/2022 ANTERIOR SURGERY DALLAS TX ACTIVE 5/4/2017 None N/A

Q8104 MANDOLA, VINCENT JOSEPH, MD 5/2/2016 5/2/2021 FAMILY MEDICINE HOUSTON TX ACTIVE 5/6/2016 None N/A MANDVIWALA, TAHER MUSTAFA, R3377 MD 6/2/2017 6/2/2022 INTERNAL MEDICINE HOUSTON TX ACTIVE 6/5/2017 None N/A ALLERGY AND LICENSE Q4801 MANE, SHIKHA KAUSHIK, MD 6/12/2015 6/12/2020 PEDIATRICS IMMUNOLOGY ISSUED 6/12/2015 None N/A EMERGENCY EMERGENCY Q5482 MANGALAT, NEAL, MD 8/3/2015 8/3/2020 MEDICINE MEDICAL SERVICES HOUSTON TX ACTIVE 8/4/2015 None N/A EMERGENCY Q8297 MANGEL, RYAN SEAN, MD 5/16/2016 5/16/2021 MEDICINE FAMILY MEDICINE BIRMINGHAM AL ACTIVE 5/19/2016 None N/A

S6445 MANGINANI, SRIDEVI, MD 5/1/2020 5/1/2025 INTERNAL MEDICINE BROOKSVILLE FL ACTIVE 5/6/2020 None N/A MANGONA, VICTOR SUVA-VIOLA, RADIATION Q5028 MD 7/1/2015 7/1/2020 ONCOLOGY IRVING TX ACTIVE 7/3/2015 None N/A Page 173 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date MANGUBAT, PETER MICHAEL PEDIATRIC CRITICAL CORPUS Q9427 BAUTISTA, MD 8/1/2016 8/1/2021 CARE MEDICINE PEDIATRICS CHRISTI TX ACTIVE 8/2/2016 None N/A PEDIATRIC HEMATOLOGY/ONCOL S4340 MANGUM, MICHAEL ROSS, MD 12/6/2019 12/6/2024 OGY HOUSTON TX ACTIVE 12/10/2019 None N/A PEDIATRIC HEMATOLOGY/ONCOL S4340 MANGUM, MICHAEL ROSS, MD 12/6/2019 12/6/2024 OGY HOUSTON TX ACTIVE 12/10/2019 None N/A S5009 MANI, ANNE ELIZABETH, MD 2/7/2020 2/7/2025 CARDIOLOGY INTERNAL MEDICINE BETHLEHEM PA ACTIVE 2/17/2020 None N/A

Q8299 MANI, JULIE MARY, MD 5/16/2016 5/16/2021 ANESTHESIOLOGY PHILADELPHIA PA ACTIVE 5/30/2016 None N/A Q5029 MANI, PREETHI , MD 7/1/2015 7/1/2020 INTERNAL MEDICINE ACTIVE 7/6/2015 None N/A R4271 MANIAR, SANJAY, MD 8/15/2017 8/15/2022 CARDIOLOGY INTERNAL MEDICINE HOUSTON TX ACTIVE 8/16/2017 None N/A R5770 MANIKAT, RICHIE V, MD 1/19/2018 1/19/2023 INTERNAL MEDICINE SIOUX FALLS SD ACTIVE 1/29/2018 None N/A EMERGENCY WEATHERFOR R1242 MANKOWSKI, ADAM , MD 1/6/2017 1/6/2022 MEDICINE D TX ACTIVE 1/23/2017 None N/A R0448 MANLLO DIECK, JOHN, MD 10/14/2016 10/14/2021 NEPHROLOGY MCALLEN TX ACTIVE 10/24/2016 None N/A CRITICAL CARE Q5220 MANN, DEEPINDER , DO 7/15/2015 7/15/2020 ANESTHESIOLOGY ANESTHESIOLOGY GALVESTON TX ACTIVE 7/17/2015 None N/A Q7072 MANN, MICAH DAVID, MD 2/1/2016 2/1/2021 INTERNAL MEDICINE HOSPITALIST AUSTIN TX ACTIVE 2/26/2016 None N/A

Q6228 MANN, MONICA JOY SUZANNE, MD 10/1/2015 10/1/2020 PEDIATRICS MIDLAND TX ACTIVE 10/2/2015 None N/A OBSTETRICS AND R4272 MANNING, MADELINE PAIGE, DO 8/15/2017 8/15/2022 GYNECOLOGY FORT WORTH TX ACTIVE 8/22/2017 None N/A R4870 MANOCK, STEPHEN, MD 10/6/2017 10/6/2022 FAMILY PRACTICE FORT WORTH TX ACTIVE 10/19/2017 None N/A ENDOCRINOLOGY, DIABETES AND S6240 MANROA, POOJA, MD 4/17/2020 4/17/2025 METABOLISM LEAGUE CITY TX ACTIVE 4/23/2020 None N/A Q5692 MANSON, PAUL VINCENT, MD 8/14/2015 8/14/2020 INTERNAL MEDICINE LUBBOCK TX ACTIVE 8/19/2015 None N/A CHILD AND ADOLESCENT R0070 MANSOOR, RABEEA, MD 9/15/2016 9/15/2021 PSYCHIATRY PSYCHIATRY CLEVELAND OH ACTIVE 9/20/2016 None N/A LICENSE Q5860 MANSOOR, UROOJ, MD 8/28/2015 8/28/2020 HOSPITALIST ISSUED 8/28/2015 None N/A ANATOMIC/CLINICAL DERMATOPATHOLO S4525 MANSOORI, PARISA, MD 12/20/2019 12/20/2024 PATHOLOGY GY ATLANTA GA ACTIVE 1/13/2020 None N/A PULMONARY CRITICAL CARE S4341 MANSOUR, ALI YOUSSEF, MD 12/6/2019 12/6/2024 MEDICINE SLEEP MEDICINE ROUNDROCK TX ACTIVE 2/18/2020 None N/A

Page 174 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PULMONARY CRITICAL CARE S4341 MANSOUR, ALI YOUSSEF, MD 12/6/2019 12/6/2024 MEDICINE SLEEP MEDICINE ROUNDROCK TX ACTIVE 2/18/2020 None N/A DIAGNOSTIC S4342 MANSOUR, MOHAMED , MD 12/6/2019 12/6/2024 GENERAL PRACTICE RADIOLOGY HOUSTON TX ACTIVE 12/10/2019 None N/A DIAGNOSTIC S4342 MANSOUR, MOHAMED , MD 12/6/2019 12/6/2024 GENERAL PRACTICE RADIOLOGY HOUSTON TX ACTIVE 12/10/2019 None N/A LICENSE Q6063 MANSOUR, RANA, MD 9/15/2015 9/15/2020 INTERNAL MEDICINE HOSPITALIST ISSUED 9/15/2015 None N/A EMERGENCY LICENSE Q6651 MANTENA, YOGITA, DO 12/4/2015 12/4/2020 MEDICINE INTERNAL MEDICINE ISSUED 12/4/2015 None N/A EMERGENCY Q6651 MANTENA, YOGITA, DO 12/4/2015 12/4/2020 MEDICINE INTERNAL MEDICINE SUGARLAND TX ACTIVE 1/26/2016 None N/A EMERGENCY Q6651 MANTENA, YOGITA, DO 12/4/2015 12/4/2020 MEDICINE INTERNAL MEDICINE SUGARLAND TX ACTIVE 1/26/2016 None N/A MANTHA, VENKAT RAMANA RAO, Q9191 MD 7/15/2016 7/15/2021 ANESTHESIOLOGY HOUSTON TX ACTIVE 7/29/2016 None N/A MANTHURUTHIL, CHRISTINE S4343 GRACE, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE DALLAS TX ACTIVE 12/30/2019 None N/A MANTHURUTHIL, CHRISTINE S4343 GRACE, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE DALLAS TX ACTIVE 12/30/2019 None N/A

R2664 MANU, GURUSIDDA PRABHU, MD 4/20/2017 4/20/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 4/24/2017 None N/A PEDIATRIC EMERGENCY S5010 MANUEL, MATTHIAS , MD 2/7/2020 2/7/2025 PEDIATRICS MEDICINE (PEDS) DALLAS TX ACTIVE 3/6/2020 None N/A MANZANILLA LUBERTI, LAURA R5891 ELENA, MD 2/2/2018 2/2/2023 FAMILY MEDICINE ACTIVE 2/13/2018 None N/A PHYSICAL MED. & M6744 MAPA, MEILANI HASMIN C, MD 12/6/2019 12/6/2024 REHABILITATION ACTIVE 12/11/2019 None N/A PHYSICAL MED. & M6744 MAPA, MEILANI HASMIN C, MD 12/6/2019 12/6/2024 REHABILITATION ACTIVE 12/11/2019 None N/A Q7230 MAPAKSHI, SRIKAR REDDY, MD 2/16/2016 2/16/2021 INTERNAL MEDICINE ACTIVE 4/21/2016 None N/A ADDICTION R4740 MARAMBAGE, KAPILA, MD 9/22/2017 9/22/2022 PSYCHIATRY PSYCHIATRY DALLAS TX ACTIVE 9/28/2017 None N/A EMERGENCY Q5861 MARANTO, LISMAIDA, DO 8/28/2015 8/28/2020 MEDICINE DALLAS TX ACTIVE 9/1/2015 None N/A R3137 MARCANO, JUAN EDUARDO, MD 5/22/2017 5/22/2022 GENERAL SURGERY ACTIVE 6/12/2017 None N/A EMERGENCY R2404 MARCANTEL, DEREK LEE, MD 4/4/2017 4/4/2022 MEDICINE HOUSTON TX ACTIVE 5/15/2017 None N/A

Page 175 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date CRITICAL CARE LICENSE Q5221 MARCUS, JONATHAN EVAN, MD 7/15/2015 7/15/2020 INTERNAL MEDICINE MEDICINE (IM) ISSUED 7/15/2015 None N/A PEDIATRIC Q6229 MARCUS, MONICA LAUREN, DO 10/1/2015 10/1/2020 RHEUMATOLOGY HOUSTON TX ACTIVE 10/12/2015 None N/A CARDIOVASCULAR S5979 MARCUS, PATRICK NEAL, MD 4/3/2020 4/3/2025 INTERNAL MEDICINE DISEASES HOUSTON TX ACTIVE 4/6/2020 None N/A DELINQUEN T-NON Q6963 MARDAKH, SIMON, MD 1/15/2016 1/15/2021 ANESTHESIOLOGY PAYMENT 4/14/2016 None N/A EMERGENCY R1579 MARDECHIA, BORA, MD 2/6/2017 2/6/2022 MEDICINE SAN ANTONIO TX ACTIVE 3/21/2017 None N/A R0277 MAREK, RACHEL LYNN, MD 9/30/2016 9/30/2021 PEDIATRICS HOSPITALIST HOUSTON TX ACTIVE 10/6/2016 None N/A THE Q6769 MARES, JON WILLIAM, DO 12/15/2015 12/15/2020 INTERNAL MEDICINE WOODLANDS TX ACTIVE 12/17/2015 None N/A TRAUMATIC S4814 MARGOLICK, JOSEPH FRANK, MD 1/24/2020 1/24/2025 GENERAL SURGERY SURGERY DALLAS TX ACTIVE 1/27/2020 None N/A SURGICAL CRITICAL R2405 MARIANO, ROSALIND S, MD 4/4/2017 4/4/2022 GENERAL SURGERY CARE ACTIVE 4/28/2017 None N/A PLASTIC & MARICEVICH, MARCO ANDRE RECONSTRUCTIVE Q7073 BORGES RODRIGUES, MD 2/1/2016 2/1/2021 SURGERY GENERAL SURGERY ACTIVE 2/16/2016 None N/A MARIGOWDA, LOKESH PALLIATIVE Q7740 KEBBEHUNDI, MD 4/1/2016 4/1/2021 INTERNAL MEDICINE MEDICINE FAYETTEVILLE NC ACTIVE 4/4/2016 None N/A HEMATOLOGY/ONCOL R3138 MARIN COSTA, DAVID, MD 5/22/2017 5/22/2022 OGY HOUSTON TX ACTIVE 6/6/2017 None N/A MARINES COPADO, DIEGO COLON AND RECTAL Q4802 CARLOS, MD 6/12/2015 6/12/2020 SURGERY ACTIVE 6/15/2015 None N/A R1821 MARINO, MORGAN, MD 2/22/2017 2/22/2022 ANESTHESIOLOGY TEMPLE TX ACTIVE 3/8/2017 None N/A Q6445 MARIONI, NOE , MD 11/2/2015 11/2/2020 INTERNAL MEDICINE ACTIVE 11/13/2015 None N/A RADIATION R4274 MARISCAL, LUIS H, MD 8/15/2017 8/15/2022 ONCOLOGY ONCOLOGY BAKERSFIELD CA ACTIVE 8/28/2017 None N/A OBSTETRICS AND R0071 MARK, ALICE GRACE, MD 9/15/2016 9/15/2021 GYNECOLOGY BOSTON MA ACTIVE 9/26/2016 None N/A OBSTETRICS & GYNECOLOGICAL GYNECOLOGIC S5980 MARK, JARON EVAN, MD 4/3/2020 4/3/2025 SURGERY ONCOLOGY SAN ANTONIO TX ACTIVE 4/7/2020 None N/A Q9193 MARKER, DAVID REEVE, MD 7/15/2016 7/15/2021 RADIOLOGY HOUSTON TX ACTIVE 7/25/2016 None N/A ORTHOPEDIC SPORTS MEDICINE Q6230 MARKMAN, BRUCE SCOTT, MD 10/1/2015 10/1/2020 SURGERY (ORTH SURG) DALLAS TX ACTIVE 10/6/2015 None N/A PEDIATRICS, Q8301 MARKUS, RICHARD WILLIAM, MD 5/16/2016 5/16/2021 PEDIATRICS CARDIOLOGY DALLAS TX ACTIVE 5/18/2016 None N/A Page 176 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PEDIATRIC EMERGENCY Q7921 MARNENI, SHASHIDHAR RAO, MD 4/15/2016 4/15/2021 PEDIATRICS MEDICINE (PEDS) DALLAS TX ACTIVE 5/2/2016 None N/A R4275 MARROQUIN, OKSANA , MD 8/15/2017 8/15/2022 FAMILY MEDICINE DALLAS TX ACTIVE 8/16/2017 None N/A OPHTHALMOLOGY - LICENSE S6684 MARSHALL, BRIGID KATHLEEN, MD 5/15/2020 5/15/2025 VITREOUS SURGERY ISSUED 5/15/2020 None N/A SURGICAL CRITICAL R3710 MARSHALL, GARY THOMAS, MD 6/30/2017 6/30/2022 TRAUMATIC SURGERY CARE PLANO TX ACTIVE 7/5/2017 None N/A OBSTETRICS AND R1414 MARSHALL, HAYLEY M, DO 1/20/2017 1/20/2022 GYNECOLOGY FORT WORTH TX ACTIVE 3/8/2017 None N/A R3141 MARSHALL, JESSICA LYNN, DO 5/22/2017 5/22/2022 GENERAL SURGERY ACTIVE 5/29/2017 None N/A S5221 MARSHALL, PETER, MD 2/21/2020 2/21/2025 PAIN MEDICINE ANESTHESIOLOGY FORT WORTH TX ACTIVE 5/19/2020 None N/A Q9428 MARTAK, JOSHUA GEORGE, MD 8/1/2016 8/1/2021 FAMILY MEDICINE MIDLOTHIAN TX ACTIVE 8/4/2016 None N/A

