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 practice city, then by primary specialty, then 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 ADOLESCENT LICENSE S6779 ADEGITE, ENITAN, MD 5/29/2020 5/29/2025 MEDICINE - PD PEDIATRICS ISSUED 5/29/2020 None N/A ADULT ORTHOPEDIC S4902 WRIGHT, ADAM PATRICK, MD 1/24/2020 1/24/2025 RECONSTRUCTION SURGERY ACTIVE 2/4/2020 None N/A ADULT RECONSTRUCTIVE ORTHOPEDIC R5665 TORRES, ERICK GABRIEL, MD 1/5/2018 1/5/2023 ORTHOPEDICS SURGERY ACTIVE 1/15/2018 None N/A ALLERGY AND LICENSE Q7942 PATEL, ADESH, MD 4/15/2016 4/15/2021 IMMUNOLOGY ISSUED 4/15/2016 None N/A ALLERGY AND S4411 VILLARREAL, RAUL SERGIO JR, MD 12/6/2019 12/6/2024 IMMUNOLOGY INTERNAL MEDICINE ACTIVE 12/18/2019 None N/A ALLERGY AND S4411 VILLARREAL, RAUL SERGIO JR, MD 12/6/2019 12/6/2024 IMMUNOLOGY INTERNAL MEDICINE ACTIVE 12/18/2019 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 ANATOMIC/CLINICAL R1787 JONES, ANDREA, MD 2/22/2017 2/22/2022 PATHOLOGY ACTIVE 3/13/2017 None N/A ANATOMIC/CLINICAL LICENSE Q7987 XIA, MICHELLE , MD 4/15/2016 4/15/2021 PATHOLOGY ISSUED 4/15/2016 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 Q5750 ALIKAH, MAUREEN, MD 8/28/2015 8/28/2020 ANESTHESIOLOGY ACTIVE 9/2/2015 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

R1169 AUSTIN-GLASS, ANTOINETTE, MD 1/6/2017 1/6/2022 ANESTHESIOLOGY ACTIVE 1/9/2017 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

Page 1 of 332 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 Q7634 AZZAM, MOHAMAD ALI, MD 4/1/2016 4/1/2021 ANESTHESIOLOGY PAIN MANAGEMENT ACTIVE 6/21/2016 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 BANGALORE ANNAIAH, PUTTA S6355 SHANKAR, MD 5/1/2020 5/1/2025 ANESTHESIOLOGY ACTIVE 5/6/2020 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 R5985 CASTRO, PETER LAURENCE, MD 2/16/2018 2/16/2023 ANESTHESIOLOGY ACTIVE 2/26/2018 None N/A

R4528 CHERUKU, RAVINDER REDDY, MD 9/8/2017 9/8/2022 ANESTHESIOLOGY ACTIVE 9/12/2017 None N/A COBOS, FRANKLIN VERGARA II, S6816 MD 5/29/2020 5/29/2025 ANESTHESIOLOGY ACTIVE 6/2/2020 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 LICENSE R5993 CRUZ NAVARRO, JOVANY , MD 2/16/2018 2/16/2023 ANESTHESIOLOGY ISSUED 2/16/2018 None N/A CRITICAL CARE Q7177 DIDYUK, OKSANA, MD 2/16/2016 2/16/2021 ANESTHESIOLOGY ANESTHESIOLOGY ACTIVE 2/29/2016 None N/A Q6181 DUTTER, TAMARA LYNN, MD 10/1/2015 10/1/2020 ANESTHESIOLOGY ACTIVE 11/17/2015 None N/A S4948 FITZPATRICK, JAMES KEVIN, MD 2/7/2020 2/7/2025 ANESTHESIOLOGY ACTIVE 2/26/2020 None N/A DELINQUEN T-NON R3850 GORDON, TRACY ALAN, MD 7/17/2017 7/17/2022 ANESTHESIOLOGY PAYMENT 12/4/2017 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 LICENSE S7060 HADDAD, JEBRAN MICHAEL, MD 6/12/2020 6/12/2025 ANESTHESIOLOGY ISSUED 6/12/2020 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 PEDIATRIC ANESTHESIOLOGY LICENSE S7065 HENRY, TEKESHA T, DO 6/12/2020 6/12/2025 ANESTHESIOLOGY (PEDS) ISSUED 6/12/2020 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 ANESTHESIOLOGY LICENSE Q8512 HUSAIN, KAMRAN, MD 6/1/2016 6/1/2021 ANESTHESIOLOGY (PEDS) ISSUED 6/1/2016 None N/A

Page 2 of 332 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 LICENSE Q4783 KANJIA, MEGHA KARKERA, MD 6/12/2015 6/12/2020 ANESTHESIOLOGY (PEDS) ISSUED 6/12/2015 None N/A KESSINGER, THOMAS WILLIAM, CARDIOTHORACIC R5277 MD 11/17/2017 11/17/2022 ANESTHESIOLOGY ANESTHESIOLOGY ACTIVE 11/22/2017 None N/A R2894 KHAN, ZESHAN MALIK, DO 5/5/2017 5/5/2022 ANESTHESIOLOGY ACTIVE 5/22/2017 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 S4512 KOERPER, KARL PHILIP, MD 12/20/2019 12/20/2024 ANESTHESIOLOGY ACTIVE 1/15/2020 None N/A

Q6057 LANGMADE, LAURA LAWSON, MD 9/15/2015 9/15/2020 ANESTHESIOLOGY ACTIVE 12/7/2015 None N/A LICENSE Q4796 LEE, HELEN HEEYOUNG, MD 6/12/2015 6/12/2020 ANESTHESIOLOGY ISSUED 6/12/2015 None N/A Q6869 LI, JINGYI, MD 1/6/2016 1/6/2021 ANESTHESIOLOGY ACTIVE 3/9/2016 None N/A LICENSE Q6648 LIN, PETER CHARLIE, MD 12/4/2015 12/4/2020 ANESTHESIOLOGY ISSUED 12/4/2015 None N/A MAGBEGOR, SAINT S5693 OGHENEWEMO, MD 3/20/2020 3/20/2025 ANESTHESIOLOGY ACTIVE 3/23/2020 None N/A LICENSE R5593 MALLU, SRILATHA, MD 1/5/2018 1/5/2023 ANESTHESIOLOGY ISSUED 1/5/2018 None N/A DELINQUEN T-NON Q6963 MARDAKH, SIMON, MD 1/15/2016 1/15/2021 ANESTHESIOLOGY PAYMENT 4/14/2016 None N/A S6244 MAXWELL, ELISA, MD 4/17/2020 4/17/2025 ANESTHESIOLOGY ACTIVE 4/21/2020 None N/A LICENSE S5989 MENA, JESSICA, MD 4/3/2020 4/3/2025 ANESTHESIOLOGY ISSUED 4/3/2020 None N/A S5705 MILLER, MAGDA DENES, MD 3/20/2020 3/20/2025 ANESTHESIOLOGY ACTIVE 6/4/2020 None N/A LICENSE S6897 MILLER, TRIS MONET, MD 5/29/2020 5/29/2025 ANESTHESIOLOGY ISSUED 5/29/2020 None N/A LICENSE Q6662 MOLNAR, ARTHUR FRANCIS, MD 12/4/2015 12/4/2020 ANESTHESIOLOGY ISSUED 12/4/2015 None N/A LICENSE S6459 MOUNT, ANDREW , MD 5/1/2020 5/1/2025 ANESTHESIOLOGY ISSUED 5/1/2020 None N/A Q7754 MURRELL, MATTHEW , MD 4/1/2016 4/1/2021 ANESTHESIOLOGY ACTIVE 4/6/2016 None N/A NEBAB, EMMANUEL GUILLERMO, ANESTHESIOLOGY - Q6076 MD 9/15/2015 9/15/2020 ANESTHESIOLOGY PAIN MANAGEMENT ACTIVE 9/24/2015 None N/A R5019 NWAZOTA, NENNA , MD 10/20/2017 10/20/2022 ANESTHESIOLOGY ACTIVE 11/2/2017 None N/A LICENSE S7112 OLDEBEKEN, SCOTT R, MD 6/12/2020 6/12/2025 ANESTHESIOLOGY ISSUED 6/12/2020 None N/A

Page 3 of 332 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 Q8326 PATEL, NAYAN M, MD 5/16/2016 5/16/2021 ANESTHESIOLOGY ACTIVE 5/17/2016 None N/A LICENSE S7116 PAUL, JAISON , MD 6/12/2020 6/12/2025 ANESTHESIOLOGY ISSUED 6/12/2020 None N/A PEDIATRIC ANESTHESIOLOGY LICENSE Q5540 RAHIMZADEH, MARYAM, DO 8/3/2015 8/3/2020 ANESTHESIOLOGY (PEDS) ISSUED 8/3/2015 None N/A PEDIATRIC ANESTHESIOLOGY R2449 RAHMAN, RAZI, MD 4/4/2017 4/4/2022 ANESTHESIOLOGY (PEDS) ACTIVE 4/11/2017 None N/A LICENSE R6267 RIVERA, DANIEL, MD 3/2/2018 3/2/2023 ANESTHESIOLOGY ISSUED 3/2/2018 None N/A ANESTHESIOLOGY - LICENSE Q5547 RIZVI, FAWAD, DO 8/3/2015 8/3/2020 ANESTHESIOLOGY PAIN MANAGEMENT ISSUED 8/3/2015 None N/A RODRIGUEZ, DAVID FRANCISCO, Q7600 MD 3/15/2016 3/15/2021 ANESTHESIOLOGY ACTIVE 3/21/2016 None N/A Q5922 SALDANHA, USHA, MD 8/28/2015 8/28/2020 ANESTHESIOLOGY ACTIVE 9/14/2015 None N/A

Q5275 SANGHVI, REEMA INDUKUMAR, MD 7/15/2015 7/15/2020 ANESTHESIOLOGY ACTIVE 8/17/2015 None N/A PEDIATRIC ANESTHESIOLOGY CANC NON- R0318 SAWI, ZIAD AHMED, MD 9/30/2016 9/30/2021 ANESTHESIOLOGY (PEDS) PAYMENT 3/5/2018 None N/A ANESTHESIOLOGY - R2736 SHAH, BAKHTIAR A, MD 4/20/2017 4/20/2022 ANESTHESIOLOGY PAIN MANAGEMENT ACTIVE 5/18/2017 None N/A DELINQUEN T-NON R4149 SYKORA, PETER, DO 8/1/2017 8/1/2022 ANESTHESIOLOGY PAIN MANAGEMENT PAYMENT 12/4/2017 None N/A LICENSE Q6580 SZOLLAS, LASZLO, MD 11/16/2015 11/16/2020 ANESTHESIOLOGY PAIN MANAGEMENT ISSUED 11/16/2015 None N/A R4333 TERRASSO, TY ANDREW, MD 8/15/2017 8/15/2022 ANESTHESIOLOGY ACTIVE 8/28/2017 None N/A LICENSE S6966 TRAN, HUNG, MD 5/29/2020 5/29/2025 ANESTHESIOLOGY ISSUED 5/29/2020 None N/A PEDIATRIC ANESTHESIOLOGY R0670 VED, SUDHA ARUNKUMAR, MD 10/31/2016 10/31/2021 ANESTHESIOLOGY (PEDS) TX ACTIVE 11/14/2016 None N/A LICENSE R5674 VINJIRAYER, ANITA , MD 1/5/2018 1/5/2023 ANESTHESIOLOGY ISSUED 1/5/2018 None N/A S6767 VOOSOUGHI, REZA, MD 5/15/2020 5/15/2025 ANESTHESIOLOGY ACTIVE 5/18/2020 None N/A

Page 4 of 332 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 Q7615 WHITERU, UVIE CHRISTINA, MD 3/15/2016 3/15/2021 ANESTHESIOLOGY PAYMENT 6/13/2016 None N/A PEDIATRIC ANESTHESIOLOGY LICENSE Q8812 YAMANI, AMMAR NOORUDDIN, MD 6/10/2016 6/10/2021 ANESTHESIOLOGY (PEDS) ISSUED 6/10/2016 None N/A CRITICAL CARE LICENSE S7161 ZHENG, STEVEN YUN, MD 6/12/2020 6/12/2025 ANESTHESIOLOGY ANESTHESIOLOGY ISSUED 6/12/2020 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 ANESTHESIOLOGY - R4544 FITZGERALD, COLE ANDREW, MD 9/8/2017 9/8/2022 PAIN MANAGEMENT ANESTHESIOLOGY ACTIVE 9/11/2017 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 ANESTHESIOLOGY - S5190 JAIN, AYESHA , MD 2/21/2020 2/21/2025 PAIN MANAGEMENT ANESTHESIOLOGY ACTIVE 3/23/2020 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 ANESTHESIOLOGY - LICENSE S5071 SHEIKH, EDNAN, MD 2/7/2020 2/7/2025 PAIN MANAGEMENT PAIN & SPINE ISSUED 2/7/2020 None N/A ANESTHESIOLOGY - R5220 VYAS, JAY RAJEN, MD 11/3/2017 11/3/2022 PAIN MANAGEMENT ACTIVE 11/13/2017 None N/A ANESTHESIOLOGY - LICENSE Q5607 WRIGHT, GARRETT K , MD 8/3/2015 8/3/2020 PAIN MANAGEMENT ISSUED 8/3/2015 None N/A ANESTHESIOLOGY - R3458 YE, RAPHAEL XUYAN, DO 6/2/2017 6/2/2022 PAIN MANAGEMENT ANESTHESIOLOGY ACTIVE 6/8/2017 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 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 CARDIAC ELECTROPHYSIOLOG CARDIOVASCULAR S6872 KONG, MELISSA H, MD 5/29/2020 5/29/2025 Y DISEASES ACTIVE 6/5/2020 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 CARDIAC ELECTROPHYSIOLOG Q6549 OJEDA, WILLIBALDO, MD 11/16/2015 11/16/2020 Y CARDIOLOGY ACTIVE 11/18/2015 None N/A