OBSTETRICS AND 4502 MEDICAL S4654 MARTIN, ELIZABETH MONIER, MD 1/10/2020 1/10/2025 GYNECOLOGY DRIVE TX ACTIVE 1/20/2020 None N/A EMERGENCY Q6964 MARTIN, ERIK CHARLES, DO 1/15/2016 1/15/2021 MEDICINE IRVING TX ACTIVE 1/21/2016 None N/A EMERGENCY Q9429 MARTIN, ERIK JEFF, MD 8/1/2016 8/1/2021 MEDICINE MONETT MO ACTIVE 8/9/2016 None N/A S4344 MARTIN, PATRICK WILLIAM, MD 12/6/2019 12/6/2024 FAMILY PRACTICE LEWISVILLE TX ACTIVE 12/17/2019 None N/A S4344 MARTIN, PATRICK WILLIAM, MD 12/6/2019 12/6/2024 FAMILY PRACTICE LEWISVILLE TX ACTIVE 12/17/2019 None N/A Q5693 MARTIN, ROBERT LEE, MD 8/14/2015 8/14/2020 ANESTHESIOLOGY TEMPLE TX ACTIVE 8/20/2015 None N/A MEDICAL TOXICOLOGY EMERGENCY (EMERGENCY Q8553 MARTIN, THOMAS GEORGE, MD 6/1/2016 6/1/2021 MEDICINE MEDICINE) AMARILLO TX ACTIVE 6/3/2016 None N/A MARTIN-ENGEL, LINDSAY MARIE, R2165 MD 3/20/2017 3/20/2022 FAMILY MEDICINE DALLAS TX ACTIVE 3/27/2017 None N/A MARTINEZ PRO, SYLVIA R6044 ALEJANDRA, MD 2/16/2018 2/16/2023 PEDIATRICS DALLAS TX ACTIVE 2/26/2018 None N/A MARTINEZ RUMAYOR, ABELARDO INTERVENTIONAL Q6065 ALFONSO, MD 9/15/2015 9/15/2020 CARDIOLOGY INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 9/22/2015 None N/A MARTINEZ SELLERS, VALENA R2914 CAMILLE, MD 5/5/2017 5/5/2022 PEDIATRICS HOUSTON TX ACTIVE 5/10/2017 None N/A R0279 MARTINEZ, ANTONIO , MD 9/30/2016 9/30/2021 FAMILY MEDICINE HARLINGEN TX ACTIVE 12/19/2016 None N/A Q7418 MARTINEZ, HIRAM ALBERTO, MD 3/4/2016 3/4/2021 FAMILY MEDICINE GALVESTON TX ACTIVE 4/8/2016 None N/A

Q7232 MARTINEZ, LAUREN CARTER, MD 2/16/2016 2/16/2021 RADIOLOGY DALLAS TX ACTIVE 2/29/2016 None N/A R1580 MARTINEZ, MARIO ITALO, MD 2/6/2017 2/6/2022 PEDIATRICS SAN ANTONIO TX ACTIVE 2/13/2017 None N/A

Page 177 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date EMERGENCY Q9672 MARTINEZ, MATHEW T, MD 8/15/2016 8/15/2021 MEDICINE SUGAR LAND TX ACTIVE 8/16/2016 None N/A Q7579 MARTINEZ, MONICA ANNE, MD 3/15/2016 3/15/2021 FAMILY MEDICINE ACTIVE 3/22/2016 None N/A MARTINEZ, PRISCILA EMMANUEL, Q9431 MD 8/1/2016 8/1/2021 PEDIATRICS ALVIN TX ACTIVE 8/4/2016 None N/A S6885 MARTORELLA, GULNARA R, MD 5/29/2020 5/29/2025 INTERNAL MEDICINE KYLE TX ACTIVE 6/1/2020 None N/A EMERGENCY Q5695 MARTUS, WESLEY DANIEL, MD 8/14/2015 8/14/2020 MEDICINE WARREN MI ACTIVE 8/20/2015 None N/A R2166 MARWAH, ASMITA, MD 3/20/2017 3/20/2022 FAMILY MEDICINE FAMILY MEDICINE KITTANING PA ACTIVE 4/18/2017 None N/A MAS RODRIGUEZ, MANUEL PHYSICAL MED. & R0073 FERNANDO, MD 9/15/2016 9/15/2021 REHABILITATION HOUSTON TX ACTIVE 10/28/2016 None N/A SPORTS MEDICINE - SPORTS MEDICINE Q7419 MASCARENHAS, RANDHIR , MD 3/4/2016 3/4/2021 ORTHOPEDICS (ORTH SURG) HOUSTON TX ACTIVE 3/11/2016 None N/A LICENSE Q4804 MASDEU, JOSE CRUZ, MD 6/12/2015 6/12/2020 NEUROLOGY HOUSTON TX ISSUED 6/12/2015 None N/A PEDIATRIC ANESTHESIOLOGY R4428 MASEL, BRIAN DAVID, MD 8/25/2017 8/25/2022 ANESTHESIOLOGY (PEDS) GALVESTON TX ACTIVE 10/3/2017 None N/A Q6066 MASHA, LUKE IVAN , MD 9/15/2015 9/15/2020 INTERNAL MEDICINE INTERNAL MEDICINE HOUSTON TX ACTIVE 10/26/2015 None N/A SURGICAL CRITICAL S5430 MASHAS, WAYNE EDWARD, MD 3/6/2020 3/6/2025 TRAUMATIC SURGERY CARE TEMPLE TX ACTIVE 3/10/2020 None N/A Q9433 MASHAYEKHI, PEGAH , DO 8/1/2016 8/1/2021 INTERNAL MEDICINE SLEEP MEDICINE ESCONDIDO CA ACTIVE 10/31/2016 None N/A MASHMOUSHI, AHMAD KABALAN, R5007 MD 10/20/2017 10/20/2022 PEDIATRICS DALLAS TX ACTIVE 12/12/2017 None N/A R2406 MASON, AJANI WAYNE, MD 4/4/2017 4/4/2022 INTERNAL MEDICINE HOUSTON TX ACTIVE 4/14/2017 None N/A EMERGENCY R3142 MASON, BENJAMIN, MD 5/22/2017 5/22/2022 MEDICINE PENDING TX ACTIVE 5/31/2017 None N/A ENDOCRINOLOGY, DIABETES AND R0074 MASOOD, AWAIS, MD 9/15/2016 9/15/2021 INTERNAL MEDICINE METABOLISM SAVANNAH GA ACTIVE 12/1/2016 None N/A S6242 MASOOD, FARAZ, MD 4/17/2020 4/17/2025 FAMILY MEDICINE HOSPITALIST DULLES VA ACTIVE 4/21/2020 None N/A CRITICAL CARE R5895 MASRI, KAMAL ALI, MD 2/2/2018 2/2/2023 INTERNAL MEDICINE MEDICINE (IM) LONGVIEW TX ACTIVE 2/6/2018 None N/A S6685 MASSERANO, BENJAMIN , MD 5/15/2020 5/15/2025 PEDIATRICS DALLAS TX ACTIVE 5/27/2020 None N/A R4276 MASSOUD, JOHN MICHAEL, MD 8/15/2017 8/15/2022 FAMILY MEDICINE BRYAN TX ACTIVE 8/16/2017 None N/A LICENSE Q4806 MASSOUD, MONA , MD 6/12/2015 6/12/2020 FAMILY PRACTICE ISSUED 6/12/2015 None N/A CARDIOVASCULAR Q5696 MASUD, ALI, MD 8/14/2015 8/14/2020 INTERNAL MEDICINE DISEASES ACTIVE 9/1/2015 None N/A R1245 MATA, MAGGY, MD 1/6/2017 1/6/2022 INTERNAL MEDICINE LAFAYETTE LA ACTIVE 2/21/2017 None N/A Q9434 MATEEN, NIDA, MD 8/1/2016 8/1/2021 INTERNAL MEDICINE PIKEVILLE KY ACTIVE 9/20/2016 None N/A Page 178 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PULMONARY MATHAI, SUSAN KADAKATHINKEL, CRITICAL CARE R5594 MD 1/5/2018 1/5/2023 MEDICINE INTERNAL MEDICINE AURORA CO ACTIVE 1/19/2018 None N/A VASCULAR AND MATHESON, MICHAEL ROBERT, DIAGNOSTIC INTERVENTIONAL G9036 MD 7/1/2015 7/1/2020 RADIOLOGY RADIOLOGY PARKER CO ACTIVE 7/9/2015 None N/A ORTHOPEDIC Q7744 MATHEW, STEPHEN THOMAS, MD 4/1/2016 4/1/2021 SURGERY DALLAS TX ACTIVE 6/15/2016 None N/A LICENSE Q5865 MATHEW, TEENA, MD 8/28/2015 8/28/2020 INTERNAL MEDICINE ISSUED 8/28/2015 None N/A INTERVENTIONAL N3873 MATHEWKUTTY, SHINY , MD 7/15/2015 7/15/2020 CARDIOLOGY CARDIOLOGY NEW YORK NY ACTIVE 7/31/2015 None N/A PHYSICAL MED. & R3909 MATHEWS, AMY ANN, MD 7/17/2017 7/17/2022 REHABILITATION DALLAS TX ACTIVE 7/27/2017 None N/A Q8106 MATHIS, SAMUEL ELI, MD 5/2/2016 5/2/2021 FAMILY MEDICINE SUGAR LAND TX ACTIVE 5/4/2016 None N/A INTERVENTIONAL S6446 MATHUR, ATISH PRATAP, MD 5/1/2020 5/1/2025 CARDIOLOGY CARDIOLOGY PARAMUS NJ ACTIVE 5/4/2020 None N/A CHILD AND ADOLESCENT Q9861 MATIN, ASNA ANIKA, MD 8/26/2016 8/26/2021 PSYCHIATRY PSYCHIATRY HOUSTON TX ACTIVE 8/30/2016 None N/A R4872 MATSUI, JOY TAMIKO, MD 10/6/2017 10/6/2022 RADIOLOGY DALLAS TX ACTIVE 10/9/2017 None N/A R4092 MATTAMAL, RAPHAEL JOSY, MD 8/1/2017 8/1/2022 PEDIATRICS AMARILLO TX ACTIVE 1/24/2018 None N/A R2408 MATTHEWS, VARGHESE , MD 4/4/2017 4/4/2022 ANESTHESIOLOGY DALLAS TX ACTIVE 4/13/2017 None N/A S5981 MATTHYS, ALLYSON MARIE, DO 4/3/2020 4/3/2025 FAMILY MEDICINE FORT WORTH TX ACTIVE 4/13/2020 None N/A EMERGENCY BROWNSVILL R2915 MATTINGLY, JOSEPH DONALD, MD 5/5/2017 5/5/2022 MEDICINE E TX ACTIVE 5/9/2017 None N/A MATTREY, ROBERT FREDERICK, DIAGNOSTIC R3143 MD 5/22/2017 5/22/2022 RADIOLOGY RADIOLOGY DALLAS TX ACTIVE 5/26/2017 None N/A FAMILY Q9862 MATTSON, RODGER CURTIS, DO 8/26/2016 8/26/2021 PRACTICE/OMM SHERMAN TX ACTIVE 9/5/2016 None N/A URGENT CARE Q9436 MATZEN, DORIAN RAIN, DO 8/1/2016 8/1/2021 MEDICINE FAMILY MEDICINE AMARILLO TX ACTIVE 8/5/2016 None N/A EMERGENCY R4430 MAUR, ERIC EVAN, MD 8/25/2017 8/25/2022 MEDICINE ACTIVE 9/4/2017 None N/A HEMATOLOGY/ONCO LICENSE S6243 MAURE, BERNARDITA MATOL, MD 4/17/2020 4/17/2025 INTERNAL MEDICINE LOGY ISSUED 4/17/2020 None N/A S6887 MAURICIO, RINA , MD 5/29/2020 5/29/2025 INTERNAL MEDICINE CARDIOLOGY DALLAS TX ACTIVE 6/1/2020 None N/A GASTROENTEROLOG S6686 MAXIMOS, ALEXIS, MD 5/15/2020 5/15/2025 Y INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 6/1/2020 None N/A Q5032 MAXWELL, DANIEL , MD 7/1/2015 7/1/2020 INTERNAL MEDICINE DALLAS TX ACTIVE 7/6/2015 None N/A S6244 MAXWELL, ELISA, MD 4/17/2020 4/17/2025 ANESTHESIOLOGY ACTIVE 4/21/2020 None N/A Page 179 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date EMERGENCY S6245 MAXWELL, STUART JAMES, MD 4/17/2020 4/17/2025 MEDICINE ACTIVE 5/8/2020 None N/A R0903 MAY, JOHN PATRICK, MD 12/2/2016 12/2/2021 INTERNAL MEDICINE MIAMI FL ACTIVE 1/5/2017 None N/A S5982 MAYO, KRISTINA MARIE, MD 4/3/2020 4/3/2025 ANESTHESIOLOGY MORRISVILLE NC ACTIVE 4/7/2020 None N/A THORACIC CARDIOVASCULAR J2192 MAYOR, KEVIN LEE, MD 7/1/2016 7/1/2021 SURGERY AMARILLO TX ACTIVE 7/18/2016 None N/A WINSTON Q6539 MAYS, ASHLEY C, MD 11/16/2015 11/16/2020 OTOLARYNGOLOGY SALEM NC ACTIVE 11/23/2015 None N/A Q9438 MAZAL, NICOLAS JAMES, MD 8/1/2016 8/1/2021 RADIOLOGY HOUSTON TX ACTIVE 8/31/2016 None N/A HEMATOLOGY/ONCOL Q8559 MAZO CANOLA, MARCELA , MD 6/1/2016 6/1/2021 OGY SAN ANTONIO TX ACTIVE 6/2/2016 None N/A MAZZARELLA, BRIAN CONFREY, R5008 MD 10/20/2017 10/20/2022 UROLOGY AUSTIN TX ACTIVE 11/2/2017 None N/A ADDICTION M6752 MAZZARULLI, ANTHONY, MD 6/16/2017 6/16/2022 PSYCHIATRY MEDICINE PINEHURST NC ACTIVE 6/22/2017 None N/A EMERGENCY EMERGENCY R0754 MBUGUA, ROSALIA NJERI, MD 11/15/2016 11/15/2021 MEDICINE MEDICINE FORT WORTH TX ACTIVE 1/11/2017 None N/A S5223 MCADAMS, JILLIAN, MD 2/21/2020 2/21/2025 PEDIATRICS BOSTON MA ACTIVE 2/26/2020 None N/A EMERGENCY NEW R3380 MCARTHUR, ROBERT DANIEL, MD 6/2/2017 6/2/2022 MEDICINE BEDFORD MA ACTIVE 7/14/2017 None N/A EMERGENCY Q7233 MCATEE, ROBERT GORHAM, MD 2/16/2016 2/16/2021 MEDICINE SEGUIN TX ACTIVE 2/18/2016 None N/A R4874 MCBRIDE, CAMERON LEE, MD 10/6/2017 10/6/2022 INTERNAL MEDICINE HOUSTON TX ACTIVE 10/9/2017 None N/A MCCAFFREY, THOMAS JOSEPH OBSTETRICS AND R0615 JR, MD 10/31/2016 10/31/2021 GYNECOLOGY OAK LAWN IL ACTIVE 12/5/2016 None N/A Q9439 MCCAIN, TAYLOR DALE, DO 8/1/2016 8/1/2021 FAMILY MEDICINE WACO TX ACTIVE 8/8/2016 None N/A LICENSE R6243 MCCALL, DAVID TIMMONS, DO 3/2/2018 3/2/2023 GENERAL SURGERY ISSUED 3/2/2018 None N/A ORTHOPEDIC R1582 MCCALL, KRISTOPHER BLAKE, MD 2/6/2017 2/6/2022 SURGERY LUFKIN TX ACTIVE 2/9/2017 None N/A R4093 MCCALL, STEPHEN MOORE, MD 8/1/2017 8/1/2022 FAMILY MEDICINE WACO TX ACTIVE 8/16/2017 None N/A R2667 MCCARTY, JENNIFER LYNN, MD 4/20/2017 4/20/2022 RADIOLOGY NEURO-RADIOLOGY LITTLE ROCK AR ACTIVE 5/1/2017 None N/A PEDIATRIC MCCARTY, THOMAS RANDOLPH, EMERGENCY R2668 MD 4/20/2017 4/20/2022 PEDIATRICS MEDICINE (PEDS) LITTLE ROCK AR ACTIVE 5/2/2017 None N/A MCCARUS, STEVEN DOUGLAS SR, GYNECOLOGIC Q8107 MD 5/2/2016 5/2/2021 SURGERY ACTIVE 5/9/2016 None N/A ANATOMIC/CLINICAL S6247 MCCAY, JULI ANNE, MD 4/17/2020 4/17/2025 PATHOLOGY NASHVILLE TN ACTIVE 4/22/2020 None N/A