Page 5 of 332 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 CARDIO- INTERVENTIONAL LICENSE S6108 ALI, ZIAD ANWAR, MD 4/17/2020 4/17/2025 RADIOLOGY CARDIOLOGY ISSUED 4/17/2020 None N/A CARDIO- INTERVENTIONAL LICENSE Q4632 MCDONOUGH, RYAN , DO 6/1/2015 6/1/2020 RADIOLOGY ISSUED 6/1/2015 None N/A DELINQUEN T-NON R3982 ABBAS, AAMIR , MD 8/1/2017 8/1/2022 CARDIOLOGY INTERNAL MEDICINE PAYMENT 12/20/2017 None N/A LICENSE R6142 ALI, OMAIR MOHAMMAD, MD 3/2/2018 3/2/2023 CARDIOLOGY ISSUED 3/2/2018 None N/A INTERVENTIONAL Q8414 ANSINELLI, RICHARD ALLEN, MD 6/1/2016 6/1/2021 CARDIOLOGY CARDIOLOGY ACTIVE 6/3/2016 None N/A Q5181 FEDSON, SAVITRI, MD 7/15/2015 7/15/2020 CARDIOLOGY INTERNAL MEDICINE ACTIVE 7/22/2015 None N/A R5278 KHAN, ABDUL RAHIM, MD 11/17/2017 11/17/2022 CARDIOLOGY ACTIVE 1/8/2018 None N/A INTERVENTIONAL LICENSE Q5011 KUMAR, SACHIN, MD 7/1/2015 7/1/2020 CARDIOLOGY CARDIOLOGY ISSUED 7/1/2015 None N/A LICENSE Q6534 LIU, YAN , MD 11/16/2015 11/16/2020 CARDIOLOGY INTERNAL MEDICINE ISSUED 11/16/2015 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 R0454 MOGALI, KIRAN KUMAR, MD 10/14/2016 10/14/2021 CARDIOLOGY INTERNAL MEDICINE ACTIVE 12/22/2016 None N/A DELINQUEN CARDIOVASCULAR T-NON R1435 PENSABENE, JOSEPH F, MD 1/20/2017 1/20/2022 CARDIOLOGY IMAGING PAYMENT 4/20/2017 None N/A F7091 REYNOLDS, GARY ALAN, MD 11/3/2017 11/3/2022 CARDIOLOGY INTERNAL MEDICINE TX ACTIVE 11/14/2017 None N/A CARDIO- INTERVENTIONAL LICENSE Q6568 SASTRY, ASHWANI, MD 11/16/2015 11/16/2020 CARDIOLOGY RADIOLOGY ISSUED 11/16/2015 None N/A INTERVENTIONAL S6300 SEN, PRIYANKA , MD 4/17/2020 4/17/2025 CARDIOLOGY CARDIOLOGY ACTIVE 5/11/2020 None N/A R1887 STEWART, DANIEL PAUL, DO 2/22/2017 2/22/2022 CARDIOLOGY INTERNAL MEDICINE ACTIVE 2/24/2017 None N/A LICENSE Q8650 SUBRAYAPPA, NAVIN KUMAR, MD 6/1/2016 6/1/2021 CARDIOLOGY INTERNAL MEDICINE ISSUED 6/1/2016 None N/A

S5806 WILLIAMS, NINA EFUA ASAABA, MD 3/20/2020 3/20/2025 CARDIOLOGY INTERNAL MEDICINE ACTIVE 4/13/2020 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

Page 6 of 332 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 BANDEALI, SALMAN JAMALUDDIN, CARDIOVASCULAR INTERVENTIONAL R2050 MD 3/20/2017 3/20/2022 DISEASES CARDIOLOGY ACTIVE 3/22/2017 None N/A CARDIOVASCULAR S5401 KELLEY, MOSES III, MD 3/6/2020 3/6/2025 DISEASES ACTIVE 3/10/2020 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 CARDIOVASCULAR LICENSE Q5912 RAJAGOPAL, SURESH KUMAR, MD 8/28/2015 8/28/2020 DISEASES ISSUED 8/28/2015 None N/A CARDIOVASCULAR INTERVENTIONAL LICENSE Q5569 SHARMA, SURESH, MD 8/3/2015 8/3/2020 DISEASES CARDIOLOGY ISSUED 8/3/2015 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 CHILD AND ADOLESCENT Q7474 SHETTY, SHALINI, MD 3/4/2016 3/4/2021 PSYCHIATRY PSYCHIATRY ACTIVE 3/11/2016 None N/A CHILD AND ADOLESCENT R0338 VEXLER, SANDRA, MD 9/30/2016 9/30/2021 PSYCHIATRY PSYCHIATRY ACTIVE 12/28/2016 None N/A LICENSE Q8652 ACORD, STEPHANIE NOELLE, MD 6/1/2016 6/1/2021 CHILD NEUROLOGY ISSUED 6/1/2016 None N/A LICENSE R6068 OSSO-RIVERA, HENRY , MD 2/16/2018 2/16/2023 CHILD NEUROLOGY ISSUED 2/16/2018 None N/A COLON AND RECTAL R1201 EMUAKHAGBON, VALERIE, MD 1/6/2017 1/6/2022 SURGERY ACTIVE 2/13/2017 None N/A COLON AND RECTAL LICENSE Q8483 GEISLER, DANIEL PHILLIP, MD 6/1/2016 6/1/2021 SURGERY ISSUED 6/1/2016 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 MARINES COPADO, DIEGO COLON AND RECTAL Q4802 CARLOS, MD 6/12/2015 6/12/2020 SURGERY ACTIVE 6/15/2015 None N/A PETERS, WALTER RUSSELL JR, COLON AND RECTAL LICENSE Q6358 MD 10/15/2015 10/15/2020 SURGERY ISSUED 10/15/2015 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 CRITICAL CARE EMERGENCY R2528 BANG, ERICA, MD 4/20/2017 4/20/2022 MEDICINE (IM) MEDICINE ACTIVE 5/2/2017 None N/A DERMATOLOGIC R1281 REISINGER, DIANE MARIE, MD 1/6/2017 1/6/2022 SURGERY ACTIVE 1/17/2017 None N/A

Page 7 of 332 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 DERMATOPATHOLO R1926 ALBAHRANI, YASSER A, MD 3/3/2017 3/3/2022 DERMATOLOGY GY ACTIVE 3/10/2017 None N/A

S6145 CAVALLIN, LUCAS EDGARDO, MD 4/17/2020 4/17/2025 DERMATOLOGY ACTIVE 5/12/2020 None N/A CHAPPELL, JEANEEN LICENSE Q6501 ANTOINETTE, MD 11/16/2015 11/16/2020 DERMATOLOGY ISSUED 11/16/2015 None N/A CHODKIEWICZ, HUBERT MARTIN, DERMATOLOGIC Q5371 MD 8/3/2015 8/3/2020 DERMATOLOGY SURGERY ACTIVE 8/14/2015 None N/A FORERO, JULIE FREDERICKSON, LICENSE Q8056 DO 5/2/2016 5/2/2021 DERMATOLOGY ISSUED 5/2/2016 None N/A

S5626 GLEGHORN, KRISTYNA LENEE, MD 3/20/2020 3/20/2025 DERMATOLOGY ACTIVE 6/15/2020 None N/A Q6943 GUERRERO, KAREN TARM, MD 1/15/2016 1/15/2021 DERMATOLOGY ACTIVE 1/22/2016 None N/A LICENSE Q6533 LING, CARL H, MD 11/16/2015 11/16/2020 DERMATOLOGY ISSUED 11/16/2015 None N/A R3404 PHAM, CATHERINE MAI, MD 6/2/2017 6/2/2022 DERMATOLOGY ACTIVE 6/20/2017 None N/A RAINWATER, YEVGENIYA LICENSE Q8612 BYEKOVA, MD 6/1/2016 6/1/2021 DERMATOLOGY ISSUED 6/1/2016 None N/A PEDIATRIC Q7787 SEWELL, MATTHEW JAMES, MD 4/1/2016 4/1/2021 DERMATOLOGY DERMATOLOGY ACTIVE 4/4/2016 None N/A DERMATOLOGIC Q5953 WU, WESLEY JONATHAN, MD 8/28/2015 8/28/2020 DERMATOLOGY SURGERY ACTIVE 9/9/2015 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 DIAGNOSTIC LICENSE S7015 BRYAN, ROY II, MD 6/12/2020 6/12/2025 RADIOLOGY NEURO-RADIOLOGY ISSUED 6/12/2020 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 DIAGNOSTIC Q4923 CHUA-TUAN, JOHN JAMES, MD 7/1/2015 7/1/2020 RADIOLOGY NEURO-RADIOLOGY ACTIVE 7/6/2015 None N/A DIAGNOSTIC LICENSE TM00607 CROCE, KEVIN JAMES, MD 7/15/2015 7/15/2020 RADIOLOGY ISSUED 7/15/2015 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 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 DIAGNOSTIC LICENSE R5732 GURUSAMY, VARSHANA , MD 1/19/2018 1/19/2023 RADIOLOGY ISSUED 1/19/2018 None N/A

Page 8 of 332 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 R4059 HEWETT, LEE , MD 8/1/2017 8/1/2022 RADIOLOGY ACTIVE 9/6/2017 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 DIAGNOSTIC DIAGNOSTIC R1794 KEY, BRANDON MARTIN, MD 2/22/2017 2/22/2022 RADIOLOGY RADIOLOGY ACTIVE 3/20/2017 None N/A DIAGNOSTIC LICENSE Q6647 LIN, CAROL, MD 12/4/2015 12/4/2020 RADIOLOGY ISSUED 12/4/2015 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 DIAGNOSTIC R4444 OFSTEIN, RICHARD ALAN, MD 8/25/2017 8/25/2022 RADIOLOGY NEURO-RADIOLOGY ACTIVE 9/28/2017 None N/A DIAGNOSTIC LICENSE S7120 PRITCHARD, RONALD, MD 6/12/2020 6/12/2025 RADIOLOGY ISSUED 6/12/2020 None N/A DIAGNOSTIC INTERVENTIONAL LICENSE R5802 RIBEIRO, MARCELO DASSOW, MD 1/19/2018 1/19/2023 RADIOLOGY RADIOLOGY ISSUED 1/19/2018 None N/A DELINQUEN DIAGNOSTIC EMERGENCY/TRAUM T-NON R5200 ROLEN, MICHAEL FITZGERALD, MD 11/3/2017 11/3/2022 RADIOLOGY A RADIOLOGY PAYMENT 2/1/2018 None N/A DIAGNOSTIC MUSCULOSKELETAL Q8143 SCHULTZ, JOSEPH, MD 5/2/2016 5/2/2021 RADIOLOGY RADIOLOGY ACTIVE 5/4/2016 None N/A DIAGNOSTIC Q8638 SHI, XIAO , MD 6/1/2016 6/1/2021 RADIOLOGY ACTIVE 6/13/2016 None N/A EMERGENCY LICENSE Q4552 ABERCROMBIE, JOHN F, MD 6/1/2015 6/1/2020 MEDICINE ISSUED 6/1/2015 None N/A EMERGENCY R0821 ADAMS, DAWN, MD 12/2/2016 12/2/2021 MEDICINE ACTIVE 1/23/2017 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 EMERGENCY R2044 ASHFAQ, SHAH MUHAMMAD, MD 3/20/2017 3/20/2022 MEDICINE ACTIVE 3/23/2017 None N/A EMERGENCY LICENSE Q6603 AUBIN, DEAN JR, MD 12/4/2015 12/4/2020 MEDICINE ISSUED 12/4/2015 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 EMERGENCY R4365 BARTON, KATHERINE, MD 8/25/2017 8/25/2022 MEDICINE ACTIVE 9/11/2017 None N/A EMERGENCY LICENSE Q6605 BATEMAN, JOHN BRIAN, MD 12/4/2015 12/4/2020 MEDICINE ISSUED 12/4/2015 None N/A