Page 180 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date DIAGNOSTIC S5014 MCCAY, TIMOTHY, DO 2/7/2020 2/7/2025 RADIOLOGY TULSA OK ACTIVE 2/18/2020 None N/A MCCLELLAN, ANDREW JOSEPH, OPHTHALMOLOGY - R1988 MD 3/3/2017 3/3/2022 VITREOUS SURGERY OPHTHALMOLOGY DALLAS TX ACTIVE 3/8/2017 None N/A Q7925 MCCLUNG, MEGAN, MD 4/15/2016 4/15/2021 PEDIATRICS AUSTIN TX ACTIVE 4/25/2016 None N/A R2412 MCCONNELL, JENNIFER AI, MD 4/4/2017 4/4/2022 PEDIATRICS NEW YORK NY ACTIVE 4/5/2017 None N/A ORTHOPEDIC SPORTS MEDICINE - Q5033 MCCORMICK, FRANK, MD 7/1/2015 7/1/2020 SURGERY ORTHOPEDICS BEDFORD TX ACTIVE 7/14/2015 None N/A

R3558 MCCORMICK, ROBERT DEVLIN, DO 6/16/2017 6/16/2022 GENERAL SURGERY ARLINGTON TX ACTIVE 6/20/2017 None N/A LICENSE S7096 MCCOUL, EDWARD DAVID, MD 6/12/2020 6/12/2025 OTOLARYNGOLOGY ISSUED 6/12/2020 None N/A MCCOY, RODERICK LAWRENCE, LICENSE S5015 MD 2/7/2020 2/7/2025 INTERNAL MEDICINE ISSUED 2/7/2020 None N/A MCCREARY-FIELDER, RACHEL GEORGETOW R2669 ANN, MD 4/20/2017 4/20/2022 FAMILY MEDICINE N TX ACTIVE 4/26/2017 None N/A MCCULLOUGH, LOUISE DEBORAH, VASCULAR Q6233 MD 10/1/2015 10/1/2020 NEUROLOGY NEUROLOGY HOUSTON TX ACTIVE 10/12/2015 None N/A GERIATRIC MEDICINE (FAMILY CORPUS R4432 MCDANIEL, ALMA DANIELLE, MD 8/25/2017 8/25/2022 FAMILY MEDICINE PRACTICE) CHRISTI TX ACTIVE 9/7/2017 None N/A MCDANIEL, CONNER CLAYTON, CRITICAL CARE S6449 MD 5/1/2020 5/1/2025 GENERAL SURGERY (TRAUMA) DALLAS TX ACTIVE 5/4/2020 None N/A Q4631 MCDANIEL, RENNY, MD 6/1/2015 6/1/2020 FAMILY MEDICINE CUERO TX ACTIVE 6/15/2015 None N/A R0616 MCDEVITT, JOSEPH , MD 10/31/2016 10/31/2021 RADIOLOGY DALLAS TX ACTIVE 11/1/2016 None N/A

Q8751 MCDONALD, ANTHONY ROSS, MD 6/10/2016 6/10/2021 INTERNAL MEDICINE SAN ANGELO TX ACTIVE 6/14/2016 None N/A EMERGENCY LICENSE Q8561 MCDONALD, SAMUEL ARTHUR, MD 6/1/2016 6/1/2021 MEDICINE ISSUED 6/1/2016 None N/A CARDIO- INTERVENTIONAL LICENSE Q4632 MCDONOUGH, RYAN , DO 6/1/2015 6/1/2020 RADIOLOGY ISSUED 6/1/2015 None N/A CHILD AND MCEACHERN, MATTHEW ADOLESCENT R5292 DOUGLAS, MD 11/17/2017 11/17/2022 PSYCHIATRY PSYCHIATRY CLARKSVILLE VA ACTIVE 11/20/2017 None N/A CHILD AND ADOLESCENT Q7422 MCFARLANE, NADIA ANNE, MD 3/4/2016 3/4/2021 PSYCHIATRY PSYCHIATRY ROCKVILLE MD ACTIVE 3/8/2016 None N/A MCGANN, KEVIN-SEAN ANTHONY, EMERGENCY R4279 DO 8/15/2017 8/15/2022 MEDICINE DALLAS TX ACTIVE 8/31/2017 None N/A S4655 MCGEHEE, HANNA BRADEN, MD 1/10/2020 1/10/2025 FAMILY MEDICINE OBSTETRICS BRYAN TX ACTIVE 1/13/2020 None N/A Page 181 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date S5016 MCGILVERY, TARYN NICOLE, MD 2/7/2020 2/7/2025 FAMILY MEDICINE CANYON TX ACTIVE 4/6/2020 None N/A Q9863 MCGLYNN, SCOTT PAUL, DO 8/26/2016 8/26/2021 INTERNAL MEDICINE HOSPITALIST SAN ANTONIO TX ACTIVE 9/12/2016 None N/A PEDIATRIC MCGREGOR, NICHOLAS WILLIAM, HEMATOLOGY/ONCOL R3146 MD 5/22/2017 5/22/2022 OGY TEMPLE TX ACTIVE 6/1/2017 None N/A INTERVENTIONAL LICENSE Q8562 MCGREW, ALLEN DAVID, DO 6/1/2016 6/1/2021 CARDIOLOGY CARDIOLOGY ISSUED 6/1/2016 None N/A EMERGENCY R0076 MCHUGH, MARY C, MD 9/15/2016 9/15/2021 MEDICINE DALLAS TX ACTIVE 9/20/2016 None N/A

Q5223 MCHUGH, THOMAS MICHAEL, MD 7/15/2015 7/15/2020 ANESTHESIOLOGY HOUSTON TX ACTIVE 9/14/2015 None N/A ANATOMIC/CLINICAL DERMATOPATHOLO Q5035 MCINTIRE, HOLLY LEIGH, MD 7/1/2015 7/1/2020 PATHOLOGY GY BIRMINGHAM AL ACTIVE 7/3/2015 None N/A Q5487 MCINTOSH, G ANDREW, MD 8/3/2015 8/3/2020 FAMILY MEDICINE BOERNE TX ACTIVE 8/4/2015 None N/A ANESTHESIOLOGY - Q9864 MCJUNKIN, TORY LANCE, MD 8/26/2016 8/26/2021 PAIN MANAGEMENT PAIN MEDICINE SCOTTSDALE AZ ACTIVE 9/14/2016 None N/A PLASTIC & RECONSTRUCTIVE LICENSE Q4808 MCKEE, DANIEL, MD 6/12/2015 6/12/2020 SURGERY ISSUED 6/12/2015 None N/A MCKELLAR, DUNCAN LAWRENCE ORTHOPEDIC G5359 JR, MD 8/28/2015 8/28/2020 SURGERY CLARKSVILLE TN ACTIVE 9/10/2015 None N/A R3911 MCKENNY, JAMES ROBERT, MD 7/17/2017 7/17/2022 ANESTHESIOLOGY AMARILLO TX ACTIVE 7/18/2017 None N/A R4876 MCKENZIE, JERRY LAMONT, MD 10/6/2017 10/6/2022 FAMILY MEDICINE LEWISVILLE TX ACTIVE 1/4/2018 None N/A

R1584 MCKIBBEN, MAXIM JAMES, MD 2/6/2017 2/6/2022 UROLOGY UROLOGIC SURGERY DALLAS TX ACTIVE 4/12/2017 None N/A OCCUPATIONAL S4819 MCKNIGHT, SYLVIA, MD 1/24/2020 1/24/2025 INTERNAL MEDICINE MEDICINE ACTIVE 3/3/2020 None N/A NEW S5985 MCLAIN, JOHN MARK, MD 4/3/2020 4/3/2025 GENERAL SURGERY BRAUNFELS TX ACTIVE 4/23/2020 None N/A EMERGENCY R1083 MCLARTY, DAISHA LATOYA, MD 12/16/2016 12/16/2021 MEDICINE FORT WORTH TX ACTIVE 1/13/2017 None N/A MCLAUGHLIN, HSIANG CHI CATHY, Q8303 MD 5/16/2016 5/16/2021 UROLOGY FORT HOOD TX ACTIVE 5/24/2016 None N/A MCLAUGHLIN, SUSANNE FRANCIS, R3147 MD 5/22/2017 5/22/2022 NEPHROLOGY INTERNAL MEDICINE HOUSTON TX ACTIVE 8/10/2017 None N/A EMERGENCY R2671 MCLEAN, JOHN ELLIOTT III, MD 4/20/2017 4/20/2022 MEDICINE HUMBLE TX ACTIVE 4/25/2017 None N/A

Q9675 MCLEAN, ROBERT COCHRANE, MD 8/15/2016 8/15/2021 OTOLARYNGOLOGY AMARILLO TX ACTIVE 9/1/2016 None N/A MCLELLAN, SUSAN LESLIE INFECTIOUS S5433 FAVROT, MD 3/6/2020 3/6/2025 DISEASES INTERNAL MEDICINE GALVESTON TX ACTIVE 3/25/2020 None N/A Page 182 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PEDIATRIC MCLEROY WALLACE, ALEXANDRA, EMERGENCY EMERGENCY S6891 MD 5/29/2020 5/29/2025 MEDICINE MEDICINE (EM) DALLAS TX ACTIVE 6/12/2020 None N/A R0078 MCMAHAN, YOUNG T, MD 9/15/2016 9/15/2021 DERMATOLOGY GALVESTON TX ACTIVE 9/21/2016 None N/A OBSTETRICS AND MATERNAL AND R5595 MCMASTER, KRISTEN MARIE, MD 1/5/2018 1/5/2023 GYNECOLOGY FETAL MEDICINE JACKSON MS ACTIVE 1/12/2018 None N/A PEDIATRIC CRITICAL Q8957 MCMICHAEL, ALI BV, MD 7/1/2016 7/1/2021 CARE MEDICINE DALLAS TX ACTIVE 8/3/2016 None N/A EMERGENCY R4594 MCMILLAN, CODY JACKSON, DO 9/8/2017 9/8/2022 MEDICINE JOPLIN MO ACTIVE 9/15/2017 None N/A EMERGENCY Q5224 MCMILLAN, SAM, MD 7/15/2015 7/15/2020 MEDICINE HOUSTON MO ACTIVE 7/20/2015 None N/A DIAGNOSTIC S5702 MCNEER, MEGAN KRULL, DO 3/20/2020 3/20/2025 RADIOLOGY BREAST IMAGING ACTIVE 5/7/2020 None N/A Q7745 MCNUTT, GRACE MARIE, MD 4/1/2016 4/1/2021 NEPHROLOGY INTERNAL MEDICINE LAREDO TX ACTIVE 5/5/2016 None N/A

OPHTHALMOLOGY - Q7580 MCNUTT, STEPHEN ANDREW, MD 3/15/2016 3/15/2021 OPHTHALMOLOGY ANTERIOR SURGERY LAREDO TX ACTIVE 4/1/2016 None N/A PULMONARY CRITICAL CARE S4348 MCSHANE, PAMELA JEAN, MD 12/6/2019 12/6/2024 MEDICINE TYLER TX ACTIVE 12/25/2019 None N/A PULMONARY CRITICAL CARE S4348 MCSHANE, PAMELA JEAN, MD 12/6/2019 12/6/2024 MEDICINE TYLER TX ACTIVE 12/25/2019 None N/A ORTHOPEDIC R1990 MCSPADDEN, JOSHUA RYAN, DO 3/3/2017 3/3/2022 SURGERY WAXAHACHIE TX ACTIVE 3/10/2017 None N/A MCUNU, ARTHUR NTANDO CARDIOVASCULAR VASCULAR WICHITA M7420 SIBUSISO JR, MD 9/8/2017 9/8/2022 SURGERY SURGERY FALLS TX ACTIVE 1/5/2018 None N/A MEADOWS, ADELINA GUNAWAN, PEDIATRIC N8818 MD 8/1/2017 8/1/2022 ENDOCRINOLOGY TYLER TX ACTIVE 8/21/2017 None N/A MEANS, JACQUELYN MICHELLE, OBSTETRICS AND Q6448 MD 11/2/2015 11/2/2020 GYNECOLOGY ACTIVE 11/9/2015 None N/A Q9196 MEAUX, CRAIG JR, MD 7/15/2016 7/15/2021 OPHTHALMOLOGY BEAUMONT TX ACTIVE 7/25/2016 None N/A MECHAM, BENJAMEN WALLACE, FAMILY PRACTICE - R0756 DO 11/15/2016 11/15/2021 EMERGENCY MED LONGVIEW TX ACTIVE 11/16/2016 None N/A INTERVENTIONAL R5596 MEDARAMETLA, SRIKANTH, MD 1/5/2018 1/5/2023 RADIOLOGY RADIOLOGY HOUSTON TX ACTIVE 1/25/2018 None N/A OBSTETRICS AND Q6234 MEDEL, MICHELLE PHI, MD 10/1/2015 10/1/2020 GYNECOLOGY DALLAS TX ACTIVE 10/13/2015 None N/A