Page 9 of 332 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 R4188 BENDOCK, NICOLE, DO 8/15/2017 8/15/2022 MEDICINE ACTIVE 9/4/2017 None N/A EMERGENCY LICENSE S6579 BREMANG, DERRICK BOAKYE, MD 5/15/2020 5/15/2025 MEDICINE ISSUED 5/15/2020 None N/A EMERGENCY R2063 BRIA, CARLEY, MD 3/20/2017 3/20/2022 MEDICINE ACTIVE 4/4/2017 None N/A EMERGENCY LICENSE Q4730 BURNELL, CHARLES PAUL, MD 6/12/2015 6/12/2020 MEDICINE ISSUED 6/12/2015 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 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 EMERGENCY LICENSE Q8451 CHEELA, SHILPA, MD 6/1/2016 6/1/2021 MEDICINE ISSUED 6/1/2016 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 EMERGENCY LICENSE Q5780 CHOI, SE MYUNG, MD 8/28/2015 8/28/2020 MEDICINE ISSUED 8/28/2015 None N/A EMERGENCY Q7668 CLAVER, HAROLD , DO 4/1/2016 4/1/2021 MEDICINE ACTIVE 4/4/2016 None N/A EMERGENCY R5992 CROOK, JEREMY, MD 2/16/2018 2/16/2023 MEDICINE ACTIVE 2/26/2018 None N/A EMERGENCY R3496 DAVEY, KEVIN, MD 6/16/2017 6/16/2022 MEDICINE ACTIVE 6/20/2017 None N/A DAVIDSON, RUSSELL GORDON, EMERGENCY LICENSE Q5788 MD 8/28/2015 8/28/2020 MEDICINE ISSUED 8/28/2015 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 DOCKENDORF, JUSTIN GRAHAM, EMERGENCY R1521 MD 2/6/2017 2/6/2022 MEDICINE FAMILY MEDICINE 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

Page 10 of 332 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 EMERGENCY LICENSE R6002 ESCAMILLA, ANDREW, MD 2/16/2018 2/16/2023 MEDICINE ISSUED 2/16/2018 None N/A EMERGENCY S4947 FARMER, CHARLES ALTON, MD 2/7/2020 2/7/2025 MEDICINE ACTIVE 2/11/2020 None N/A EMERGENCY R3322 FERENC, MACIEJ, DO 6/2/2017 6/2/2022 MEDICINE ACTIVE 6/12/2017 None N/A EMERGENCY R1207 FREEMAN, MARTIN PAUL, MD 1/6/2017 1/6/2022 MEDICINE ACTIVE 2/8/2017 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 EMERGENCY Q7876 GARFF, ANDREW STEWART, MD 4/15/2016 4/15/2021 MEDICINE ACTIVE 4/25/2016 None N/A EMERGENCY S5622 GARZA, ANNA ALICIA, MD 3/20/2020 3/20/2025 MEDICINE ACTIVE 3/24/2020 None N/A EMERGENCY R5555 GILMAN, LAURA ANNE, MD 1/5/2018 1/5/2023 MEDICINE ACTIVE 1/11/2018 None N/A EMERGENCY R0402 GOLLAPALLI, ESLI ELIAS, DO 10/14/2016 10/14/2021 MEDICINE ACTIVE 10/20/2016 None N/A EMERGENCY R1033 GOODMAN, CLARKE WORLEY, MD 12/16/2016 12/16/2021 MEDICINE ACTIVE 12/26/2016 None N/A EMERGENCY Q6840 GRIGSBY, EMILY WYATT, MD 1/6/2016 1/6/2021 MEDICINE ACTIVE 2/5/2016 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 EMERGENCY S6203 HARRIS, CHRISTOPHER JR, MD 4/17/2020 4/17/2025 MEDICINE ACTIVE 4/27/2020 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 Q6844 HEALY, MCKENNA BALDINI, MD 1/6/2016 1/6/2021 MEDICINE ACTIVE 3/7/2016 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

Page 11 of 332 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 Q5815 HITE, PAMELA RENE, MD 8/28/2015 8/28/2020 MEDICINE ISSUED 8/28/2015 None N/A EMERGENCY S6851 HO, CALVIN, MD 5/29/2020 5/29/2025 MEDICINE ACTIVE 6/2/2020 None N/A EMERGENCY R1223 HOLLENSTEINER, CASEY, MD 1/6/2017 1/6/2022 MEDICINE ACTIVE 1/16/2017 None N/A EMERGENCY LICENSE S7075 JEANISE, SELINA ANN, DO 6/12/2020 6/12/2025 MEDICINE ISSUED 6/12/2020 None N/A EMERGENCY Q6430 JENSEN, JAMES II, MD 11/2/2015 11/2/2020 MEDICINE PEDIATRICS ACTIVE 12/1/2015 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 EMERGENCY Q4608 JYOTHINDRAN, REVATHI, MD 6/1/2015 6/1/2020 MEDICINE ACTIVE 6/5/2015 None N/A EMERGENCY R5276 KAHN, PATRICIA, DO 11/17/2017 11/17/2022 MEDICINE ACTIVE 11/29/2017 None N/A EMERGENCY LICENSE Q4782 KALSTED, CHARLES L, MD 6/12/2015 6/12/2020 MEDICINE ISSUED 6/12/2015 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 EMERGENCY Q5006 KHARBANDA, BRYAN SINGH, MD 7/1/2015 7/1/2020 MEDICINE ACTIVE 7/2/2015 None N/A EMERGENCY LICENSE Q6642 KOH, HEAJEOUNG ELIZABETH, MD 12/4/2015 12/4/2020 MEDICINE ISSUED 12/4/2015 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 EMERGENCY R4582 LAITINEN, BRADLEY, MD 9/8/2017 9/8/2022 MEDICINE ACTIVE 9/18/2017 None N/A LANDRY, DANA MARIE CHANEY, EMERGENCY Q7068 MD 2/1/2016 2/1/2021 MEDICINE ACTIVE 2/8/2016 None N/A EMERGENCY R0606 LARA, MICHAEL, MD 10/31/2016 10/31/2021 MEDICINE ACTIVE 1/22/2018 None N/A EMERGENCY R3706 LEONARD, JOHN HENRY, MD 6/30/2017 6/30/2022 MEDICINE ACTIVE 7/11/2017 None N/A EMERGENCY LICENSE Q4623 LEWIS, WHITNEY KRISTINA, DO 6/1/2015 6/1/2020 MEDICINE ISSUED 6/1/2015 None N/A

Page 12 of 332 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 S5688 LIM, JOSHUA TIMOTHY, MD 3/20/2020 3/20/2025 MEDICINE ISSUED 3/20/2020 None N/A EMERGENCY Q5476 LUCK, JOHN BENJAMIN, MD 8/3/2015 8/3/2020 MEDICINE ACTIVE 8/28/2015 None N/A EMERGENCY LICENSE S7092 MA, ZHENG BEN, MD 6/12/2020 6/12/2025 MEDICINE ISSUED 6/12/2020 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 R4430 MAUR, ERIC EVAN, MD 8/25/2017 8/25/2022 MEDICINE ACTIVE 9/4/2017 None N/A EMERGENCY S6245 MAXWELL, STUART JAMES, MD 4/17/2020 4/17/2025 MEDICINE ACTIVE 5/8/2020 None N/A EMERGENCY LICENSE Q8561 MCDONALD, SAMUEL ARTHUR, MD 6/1/2016 6/1/2021 MEDICINE ISSUED 6/1/2016 None N/A EMERGENCY Q8564 MEINDL HOLMAN, JUDI D, MD 6/1/2016 6/1/2021 MEDICINE ACTIVE 6/3/2016 None N/A EMERGENCY Q4636 MERRITT, JUDSON, MD 6/1/2015 6/1/2020 MEDICINE ACTIVE 6/15/2015 None N/A EMERGENCY LICENSE R6053 MONTOYA, JUAN DAVID, MD 2/16/2018 2/16/2023 MEDICINE ISSUED 2/16/2018 None N/A EMERGENCY R0911 MOORE, DEVON JELANI, MD 12/2/2016 12/2/2021 MEDICINE ACTIVE 12/7/2016 None N/A EMERGENCY LICENSE Q5874 MORRISON, MATTHEW ELLIS, MD 8/28/2015 8/28/2020 MEDICINE ISSUED 8/28/2015 None N/A EMERGENCY Q5045 MULLEN, CASEY KYLEE, MD 7/1/2015 7/1/2020 MEDICINE ACTIVE 7/3/2015 None N/A EMERGENCY Q7434 MURPHY, SEAN MICHAEL, MD 3/4/2016 3/4/2021 MEDICINE ACTIVE 3/9/2016 None N/A EMERGENCY LICENSE Q8579 MYNATT, IRENE ANN, DO 6/1/2016 6/1/2021 MEDICINE ISSUED 6/1/2016 None N/A EMERGENCY PALLIATIVE LICENSE S4353 NAUMAN, LYNN ELIZABETH, MD 12/6/2019 12/6/2024 MEDICINE MEDICINE ISSUED 12/6/2020 None N/A EMERGENCY PALLIATIVE LICENSE S4353 NAUMAN, LYNN ELIZABETH, MD 12/6/2019 12/6/2024 MEDICINE MEDICINE ISSUED 12/6/2020 None N/A EMERGENCY Q5233 NDI, JULIUS SAMA, MD 7/15/2015 7/15/2020 MEDICINE FAMILY MEDICINE ACTIVE 7/16/2015 None N/A EMERGENCY Q4650 NGUYEN, JULIE M, MD 6/1/2015 6/1/2020 MEDICINE ACTIVE 6/2/2015 None N/A

Page 13 of 332 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 S6002 NGUYEN, NANCY, DO 4/3/2020 4/3/2025 MEDICINE ISSUED 4/3/2020 None N/A PEDIATRIC EMERGENCY EMERGENCY LICENSE S5718 NIELSON, JONATHAN PAUL, MD 3/20/2020 3/20/2025 MEDICINE MEDICINE (EM) ISSUED 3/20/2020 None N/A EMERGENCY LICENSE Q8763 NORVELL, CARA BRIANNE, DO 6/10/2016 6/10/2021 MEDICINE ISSUED 6/10/2016 None N/A EMERGENCY R3927 NORWOOD, SAMUEL W II, MD 7/17/2017 7/17/2022 MEDICINE ACTIVE 8/3/2017 None N/A EMERGENCY LICENSE R6065 NUGENT, KENNETH RYAN, MD 2/16/2018 2/16/2023 MEDICINE ISSUED 2/16/2018 None N/A EMERGENCY R0086 NWACHUKWU, ERNEST JR, MD 9/15/2016 9/15/2021 MEDICINE ACTIVE 9/19/2016 None N/A EMERGENCY Q9462 ORTIZ, GERARDO, MD 8/1/2016 8/1/2021 MEDICINE ACTIVE 8/3/2016 None N/A EMERGENCY R4301 PADDOCK, CLARK STUART, MD 8/15/2017 8/15/2022 MEDICINE ACTIVE 8/21/2017 None N/A EMERGENCY LICENSE R5913 PARKES, STEVEN WILLIAM, MD 2/2/2018 2/2/2023 MEDICINE ISSUED 2/2/2018 None N/A EMERGENCY LICENSE Q4665 PATEL, REEVA YOGESH, MD 6/1/2015 6/1/2020 MEDICINE ISSUED 6/1/2015 None N/A PAUL, CHRISTOPHER MICHAEL, EMERGENCY EMERGENCY R5180 MD 11/3/2017 11/3/2022 MEDICINE MEDICINE ACTIVE 12/1/2017 None N/A EMERGENCY LICENSE Q4825 PERRY, MICHAEL CHARLES JR, MD 6/12/2015 6/12/2020 MEDICINE ISSUED 6/12/2015 None N/A EMERGENCY R3182 PEZZELLA, LINA CATHERINE, MD 5/22/2017 5/22/2022 MEDICINE ACTIVE 5/29/2017 None N/A EMERGENCY LICENSE Q8330 PIERCE, CALEB ANDREW, MD 5/16/2016 5/16/2021 MEDICINE ISSUED 5/16/2016 None N/A EMERGENCY R2442 PLATT, GERALD WILLIAM, MD 4/4/2017 4/4/2022 MEDICINE ACTIVE 4/7/2017 None N/A EMERGENCY Q8123 POLYNICE, PAMELA, DO 5/2/2016 5/2/2021 MEDICINE ACTIVE 5/17/2016 None N/A EMERGENCY R5628 PONCHER, EVAN, MD 1/5/2018 1/5/2023 MEDICINE ACTIVE 1/17/2018 None N/A UNDERSEA EMERGENCY HYPERBARIC MED Q8125 PORTOUW, STEVEN, MD 5/2/2016 5/2/2021 MEDICINE (EMER MED) ACTIVE 5/3/2016 None N/A