Page 183 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date DELINQUEN EMERGENCY T-NON R4742 MEDEPALLI, SAMPATH KUMAR, MD 9/22/2017 9/22/2022 FAMILY MEDICINE MEDICINE PAYMENT 12/21/2017 None N/A R0617 MEDINA PARRILLA, NADYA, MD 10/31/2016 10/31/2021 PEDIATRICS HOUSTON TX ACTIVE 11/11/2016 None N/A Q6235 MEDINA, ALFREDO , MD 10/1/2015 10/1/2020 FAMILY MEDICINE ODESSA TX ACTIVE 11/9/2015 None N/A Q9198 MEDINA, CARLOS A, MD 7/15/2016 7/15/2021 FAMILY MEDICINE MERCEDES TX ACTIVE 7/19/2016 None N/A R5774 MEDINA, MELECIO JESUS, MD 1/19/2018 1/19/2023 OTOLARYNGOLOGY DALLAS TX ACTIVE 1/30/2018 None N/A PEDIATRIC GASTROENTEROLOG R2413 MEDINA-CENTENO, RICARDO , MD 4/4/2017 4/4/2022 Y DALLAS TX ACTIVE 4/10/2017 None N/A Q9199 MEDLEY, MELISSA KAY, MD 7/15/2016 7/15/2021 INTERNAL MEDICINE INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 7/19/2016 None N/A R2918 MEEK, CAMERON ALAN, MD 5/5/2017 5/5/2022 ANESTHESIOLOGY DALLAS TX ACTIVE 5/15/2017 None N/A S5434 MEESALA, YASODA , MD 3/6/2020 3/6/2025 INTERNAL MEDICINE HOSPITALIST SAVANNAH GA ACTIVE 5/12/2020 None N/A FAMILY PRACTICE - LICENSE S5703 MEFFORD, TRENTON LLOYD, DO 3/20/2020 3/20/2025 EMERGENCY MED ISSUED 3/20/2020 None N/A EMERGENCY EMERGENCY S4822 MEHKRI, FAROUKH M, DO 1/24/2020 1/24/2025 MEDICINE MEDICAL SERVICES DALLAS TX ACTIVE 1/28/2020 None N/A OLYMPIA S4657 MEHTA, ANKEETA, DO 1/10/2020 1/10/2025 GENERAL SURGERY FIELDS IL ACTIVE 2/11/2020 None N/A GASTROENTEROLOG S6893 MEHTA, DHRUV SOHANRAJ, MD 5/29/2020 5/29/2025 Y INTERNAL MEDICINE SAN ANTONIO TX ACTIVE 6/4/2020 None N/A PEDIATRIC CARDIOVASCULAR CARDIOTHORACIC CORPUS R0281 MEHTA, INDER D, MD 9/30/2016 9/30/2021 SURGERY SURGERY CHRISTI TX ACTIVE 11/17/2016 None N/A PEDIATRIC GASTROENTEROLOG Q8304 MEHTA, MEGHA SATISH, MD 5/16/2016 5/16/2021 PEDIATRICS Y DALLAS TX ACTIVE 6/3/2016 None N/A EMERGENCY ALAMOGORD Q6658 MEHTA, NIKHIL K, MD 12/4/2015 12/4/2020 GENERAL SURGERY MEDICINE O NM ACTIVE 12/7/2015 None N/A EMERGENCY ALAMOGORD Q6658 MEHTA, NIKHIL K, MD 12/4/2015 12/4/2020 GENERAL SURGERY MEDICINE O NM ACTIVE 12/7/2015 None N/A EMERGENCY ALAMOGORD Q6658 MEHTA, NIKHIL K, MD 12/4/2015 12/4/2020 GENERAL SURGERY MEDICINE O NM ACTIVE 12/7/2015 None N/A INTERVENTIONAL DIAGNOSTIC R5900 MEHTA, NILAY V, MD 2/2/2018 2/2/2023 RADIOLOGY RADIOLOGY AMARILLO TX ACTIVE 2/14/2018 None N/A S6894 MEHTA, ROHAN, MD 5/29/2020 5/29/2025 CARDIOLOGY KILLEEN TX ACTIVE 6/9/2020 None N/A HEMATOLOGY/ONCOL PALLIATIVE Q9444 MEHTA, ROHTESH S, MD 8/1/2016 8/1/2021 OGY MEDICINE HOUSTON TX ACTIVE 8/3/2016 None N/A S4658 MEHTA, TAPAN RAJARSHI, MD 1/10/2020 1/10/2025 INTERNAL MEDICINE EVANSVILLE IN ACTIVE 1/15/2020 None N/A OBSTETRICS AND R4281 MEIKLE, SUSAN FRANCES, MD 8/15/2017 8/15/2022 PALLIATIVE MEDICINE GYNECOLOGY AMARILLO TX ACTIVE 8/17/2017 None N/A Page 184 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date EMERGENCY Q8564 MEINDL HOLMAN, JUDI D, MD 6/1/2016 6/1/2021 MEDICINE ACTIVE 6/3/2016 None N/A

Q7236 MEISSNER, MARISSA NICOLE, MD 2/16/2016 2/16/2021 RHEUMATOLOGY INTERNAL MEDICINE ACTIVE 3/8/2016 None N/A MEISSNER, MATTHEW ARTHUR, UROLOGIC Q7423 MD 3/4/2016 3/4/2021 UROLOGIC SURGERY ONCOLOGY ACTIVE 3/8/2016 None N/A MEJIA GARCIA, ALEX VLADIMIR, HEMATOLOGY/ONCO Q5038 MD 7/1/2015 7/1/2020 INTERNAL MEDICINE LOGY SAN ANTONIO TX ACTIVE 7/31/2015 None N/A PEDIATRIC Q9677 MEJIA OTERO, JUAN DIEGO , MD 8/15/2016 8/15/2021 ENDOCRINOLOGY DALLAS TX ACTIVE 8/17/2016 None N/A R3913 MEKALA, ASHLEY VIJAY, DO 7/17/2017 7/17/2022 GENERAL SURGERY FORT WORTH TX ACTIVE 7/26/2017 None N/A INFECTIOUS R6244 MEKALA, VIJAYASHREE, MD 3/2/2018 3/2/2023 DISEASES INTERNAL MEDICINE ACTIVE 3/6/2018 None N/A NEUROLOGY & Q7746 MELAMED, ESTHER, MD 4/1/2016 4/1/2021 PSYCHIATRY NEUROLOGY AUSTIN TX ACTIVE 5/4/2016 None N/A S6451 MELANCON, CALEB GRAY, MD 5/1/2020 5/1/2025 INTERNAL MEDICINE HOSPITALIST HOUSTON TX ACTIVE 5/5/2020 None N/A R0449 MELGREN, KEVIN ARLIN, MD 10/14/2016 10/14/2021 FAMILY MEDICINE FORT WORTH TX ACTIVE 10/20/2016 None N/A OBSTETRICS AND LICENSE Q4635 MELLO, LEAH , MD 6/1/2015 6/1/2020 GYNECOLOGY ISSUED 6/1/2015 None N/A EMERGENCY R3914 MELOY, PATRICK, MD 7/17/2017 7/17/2022 MEDICINE ATLANTA GA ACTIVE 7/27/2017 None N/A VASCULAR R2675 MEMON, AURANGZEB , MD 4/20/2017 4/20/2022 NEUROLOGY NEUROLOGY HOUSTON TX ACTIVE 5/22/2017 None N/A LICENSE S5989 MENA, JESSICA, MD 4/3/2020 4/3/2025 ANESTHESIOLOGY ISSUED 4/3/2020 None N/A EMERGENCY R0282 MENARD, CHRISTIAN, MD 9/30/2016 9/30/2021 MEDICINE HOUSTON TX ACTIVE 10/4/2016 None N/A OBSTETRICS AND D2525 MENCONI, LAWRENCE RALPH, MD 12/16/2016 12/16/2021 FAMILY PRACTICE GYNECOLOGY ACTIVE 1/10/2017 None N/A

R0876 MENDELOW, ILANA MICHAL, MD 12/2/2016 12/2/2021 UROLOGY UROLOGIC SURGERY ROUND ROCK TX ACTIVE 12/30/2016 None N/A MENDEZ BAYLON, MAURO LICENSE S5990 ALBERTO, MD 4/3/2020 4/3/2025 SLEEP MEDICINE INTERNAL MEDICINE ISSUED 4/3/2020 None N/A NEUROMUSCULAR Q7929 MENDEZ VARGAS, KARINA, MD 4/15/2016 4/15/2021 NEUROLOGY DISEASE EL PASO TX ACTIVE 4/18/2016 None N/A Q6236 MENDEZ, ILEANA ELITA, MD 10/1/2015 10/1/2020 FAMILY MEDICINE ACTIVE 10/5/2015 None N/A R0451 MENDIOLA, LUIS GARCIA JR, MD 10/14/2016 10/14/2021 PSYCHIATRY EL PASO TX ACTIVE 11/16/2016 None N/A CHILD AND MENDIOLA, NADIA EVANGELINA, ADOLESCENT R5009 MD 10/20/2017 10/20/2022 PSYCHIATRY PSYCHIATRY ACTIVE 10/23/2017 None N/A

Page 185 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date GERIATRIC MEDICINE (FAMILY R0452 MENDOZA, JOSE AMERICO , MD 10/14/2016 10/14/2021 FAMILY MEDICINE PRACTICE) SAN ANTONIO TX ACTIVE 10/18/2016 None N/A Q9203 MENEES, AARIKA LESLIE, MD 7/15/2016 7/15/2021 OPHTHALMOLOGY ACTIVE 7/19/2016 None N/A Q7237 MENG, HSIANG-CHI, DO 2/16/2016 2/16/2021 INTERNAL MEDICINE NEW YORK NY ACTIVE 3/2/2016 None N/A PHYSICAL MED. & S5991 MENG, LUKE, MD 4/3/2020 4/3/2025 REHABILITATION ROUND ROCK TX ACTIVE 5/4/2020 None N/A Q9204 MENON, INDU, MD 7/15/2016 7/15/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 7/22/2016 None N/A PEDIATRIC Q8958 MENON, VANI SUNDARAM, MD 7/1/2016 7/1/2021 UROLOGY UROLOGY AUSTIN TX ACTIVE 7/8/2016 None N/A S5436 MENON, VINAY KUMAR, MD 3/6/2020 3/6/2025 HOSPITALIST WORCESTER MA ACTIVE 5/14/2020 None N/A R0757 MENSAH, VICTOR OLAWALE, MD 11/15/2016 11/15/2021 FAMILY MEDICINE HOSPITALIST ACTIVE 12/23/2016 None N/A SURGICAL CRITICAL R4098 MENTZER, CALEB JAMES, DO 8/1/2017 8/1/2022 TRAUMATIC SURGERY CARE HOUSTON TX ACTIVE 8/3/2017 None N/A LICENSE S6688 MERCADO, MICHAEL JASON, DO 5/15/2020 5/15/2025 FAMILY MEDICINE HOSPITALIST ISSUED 5/15/2020 None N/A NEONATAL- PERINATAL R3973 MERCADO, VANESSA MARIA V, MD 7/17/2017 7/17/2022 PEDIATRICS MEDICINE HOUSTON TX ACTIVE 7/26/2017 None N/A MERCER, TIMOTHY IAN R4099 MACKENZIE, MD 8/1/2017 8/1/2022 INTERNAL MED - PEDS AUSTIN TX ACTIVE 8/15/2017 None N/A GERIATRICS - SPORTS MEDICINE - LICENSE Q8752 MERCER, YOLANDA JANE, MD 6/10/2016 6/10/2021 INTERNAL MEDICINE IM ISSUED 6/10/2016 None N/A MERCHANT, DELWIN SHELDON, EMERGENCY Q7747 MD 4/1/2016 4/1/2021 MEDICINE BELLEVILLE IL ACTIVE 4/13/2016 None N/A R4744 MERCHANT, OMAR , MD 9/22/2017 9/22/2022 INTERNAL MEDICINE HOUSTON TX ACTIVE 9/27/2017 None N/A R4745 MERID, FANTAYE, MD 9/22/2017 9/22/2022 FAMILY MEDICINE ACTIVE 9/27/2017 None N/A Q7078 MERJANEH, ZAHI, MD 2/1/2016 2/1/2021 INTERNAL MEDICINE CLEVELAND OH ACTIVE 3/17/2016 None N/A R1420 MERLI, NICOLE MARIE, MD 1/20/2017 1/20/2022 FAMILY MEDICINE ACTIVE 2/13/2017 None N/A EMERGENCY R0079 MERLIS, JENNIFER KAY, MD 9/15/2016 9/15/2021 MEDICINE DULUTH MN ACTIVE 9/23/2016 None N/A LICENSE Q5868 MERRITT, CURTIS JAMES, DO 8/28/2015 8/28/2020 HOSPITALIST INTERNAL MEDICINE ISSUED 8/28/2015 None N/A EMERGENCY Q4636 MERRITT, JUDSON, MD 6/1/2015 6/1/2020 MEDICINE ACTIVE 6/15/2015 None N/A HEMATOLOGY/ONCOL HEMATOLOGY/ONCO R4282 MESA, RUBEN ANTHONY, MD 8/15/2017 8/15/2022 OGY LOGY SAN ANTONIO TX ACTIVE 10/3/2017 None N/A OBSTETRICS & GYNECOLOGICAL Q5869 MESHRI, GITA DAYAL, DO 8/28/2015 8/28/2020 SURGERY FORT WORTH TX ACTIVE 9/10/2015 None N/A Q6966 MESKI, ALEXANDER, MD 1/15/2016 1/15/2021 PSYCHIATRY SAN ANTONIO TX ACTIVE 1/18/2016 None N/A Page 186 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PEDIATRIC S4659 MESSNER, ANNA HOPEMAN, MD 1/10/2020 1/10/2025 OTOLARYNGOLOGY OTOLARYNGOLOGY HOUSTON TX ACTIVE 1/21/2020 None N/A R6048 METTER, DAVID MATTHEW, MD 2/16/2018 2/16/2023 PATHOLOGY DALLAS TX ACTIVE 2/26/2018 None N/A EMERGENCY Q6877 METWALLI, OMAR AHMED, MD 1/6/2016 1/6/2021 MEDICINE HOUSTON TX ACTIVE 1/13/2016 None N/A R1248 METZGER, DAVID TYLER, DO 1/6/2017 1/6/2022 FAMILY MEDICINE GARLAND TX ACTIVE 1/16/2017 None N/A MEWADA, NISHITH LICENSE Q5490 MAHENDRABHAI, MD 8/3/2015 8/3/2020 INTERNAL MEDICINE HOSPITALIST ISSUED 8/3/2015 None N/A SURGICAL CRITICAL Q7079 MEYER, DAVID EVAN, MD 2/1/2016 2/1/2021 GENERAL SURGERY CARE HOUSTON TX ACTIVE 2/2/2016 None N/A ANESTHESIOLOGY - L0868 MEYER, JEFFREY PAUL, MD 8/25/2017 8/25/2022 PAIN MANAGEMENT DALLAS TX ACTIVE 9/4/2017 None N/A MGBEMENA, OKECHUKWU R3150 NWAKILE, MD 5/22/2017 5/22/2022 INTERNAL MEDICINE HOSPITALIST HOUSTON TX ACTIVE 5/29/2017 None N/A DIAGNOSTIC R5597 MIAN, FARUKH SAEED, MD 1/5/2018 1/5/2023 RADIOLOGY NEURO-RADIOLOGY COLUMBIA MO ACTIVE 1/29/2018 None N/A R4596 MIAN, KHURAM M, DO 9/8/2017 9/8/2022 NEUROLOGY SHERMAN TX ACTIVE 9/28/2017 None N/A CHATTANOOG R5432 MICHAELIS, NANCY GADAMS, MD 12/8/2017 12/8/2022 INTERNAL MEDICINE HOSPITALIST A TN ACTIVE 1/1/2018 None N/A MICHAELS, BROOKS CARLTON, PALLIATIVE PORTER Q5228 MD 7/15/2015 7/15/2020 FAMILY MEDICINE MEDICINE RANCH CA ACTIVE 7/20/2015 None N/A ADULT ORTHOPEDIC RECONSTRUCTIVE S6249 MICHEL, DAVID, MD 4/17/2020 4/17/2025 SURGERY ORTHOPEDICS AUSTIN TX ACTIVE 5/15/2020 None N/A EMERGENCY R2677 MICHEL, JOSE ALEJANDRO , MD 4/20/2017 4/20/2022 MEDICINE SHREVEPORT LA ACTIVE 6/19/2017 None N/A R5779 MICHELETTI, JOHN MORGAN, MD 1/19/2018 1/19/2023 OPHTHALMOLOGY HOUSTON TX ACTIVE 2/19/2018 None N/A EMERGENCY R2172 MICHELSON, EDWARD A, MD 3/20/2017 3/20/2022 MEDICINE INTERNAL MEDICINE EL PASO TX ACTIVE 4/17/2017 None N/A