Page 14 of 332 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 R5027 PRUDOFF, RYAN SANFORD, DO 10/20/2017 10/20/2022 MEDICINE ACTIVE 12/11/2017 None N/A EMERGENCY LICENSE Q4828 QUALLS, TED RICHARD, MD 6/12/2015 6/12/2020 MEDICINE ISSUED 6/12/2015 None N/A EMERGENCY LICENSE S6487 RAHIM, SALMAN , DO 5/1/2020 5/1/2025 MEDICINE ISSUED 5/1/2020 None N/A RAMIREZ OCAMPO, JUAN DAVID, EMERGENCY INTERNAL MED - R2713 MD 4/20/2017 4/20/2022 MEDICINE EMERGENCY MED ACTIVE 5/1/2017 None N/A EMERGENCY R0938 RATNABALASURIAR, RADHIKA, MD 12/2/2016 12/2/2021 MEDICINE ACTIVE 2/21/2017 None N/A EMERGENCY Q6268 RAY, DANIEL BUTLER, MD 10/1/2015 10/1/2020 MEDICINE INTERNAL MEDICINE ACTIVE 10/6/2015 None N/A EMERGENCY LICENSE Q6689 REAVES, JASON SCOTT, MD 12/4/2015 12/4/2020 MEDICINE ISSUED 12/4/2015 None N/A EMERGENCY CRITICAL CARE Q7455 REZVANKHOO, KABIR, MD 3/4/2016 3/4/2021 MEDICINE MEDICINE (IM) ACTIVE 3/21/2016 None N/A EMERGENCY R4133 ROLSTON-CREGLER, LOUIS, MD 8/1/2017 8/1/2022 MEDICINE ACTIVE 8/8/2017 None N/A EMERGENCY Q6271 ROMAN, MARIA CARMEN, MD 10/1/2015 10/1/2020 MEDICINE ACTIVE 10/8/2015 None N/A ROSS, DAVID WILLIAM MALCOLM, EMERGENCY EMERGENCY LICENSE Q6273 DO 10/1/2015 10/1/2020 MEDICINE MEDICAL SERVICES ISSUED 10/1/2015 None N/A SALTARELLI, NICHOLAS ANTHONY, EMERGENCY LICENSE S6927 MD 5/29/2020 5/29/2025 MEDICINE ISSUED 5/29/2020 None N/A EMERGENCY R3589 SAMDANI, SHEEMA, DO 6/16/2017 6/16/2022 MEDICINE ACTIVE 6/20/2017 None N/A SASSER, DAVID CHARLES EMERGENCY LICENSE Q7784 HEMINGWAY, MD 4/1/2016 4/1/2021 MEDICINE ISSUED 4/1/2016 None N/A EMERGENCY R2968 SHAH, KANT PRADIP, MD 5/5/2017 5/5/2022 MEDICINE ACTIVE 5/24/2017 None N/A EMERGENCY Q7961 SHAH, RAJNIL G, MD 4/15/2016 4/15/2021 MEDICINE PEDIATRICS ACTIVE 5/10/2016 None N/A EMERGENCY LICENSE S6042 SHEIDE, MARSHALL , DO 4/3/2020 4/3/2025 MEDICINE ISSUED 4/3/2020 None N/A EMERGENCY Q9512 SHNOWSKE, KRISTIN, DO 8/1/2016 8/1/2021 MEDICINE ACTIVE 8/23/2016 None N/A EMERGENCY LICENSE Q5281 SMITH, MATTHEW KEITH, MD 7/15/2015 7/15/2020 MEDICINE ISSUED 7/15/2015 None N/A

Page 15 of 332 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 S5082 STERN, DOUGLAS D, DO 2/7/2020 2/7/2025 MEDICINE ACTIVE 2/21/2020 None N/A EMERGENCY R3601 SUERO SALVADOR, TITO, MD 6/16/2017 6/16/2022 MEDICINE ACTIVE 6/27/2017 None N/A EMERGENCY LICENSE S6960 TESTA, DANIEL ALEXANDER, MD 5/29/2020 5/29/2025 MEDICINE ISSUED 5/29/2020 None N/A EMERGENCY LICENSE R6299 THERWHANGER, JOHN, MD 3/2/2018 3/2/2023 MEDICINE ISSUED 3/2/2018 None N/A EMERGENCY R4150 THIBODEAU, KYLE HARRISON, MD 8/1/2017 8/1/2022 MEDICINE ACTIVE 8/11/2017 None N/A EMERGENCY S4887 TOLAR, ADAM MICHAEL, MD 1/24/2020 1/24/2025 MEDICINE ACTIVE 1/29/2020 None N/A EMERGENCY LICENSE Q8660 TRUONG, VINCE, DO 6/1/2016 6/1/2021 MEDICINE ISSUED 6/1/2016 None N/A EMERGENCY EMERGENCY LICENSE S6760 TSAU, JOSHUA GERSHOM, MD 5/15/2020 5/15/2025 MEDICINE MEDICAL SERVICES ISSUED 5/15/2020 None N/A EMERGENCY CRITICAL CARE LICENSE Q5941 TSUNG, ANN HANYI, MD 8/28/2015 8/28/2020 MEDICINE MEDICINE ISSUED 8/28/2015 None N/A DELINQUEN EMERGENCY T-NON Q9263 VELAMATI, RUKMINI, MD 7/15/2016 7/15/2021 MEDICINE PEDIATRICS PAYMENT 12/30/2017 None N/A DELINQUEN EMERGENCY T-NON R4164 WANG, STEVE CHENCHIEH, DO 8/1/2017 8/1/2022 MEDICINE PAYMENT 12/4/2017 None N/A DELINQUEN EMERGENCY T-NON R0807 WARD, REGINALD ANTHONY, MD 11/15/2016 11/15/2021 MEDICINE PAYMENT 12/30/2017 None N/A EMERGENCY Q6919 WATTS, ADRIEL MARCUSEN, MD 1/6/2016 1/6/2021 MEDICINE ACTIVE 1/8/2016 None N/A EMERGENCY S5104 WIESNER, THEODORE, MD 2/7/2020 2/7/2025 MEDICINE ACTIVE 4/13/2020 None N/A EMERGENCY Q7303 WINCKLER, CHRISTOPHER, MD 2/16/2016 2/16/2021 MEDICINE ACTIVE 2/18/2016 None N/A EMERGENCY R3008 WON, CHUNG Y, MD 5/5/2017 5/5/2022 MEDICINE ACTIVE 5/8/2017 None N/A EMERGENCY Q7990 YERTON, JEREMIAH, MD 4/15/2016 4/15/2021 MEDICINE ACTIVE 4/25/2016 None N/A EMERGENCY R5957 ZHU, GLORY RONG, MD 2/2/2018 2/2/2023 MEDICINE ACTIVE 2/6/2018 None N/A

Page 16 of 332 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 R6187 FOLKARD, CAMILLE, MD 3/2/2018 3/2/2023 METABOLISM ACTIVE 3/19/2018 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 ENDOCRINOLOGY, DIABETES AND Q7576 LEE, MARIA NIEN-FENG, MD 3/15/2016 3/15/2021 METABOLISM ACTIVE 4/14/2016 None N/A ENDOCRINOLOGY, DIABETES AND R5341 YEHYA, AHMAD , MD 11/17/2017 11/17/2022 METABOLISM ACTIVE 11/22/2017 None N/A R4173 ADANE, TIRSIT, MD 8/15/2017 8/15/2022 FAMILY MEDICINE ACTIVE 11/16/2017 None N/A LICENSE Q4712 ALAM, HILMI, MD 6/12/2015 6/12/2020 FAMILY MEDICINE ISSUED 6/12/2015 None N/A Q9106 ALAMO, JORGE GUILLERMO, MD 7/15/2016 7/15/2021 FAMILY MEDICINE ACTIVE 8/2/2016 None N/A LICENSE R5692 AMIN, RANJANI DAVALATH, DO 1/19/2018 1/19/2023 FAMILY MEDICINE ISSUED 1/19/2018 None N/A Q5616 ARRIETA, SOLEIL , MD 8/14/2015 8/14/2020 FAMILY MEDICINE ACTIVE 8/31/2015 None N/A R4662 ATHER, SYED, MD 9/22/2017 9/22/2022 FAMILY MEDICINE ACTIVE 10/2/2017 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 Q9118 AWWAD, MAHDI MANSOUR, MD 7/15/2016 7/15/2021 FAMILY MEDICINE OBSTETRICS ACTIVE 8/5/2016 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 LICENSE Q8213 BODOKY, ANETTE, MD 5/16/2016 5/16/2021 FAMILY MEDICINE ISSUED 5/16/2016 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 Q6157 BUDHARAJU, SUBBARAJU, MD 10/1/2015 10/1/2020 FAMILY MEDICINE HOSPITALIST ACTIVE 10/6/2015 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 Q8846 CARMICAL, JIM , MD 7/1/2016 7/1/2021 FAMILY MEDICINE ACTIVE 7/6/2016 None N/A

Q7664 CHARLES, LORRAINE ALEXIS, MD 4/1/2016 4/1/2021 FAMILY MEDICINE ACTIVE 4/6/2016 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 S5863 CHEN, VICTORIA IAN, DO 4/3/2020 4/3/2025 FAMILY MEDICINE ACTIVE 6/11/2020 None N/A

Page 17 of 332 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 Q8706 CHHABRIA, ARUNA JYOTHI, MD 6/10/2016 6/10/2021 FAMILY MEDICINE MEDICINE ISSUED 6/10/2016 None N/A LICENSE S6591 CHINTALAPALLY, RAGHAV, MD 5/15/2020 5/15/2025 FAMILY MEDICINE ISSUED 5/15/2020 None N/A Q6167 COLEMAN, KIONA P, MD 10/1/2015 10/1/2020 FAMILY MEDICINE ACTIVE 10/6/2015 None N/A LICENSE S5869 CONWAY, JORDAN WILLIAM, MD 4/3/2020 4/3/2025 FAMILY MEDICINE ISSUED 4/3/2020 None N/A

R0702 CULBERSON, NATHAN JAMES, MD 11/15/2016 11/15/2021 FAMILY MEDICINE ACTIVE 11/17/2016 None N/A R5107 DANG, ANNA MARGARET, DO 11/3/2017 11/3/2022 FAMILY MEDICINE ACTIVE 11/7/2017 None N/A LICENSE S6602 DAVIES, TABITHA , DO 5/15/2020 5/15/2025 FAMILY MEDICINE OBSTETRICS ISSUED 5/15/2020 None N/A 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 R0222 EDE, CHINEDU DONATUS, MD 9/30/2016 9/30/2021 FAMILY MEDICINE ACTIVE 11/22/2016 None N/A

R0856 ELHAJ, CHRISTIAN , MD 12/2/2016 12/2/2021 FAMILY MEDICINE GENERAL PRACTICE ACTIVE 12/7/2016 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 R4966 FAN, CHUAN-LI, DO 10/20/2017 10/20/2022 FAMILY MEDICINE ACTIVE 11/29/2017 None N/A Q8473 FATIMA, ANEES, MD 6/1/2016 6/1/2021 FAMILY MEDICINE ACTIVE 6/6/2016 None N/A S5896 FIGUEROA, ELISADEL , MD 4/3/2020 4/3/2025 FAMILY MEDICINE ACTIVE 6/2/2020 None N/A FRUCHTMAN, PARINDA R1752 KANAIYALAL, MD 2/22/2017 2/22/2022 FAMILY MEDICINE ACTIVE 3/5/2018 None N/A LICENSE S6840 GALLAGHER, MARIAM, DO 5/29/2020 5/29/2025 FAMILY MEDICINE ISSUED 5/29/2020 None N/A Q5406 GARAGHTY, ANNIE TOUNG, DO 8/3/2015 8/3/2020 FAMILY MEDICINE ACTIVE 8/17/2015 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

R5120 GILES, MERCEDES ANTONIA, MD 11/3/2017 11/3/2022 FAMILY MEDICINE ACTIVE 1/8/2018 None N/A Q8251 GLOYD, TIMOTHY, MD 5/16/2016 5/16/2021 FAMILY MEDICINE ACTIVE 6/2/2016 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 Q6941 GOUNDEN, RENEE , MD 1/15/2016 1/15/2021 FAMILY MEDICINE ACTIVE 2/2/2016 None N/A GUTIERREZ RAMAL, MITSI LISET, R1038 MD 12/16/2016 12/16/2021 FAMILY MEDICINE ACTIVE 12/20/2016 None N/A

Page 18 of 332 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 Q6320 GUTIERREZ, ARMANDO I, MD 10/15/2015 10/15/2020 FAMILY MEDICINE ISSUED 10/15/2015 None N/A Q5194 HAGEN, MICHAEL PETER JR, MD 7/15/2015 7/15/2020 FAMILY MEDICINE ACTIVE 7/27/2015 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 DELINQUEN T-NON R1776 HOUSTON, COLE JACKSON, MD 2/22/2017 2/22/2022 FAMILY MEDICINE PAYMENT 5/23/2017 None N/A

S5390 HUGHES, ANDREA BREANNA, DO 3/6/2020 3/6/2025 FAMILY MEDICINE ACTIVE 4/1/2020 None N/A Q7710 HUSSAIN, SYED SHOIB, DO 4/1/2016 4/1/2021 FAMILY MEDICINE ACTIVE 6/13/2016 None N/A Q7208 HUYNH, MYLIEN , MD 2/16/2016 2/16/2021 FAMILY MEDICINE ACTIVE 3/10/2016 None N/A LICENSE R5871 IFEDI, BENEDICT , MD 2/2/2018 2/2/2023 FAMILY MEDICINE ISSUED 2/2/2018 None N/A Q7892 JAHOOR, ANIL FAROOK, DO 4/15/2016 4/15/2021 FAMILY MEDICINE ACTIVE 4/20/2016 None N/A S6217 JAVADI, JASMINE , MD 4/17/2020 4/17/2025 FAMILY MEDICINE GERIATRICS ACTIVE 4/21/2020 None N/A JILES, ELISICIA LOUISE TAYLOR, R4725 MD 9/22/2017 9/22/2022 FAMILY MEDICINE ACTIVE 9/29/2017 None N/A Q6950 JOSEPH, JEAN MANASSE, MD 1/15/2016 1/15/2021 FAMILY MEDICINE FAMILY PRACTICE ACTIVE 1/18/2016 None N/A R4405 JUNG, JENNIFER KO, MD 8/25/2017 8/25/2022 FAMILY MEDICINE ACTIVE 9/26/2017 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 Q4614 KHAN, MAZHAR AHMED, MD 6/1/2015 6/1/2020 FAMILY MEDICINE FAMILY PRACTICE ACTIVE 6/2/2015 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

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 URGENT CARE - Q8088 KIM, CLAIRE HYAEKYONG, DO 5/2/2016 5/2/2021 FAMILY MEDICINE FAMILY PRACTICE ACTIVE 5/3/2016 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

S5411 KUMAR, VINEETH NARAYANA, MD 3/6/2020 3/6/2025 FAMILY MEDICINE ACTIVE 3/24/2020 None N/A KYATHANAHALLI PUTTALINGAPPA, Q5014 LOKESH, MD 7/1/2015 7/1/2020 FAMILY MEDICINE ACTIVE 8/18/2015 None N/A

Page 19 of 332 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 R4419 LA ROCCA, JULIETA GARCIA, MD 8/25/2017 8/25/2022 FAMILY MEDICINE ACTIVE 8/28/2017 None N/A

Q8940 LASTOVICA, BRYNN LENANN, MD 7/1/2016 7/1/2021 FAMILY MEDICINE ACTIVE 7/6/2016 None N/A LICENSE Q5471 LEWIS, SPENCER RYAN, MD 8/3/2015 8/3/2020 FAMILY MEDICINE ISSUED 8/3/2015 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 LICENSE S7090 LIN, WILLIAM I, MD 6/12/2020 6/12/2025 FAMILY MEDICINE OBSTETRICS ISSUED 6/12/2020 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 LICENSE Q5020 LOPEZ SEPULVEDA, JAXEL, MD 7/1/2015 7/1/2020 FAMILY MEDICINE ISSUED 7/1/2015 None N/A MANZANILLA LUBERTI, LAURA R5891 ELENA, MD 2/2/2018 2/2/2023 FAMILY MEDICINE ACTIVE 2/13/2018 None N/A Q7579 MARTINEZ, MONICA ANNE, MD 3/15/2016 3/15/2021 FAMILY MEDICINE ACTIVE 3/22/2016 None N/A 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 Q6236 MENDEZ, ILEANA ELITA, MD 10/1/2015 10/1/2020 FAMILY MEDICINE ACTIVE 10/5/2015 None N/A R0757 MENSAH, VICTOR OLAWALE, MD 11/15/2016 11/15/2021 FAMILY MEDICINE HOSPITALIST ACTIVE 12/23/2016 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 R4745 MERID, FANTAYE, MD 9/22/2017 9/22/2022 FAMILY MEDICINE ACTIVE 9/27/2017 None N/A R1420 MERLI, NICOLE MARIE, MD 1/20/2017 1/20/2022 FAMILY MEDICINE ACTIVE 2/13/2017 None N/A R3155 MJALTAJ, MARIOLA, MD 5/22/2017 5/22/2022 FAMILY MEDICINE ACTIVE 8/14/2017 None N/A Q8570 MOCHERLA, BHAVANA , MD 6/1/2016 6/1/2021 FAMILY MEDICINE ACTIVE 6/3/2016 None N/A LICENSE Q4641 MOHAMED, OSAMA , MD 6/1/2015 6/1/2020 FAMILY MEDICINE ISSUED 6/1/2015 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 Q5496 MONTOYA, JUAN PABLO, MD 8/3/2015 8/3/2020 FAMILY MEDICINE ACTIVE 8/6/2015 None N/A Q7241 MOORE, SHAMIER E'LAN, DO 2/16/2016 2/16/2021 FAMILY MEDICINE ACTIVE 3/1/2016 None N/A LICENSE Q5872 MORALES-RALAT, ASTRID, MD 8/28/2015 8/28/2020 FAMILY MEDICINE ISSUED 8/28/2015 None N/A R1589 MORENO, JAIME ENRIQUE, MD 2/6/2017 2/6/2022 FAMILY MEDICINE ACTIVE 4/27/2017 None N/A MOSHIREE THOMAS, BANAFSHEH, LICENSE Q4814 MD 6/12/2015 6/12/2020 FAMILY MEDICINE ISSUED 6/12/2015 None N/A

Page 20 of 332 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 Q6667 MUGHAL, TANVEER HAIDER, MD 12/4/2015 12/4/2020 FAMILY MEDICINE ACTIVE 12/8/2015 None N/A

J1120 MURPHEY, SUSAN ELIZABETH, MD 1/10/2020 1/10/2025 FAMILY MEDICINE ACTIVE 1/16/2020 None N/A Q5502 MURPHY, DANIEL , MD 8/3/2015 8/3/2020 FAMILY MEDICINE SPORTS MEDICINE ACTIVE 8/5/2015 None N/A Q7758 NAZIR, FIZA , MD 4/1/2016 4/1/2021 FAMILY MEDICINE GERIATRICS ACTIVE 6/6/2016 None N/A LICENSE Q6670 NELSON, KIMBERLY C, MD 12/4/2015 12/4/2020 FAMILY MEDICINE ISSUED 12/4/2015 None N/A R0768 NGARE, ESTHER MWIYERIA, MD 11/15/2016 11/15/2021 FAMILY MEDICINE ACTIVE 11/21/2016 None N/A NWANKWO, CHINEDU Q9458 IKEOTUONYE, MD 8/1/2016 8/1/2021 FAMILY MEDICINE FAMILY MEDICINE ACTIVE 9/14/2016 None N/A EMERGENCY LICENSE Q6675 O'CONNELL, ETHAN, MD 12/4/2015 12/4/2020 FAMILY MEDICINE MEDICINE ISSUED 12/4/2015 None N/A S5236 O'DELL, MONTANA JOE, MD 2/21/2020 2/21/2025 FAMILY MEDICINE ACTIVE 4/17/2020 None N/A ODUKOYA, ADEWALE ADEYINKA, EMERGENCY S5721 MD 3/20/2020 3/20/2025 FAMILY MEDICINE MEDICINE ACTIVE 3/27/2020 None N/A LICENSE Q4822 OKPUKPARA, ONYINYE, MD 6/12/2015 6/12/2020 FAMILY MEDICINE ISSUED 6/12/2015 None N/A Q5704 OLANREWAJU, IFEDOLAPO , MD 8/14/2015 8/14/2020 FAMILY MEDICINE HOSPITALIST ACTIVE 8/18/2015 None N/A LICENSE Q5522 OPHORI, EMUEJE, MD 8/3/2015 8/3/2020 FAMILY MEDICINE SPORTS MEDICINE ISSUED 8/3/2015 None N/A LICENSE S6272 PALMER, AUBREY , MD 4/17/2020 4/17/2025 FAMILY MEDICINE ISSUED 4/17/2020 None N/A R5022 PANDEY, PRAGATI, MD 10/20/2017 10/20/2022 FAMILY MEDICINE ACTIVE 10/24/2017 None N/A LICENSE Q6553 PANUGANTI, KIRAN KUMAR, MD 11/16/2015 11/16/2020 FAMILY MEDICINE HOSPITALIST ISSUED 11/16/2015 None N/A LICENSE R5617 PATEL, ANKIT , MD 1/5/2018 1/5/2023 FAMILY MEDICINE ISSUED 1/5/2018 None N/A LICENSE Q5896 PATEL, MITESH MAHESH, DO 8/28/2015 8/28/2020 FAMILY MEDICINE ISSUED 8/28/2015 None N/A URGENT CARE - LICENSE R6257 PERRY, JORDAN, MD 3/2/2018 3/2/2023 FAMILY MEDICINE FAMILY PRACTICE ISSUED 3/2/2018 None N/A Q9476 PHAN, TINA, DO 8/1/2016 8/1/2021 FAMILY MEDICINE ACTIVE 8/3/2016 None N/A LICENSE Q6561 RAHMAN, ALYSHA, MD 11/16/2015 11/16/2020 FAMILY MEDICINE ISSUED 11/16/2015 None N/A RAMANUJAM, SATHYAVANI LICENSE Q8127 MUTHU, MD 5/2/2016 5/2/2021 FAMILY MEDICINE ISSUED 5/2/2016 None N/A LICENSE S6024 ROMENSKA, OLENA, MD 4/3/2020 4/3/2025 FAMILY MEDICINE ISSUED 4/3/2020 None N/A

Page 21 of 332 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 RONCALLO, JENNIFER LICENSE Q6696 MARGARITA, MD 12/4/2015 12/4/2020 FAMILY MEDICINE ISSUED 12/4/2015 None N/A LICENSE Q8142 SAGAR, YESHODRA, MD 5/2/2016 5/2/2021 FAMILY MEDICINE ISSUED 5/2/2016 None N/A LICENSE Q5921 SALAZAR, HUGO PASTOR JR, MD 8/28/2015 8/28/2020 FAMILY MEDICINE ISSUED 8/28/2015 None N/A SANTA MARIA, AMANDA LICENSE S7131 MICHELLE, MD 6/12/2020 6/12/2025 FAMILY MEDICINE ISSUED 6/12/2020 None N/A SANTIAGO DELGADO, ZULEICA LICENSE S7132 MARIE, MD 6/12/2020 6/12/2025 FAMILY MEDICINE ISSUED 6/12/2020 None N/A LICENSE Q6700 SANUSI, MONISOLA MODUPE, MD 12/4/2015 12/4/2020 FAMILY MEDICINE ISSUED 12/4/2015 None N/A LICENSE Q6703 SCHUERGER, JOSEPH B, MD 12/4/2015 12/4/2020 FAMILY MEDICINE ISSUED 12/4/2015 None N/A R4471 SELVADURAY, PRAVEENA, MD 8/25/2017 8/25/2022 FAMILY MEDICINE ACTIVE 9/15/2017 None N/A R5036 SELZER, KODY LEE, MD 10/20/2017 10/20/2022 FAMILY MEDICINE ACTIVE 10/26/2017 None N/A R2474 SHAH, MEERA, MD 4/4/2017 4/4/2022 FAMILY MEDICINE ACTIVE 4/26/2017 None N/A LICENSE S6738 SHEN, HAO, DO 5/15/2020 5/15/2025 FAMILY MEDICINE ISSUED 5/15/2020 None N/A R4325 SIDDIQUI, ZUBAIR PASHA, MD 8/15/2017 8/15/2022 FAMILY MEDICINE ACTIVE 8/16/2017 None N/A R5320 SIMPSON, CHRIS ROYEL, MD 11/17/2017 11/17/2022 FAMILY MEDICINE ACTIVE 11/24/2017 None N/A S5075 SINGH, AJAYPAL, MD 2/7/2020 2/7/2025 FAMILY MEDICINE ACTIVE 3/9/2020 None N/A LICENSE S6308 SINGH, JASJIT, MD 4/17/2020 4/17/2025 FAMILY MEDICINE ISSUED 4/17/2020 None N/A DELINQUEN T-NON R5322 SIREK, ADAM, MD 11/17/2017 11/17/2022 FAMILY MEDICINE PAYMENT 2/15/2018 None N/A S4393 SIZAR, OMEED, DO 12/6/2019 12/6/2024 FAMILY MEDICINE HOSPITALIST ACTIVE 2/19/2020 None N/A S4393 SIZAR, OMEED, DO 12/6/2019 12/6/2024 FAMILY MEDICINE HOSPITALIST ACTIVE 2/19/2020 None N/A Q8154 SOLIZ, PATRICIA ELENA, MD 5/2/2016 5/2/2021 FAMILY MEDICINE ACTIVE 5/9/2016 None N/A Q7112 SOLOMON, ERIC STEPHEN, MD 2/1/2016 2/1/2021 FAMILY MEDICINE ACTIVE 2/8/2016 None N/A R5324 SOTO, PREETINDER KAUR, MD 11/17/2017 11/17/2022 FAMILY MEDICINE ACTIVE 12/28/2017 None N/A DELINQUEN T-NON R3758 SOUTHWELL, TYLER JOHN, MD 6/30/2017 6/30/2022 FAMILY MEDICINE PAYMENT 12/4/2017 None N/A SPORTS MEDICINE LICENSE Q8796 SPERO, ELIZABETH MIRDZA, MD 6/10/2016 6/10/2021 FAMILY MEDICINE (FAMILY PRACTICE) ISSUED 6/10/2016 None N/A LICENSE Q6294 TANVEER, UZMA, MD 10/1/2015 10/1/2020 FAMILY MEDICINE ISSUED 10/1/2015 None N/A