CLINICAL Q4637 MICIC, VESNA MILOJE, MD 6/1/2015 6/1/2020 CHILD NEUROLOGY NEUROPHYSIOLOGY HUNT VALLEY MD ACTIVE 6/9/2015 None N/A

R2678 MIDDLETON JONES, JAMELA, MD 4/20/2017 4/20/2022 ANESTHESIOLOGY DALLAS TX ACTIVE 7/10/2017 None N/A SPORTS MEDICINE Q8566 MIDDLETON, BLAKE, DO 6/1/2016 6/1/2021 (FAMILY PRACTICE) FAMILY MEDICINE BRYAN TX ACTIVE 6/3/2016 None N/A

R1249 MIGGINS, MAKESHA VERNEE, MD 1/6/2017 1/6/2022 BREAST ONCOLOGY GENERAL SURGERY SUGAR LAND TX ACTIVE 1/10/2017 None N/A PEDIATRIC ANESTHESIOLOGY Q5493 MIKHAEL, MARCO NAGY, MD 8/3/2015 8/3/2020 ANESTHESIOLOGY (PEDS) MAYWOOD IL ACTIVE 8/10/2015 None N/A Page 187 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date EMERGENCY R3151 MIKKILINENI, MONICA, MD 5/22/2017 5/22/2022 MEDICINE DALLAS TX ACTIVE 5/29/2017 None N/A S5992 MILAD, MOHEB , MD 4/3/2020 4/3/2025 PEDIATRICS ACTIVE 5/20/2020 None N/A R6245 MILBURN, PRESTON ALLAN, MD 3/2/2018 3/2/2023 UROLOGY TEMPLE TX ACTIVE 3/8/2018 None N/A ANATOMIC/CLINICAL FORTH Q7080 MILES, JANET MARY, MD 2/1/2016 2/1/2021 PATHOLOGY NEURO-PATHOLOGY WORTH TX ACTIVE 4/6/2016 None N/A EMERGENCY R0618 MILLER, AMANDA BARBARA, MD 10/31/2016 10/31/2021 MEDICINE AUSTIN TX ACTIVE 11/3/2016 None N/A EMERGENCY EMERGENCY R3153 MILLER, BRIAN LEONARD, MD 5/22/2017 5/22/2022 MEDICINE MEDICAL SERVICES DALLAS TX ACTIVE 5/29/2017 None N/A DIAGNOSTIC INTERVENTIONAL R4103 MILLER, CARL NORMAN, MD 8/1/2017 8/1/2022 RADIOLOGY RADIOLOGY LONGVIEW TX ACTIVE 8/14/2017 None N/A R1829 MILLER, DALE KATHERINE, MD 2/22/2017 2/22/2022 PSYCHIATRY DALLAS TX ACTIVE 2/23/2017 None N/A LICENSE S6250 MILLER, DANIEL LEE, MD 4/17/2020 4/17/2025 PATHOLOGY CYTOPATHOLOGY ISSUED 4/17/2020 None N/A ORTHOPEDIC ADULT LICENSE Q7748 MILLER, DOUGLAS MICHAEL, DO 4/1/2016 4/1/2021 SURGERY RECONSTRUCTION ISSUED 4/1/2016 None N/A EMERGENCY ALAMOGORD R1830 MILLER, GARETT PIKE, MD 2/22/2017 2/22/2022 MEDICINE O NM ACTIVE 3/28/2017 None N/A R3381 MILLER, JENNIFER MEHL, MD 6/2/2017 6/2/2022 PEDIATRICS HOUSTON TX ACTIVE 7/3/2017 None N/A Q4638 MILLER, KYLE SCOTT, DO 6/1/2015 6/1/2020 PEDIATRICS ACTIVE 6/17/2015 None N/A S4350 MILLER, LAUREN, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE ACTIVE 1/8/2020 None N/A S4350 MILLER, LAUREN, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE ACTIVE 1/8/2020 None N/A S5705 MILLER, MAGDA DENES, MD 3/20/2020 3/20/2025 ANESTHESIOLOGY ACTIVE 6/4/2020 None N/A ORAL & CRANIOFACIAL MAXILLOFACIAL R4283 MILLER, MARK ALLEN, MD 8/15/2017 8/15/2022 SURGERY SURGERY SAN ANTONIO TX ACTIVE 8/16/2017 None N/A Q8753 MILLER, MICHAEL STEPHEN, MD 6/10/2016 6/10/2021 PSYCHIATRY SAN ANTONIO TX ACTIVE 6/15/2016 None N/A OBSTETRICS AND Q7930 MILLER, PATRICIA ANN, DO 4/15/2016 4/15/2021 GYNECOLOGY DALLAS TX ACTIVE 4/18/2016 None N/A Q8959 MILLER, PAUL ELLIOT, MD 7/1/2016 7/1/2021 INTERNAL MEDICINE NEPHROLOGY TEXARKANA TX ACTIVE 7/12/2016 None N/A SURGICAL CRITICAL S6251 MILLER, RICHARD STEPHEN, MD 4/17/2020 4/17/2025 GENERAL SURGERY CARE FORT WORTH TX ACTIVE 4/21/2020 None N/A LICENSE Q4810 MILLER, SPENCER OWEN, MD 6/12/2015 6/12/2020 NEUROLOGY HOSPITALIST ISSUED 6/12/2015 None N/A

Q7081 MILLER, SUZANNE KILCOYNE, MD 2/1/2016 2/1/2021 HOSPITALIST INTERNAL MEDICINE HOUSTON TX ACTIVE 2/15/2016 None N/A LICENSE S6897 MILLER, TRIS MONET, MD 5/29/2020 5/29/2025 ANESTHESIOLOGY ISSUED 5/29/2020 None N/A PEDIATRIC R0620 MILLINGTON, KARMAINE , MD 10/31/2016 10/31/2021 PATHOLOGY PATHOLOGY ACTIVE 11/7/2016 None N/A Page 188 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date R2920 MILLS, CHRISTINA SHANTE, MD 5/5/2017 5/5/2022 PSYCHIATRY ACTIVE 6/7/2017 None N/A

R0284 MILLS, JOSEPH L SR, MD 9/30/2016 9/30/2021 VASCULAR SURGERY GENERAL SURGERY HOUSTON TX ACTIVE 10/27/2016 None N/A ANATOMIC/CLINICAL Q7082 MILLS, KYLE CHARLES, MD 2/1/2016 2/1/2021 PATHOLOGY DERMOPATHOLOGY ALPHARETTA GA ACTIVE 2/24/2016 None N/A Q7749 MILLS, SHERYL, MD 4/1/2016 4/1/2021 FAMILY PRACTICE CUERO TX ACTIVE 5/10/2016 None N/A EMERGENCY R2921 MILLSAP, WILLIAM GRAY, MD 5/5/2017 5/5/2022 MEDICINE FORT WORTH TX ACTIVE 5/10/2017 None N/A PEDIATRIC GASTROENTEROLOG Q5697 MILOH, TAMIR, MD 8/14/2015 8/14/2020 Y HEPATOLOGY HOUSTON TX ACTIVE 8/27/2015 None N/A LICENSE Q5494 MILTON, ROBERT MICHAEL, MD 8/3/2015 8/3/2020 PSYCHIATRY ISSUED 8/3/2015 None N/A R5433 MINA, DIANA, MD 12/8/2017 12/8/2022 NEPHROLOGY INTERNAL MEDICINE DALLAS TX ACTIVE 12/15/2017 None N/A CORPUS Q4811 MINAIE, ARASH, DO 6/12/2015 6/12/2020 INTERNAL MEDICINE CHRISTI TX ACTIVE 6/16/2015 None N/A GASTROENTEROLOG Q7427 MINDIKOGLU, AYSE LEYLA, MD 3/4/2016 3/4/2021 INTERNAL MEDICINE Y BALTIMORE MD ACTIVE 3/18/2016 None N/A CORPUS R5012 MINKA, EREZ, DO 10/20/2017 10/20/2022 GENERAL PRACTICE DERMATOLOGY CHRISTI TX ACTIVE 11/21/2017 None N/A R0751 MINKA, SARAH, DO 11/15/2016 11/15/2021 DERMATOLOGY PORTLAND TX ACTIVE 12/2/2016 None N/A Q6449 MINNA, DAVID GIOVANNI, MD 11/2/2015 11/2/2020 INTERNAL MEDICINE MANSFIELD TX ACTIVE 11/4/2015 None N/A RADIATION GEORGETOW R4433 MINOR, GLADYS IRENE, MD 8/25/2017 8/25/2022 ONCOLOGY N TX ACTIVE 8/29/2017 None N/A SURGICAL Q6068 MINTER, REBECCA MANGET, MD 9/15/2015 9/15/2020 GENERAL SURGERY ONCOLOGY DALLAS TX ACTIVE 9/16/2015 None N/A EMERGENCY R3154 MIRANDA, RAY CESPEDES, MD 5/22/2017 5/22/2022 INTERNAL MEDICINE MEDICINE ACTIVE 7/6/2017 None N/A Q7582 MIRO, VIKTOR, MD 3/15/2016 3/15/2021 HOSPITALIST INTERNAL MEDICINE ACTIVE 3/22/2016 None N/A R4747 MIRZA, NAJAB MOHAMMED, DO 9/22/2017 9/22/2022 HOSPITALIST INTERNAL MEDICINE HUMBLE TX ACTIVE 9/27/2017 None N/A R1421 MIRZA, SAIYADA, MD 1/20/2017 1/20/2022 INTERNAL MEDICINE ACTIVE 1/30/2017 None N/A CHILD AND ADOLESCENT Q6069 MISELIS, KRISTIN ANN, MD 9/15/2015 9/15/2020 PSYCHIATRY PSYCHIATRY AUSTIN TX ACTIVE 9/22/2015 None N/A OBSTETRICS & MISHAW, STEPHANIE MICHELE, GYNECOLOGICAL S6898 MD 5/29/2020 5/29/2025 SURGERY EL PASO TX ACTIVE 6/11/2020 None N/A PEDIATRIC ANESTHESIOLOGY R4748 MISHRA, PRAGNYADIPTA, MD 9/22/2017 9/22/2022 ANESTHESIOLOGY (PEDS) ALBANY NY ACTIVE 9/27/2017 None N/A R1250 MISRA, SUTANU, MD 1/6/2017 1/6/2022 ANESTHESIOLOGY BRIDGEPORT WV ACTIVE 1/17/2017 None N/A Page 189 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date Q6450 MITCHELL, JAMES ROBERT, MD 11/2/2015 11/2/2020 PEDIATRICS HOUSTON TX ACTIVE 11/3/2015 None N/A PEDIATRIC MITCHELL, MICHAEL MARSHALL, HEMATOLOGY/ONCOL R2922 DO 5/5/2017 5/5/2022 OGY DALLAS TX ACTIVE 5/8/2017 None N/A CORPUS Q5229 MITCHELL, ROBERT BYRON, DO 7/15/2015 7/15/2020 FAMILY MEDICINE CHRISTI TX ACTIVE 7/20/2015 None N/A Q7750 MITTAL, ANGELA, MD 4/1/2016 4/1/2021 PEDIATRIC UROLOGY MIAMI FL ACTIVE 4/5/2016 None N/A R3155 MJALTAJ, MARIOLA, MD 5/22/2017 5/22/2022 FAMILY MEDICINE ACTIVE 8/14/2017 None N/A OBSTETRICS AND R6051 MOAYEDI, GHAZALEH , DO 2/16/2018 2/16/2023 GYNECOLOGY HONOLULU HI ACTIVE 2/22/2018 None N/A Q8570 MOCHERLA, BHAVANA , MD 6/1/2016 6/1/2021 FAMILY MEDICINE ACTIVE 6/3/2016 None N/A MOEMEKA, ANGELA NNEBUCHI, Q5495 MD 8/3/2015 8/3/2020 PEDIATRICS DALLAS TX ACTIVE 8/7/2015 None N/A R0454 MOGALI, KIRAN KUMAR, MD 10/14/2016 10/14/2021 CARDIOLOGY INTERNAL MEDICINE ACTIVE 12/22/2016 None N/A EMERGENCY R0761 MOHAMED, ABDIWAHAB , MD 11/15/2016 11/15/2021 MEDICINE PEARLAND TX ACTIVE 11/24/2016 None N/A Q7083 MOHAMED, ASHREF , MD 2/1/2016 2/1/2021 INTERNAL MEDICINE LUBBOCK TX ACTIVE 2/10/2016 None N/A LICENSE Q4641 MOHAMED, OSAMA , MD 6/1/2015 6/1/2020 FAMILY MEDICINE ISSUED 6/1/2015 None N/A MOHAMED, SHARIF SAMY FAHMY, Q7239 MD 2/16/2016 2/16/2021 ANESTHESIOLOGY GALVESTON TX ACTIVE 5/9/2016 None N/A PEDIATRIC ANESTHESIOLOGY R4749 MOHAMMAD, SHAZIA , MD 9/22/2017 9/22/2022 ANESTHESIOLOGY (PEDS) HOUSTON TX ACTIVE 9/26/2017 None N/A