Page 22 of 332 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 Q6715 TAROKH, SAEED, MD 12/4/2015 12/4/2020 FAMILY MEDICINE MEDICINE ISSUED 12/4/2015 None N/A Q8161 TAWBI, URSULA, MD 5/2/2016 5/2/2021 FAMILY MEDICINE ACTIVE 5/10/2016 None N/A URGENT CARE Q5936 THANDRA, VIJAYA RAO, MD 8/28/2015 8/28/2020 FAMILY MEDICINE MEDICINE ACTIVE 9/3/2015 None N/A THOMAS, SARAH ELIZABETH URGENT CARE - R4152 YODER, MD 8/1/2017 8/1/2022 FAMILY MEDICINE FAMILY PRACTICE ACTIVE 8/4/2017 None N/A GERIATRIC MEDICINE (FAMILY R4644 TRÍO-MARTÍNEZ, ISABEL, MD 9/8/2017 9/8/2022 FAMILY MEDICINE PRACTICE) ACTIVE 9/21/2017 None N/A LICENSE Q6296 UKKADAM, SREELATHA, MD 10/1/2015 10/1/2020 FAMILY MEDICINE ISSUED 10/1/2015 None N/A VAZ GUIMARAES, WAGNER JOSE, S5099 MD 2/7/2020 2/7/2025 FAMILY MEDICINE FAMILY MEDICINE ACTIVE 4/3/2020 None N/A VAZQUEZ-SANTOS, GABRIELA Q8176 IVONNE, MD 5/2/2016 5/2/2021 FAMILY MEDICINE ACTIVE 5/25/2016 None N/A R6127 VIERA, VIVIAN, MD 2/16/2018 2/16/2023 FAMILY MEDICINE ACTIVE 2/21/2018 None N/A R1147 VO, THI NGOC ANH, DO 12/16/2016 12/16/2021 FAMILY MEDICINE FAMILY MEDICINE ACTIVE 1/2/2017 None N/A S5518 WALKER, DANNY TREVOR, DO 3/6/2020 3/6/2025 FAMILY MEDICINE ACTIVE 3/16/2020 None N/A

S6090 WALTHIUS, KELLY MICHELLE, DO 4/3/2020 4/3/2025 FAMILY MEDICINE ACTIVE 4/9/2020 None N/A S6092 WAWERU, MARK NDICHU, MD 4/3/2020 4/3/2025 FAMILY MEDICINE FAMILY MEDICINE ACTIVE 6/9/2020 None N/A LICENSE R6311 WILKING-JOHNSON, JULIANA , MD 3/2/2018 3/2/2023 FAMILY MEDICINE ISSUED 3/2/2018 None N/A R5348 AHMED, NUSRAT, MD 12/8/2017 12/8/2022 FAMILY PRACTICE ACTIVE 12/14/2017 None N/A R5361 BERGES, CHELSEA ELAINE, DO 12/8/2017 12/8/2022 FAMILY PRACTICE OBSTETRICS ACTIVE 12/12/2017 None N/A

R2815 BILOLIKAR, VARSHA SURESH, MD 5/5/2017 5/5/2022 FAMILY PRACTICE ACTIVE 5/8/2017 None N/A LICENSE Q6400 CAMPBELL, JAMIE RENEE, MD 11/2/2015 11/2/2020 FAMILY PRACTICE ISSUED 11/2/2015 None N/A LICENSE Q8701 CASTRO-URGANUS, SANDRA, MD 6/10/2016 6/10/2021 FAMILY PRACTICE ISSUED 6/10/2016 None N/A Q6046 KHAN, SAMAD HASSAN, MD 9/15/2015 9/15/2020 FAMILY PRACTICE ACTIVE 9/16/2015 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 R6231 MACHADO, GASTON JR, MD 3/2/2018 3/2/2023 FAMILY PRACTICE GENERAL PRACTICE ISSUED 3/2/2018 None N/A LICENSE Q4806 MASSOUD, MONA , MD 6/12/2015 6/12/2020 FAMILY PRACTICE ISSUED 6/12/2015 None N/A

Page 23 of 332 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 D2525 MENCONI, LAWRENCE RALPH, MD 12/16/2016 12/16/2021 FAMILY PRACTICE GYNECOLOGY ACTIVE 1/10/2017 None N/A Q5700 MUELLER, LYNDA LEA, MD 8/14/2015 8/14/2020 FAMILY PRACTICE ACTIVE 9/11/2015 None N/A LICENSE R5906 NARANJO, TAMMIE SUZANNE, MD 2/2/2018 2/2/2023 FAMILY PRACTICE ISSUED 2/2/2018 None N/A OSAYOMORE, AMADIN ONOME, FAMILY PRACTICE - LICENSE Q8592 MD 6/1/2016 6/1/2021 FAMILY PRACTICE EMERGENCY MED ISSUED 6/1/2016 None N/A R4888 PATEL, VIDHI S, MD 10/6/2017 10/6/2022 FAMILY PRACTICE ACTIVE 10/23/2017 None N/A RAMIREZ ATAMOROS, MARIA R5189 TERESA, MD 11/3/2017 11/3/2022 FAMILY PRACTICE ACTIVE 11/8/2017 None N/A

R4622 RANDDOLF, DERRICK ENOCH, MD 9/8/2017 9/8/2022 FAMILY PRACTICE HOSPITALIST ACTIVE 9/11/2017 None N/A M1331 SAMMARELLI, PATRICIA, MD 8/3/2015 8/3/2020 FAMILY PRACTICE ACTIVE 8/6/2015 None N/A R0144 TAFOYA, JESUS ALBERTO, MD 9/15/2016 9/15/2021 FAMILY PRACTICE ACTIVE 9/22/2016 None N/A LICENSE Q5945 VARKEY, MARY, MD 8/28/2015 8/28/2020 FAMILY PRACTICE ISSUED 8/28/2015 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 - LICENSE S5703 MEFFORD, TRENTON LLOYD, DO 3/20/2020 3/20/2025 EMERGENCY MED ISSUED 3/20/2020 None N/A FAMILY PRACTICE - LICENSE Q6682 PATTON, HEATHER TILL, MD 12/4/2015 12/4/2020 EMERGENCY MED ISSUED 12/4/2015 None N/A FAMILY PRACTICE - LICENSE Q8626 SAIFULLAH, MONA SIDDIQI, MD 6/1/2016 6/1/2021 EMERGENCY MED ISSUED 6/1/2016 None N/A FAMILY LICENSE Q6709 SOURIAL, SOURIAL MORRIS, DO 12/4/2015 12/4/2020 PRACTICE/OMM PAIN MEDICINE ISSUED 12/4/2015 None N/A FOOT AND ANKLE, R5788 PAO, ANDREW WILLIAM, MD 1/19/2018 1/19/2023 ORTHOPEDICS ACTIVE 1/26/2018 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 GASTROENTEROLOG Q9930 ABIDI, WASIF M, MD 9/15/2016 9/15/2021 Y ACTIVE 10/25/2016 None N/A GASTROENTEROLOG R1332 ADENIJI, OLAITAN ABIDEMI, MD 1/20/2017 1/20/2022 Y INTERNAL MEDICINE ACTIVE 1/30/2017 None N/A GASTROENTEROLOG Q7311 AKPAN, IMO MURRAY, MD 3/4/2016 3/4/2021 Y ACTIVE 3/14/2016 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

Page 24 of 332 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 LICENSE R6247 MORI, AMIT BABULAL, MD 3/2/2018 3/2/2023 Y INTERNAL MEDICINE ISSUED 3/2/2018 None N/A GASTROENTEROLOG R3933 PARAVA, PRATYUSHA, MD 7/17/2017 7/17/2022 Y HEPATOLOGY ACTIVE 7/19/2017 None N/A GASTROENTEROLOG S4839 PATEL, KAVAN GIRISHBHAI, MD 1/24/2020 1/24/2025 Y INTERNAL MEDICINE ACTIVE 3/23/2020 None N/A GASTROENTEROLOG S5061 SALIGRAM, SHREYAS, MD 2/7/2020 2/7/2025 Y INTERNAL MEDICINE ACTIVE 2/27/2020 None N/A GASTROENTEROLOG Q7795 SOHAIL, UMAIR, MD 4/1/2016 4/1/2021 Y INTERNAL MEDICINE ACTIVE 4/29/2016 None N/A GASTROENTEROLOG LICENSE Q8655 TANSEL, AYLIN , MD 6/1/2016 6/1/2021 Y INTERNAL MEDICINE ISSUED 6/1/2016 None N/A UMAPATHY, CHANDRAPRAKASH, GASTROENTEROLOG S5096 MD 2/7/2020 2/7/2025 Y INTERNAL MEDICINE ACTIVE 5/4/2020 None N/A GASTROENTEROLOG Q9760 VERNE, G NICHOLAS, MD 8/15/2016 8/15/2021 Y INTERNAL MEDICINE ACTIVE 9/5/2016 None N/A GASTROENTEROLOG GASTROENTEROLOG Q7613 WANG, YINGHONG, MD 3/15/2016 3/15/2021 Y Y ACTIVE 3/23/2016 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 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 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 AEROSPACE LICENSE R6180 EAKIN, JOHN LARKIN, MD 3/2/2018 3/2/2023 GENERAL PRACTICE MEDICINE ISSUED 3/2/2018 None N/A

R2109 GRAHAM, JENNIFER BLADES, MD 3/20/2017 3/20/2022 GENERAL PRACTICE ACTIVE 3/28/2017 None N/A S4851 RIOS, JULIAN ALFREDO, MD 1/24/2020 1/24/2025 GENERAL PRACTICE ACTIVE 1/28/2020 None N/A R5949 VERLA, MARIATU , MD 2/2/2018 2/2/2023 GENERAL PRACTICE ACTIVE 2/5/2018 None N/A

Page 25 of 332 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 AEROSPACE S6095 WITTEMAN, DEREK TYLER, DO 4/3/2020 4/3/2025 GENERAL PRACTICE MEDICINE ACTIVE 4/6/2020 None N/A Q7822 ADAMS, BARBARA JEANNE, MD 4/15/2016 4/15/2021 GENERAL SURGERY ACTIVE 4/25/2016 None N/A LICENSE Q7824 ALBINI, PAUL THOMAS, MD 4/15/2016 4/15/2021 GENERAL SURGERY ISSUED 4/15/2016 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 ANDERSON, KATHRYN TINSLEY, LICENSE Q5614 MD 8/14/2015 8/14/2020 GENERAL SURGERY ISSUED 8/14/2015 None N/A LICENSE S7005 BANSAL, SUKRITI , MD 6/12/2020 6/12/2025 GENERAL SURGERY ISSUED 6/12/2020 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 SURGICAL BREAST Q5630 CARTER, STACEY ANN , MD 8/14/2015 8/14/2020 GENERAL SURGERY ONCOLOGY ACTIVE 8/20/2015 None N/A LICENSE Q5774 CHA, DAVID JEANGUP, MD 8/28/2015 8/28/2020 GENERAL SURGERY ISSUED 8/28/2015 None N/A LICENSE R6169 CROSBY, JOSHUA HOLT, MD 3/2/2018 3/2/2023 GENERAL SURGERY ISSUED 3/2/2018 None N/A R1517 DAVIS, JAMES RICHARD, MD 2/6/2017 2/6/2022 GENERAL SURGERY ACTIVE 3/15/2017 None N/A LICENSE S7041 DUPREE, PHYLICIA DANIELLE, MD 6/12/2020 6/12/2025 GENERAL SURGERY ISSUED 6/12/2020 None N/A LICENSE Q6624 EARLY, MARSHALL DON, DO 12/4/2015 12/4/2020 GENERAL SURGERY ISSUED 12/4/2015 None N/A R1027 FREEMAN, KIRSTEN ANN, MD 12/16/2016 12/16/2021 GENERAL SURGERY ACTIVE 12/19/2016 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 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 LICENSE Q6509 GOPAL, JEGAN, MD 11/16/2015 11/16/2020 GENERAL SURGERY OTHER SPECIALTY ISSUED 11/16/2015 None N/A GORANTLA, KALYAN CHOWDARY, R6197 MD 3/2/2018 3/2/2023 GENERAL SURGERY ACTIVE 3/19/2018 None N/A R4232 GUTIERREZ, TIMOTHY , MD 8/15/2017 8/15/2022 GENERAL SURGERY ACTIVE 8/24/2017 None N/A Q9822 HAQ, IMRAN UL, MD 8/26/2016 8/26/2021 GENERAL SURGERY ACTIVE 12/21/2016 None N/A LICENSE S7063 HEGDE, BRITTANY NICOLE, MD 6/12/2020 6/12/2025 GENERAL SURGERY ISSUED 6/12/2020 None N/A