R3713 MOHAMMADI, MILAD , MD 6/30/2017 6/30/2022 VASCULAR SURGERY GENERAL SURGERY SAN ANTONIO TX ACTIVE 7/3/2017 None N/A OPHTHALMOLOGY - Q6070 MOHAMMED, ANDREW ALIEEL, MD 9/15/2015 9/15/2020 ANTERIOR SURGERY LAS CRUCES NM ACTIVE 12/2/2015 None N/A MOHAMMED, NAZIMUDDIN TALHA, R1586 MD 2/6/2017 2/6/2022 PSYCHIATRY GARLAND TX ACTIVE 2/9/2017 None N/A Q9681 MOHAMMED, SHOEB, MD 8/15/2016 8/15/2021 INTERNAL MEDICINE ROCKWALL TX ACTIVE 9/13/2016 None N/A NEONATAL- DELINQUEN PERINATAL T-NON R3559 MOHAMMED, TAZUDDIN AZMI, MD 6/16/2017 6/16/2022 PEDIATRICS MEDICINE PAYMENT 12/4/2017 None N/A R3714 MOHAN, DESH PRAKASH, MD 6/30/2017 6/30/2022 INTERNAL MEDICINE ENGLEWOOD CO ACTIVE 9/19/2017 None N/A PAIN MANAGEMENT/REHAB PHYSICAL MED. & S5018 MOHAN, MAHESH, MD 2/7/2020 2/7/2025 MED REHABILITATION WATERLOO IA ACTIVE 4/27/2020 None N/A Q8572 MOLCHEN, WALLIS ANNE, DO 6/1/2016 6/1/2021 OTHER SPECIALTY HOUSTON TX ACTIVE 6/9/2016 None N/A MOLINA BERGANZA, FERNANDO, PEDIATRICS, S6455 MD 5/1/2020 5/1/2025 PEDIATRICS CARDIOLOGY LAREDO TX ACTIVE 5/5/2020 None N/A Page 190 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date

R3917 MOLINA PAREDES, SONARIS , MD 7/17/2017 7/17/2022 INTERNAL MEDICINE EL PASO TX ACTIVE 7/24/2017 None N/A

Q8961 MOLINA, CARLOS GUILLERMO, DO 7/1/2016 7/1/2021 GENERAL SURGERY ANDREWS TX ACTIVE 8/17/2016 None N/A MOLINARI, ALEXANDER HOWARD LICENSE S6691 WALLACE, DO 5/15/2020 5/15/2025 FAMILY MEDICINE ISSUED 5/15/2020 None N/A EMERGENCY R2925 MOLLMAN, MATTHEW , MD 5/5/2017 5/5/2022 MEDICINE TEMPLE TX ACTIVE 6/6/2017 None N/A LICENSE Q6662 MOLNAR, ARTHUR FRANCIS, MD 12/4/2015 12/4/2020 ANESTHESIOLOGY ISSUED 12/4/2015 None N/A Q6662 MOLNAR, ARTHUR FRANCIS, MD 12/4/2015 12/4/2020 ANESTHESIOLOGY LUBBOCK TX ACTIVE 12/9/2015 None N/A Q6662 MOLNAR, ARTHUR FRANCIS, MD 12/4/2015 12/4/2020 ANESTHESIOLOGY LUBBOCK TX ACTIVE 12/9/2015 None N/A MOLOKWU, REGINA R2176 IFEANYICHUKWU, MD 3/20/2017 3/20/2022 FAMILY MEDICINE MEDFORD OR ACTIVE 3/27/2017 None N/A ENDOCRINOLOGY, MOLS- KOWALCZEWSKI, BARBARA DIABETES AND S5708 LIDIA, MD 3/20/2020 3/20/2025 INTERNAL MEDICINE METABOLISM SAYRE PA ACTIVE 3/24/2020 None N/A R6052 MOMIN, SONIKA HASANALI, MD 2/16/2018 2/16/2023 FAMILY MEDICINE FORT WORTH TX ACTIVE 2/19/2018 None N/A SURGICAL CRITICAL R4600 MONDAY, KARA ANNE, MD 9/8/2017 9/8/2022 TRAUMATIC SURGERY CARE DALLAS TX ACTIVE 9/11/2017 None N/A MONDRAGON, DONALD GENE II, Q6239 MD 10/1/2015 10/1/2020 INTERNAL MEDICINE PHOENIX AZ ACTIVE 11/24/2015 None N/A R2926 MONFARED, MARJON ZARA, MD 5/5/2017 5/5/2022 FAMILY MEDICINE SHAWNEE KS ACTIVE 5/22/2017 None N/A OBSTETRICS AND R1422 MONSIVAIS, LUIS ALBERTO, MD 1/20/2017 1/20/2022 GYNECOLOGY GALVESTON TX ACTIVE 2/1/2017 None N/A Q7085 MONTALVO, TIMOTHY RAY, MD 2/1/2016 2/1/2021 INTERNAL MEDICINE TEMPLE TX ACTIVE 2/15/2016 None N/A MONTANEZ VILLACAMPA, MARIA R4109 DEL PILAR , MD 8/1/2017 8/1/2022 FAMILY MEDICINE SAN ANTONIO TX ACTIVE 10/3/2017 None N/A S5995 MONTANEZ, RUBEN JR, MD 4/3/2020 4/3/2025 INTERNAL MEDICINE CARDIOLOGY EL PASO TX ACTIVE 4/13/2020 None N/A INTERVENTIONAL Q8962 MONTELEONE, PETER PHILIP, MD 7/1/2016 7/1/2021 CARDIOLOGY VASCULAR MEDICINE KYLE TX ACTIVE 7/6/2016 None N/A MONTERO, MIGUEL FEDERICO, R5600 MD 1/5/2018 1/5/2023 VASCULAR SURGERY HOUSTON TX ACTIVE 3/13/2018 None N/A MONTGOMERY, NICOLE IRENE, PEDIATRIC MUSCULOSKELETAL R1992 MD 3/3/2017 3/3/2022 ORTHOPEDICS ONCOLOGY HOUSTON TX ACTIVE 3/6/2017 None N/A EMERGENCY COCONUT R1834 MONTOYA, DENNIS, MD 2/22/2017 2/22/2022 MEDICINE CREEK FL ACTIVE 3/7/2017 None N/A EMERGENCY LICENSE R6053 MONTOYA, JUAN DAVID, MD 2/16/2018 2/16/2023 MEDICINE ISSUED 2/16/2018 None N/A Q5496 MONTOYA, JUAN PABLO, MD 8/3/2015 8/3/2020 FAMILY MEDICINE ACTIVE 8/6/2015 None N/A

Page 191 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date MONTOYA, MELISSA MARGARITA, S5019 DO 2/7/2020 2/7/2025 FAMILY MEDICINE EL PASO TX ACTIVE 2/24/2020 None N/A CRITICAL CARE EMERGENCY MYRTLE Q6771 MOODLEY, ENASH, DO 12/15/2015 12/15/2020 MEDICINE MEDICINE BEACH SC ACTIVE 1/8/2016 None N/A PEDIATRIC HEMATOLOGY/ONCO R4110 MOODY, KAREN MARIE, MD 8/1/2017 8/1/2022 PEDIATRICS LOGY HOUSTON TX ACTIVE 8/2/2017 None N/A EMERGENCY Q7752 MOOK, JASON SCOTT, MD 4/1/2016 4/1/2021 MEDICINE LONGVIEW TX ACTIVE 4/21/2016 None N/A OBSTETRICS AND Q7431 MOOKEN, GRACE MARIE , MD 3/4/2016 3/4/2021 GYNECOLOGY DALLAS TX ACTIVE 3/10/2016 None N/A OBSTETRICS AND Q8574 MOON, LISA MICHELLE, MD 6/1/2016 6/1/2021 GYNECOLOGY HOUSTON TX ACTIVE 6/15/2016 None N/A SPORTS MEDICINE- Q9868 MOONEY, CAITLYN CHRISTINE, MD 8/26/2016 8/26/2021 PEDS PEDIATRICS ACTIVE 11/24/2016 None N/A CARDIOTHORACIC FORT SAM S5228 MOONEY, TIMOTHY JAMES JR, MD 2/21/2020 2/21/2025 ANESTHESIOLOGY ANESTHESIOLOGY HOUSTON TX ACTIVE 3/9/2020 None N/A R3157 MOORE, ALASTAIR, MD 5/22/2017 5/22/2022 RADIOLOGY DALLAS TX ACTIVE 5/24/2017 None N/A ORTHOPEDIC ADULT S5229 MOORE, CHANCE CAMERON, MD 2/21/2020 2/21/2025 SURGERY RECONSTRUCTION ACTIVE 2/27/2020 None N/A EMERGENCY R0911 MOORE, DEVON JELANI, MD 12/2/2016 12/2/2021 MEDICINE ACTIVE 12/7/2016 None N/A DELINQUEN EMERGENCY T-NON Q9447 MOORE, JUSTIN BOONE, MD 8/1/2016 8/1/2021 MEDICINE LONGVIEW TX PAYMENT 12/30/2017 None N/A PEDIATRIC ANESTHESIOLOGY S5996 MOORE, LAUREN BRITTANY, MD 4/3/2020 4/3/2025 ANESTHESIOLOGY (PEDS) SAN ANTONIO TX ACTIVE 4/7/2020 None N/A Q9684 MOORE, SARAH W, MD 8/15/2016 8/15/2021 HOSPITALIST SAN ANTONIO TX ACTIVE 10/19/2016 None N/A Q7241 MOORE, SHAMIER E'LAN, DO 2/16/2016 2/16/2021 FAMILY MEDICINE ACTIVE 3/1/2016 None N/A EMERGENCY R1588 MOR, NADAV, MD 2/6/2017 2/6/2022 MEDICINE MCALLEN TX ACTIVE 2/10/2017 None N/A INTERNAL MED - PREV R4751 MORA, ALEJANDRO, MD 9/22/2017 9/22/2022 MED NEEDVILLE TX ACTIVE 9/28/2017 None N/A EMERGENCY Q8307 MORADI, MEHRAN , DO 5/16/2016 5/16/2021 MEDICINE HOSPITALIST HILLSBORO TX ACTIVE 5/24/2016 None N/A MORALES GARCIA, CARLOS COLON AND RECTAL Q5498 SAMUEL, MD 8/3/2015 8/3/2020 SURGERY GENERAL SURGERY BEAUMONT TX ACTIVE 9/10/2015 None N/A OBSTETRICS AND R3715 MORALES, KRISTY, MD 6/30/2017 6/30/2022 GYNECOLOGY ACTIVE 7/11/2017 None N/A

Page 192 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date LICENSE Q5872 MORALES-RALAT, ASTRID, MD 8/28/2015 8/28/2020 FAMILY MEDICINE ISSUED 8/28/2015 None N/A MOREDOCK, ELISABETH PARISH, DIAGNOSTIC Q8964 MD 7/1/2016 7/1/2021 RADIOLOGY DALLAS TX ACTIVE 7/4/2016 None N/A S4825 MORENO, DIEGO , MD 1/24/2020 1/24/2025 FAMILY MEDICINE MERCEDES TX ACTIVE 1/27/2020 None N/A Q9448 MORENO, ITTAY ORLANDO, MD 8/1/2016 8/1/2021 PEDIATRICS ACTIVE 8/3/2016 None N/A R1589 MORENO, JAIME ENRIQUE, MD 2/6/2017 2/6/2022 FAMILY MEDICINE ACTIVE 4/27/2017 None N/A

R5601 MORESCO, BENJAMIN LOUIS, MD 1/5/2018 1/5/2023 PEDIATRICS SAN ANTONIO TX ACTIVE 1/23/2018 None N/A

S6693 MORGADO PEREZ, ANDRES , MD 5/15/2020 5/15/2025 FAMILY MEDICINE FAMILY PRACTICE MCALLEN TX ACTIVE 5/26/2020 None N/A CARDIOVASCULAR TRANSPLANT Q6665 MORGAN, JEFFREY ADAM, MD 12/4/2015 12/4/2020 SURGERY SURGERY HOUSTON TX ACTIVE 12/8/2015 None N/A CARDIOVASCULAR TRANSPLANT Q6665 MORGAN, JEFFREY ADAM, MD 12/4/2015 12/4/2020 SURGERY SURGERY HOUSTON TX ACTIVE 12/8/2015 None N/A CARDIOVASCULAR TRANSPLANT Q6665 MORGAN, JEFFREY ADAM, MD 12/4/2015 12/4/2020 SURGERY SURGERY HOUSTON TX ACTIVE 12/8/2015 None N/A OBSTETRICS AND S5709 MORGAN, NURAH M, MD 3/20/2020 3/20/2025 GYNECOLOGY ACTIVE 5/20/2020 None N/A GASTROENTEROLOG LICENSE R6247 MORI, AMIT BABULAL, MD 3/2/2018 3/2/2023 Y INTERNAL MEDICINE ISSUED 3/2/2018 None N/A MORIATES, CHRISTOPHER PAUL, Q8308 MD 5/16/2016 5/16/2021 HOSPITALIST AUSTIN TX ACTIVE 5/19/2016 None N/A Q6240 MORPER, JACK GREGORY, MD 10/1/2015 10/1/2020 INTERNAL MEDICINE KERRVILLE TX ACTIVE 10/5/2015 None N/A EMERGENCY R4286 MORRELL, TODD DAVID, MD 8/15/2017 8/15/2022 MEDICINE JASPER TX ACTIVE 8/17/2017 None N/A Q8965 MORRIS, ARNOLD J III, DO 7/1/2016 7/1/2021 FAMILY MEDICINE FORT WORTH TX ACTIVE 7/27/2016 None N/A S6257 MORRIS, KATHERINE CROW, MD 4/17/2020 4/17/2025 ANESTHESIOLOGY TEMPLE TX ACTIVE 5/18/2020 None N/A DIAGNOSTIC R5171 MORRIS, LEE CHARLES III, MD 11/3/2017 11/3/2022 RADIOLOGY DALLAS TX ACTIVE 11/6/2017 None N/A S6456 MORRIS, PHILLIP MICHAEL, MD 5/1/2020 5/1/2025 ANESTHESIOLOGY TEMPLE TX ACTIVE 5/15/2020 None N/A PEDIATRIC R5602 MORRIS, WILLIAM ZACHARY, MD 1/5/2018 1/5/2023 ORTHOPEDICS ORTHOPEDICS DALLAS TX ACTIVE 2/6/2018 None N/A GASTROENTEROLOG WICHITA Q7931 MORRISON, CHRISTOPHER, MD 4/15/2016 4/15/2021 Y FALLS TX ACTIVE 4/18/2016 None N/A EMERGENCY LICENSE Q5874 MORRISON, MATTHEW ELLIS, MD 8/28/2015 8/28/2020 MEDICINE ISSUED 8/28/2015 None N/A PLASTIC & RECONSTRUCTIVE CRANIOFACIAL R2682 MORROW, BRAD THOMAS, MD 4/20/2017 4/20/2022 SURGERY SURGERY DALLAS TX ACTIVE 5/3/2017 None N/A