Page 26 of 332 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 Q6425 HERBERT, GARTH, MD 11/2/2015 11/2/2020 GENERAL SURGERY ISSUED 11/2/2015 None N/A Q5821 IKEKPEAZU, NKEMAKONAM, MD 8/28/2015 8/28/2020 GENERAL SURGERY ACTIVE 9/14/2015 None N/A LICENSE Q4777 JOHNSON, PAUL, MD 6/12/2015 6/12/2020 GENERAL SURGERY ISSUED 6/12/2015 None N/A DELINQUEN T-NON R4073 KENT, MICHAEL GRANT, MD 8/1/2017 8/1/2022 GENERAL SURGERY PAYMENT 12/4/2017 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 LICENSE Q6644 LAHOURCADE, JOHN AUSTIN, MD 12/4/2015 12/4/2020 GENERAL SURGERY ISSUED 12/4/2015 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 S5211 LE, CAROL KIM, DO 2/21/2020 2/21/2025 GENERAL SURGERY ACTIVE 5/29/2020 None N/A S5965 LEE, ISAAC LEONGKIT, MD 4/3/2020 4/3/2025 GENERAL SURGERY ACTIVE 4/7/2020 None N/A R2156 LIANG, BUQING, MD 3/20/2017 3/20/2022 GENERAL SURGERY ACTIVE 3/30/2017 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 R3137 MARCANO, JUAN EDUARDO, MD 5/22/2017 5/22/2022 GENERAL SURGERY ACTIVE 6/12/2017 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 R3141 MARSHALL, JESSICA LYNN, DO 5/22/2017 5/22/2022 GENERAL SURGERY ACTIVE 5/29/2017 None N/A LICENSE R6243 MCCALL, DAVID TIMMONS, DO 3/2/2018 3/2/2023 GENERAL SURGERY ISSUED 3/2/2018 None N/A S5440 MRAZEK, AMY ANN, MD 3/6/2020 3/6/2025 GENERAL SURGERY ACTIVE 3/30/2020 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 LICENSE Q4660 OOMMEN, BINDHU, MD 6/1/2015 6/1/2020 GENERAL SURGERY ISSUED 6/1/2015 None N/A LICENSE Q6551 ORDONEZ, ALEX, MD 11/16/2015 11/16/2020 GENERAL SURGERY OTHER SPECIALTY ISSUED 11/16/2015 None N/A

R2436 PARTAIN, NATALIA SPINELLI, MD 4/4/2017 4/4/2022 GENERAL SURGERY BREAST ONCOLOGY ACTIVE 4/6/2017 None N/A TRAUMATIC R3181 PERSON, JOSHUA , MD 5/22/2017 5/22/2022 GENERAL SURGERY SURGERY ACTIVE 6/7/2017 None N/A

Page 27 of 332 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 R2200 PINEDA, GERSON ORLANDO, MD 3/20/2017 3/20/2022 GENERAL SURGERY ACTIVE 6/9/2017 None N/A LICENSE Q6687 QUIGLEY, LAJOHN BRADFORD, MD 12/4/2015 12/4/2020 GENERAL SURGERY ISSUED 12/4/2015 None N/A RIOS PEREZ, MAYRIM VICTORIA, S6923 MD 5/29/2020 5/29/2025 GENERAL SURGERY ACTIVE 6/1/2020 None N/A LICENSE Q6695 ROBISON, DENNIS J, MD 12/4/2015 12/4/2020 GENERAL SURGERY ISSUED 12/4/2015 None N/A ROGERS, SELWYN OLWESTON JR, SURGICAL CRITICAL LICENSE Q6466 MD 11/2/2015 11/2/2020 GENERAL SURGERY CARE ISSUED 11/2/2015 None N/A Q7265 ROHRER, DAVID A, MD 2/16/2016 2/16/2021 GENERAL SURGERY ACTIVE 2/18/2016 None N/A TRAUMATIC LICENSE Q6699 SALVINO, CHRISTOPHER K, MD 12/4/2015 12/4/2020 GENERAL SURGERY SURGERY ISSUED 12/4/2015 None N/A LICENSE S7138 SERRANO, LUIS FELIPE, MD 6/12/2020 6/12/2025 GENERAL SURGERY ISSUED 6/12/2020 None N/A Q9518 SORDO, SALVADOR ANTON, MD 8/1/2016 8/1/2021 GENERAL SURGERY ACTIVE 9/1/2016 None N/A COLON AND RECTAL Q4858 TANTCHOU, IRLNA INGRID, MD 6/12/2015 6/12/2020 GENERAL SURGERY SURGERY ACTIVE 6/16/2015 None N/A TRAUMATIC LICENSE Q6383 WEBER, JULIE PHILLIPS, MD 10/15/2015 10/15/2020 GENERAL SURGERY SURGERY ISSUED 10/15/2015 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 GERIATRIC MEDICINE Q5579 TAPIA, SHANNON MURPHY, MD 8/3/2015 8/3/2020 (FAMILY PRACTICE) FAMILY MEDICINE ACTIVE 8/17/2015 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 MCCARUS, STEVEN DOUGLAS SR, GYNECOLOGIC Q8107 MD 5/2/2016 5/2/2021 SURGERY ACTIVE 5/9/2016 None N/A GYNECOLOGIC LICENSE Q5887 OSHINOWO, ADEOTI E, MD 8/28/2015 8/28/2020 SURGERY GYNECOLOGY ISSUED 8/28/2015 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 HAND SURGERY - ORTHOPEDIC ORTHOPEDIC R3370 LICHT, HEATHER LEIGH, MD 6/2/2017 6/2/2022 SURGERY SURGERY ACTIVE 6/9/2017 None N/A HAND SURGERY - ORTHOPEDIC ORTHOPEDIC LICENSE Q4850 STEWART, DANIEL THOMAS, MD 6/12/2015 6/12/2020 SURGERY SURGERY ISSUED 6/12/2015 None N/A

Page 28 of 332 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

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 HEMATOLOGY - LICENSE S5381 HANCOCK, JOHN MATTHEW, MD 3/6/2020 3/6/2025 INTERNAL MEDICINE INTERNAL MEDICINE ISSUED 3/6/2020 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 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 HEMATOLOGY/ONCOL Q7565 JENKS, CAROLYN GERHARDT, DO 3/15/2016 3/15/2021 OGY INTERNAL MEDICINE ACTIVE 3/17/2016 None N/A HEMATOLOGY/ONCOL Q8359 SU, JINGDONG , MD 5/16/2016 5/16/2021 OGY ACTIVE 5/18/2016 None N/A HEMATOLOGY/ONCOL R1461 TANO, SHEEBA VARUGHESE, DO 1/20/2017 1/20/2022 OGY ACTIVE 2/1/2017 None N/A HEMATOLOGY/ONCOL LICENSE S5281 TRAN, PHU NGOC, MD 2/21/2020 2/21/2025 OGY INTERNAL MEDICINE ISSUED 2/21/2020 None N/A HEMATOLOGY/ONCOL LICENSE Q4707 WANG, YANG, MD 6/1/2015 6/1/2020 OGY ISSUED 6/1/2015 None N/A LICENSE S6997 AMBATI, MEGHA, MD 6/12/2020 6/12/2025 HOSPITALIST INTERNAL MEDICINE ISSUED 6/12/2020 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 Q7009 AWE, OPEYEMI ABIODUN, MD 2/1/2016 2/1/2021 HOSPITALIST INTERNAL MEDICINE ACTIVE 4/25/2016 None N/A FADAYOMI, OLADIPO BAMIDELE, R4836 MD 10/6/2017 10/6/2022 HOSPITALIST ACTIVE 10/9/2017 None N/A R3846 GARLAPATI, VINAY REDDY, MD 7/17/2017 7/17/2022 HOSPITALIST ACTIVE 10/9/2017 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 LICENSE Q6508 GOPAL, ARUN, MD 11/16/2015 11/16/2020 HOSPITALIST INTERNAL MEDICINE ISSUED 11/16/2015 None N/A LICENSE Q5660 GUNAWAN, JONAS , MD 8/14/2015 8/14/2020 HOSPITALIST ISSUED 8/14/2015 None N/A R2351 HAFEEZ, FARAZ SYED, DO 4/4/2017 4/4/2022 HOSPITALIST INTERNAL MEDICINE ACTIVE 4/10/2017 None N/A HASSOUN, LAUREN ALEXANDRIA, S4491 MD 12/20/2019 12/20/2024 HOSPITALIST ACTIVE 12/30/2019 None N/A R0430 KHAN, AASIA BASHIR, MD 10/14/2016 10/14/2021 HOSPITALIST ACTIVE 10/17/2016 None N/A

Page 29 of 332 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 KHAN, DURRESHAHWAR Q8922 KHURSHEED, MD 7/1/2016 7/1/2021 HOSPITALIST INTERNAL MEDICINE ACTIVE 7/4/2016 None N/A LICENSE S4996 KHURSHID, MADIHA, MD 2/7/2020 2/7/2025 HOSPITALIST ISSUED 2/7/2020 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 LICENSE Q5860 MANSOOR, UROOJ, MD 8/28/2015 8/28/2020 HOSPITALIST ISSUED 8/28/2015 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 Q7582 MIRO, VIKTOR, MD 3/15/2016 3/15/2021 HOSPITALIST INTERNAL MEDICINE ACTIVE 3/22/2016 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 NGONGANG, CHELSEA Q4819 KECHONSON, MD 6/12/2015 6/12/2020 HOSPITALIST ACTIVE 6/15/2015 None N/A S5487 ROMEO, JOHN, MD 3/6/2020 3/6/2025 HOSPITALIST INTERNAL MEDICINE ACTIVE 3/10/2020 None N/A DELINQUEN T-NON R4324 SIDDIQUA, TASNEEM, MD 8/15/2017 8/15/2022 HOSPITALIST PAYMENT 11/13/2017 None N/A LICENSE S6545 UGHREJA, RAJ HARIBHAI, MD 5/1/2020 5/1/2025 HOSPITALIST INTERNAL MEDICINE ISSUED 5/1/2020 None N/A Q5113 VARGHESE, ANNA, MD 7/1/2015 7/1/2020 HOSPITALIST INTERNAL MEDICINE ACTIVE 7/2/2015 None N/A LICENSE Q4872 VINDHYA, RAJESH K, MD 6/12/2015 6/12/2020 HOSPITALIST INTERNAL MEDICINE ISSUED 6/12/2015 None N/A EMERGENCY LICENSE Q8810 WOOD, HARRISON WILSON JR, MD 6/10/2016 6/10/2021 HOSPITALIST MEDICINE ISSUED 6/10/2016 None N/A INFECTIOUS LICENSE Q5391 DINARDO, ANDREW R, MD 8/3/2015 8/3/2020 DISEASES ISSUED 8/3/2015 None N/A INFECTIOUS Q7884 HAIDER, ALIYA, MD 4/15/2016 4/15/2021 DISEASES INTERNAL MEDICINE ACTIVE 4/26/2016 None N/A INFECTIOUS INTERNAL MED - Q7560 HUDSON, FRANK PARKER III, MD 3/15/2016 3/15/2021 DISEASES PEDS ACTIVE 3/17/2016 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 INFECTIOUS R6244 MEKALA, VIJAYASHREE, MD 3/2/2018 3/2/2023 DISEASES INTERNAL MEDICINE ACTIVE 3/6/2018 None N/A

Page 30 of 332 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 LICENSE Q5914 RAZZAQ, KANWAL, MD 8/28/2015 8/28/2020 DISEASES INTERNAL MEDICINE ISSUED 8/28/2015 None N/A INTERNAL MED - R4077 KOSTURAKIS, DAVID, MD 8/1/2017 8/1/2022 EMERGENCY MED ACTIVE 8/4/2017 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

Q4990 JAMES, ARTHUR, MD 7/1/2015 7/1/2020 INTERNAL MED - PEDS ACTIVE 7/14/2015 None N/A

Q8284 LESTER, SHAYLA, MD 5/16/2016 5/16/2021 INTERNAL MED - PEDS ACTIVE 6/7/2016 None N/A LICENSE Q4658 OHENE-ADJEI, RITA, MD 6/1/2015 6/1/2020 INTERNAL MED - PEDS ISSUED 6/1/2015 None N/A DELINQUEN OLAIYA, OLUWASEUN INTERNAL MED - T-NON Q8983 OLUWAKEMI, DO 7/1/2016 7/1/2021 INTERNAL MED - PEDS PEDS PAYMENT 12/30/2017 None N/A

R1608 PATEL, ROMA AATISH, MD 2/6/2017 2/6/2022 INTERNAL MED - PEDS PEDIATRICS ACTIVE 3/14/2017 None N/A LICENSE R6290 SMITH, DANIELLE MARIE, MD 3/2/2018 3/2/2023 INTERNAL MED - PEDS ISSUED 3/2/2018 None N/A