Page 193 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date EMERGENCY Q5500 MORSE, ROGER, MD 8/3/2015 8/3/2020 MEDICINE SUGAR LAND TX ACTIVE 8/6/2015 None N/A EMERGENCY Q5698 MORSHEDI, BRANDON , MD 8/14/2015 8/14/2020 MEDICINE DALLAS TX ACTIVE 8/31/2015 None N/A R3560 MORSY, AMR SAYED, MD 6/16/2017 6/16/2022 ANESTHESIOLOGY PAIN MANAGEMENT CORONA CA ACTIVE 6/27/2017 None N/A INTERVENTIONAL S6457 MOSCONA, JOHN, MD 5/1/2020 5/1/2025 CARDIOLOGY AUSTIN TX ACTIVE 5/6/2020 None N/A PEDIATRIC EMERGENCY R3158 MOSES, STEPHANIE, DO 5/22/2017 5/22/2022 MEDICINE (PEDS) FORT WORTH TX ACTIVE 6/5/2017 None N/A S4662 MOSES, VIJU, MD 1/10/2020 1/10/2025 RHEUMATOLOGY TEMPLE TX ACTIVE 1/13/2020 None N/A MOSHIREE THOMAS, BANAFSHEH, LICENSE Q4814 MD 6/12/2015 6/12/2020 FAMILY MEDICINE ISSUED 6/12/2015 None N/A ANESTHESIOLOGY - R1994 MOSHIRI, THOMAS M, MD 3/3/2017 3/3/2022 ANESTHESIOLOGY PAIN MANAGEMENT PHOENIX AZ ACTIVE 4/3/2017 None N/A R1995 MOSSLER, JEFFREY DAVID, MD 3/3/2017 3/3/2022 HOSPITALIST INTERNAL MEDICINE GREENFIELD IN ACTIVE 3/21/2017 None N/A PEDIATRIC INFECTIOUS LICENSE R6248 MOST, ZACHARY MARC, MD 3/2/2018 3/2/2023 PEDIATRICS DISEASE DALLAS TX ISSUED 3/2/2018 None N/A INTERVENTIONAL S6458 MOTIWALA, AFAQ, MD 5/1/2020 5/1/2025 CARDIOLOGY CARDIOLOGY ACTIVE 6/15/2020 None N/A

R2179 MOTSINGER, CHARLES DUKE, MD 3/20/2017 3/20/2022 PSYCHIATRY FAMILY PRACTICE ACTIVE 3/28/2017 None N/A HEMATOLOGY/ONCOL Q6242 MOUALLA, HAYAN, MD 10/1/2015 10/1/2020 OGY INTERNAL MEDICINE HARLINGEN TX ACTIVE 10/5/2015 None N/A WEST Q6243 MOUHAFFEL, ASSAD H, MD 10/1/2015 10/1/2020 CARDIOLOGY MONROE LA ACTIVE 10/28/2015 None N/A LICENSE S6459 MOUNT, ANDREW , MD 5/1/2020 5/1/2025 ANESTHESIOLOGY ISSUED 5/1/2020 None N/A OTOLARYN & FACIAL LICENSE Q6666 MOURAD, MOUSTAFA WALID, MD 12/4/2015 12/4/2020 PLASTIC SURGERY ISSUED 12/4/2015 None N/A OTOLARYN & FACIAL HEAD AND NECK Q6666 MOURAD, MOUSTAFA WALID, MD 12/4/2015 12/4/2020 PLASTIC SURGERY SURGERY FORT WORTH TX ACTIVE 12/16/2015 None N/A OTOLARYN & FACIAL HEAD AND NECK Q6666 MOURAD, MOUSTAFA WALID, MD 12/4/2015 12/4/2020 PLASTIC SURGERY SURGERY FORT WORTH TX ACTIVE 12/16/2015 None N/A S4532 MOUSA, SARA HASHIM, MD 12/20/2019 12/20/2024 INTERNAL MEDICINE ACTIVE 2/19/2020 None N/A NEUROLOGICAL R2683 MOUSSAZADEH, NELSON , MD 4/20/2017 4/20/2022 SURGERY HOUSTON TX ACTIVE 5/26/2017 None N/A PEDIATRIC ANESTHESIOLOGY R4436 MOUTON, FALAN, MD 8/25/2017 8/25/2022 ANESTHESIOLOGY (PEDS) SAN ANTONIO TX ACTIVE 10/4/2017 None N/A Page 194 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date

Q8577 MOZA, ROMA , MD 6/1/2016 6/1/2021 INTERNAL MED - PEDS DALLAS TX ACTIVE 6/8/2016 None N/A S5440 MRAZEK, AMY ANN, MD 3/6/2020 3/6/2025 GENERAL SURGERY ACTIVE 3/30/2020 None N/A ENDOCRINOLOGY, DIABETES AND ROCHESTER R1086 MSALLATY, ZAHER, MD 12/16/2016 12/16/2021 METABOLISM HILLS MI ACTIVE 12/26/2016 None N/A ANATOMIC/CLINICAL DERMATOPATHOLO CHATTANOOG Q6969 MU, XIAO CHUN, MD 1/15/2016 1/15/2021 PATHOLOGY GY A TN ACTIVE 1/19/2016 None N/A PULMONARY DELINQUEN MUDDASSIR, KHAWAJA CRITICAL CARE T-NON R0912 MUHAMMAD, MD 12/2/2016 12/2/2021 MEDICINE PAYMENT 3/2/2017 None N/A

Q8578 MUECK, KRISLYNN MICHELLE, MD 6/1/2016 6/1/2021 GENERAL SURGERY HOUSTON TX ACTIVE 6/21/2016 None N/A ORAL & MAXILLOFACIAL WICHITA R0763 MUELLER, ANDREW ROBERT, MD 11/15/2016 11/15/2021 SURGERY FALLS TX ACTIVE 11/18/2016 None N/A Q5700 MUELLER, LYNDA LEA, MD 8/14/2015 8/14/2020 FAMILY PRACTICE ACTIVE 9/11/2015 None N/A CARDIAC ELECTROPHYSIOLOG P4356 MUGHAL, ALEEM IQBAL, MD 2/6/2017 2/6/2022 Y CARDIOLOGY FORT WORTH TX ACTIVE 2/16/2017 None N/A Q6667 MUGHAL, TANVEER HAIDER, MD 12/4/2015 12/4/2020 FAMILY MEDICINE ACTIVE 12/8/2015 None N/A Q6667 MUGHAL, TANVEER HAIDER, MD 12/4/2015 12/4/2020 FAMILY MEDICINE LIVINGSTON TX ACTIVE 12/8/2015 None N/A Q6667 MUGHAL, TANVEER HAIDER, MD 12/4/2015 12/4/2020 FAMILY MEDICINE LIVINGSTON TX ACTIVE 12/8/2015 None N/A GENERAL PREVENTIVE Q7086 MUHAMMAD, AHMAD TALIB, MD 2/1/2016 2/1/2021 GENERAL PRACTICE MEDICINE HOUSTON TX ACTIVE 2/4/2016 None N/A CRITICAL CARE R1425 MUIGAI, DAVID MUCUHA, MD 1/20/2017 1/20/2022 INTERNAL MEDICINE MEDICINE (IM) HOUSTON TX ACTIVE 1/30/2017 None N/A R4287 MUJEEB, MEHRUKH, MD 8/15/2017 8/15/2022 INTERNAL MEDICINE NEPHROLOGY ACTIVE 8/21/2017 None N/A MUJTABA, MUHAMMAD AHMAD, R0622 MD 10/31/2016 10/31/2021 INTERNAL MEDICINE NEPHROLOGY GALVESTON TX ACTIVE 11/10/2016 None N/A Q7087 MUKE, MAUREEN, MD 2/1/2016 2/1/2021 INTERNAL MEDICINE TACOMA WA ACTIVE 2/23/2016 None N/A VASCULAR AND MUKKAMALLA, UMAMAHESWARI, INTERVENTIONAL Q7933 MD 4/15/2016 4/15/2021 RADIOLOGY RADIOLOGY ACTIVE 4/25/2016 None N/A MUKKERA, SATYANARAYANA CRITICAL CARE R4880 REDDY, MD 10/6/2017 10/6/2022 MEDICINE (IM) INTERNAL MEDICINE SPRINGFIELD IL ACTIVE 10/16/2017 None N/A MULDER CORROCHANO, CRITICAL CARE S5442 MAXIMILIAN, MD 3/6/2020 3/6/2025 INTERNAL MEDICINE MEDICINE DALLAS TX ACTIVE 3/9/2020 None N/A R0286 MULDREW, KENNETH LYNN, MD 9/30/2016 9/30/2021 PATHOLOGY HOUSTON TX ACTIVE 10/4/2016 None N/A

Page 195 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date ELIZABETH R0457 MULINDWA, DEO, MD 10/14/2016 10/14/2021 INTERNAL MEDICINE CITY NC ACTIVE 1/11/2017 None N/A EMERGENCY Q5045 MULLEN, CASEY KYLEE, MD 7/1/2015 7/1/2020 MEDICINE ACTIVE 7/3/2015 None N/A GERIATRIC MEDICINE R1591 MULLIGAN, REBEKAH CONDIT, MD 2/6/2017 2/6/2022 (INTERNAL MED) INTERNAL MEDICINE GRAPEVINE TX ACTIVE 2/22/2017 None N/A PSYCHOSOMATIC R3387 MULROY, MALLORY ANNE, MD 6/2/2017 6/2/2022 PSYCHIATRY MEDICINE DALLAS TX ACTIVE 7/3/2017 None N/A

Q8110 MULTANI, KIRANPREET KAUR, DO 5/2/2016 5/2/2021 FAMILY MEDICINE DECATUR IL ACTIVE 5/9/2016 None N/A CRITICAL CARE Q9869 MULVOY, WILLIAM PATRICK III, MD 8/26/2016 8/26/2021 ANESTHESIOLOGY ANESTHESIOLOGY HOUSTON TX ACTIVE 8/31/2016 None N/A OTORHINOLARYNGO Q7242 MUMFORD, LINDA ALICE, MD 2/16/2016 2/16/2021 OTHER SPECIALTY LOGY ST LOUIS MO ACTIVE 2/29/2016 None N/A Q6350 MUMME, JESSICA MARIE, MD 10/15/2015 10/15/2020 PEDIATRICS HOUSTON TX ACTIVE 10/19/2015 None N/A MUMMERT, CATHLEEN VIRGINIA, EMERGENCY Q8966 MD 7/1/2016 7/1/2021 MEDICINE EDINBURGH TX ACTIVE 7/12/2016 None N/A Q8968 MUNEZ, KENNEX , MD 7/1/2016 7/1/2021 FAMILY MEDICINE GRAPEVINE TX ACTIVE 11/10/2016 None N/A THORACIC CARDIOVASCULAR Q7243 MUNGARA, CHARAN, MD 2/16/2016 2/16/2021 SURGERY GENERAL SURGERY ACTIVE 3/3/2016 None N/A Q5046 MUNIZ, BRENNA MICHELL, MD 7/1/2015 7/1/2020 INTERNAL MEDICINE HOUSTON TX ACTIVE 7/6/2015 None N/A S7102 MUNJULURI, SARAT , MD 6/12/2020 6/12/2025 PSYCHIATRY HOUSTON TX ACTIVE 6/15/2020 None N/A PEDIATRIC EMERGENCY R2180 MUNNS, ERIN DELEIGH, MD 3/20/2017 3/20/2022 MEDICINE (PEDS) AUSTIN TX ACTIVE 3/27/2017 None N/A EMERGENCY R1426 MUNNS, MARK GARRISON, MD 1/20/2017 1/20/2022 MEDICINE AUSTIN TX ACTIVE 1/30/2017 None N/A MUNOZ MONACO, GERARDO R4881 MIGUEL, MD 10/6/2017 10/6/2022 FAMILY MEDICINE MERCEDES TX ACTIVE 10/10/2017 None N/A Q9870 MUNOZ, MELODY , MD 8/26/2016 8/26/2021 PEDIATRICS SAN ANTONIO TX ACTIVE 9/13/2016 None N/A Q9205 MUPPIDI, RAGHUNANDAN, MD 7/15/2016 7/15/2021 INTERNAL MEDICINE CARDIOLOGY BAYTOWN TX ACTIVE 8/29/2016 None N/A ORTHOPEDIC Q5047 MURADOV, PAVEL, MD 7/1/2015 7/1/2020 SURGERY HOUSTON TX ACTIVE 7/3/2015 None N/A LICENSE S5712 MURALIDHARA, ARTI RENATA, MD 3/20/2020 3/20/2025 NEUROLOGY ISSUED 3/20/2020 None N/A PLASTIC & RECONSTRUCTIVE Q9206 MURARIU, DANIEL , MD 7/15/2016 7/15/2021 SURGERY GENERAL SURGERY HOUSTON TX ACTIVE 7/21/2016 None N/A R5603 MURDOCK, DAVID RAUL, MD 1/5/2018 1/5/2023 INTERNAL MEDICINE CLINICAL GENETICS HOUSTON TX ACTIVE 1/12/2018 None N/A

Page 196 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date

J1120 MURPHEY, SUSAN ELIZABETH, MD 1/10/2020 1/10/2025 FAMILY MEDICINE ACTIVE 1/16/2020 None N/A MURPHREE, JEFFERSON JACOB, ORTHOPEDIC R4288 MD 8/15/2017 8/15/2022 SURGERY LUBBOCK TX ACTIVE 8/21/2017 None N/A Q5502 MURPHY, DANIEL , MD 8/3/2015 8/3/2020 FAMILY MEDICINE SPORTS MEDICINE ACTIVE 8/5/2015 None N/A THE S5023 MURPHY, LYNN MARIE, MD 2/7/2020 2/7/2025 FAMILY MEDICINE WOODLANDS TX ACTIVE 2/11/2020 None N/A EMERGENCY Q7434 MURPHY, SEAN MICHAEL, MD 3/4/2016 3/4/2021 MEDICINE ACTIVE 3/9/2016 None N/A CORPUS R0624 MURPHY, TIMOTHY JOSEPH, DO 10/31/2016 10/31/2021 INTERNAL MEDICINE CHRISTI TX ACTIVE 1/23/2017 None N/A Q7754 MURRELL, MATTHEW , MD 4/1/2016 4/1/2021 ANESTHESIOLOGY ACTIVE 4/6/2016 None N/A R1835 MURTHY, APOORVA , MD 2/22/2017 2/22/2022 PEDIATRICS ACTIVE 2/28/2017 None N/A Q5048 MURTHY, KENTON KUMAR, DO 7/1/2015 7/1/2020 FAMILY MEDICINE BURLESON TX ACTIVE 7/7/2015 None N/A R2685 MURTHY, STACEY LYNN, MD 4/20/2017 4/20/2022 PATHOLOGY ACTIVE 5/9/2017 None N/A S4826 MUSAU, PATRICK , MD 1/24/2020 1/24/2025 ANESTHESIOLOGY DALLAS TX ACTIVE 1/27/2020 None N/A PLASTIC & RECONSTRUCTIVE R0625 MUSHIN, OREN PAUL, MD 10/31/2016 10/31/2021 SURGERY PLASTIC SURGERY HOUSTON TX ACTIVE 1/17/2017 None N/A INFECTIOUS R4603 MUSHTAQ, ADNAN, MD 9/8/2017 9/8/2022 INTERNAL MEDICINE DISEASES QUINCY IL ACTIVE 9/15/2017 None N/A

S4827 MUSICK, RUTH LITWINOWICZ, MD 1/24/2020 1/24/2025 INTERNAL MED - PEDS HOUSTON TX ACTIVE 2/3/2020 None N/A ENDOCRINOLOGY, DIABETES AND R0459 MUSTAFA, ANILA, MD 10/14/2016 10/14/2021 INTERNAL MEDICINE METABOLISM SAN ANTONIO TX ACTIVE 10/18/2016 None N/A PULMONARY CRITICAL CARE Q8971 MUSTAFA, BILAL, MD 7/1/2016 7/1/2021 MEDICINE INTERNAL MEDICINE DALLAS TX ACTIVE 8/15/2016 None N/A R0081 MUSTAFA, BINA, MD 9/15/2016 9/15/2021 RADIOLOGY NEURO-RADIOLOGY HOUSTON TX ACTIVE 10/3/2016 None N/A Q6773 MUSTAFA, NADA FURQAAN, MD 12/15/2015 12/15/2020 INTERNAL MEDICINE SUGAR LAND TX ACTIVE 12/17/2015 None N/A HEMATOLOGY/ONCO R2422 MUSUNURU, TEJO NIHARIKA , MD 4/4/2017 4/4/2022 INTERNAL MEDICINE LOGY HOUSTON TX ACTIVE 4/10/2017 None N/A MUTHAPPA, DEEPAK Q8972 BACHARANIANDA, MD 7/1/2016 7/1/2021 FAMILY MEDICINE CLARKSVILLE TX ACTIVE 7/4/2016 None N/A Q9449 MUTUA, MARY KAVENGI, MD 8/1/2016 8/1/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 8/25/2016 None N/A EMERGENCY S5231 MYERS, GRIFFIN ROBERT, MD 2/21/2020 2/21/2025 MEDICINE CHICAGO IL ACTIVE 3/5/2020 None N/A R4289 MYERS, JOHN DAVID, DO 8/15/2017 8/15/2022 FAMILY MEDICINE WACO TX ACTIVE 8/17/2017 None N/A MINERAL S6258 MYERS, MICHAEL DENSON, MD 4/17/2020 4/17/2025 UROLOGY WELLS TX ACTIVE 4/23/2020 None N/A Page 197 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date EMERGENCY LICENSE Q8579 MYNATT, IRENE ANN, DO 6/1/2016 6/1/2021 MEDICINE ISSUED 6/1/2016 None N/A PEDIATRIC MYSORE, KRUPA RAMAPRASAD, GASTROENTEROLOG Q9688 MD 8/15/2016 8/15/2021 Y PEDIATRICS HOUSTON TX ACTIVE 9/12/2016 None N/A UNDERSEA AND MYSOREKAR, RAJEEV NAGARAJ, HYPERBARIC MED Q9450 MD 8/1/2016 8/1/2021 (PREV MED) GENERAL SURGERY MILWAUKEE WI ACTIVE 8/5/2016 None N/A LICENSE Q5506 NABI, NEELOFAR , MD 8/3/2015 8/3/2020 PEDIATRICS ISSUED 8/3/2015 None N/A NACHAWATI, SAMER MOHAMMAD Q9689 SAMIR, DO 8/15/2016 8/15/2021 INTERNAL MEDICINE MESQUITE TX ACTIVE 8/22/2016 None N/A NACHIMUTHU, NAGAKRISHNAL , INFECTIOUS LICENSE Q6451 MD 11/2/2015 11/2/2020 INTERNAL MEDICINE DISEASES ISSUED 11/2/2015 None N/A EMERGENCY EMERGENCY R4604 NACKENSON, JOSHUA , MD 9/8/2017 9/8/2022 MEDICINE MEDICAL SERVICES DALLAS TX ACTIVE 9/15/2017 None N/A

NEURO-PHYSIOLOGY Q9690 NADERI, NASSIM, MD 8/15/2016 8/15/2021 NEUROLOGY (NEUROLOGY) HOUSTON TX ACTIVE 8/31/2016 None N/A R3561 NADHEM, OMAR , MD 6/16/2017 6/16/2022 INTERNAL MEDICINE TULSA OK ACTIVE 6/30/2017 None N/A S6259 NAEEM, ARSLAN , MD 4/17/2020 4/17/2025 INTERNAL MEDICINE CARDIOLOGY SAN ANTONIO TX ACTIVE 4/30/2020 None N/A R3720 NAEEM, SARAH , MD 6/30/2017 6/30/2022 INTERNAL MEDICINE HOSPITALIST ACTIVE 7/19/2017 None N/A NAGABHUSHAN, MEGHNA EMERGENCY R1996 PANNAGA, DO 3/3/2017 3/3/2022 MEDICINE FORT WORTH TX ACTIVE 3/14/2017 None N/A Q6246 NAGARAJ, ALAKANANDA, MD 10/1/2015 10/1/2020 INTERNAL MEDICINE ACTIVE 10/9/2015 None N/A

NEURO-PHYSIOLOGY LICENSE R6055 NAGARAJ, ARUN, MD 2/16/2018 2/16/2023 NEUROLOGY (NEUROLOGY) ISSUED 2/16/2018 None N/A EMERGENCY R5437 NAGARAJ, LALITHA, MD 12/8/2017 12/8/2022 MEDICINE COLUMBUS OH ACTIVE 12/20/2017 None N/A NAGARAJARAO, HARSHA INTERVENTIONAL CARDIOVASCULAR R3161 SANTHESHIVARA, MD 5/22/2017 5/22/2022 CARDIOLOGY DISEASES EL PASO TX ACTIVE 5/31/2017 None N/A PEDIATRICS, R0765 NAGARAJU, LAKSHMI, MD 11/15/2016 11/15/2021 CARDIOLOGY PEDIATRICS SAN ANTONIO TX ACTIVE 1/12/2017 None N/A CARDIAC DELINQUEN ELECTROPHYSIOLOG CARDIOVASCULAR T-NON R3562 NAGARAKANTI, RANGADHAM, MD 6/16/2017 6/16/2022 Y DISEASES PAYMENT 12/4/2017 None N/A PLASTIC & RECONSTRUCTIVE Q5507 NAGARKAR, PURUSHOTTAM , MD 8/3/2015 8/3/2020 SURGERY DALLAS TX ACTIVE 8/5/2015 None N/A

Page 198 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date PLASTIC & RECONSTRUCTIVE Q6247 NAGEL, THEODORE WILLIAM, MD 10/1/2015 10/1/2020 SURGERY MICROSURGERY FORT WORTH TX ACTIVE 10/5/2015 None N/A Q5875 NAGRA, AMRITA, DO 8/28/2015 8/28/2020 PEDIATRICS DALLAS TX ACTIVE 9/1/2015 None N/A VASCULAR S6697 NAHHAS, MICHAEL ISSA, MD 5/15/2020 5/15/2025 NEUROLOGY NEUROLOGY HOUSTON TX ACTIVE 5/26/2020 None N/A Q7088 NAIDS, STEVEN, MD 2/1/2016 2/1/2021 OPHTHALMOLOGY ACTIVE 3/28/2016 None N/A NAIDU, SATHYABAMA RAMASAMY, R3921 MD 7/17/2017 7/17/2022 INTERNAL MEDICINE WASHINGTON DC ACTIVE 10/16/2017 None N/A RADIATION S5025 NAIK, NILAN SUBODH, MD 2/7/2020 2/7/2025 ONCOLOGY GALVESTON TX ACTIVE 2/17/2020 None N/A

R0915 NAIK, PRATIK SUDHIRKUMAR, MD 12/2/2016 12/2/2021 INTERNAL MEDICINE INTERNAL MEDICINE CLERMONT FL ACTIVE 2/28/2017 None N/A ANESTHESIOLOGY - TM00696 NAIK, RAVI, MD 1/19/2018 1/19/2023 ANESTHESIOLOGY PAIN MANAGEMENT CLIFTON NJ ACTIVE 1/30/2018 None N/A HEMATOLOGY/ONCOL HEMATOLOGY/ONCO Q6072 NAIR, JAYAN, MD 9/15/2015 9/15/2020 OGY LOGY BEMIDJI MN ACTIVE 9/22/2015 None N/A NAIR, SANJEEV UNNIKRISHNAN, INTERVENTIONAL R4605 MD 9/8/2017 9/8/2022 CARDIOLOGY CARDIOLOGY FORT WORTH TX ACTIVE 9/11/2017 None N/A INTERVENTIONAL Q7246 NAIR, SREEJIT, MD 2/16/2016 2/16/2021 RADIOLOGY VASCULAR MEDICINE NEW YORK NY ACTIVE 3/1/2016 None N/A PEDIATRIC GASTROENTEROLOG R0460 NAIR, SUPRIYA , MD 10/14/2016 10/14/2021 Y ACTIVE 10/18/2016 None N/A CHILD AND ADOLESCENT Q6669 NAJARA, JULIA ELVIRA, MD 12/4/2015 12/4/2020 PSYCHIATRY PSYCHIATRY LYTLE TX ACTIVE 12/8/2015 None N/A CHILD AND ADOLESCENT Q6669 NAJARA, JULIA ELVIRA, MD 12/4/2015 12/4/2020 PSYCHIATRY PSYCHIATRY LYTLE TX ACTIVE 12/8/2015 None N/A CHILD AND ADOLESCENT Q6669 NAJARA, JULIA ELVIRA, MD 12/4/2015 12/4/2020 PSYCHIATRY PSYCHIATRY LYTLE TX ACTIVE 12/8/2015 None N/A PULMONARY R6056 NAJJAR, HUSAM H, MD 2/16/2018 2/16/2023 DISEASES SIKESTON MO ACTIVE 2/26/2018 None N/A CRITICAL CARE Q8974 NAM, MYUNG HEE, MD 7/1/2016 7/1/2021 MEDICINE (IM) INTERNAL MEDICINE SAINT LOUIS MO ACTIVE 8/8/2016 None N/A R5605 NAMBIAR, UMA EDAYLLAM, MD 1/5/2018 1/5/2023 PEDIATRICS BETHLEHEM PA ACTIVE 1/8/2018 None N/A URGENT CARE - Q5049 NAMUDURI, ANURADHA , DO 7/1/2015 7/1/2020 FAMILY MEDICINE FAMILY PRACTICE FORT WORTH TX ACTIVE 7/2/2015 None N/A

Page 199 of 316 Medicare/Me Medicare/Me Registration Disciplinary dicaid dicaid Status of Status of License Agreement Agreement Primary Specialty (Self- Secondary Specialty Practice Texas Registration Texas Disciplinary Number Physician Name Start Date End Date Designated) (Self-Designated) Practice City State License Status Date License Status Date CHILD AND ADOLESCENT R1253 NANDAGOPAL, JAYASREE J, MD 1/6/2017 1/6/2022 PSYCHIATRY PSYCHIATRY ROUND ROCK TX ACTIVE 1/24/2017 None N/A NANDIGAM, RAM NARAYAN CANC NON- Q8975 KAVEER, MD 7/1/2016 7/1/2021 NEUROLOGY PAYMENT 12/11/2017 None N/A R5014 NANDIVADA, SRIJNA , MD 10/20/2017 10/20/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 10/23/2017 None N/A DELINQUEN T-NON R5172 NANGA, VISHNU PRIYA REDDY, MD 11/3/2017 11/3/2022 HOSPITALIST INTERNAL MEDICINE PAYMENT 2/1/2018 None N/A NANNA, ALERO R3721 TOSANMIWEWORITSE, MD 6/30/2017 6/30/2022 GENERAL SURGERY CAMDEN AR ACTIVE 9/8/2017 None N/A PULMONARY NANNAKA, VARALAXMI BHAVANI, CRITICAL CARE R2182 MD 3/20/2017 3/20/2022 MEDICINE INTERNAL MEDICINE TYLER TX ACTIVE 6/23/2017 None N/A

L7069 NAOUM, JOSEPH JOE, MD 11/3/2017 11/3/2022 VASCULAR SURGERY HOUSTON TX ACTIVE 11/29/2017 None N/A R0916 NAQVI, S ALI ABBAS, MD 12/2/2016 12/2/2021 PEDIATRICS HOUSTON TX ACTIVE 12/19/2016 None N/A NAQVI, SYED AHSAN MAHBOOB, WOONSOCKE R0766 MD 11/15/2016 11/15/2021 HOSPITALIST INTERNAL MEDICINE T RI ACTIVE 11/24/2016 None N/A PLASTIC & RECONSTRUCTIVE R1254 NARAM, APARAJIT, MD 1/6/2017 1/6/2022 SURGERY HAND SURGERY DALLAS TX ACTIVE 1/17/2017 None N/A LICENSE R5906 NARANJO, TAMMIE SUZANNE, MD 2/2/2018 2/2/2023 FAMILY PRACTICE ISSUED 2/2/2018 None N/A

NARASIMHAN, KULUMANI GENERAL VASCULAR LICENSE Q4817 MUTHUSWAMIARYA, MD 6/12/2015 6/12/2020 GENERAL SURGERY SURGERY ISSUED 6/12/2015 None N/A SURGICAL CRITICAL Q8758 NARAYAN, MAYUR, MD 6/10/2016 6/10/2021 GENERAL SURGERY CARE DALLAS TX ACTIVE 6/17/2016 None N/A GERIATRIC MEDICINE (FAMILY S4534 NARAYANAN, UMESH, MD 12/20/2019 12/20/2024 FAMILY MEDICINE PRACTICE) SUN CITY AZ ACTIVE 12/24/2019 None N/A S6260 NARLA, NIRMALA PRIYA, MD 4/17/2020 4/17/2025 PEDIATRICS HOUSTON TX ACTIVE 5/13/2020 None N/A HEMATOLOGY/ONCOL Q7247 NARMALA, SHRAVAN KUMAR, MD 2/16/2016 2/16/2021 OGY INTERNAL MEDICINE BILOXI MS ACTIVE 3/1/2016 None N/A HEMATOLOGY/ONCOL R4752 NARRA, KALYANI, MD 9/22/2017 9/22/2022 OGY INTERNAL MEDICINE POTTSTOWN PA ACTIVE 1/8/2018 None N/A S5026 NARVAEZ, EMILIO ROBERTO, DO 2/7/2020 2/7/2025 INTERNAL MEDICINE TEMPLE TX ACTIVE 2/25/2020 None N/A

R2929 NASIR, ASAD ARIF, MD 5/5/2017 5/5/2022 NUCLEAR MEDICINE GENERAL PRACTICE ACTIVE 8/4/2017 None N/A

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