Q9080 WATERS, AMI , MD 7/1/2016 7/1/2021 INTERNAL MED - PEDS ACTIVE 8/9/2016 None N/A UGA, AGHAEGBULAM HARACHI, INTERNAL MED - LICENSE Q4867 MD 6/12/2015 6/12/2020 PSYCHIATRY ISSUED 6/12/2015 None N/A LICENSE Q5611 ABEBE, EYOEL, MD 8/14/2015 8/14/2020 INTERNAL MEDICINE TX ISSUED 8/14/2015 None N/A LICENSE Q6596 AHMAD, JAZBEEN HENNA, MD 12/4/2015 12/4/2020 INTERNAL MEDICINE ISSUED 12/4/2015 None N/A LICENSE S5539 AHMED, MUSHTAQUE, MD 3/20/2020 3/20/2025 INTERNAL MEDICINE ISSUED 3/20/2020 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 GERIATRIC ALASE, JOYCE ONYINYECHUKWU, MEDICINE (INTERNAL R5686 MD 1/19/2018 1/19/2023 INTERNAL MEDICINE MED) ACTIVE 1/22/2018 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 Q7525 ALOUD, ABDRAHIM, MD 3/15/2016 3/15/2021 INTERNAL MEDICINE ACTIVE 3/24/2016 None N/A

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Q7133 ALTAKI, MUHAMMAD SOUBHI , MD 2/16/2016 2/16/2021 INTERNAL MEDICINE ACTIVE 3/1/2016 None N/A LICENSE R5690 AMBERKER, DEEPA, MD 1/19/2018 1/19/2023 INTERNAL MEDICINE NEPHROLOGY ISSUED 1/19/2018 None N/A R2806 ANCY, KAYLEY, MD 5/5/2017 5/5/2022 INTERNAL MEDICINE ACTIVE 5/18/2017 None N/A DELINQUEN T-NON R1164 ANTOINE, STEVE MARC, MD 1/6/2017 1/6/2022 INTERNAL MEDICINE PAYMENT 4/6/2017 None N/A

R4360 ANUSIONWU, OBIORA FRANK, MD 8/25/2017 8/25/2022 INTERNAL MEDICINE CARDIOLOGY ACTIVE 10/31/2017 None N/A Q7317 ARENAS, CARLITO GAVIOLA, MD 3/4/2016 3/4/2021 INTERNAL MEDICINE HOSPITALIST ACTIVE 3/14/2016 None N/A LICENSE Q4558 ARGUELLO, VANESSA , MD 6/1/2015 6/1/2020 INTERNAL MEDICINE ISSUED 6/1/2015 None N/A Q5144 ARIF, SAHAR, MD 7/15/2015 7/15/2020 INTERNAL MEDICINE HOSPITALIST ACTIVE 7/22/2015 None N/A R3995 ASGHAR, SARAH, MD 8/1/2017 8/1/2022 INTERNAL MEDICINE ACTIVE 9/19/2017 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 LICENSE S6567 ASIF, MUHAMMAD, MD 5/15/2020 5/15/2025 INTERNAL MEDICINE NEPHROLOGY ISSUED 5/15/2020 None N/A LICENSE S5117 AUSTIN, FELICIA MONIQUE, MD 2/21/2020 2/21/2025 INTERNAL MEDICINE ISSUED 2/21/2020 None N/A AWAN, AHMED ARSLAN YOUSUF, R2045 MD 3/20/2017 3/20/2022 INTERNAL MEDICINE NEPHROLOGY ACTIVE 4/3/2017 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 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 LICENSE Q4564 BARAD, BHAVESH, MD 6/1/2015 6/1/2020 INTERNAL MEDICINE CARDIOLOGY ISSUED 6/1/2015 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 R0189 BASHIR, AYESHA, MD 9/30/2016 9/30/2021 INTERNAL MEDICINE ACTIVE 12/16/2016 None N/A Q9294 BEMALGI, SWAPNA REDDY, MD 8/1/2016 8/1/2021 INTERNAL MEDICINE INTERNAL MEDICINE ACTIVE 8/22/2016 None N/A

Page 32 of 332 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 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 R0540 BHATT, SANDEEP, MD 10/31/2016 10/31/2021 INTERNAL MEDICINE ACTIVE 11/10/2016 None N/A Q9960 BHATTA, MANGESH, MD 9/15/2016 9/15/2021 INTERNAL MEDICINE HOSPITALIST ACTIVE 12/30/2016 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 Q7148 BIBINAGAR, DEEPTHI, MD 2/16/2016 2/16/2021 INTERNAL MEDICINE INTERNAL MEDICINE ACTIVE 3/15/2016 None N/A

AM00157 BINDRA, PAVELJIT SINGH, MD 6/12/2020 6/12/2025 INTERNAL MEDICINE CARDIOLOGY ACTIVE 6/15/2020 None N/A 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 BOGACHENCHU, SREENIVASULU, LICENSE Q7651 MD 4/1/2016 4/1/2021 INTERNAL MEDICINE ISSUED 4/1/2016 None N/A LICENSE Q8433 BOLANOS, ALEXANDER , MD 6/1/2016 6/1/2021 INTERNAL MEDICINE ISSUED 6/1/2016 None N/A LICENSE R6158 BYRD, ROY TOM, MD 3/2/2018 3/2/2023 INTERNAL MEDICINE ISSUED 3/2/2018 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 LICENSE Q5772 CAMPOY, ABRAHAM , MD 8/28/2015 8/28/2020 INTERNAL MEDICINE ISSUED 8/28/2015 None N/A CANTAZARO, BRANDON ROBERT, R5523 MD 1/5/2018 1/5/2023 INTERNAL MEDICINE ACTIVE 1/31/2018 None N/A LICENSE Q8218 CARRETE, LOLA , MD 5/16/2016 5/16/2021 INTERNAL MEDICINE ISSUED 5/16/2016 None N/A R3487 CHAKER, SANA, MD 6/16/2017 6/16/2022 INTERNAL MEDICINE ACTIVE 7/18/2017 None N/A CHANDRASHEKHAR, RAVINDRA, Q7024 MD 2/1/2016 2/1/2021 INTERNAL MEDICINE SLEEP MEDICINE ACTIVE 2/10/2016 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 Q7541 CHEN, LEON , DO 3/15/2016 3/15/2021 INTERNAL MEDICINE PSYCHIATRY ACTIVE 3/23/2016 None N/A LICENSE Q5636 CHILAKAPATI, RAJANI K, MD 8/14/2015 8/14/2020 INTERNAL MEDICINE ISSUED 8/14/2015 None N/A S5143 CLAIBORNE, JOSEPH LEVI III, MD 2/21/2020 2/21/2025 INTERNAL MEDICINE ACTIVE 3/11/2020 None N/A

Page 33 of 332 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 COCIANNI, RANNIERI MATHEUS, Q6166 MD 10/1/2015 10/1/2020 INTERNAL MEDICINE HOSPITALIST ACTIVE 10/12/2015 None N/A Q6406 COLAN, DAVID ROBERT, MD 11/2/2015 11/2/2020 INTERNAL MEDICINE HOSPITALIST ACTIVE 11/3/2015 None N/A COLLIE, CHARLTON EASTON JR, R1009 MD 12/16/2016 12/16/2021 INTERNAL MEDICINE ACTIVE 12/21/2016 None N/A Q6168 CONSTANTINE, GREGORY M, MD 10/1/2015 10/1/2020 INTERNAL MEDICINE ACTIVE 10/6/2015 None N/A CORADO MONTENEGRO, R1939 HENNETH ANTONIETA, MD 3/3/2017 3/3/2022 INTERNAL MEDICINE ACTIVE 3/20/2017 None N/A CORRAL GUERRERO, LUIS R2839 CARLOS, MD 5/5/2017 5/5/2022 INTERNAL MEDICINE ACTIVE 5/12/2017 None N/A LICENSE Q4738 COVIN, YVONNE NICOLLE, MD 6/12/2015 6/12/2020 INTERNAL MEDICINE HOSPITALIST ISSUED 6/12/2015 None N/A 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 LICENSE Q5387 DAS, JISHU KINGKAR, MD 8/3/2015 8/3/2020 INTERNAL MEDICINE ISSUED 8/3/2015 None N/A R1519 DAWSON, JAMES LAGAMO, DO 2/6/2017 2/6/2022 INTERNAL MEDICINE ACTIVE 2/7/2017 None N/A DUFURRENA, QUINN ALEXANDER, S6163 MD 4/17/2020 4/17/2025 INTERNAL MEDICINE ACTIVE 4/20/2020 None N/A LICENSE Q6182 EKPENIKE, ANTHONIA, MD 10/1/2015 10/1/2020 INTERNAL MEDICINE ISSUED 10/1/2015 None N/A S7043 ELHALWAGI, RAMY BAHER, DO 6/12/2020 6/12/2025 INTERNAL MEDICINE ACTIVE 6/16/2020 None N/A R5258 ELMAHI, MUTAZ A, MD 11/17/2017 11/17/2022 INTERNAL MEDICINE HOSPITALIST ACTIVE 12/18/2017 None N/A ELSHATORY, KAREEM MOHAMED, EMERGENCY Q6828 MD 1/6/2016 1/6/2021 INTERNAL MEDICINE MEDICINE ACTIVE 1/11/2016 None N/A LICENSE S6828 ELTELBANY, AHMED, MD 5/29/2020 5/29/2025 INTERNAL MEDICINE ISSUED 5/29/2020 None N/A ESFAHANI, FATEMEH LICENSE Q4750 BAGHERIANNEJAD, MD 6/12/2015 6/12/2020 INTERNAL MEDICINE ISSUED 6/12/2015 None N/A R1747 EZIGBO, CHIKA AMUCHE, MD 2/22/2017 2/22/2022 INTERNAL MEDICINE HOSPITALIST ACTIVE 3/15/2017 None N/A

S4467 FAROOQ, ABID MOHAMMED , DO 12/20/2019 12/20/2024 INTERNAL MEDICINE ACTIVE 2/7/2020 None N/A INFECTIOUS Q8717 FLOM, JUDITH, MD 6/10/2016 6/10/2021 INTERNAL MEDICINE DISEASES ACTIVE 6/15/2016 None N/A S4631 FOGELMAN, SANDRA, MD 1/10/2020 1/10/2025 INTERNAL MEDICINE ACTIVE 1/20/2020 None N/A FORERO MEDINA, NUBIA PAOLA, R2100 MD 3/20/2017 3/20/2022 INTERNAL MEDICINE ACTIVE 4/6/2017 None N/A

Page 34 of 332 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 Q4580 GAJANAYAKA, RANIL, MD 6/1/2015 6/1/2020 INTERNAL MEDICINE NEPHROLOGY ACTIVE 6/12/2015 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 LICENSE Q5405 GALLEGOS, CINTHIA , MD 8/3/2015 8/3/2020 INTERNAL MEDICINE ISSUED 8/3/2015 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 Q6627 GANDHI, AVANTI LATTHE, MD 12/4/2015 12/4/2020 INTERNAL MEDICINE ACTIVE 12/8/2015 None N/A R3675 GANDHI, JEET , MD 6/30/2017 6/30/2022 INTERNAL MEDICINE NEPHROLOGY ACTIVE 7/26/2017 None N/A Q8059 GANIM, NIDAL MAZEN, MD 5/2/2016 5/2/2021 INTERNAL MEDICINE ACTIVE 5/6/2016 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 R5396 GARZA, JOSE, MD 12/8/2017 12/8/2022 INTERNAL MEDICINE ACTIVE 12/11/2017 None N/A Q8485 GHOTRA, AMANINDERAPAL , MD 6/1/2016 6/1/2021 INTERNAL MEDICINE INTERNAL MEDICINE ACTIVE 6/17/2016 None N/A R1533 GILL, RAHUL , MD 2/6/2017 2/6/2022 INTERNAL MEDICINE ACTIVE 2/8/2017 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 GLOVER, PORTER HUDSON SR, LICENSE Q8486 MD 6/1/2016 6/1/2021 INTERNAL MEDICINE ISSUED 6/1/2016 None N/A LICENSE Q8488 GOLI, KIRAN, MD 6/1/2016 6/1/2021 INTERNAL MEDICINE NEPHROLOGY ISSUED 6/1/2016 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 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 LICENSE Q5659 GROISBERG, ROMAN , MD 8/14/2015 8/14/2020 INTERNAL MEDICINE ISSUED 8/14/2015 None N/A LICENSE S7058 GUL, ZUNAIRA, MD 6/12/2020 6/12/2025 INTERNAL MEDICINE ISSUED 6/12/2020 None N/A LICENSE Q4590 GUPTA, DIVYA, MD 6/1/2015 6/1/2020 INTERNAL MEDICINE ISSUED 6/1/2015 None N/A LICENSE Q4758 GUPTA, ROHAN , DO 6/12/2015 6/12/2020 INTERNAL MEDICINE ISSUED 6/12/2015 None N/A S5638 HADDAD, PETER SOUHEIL, MD 3/20/2020 3/20/2025 INTERNAL MEDICINE ACTIVE 3/30/2020 None N/A

Page 35 of 332 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 S6201 HANSEN, TODD PHILLIP, MD 4/17/2020 4/17/2025 INTERNAL MEDICINE ISSUED 4/17/2020 None N/A LICENSE Q5813 HASAN, ASMA, MD 8/28/2015 8/28/2020 INTERNAL MEDICINE HOSPITALIST ISSUED 8/28/2015 None N/A S6634 HASSAN, ANAM , MD 5/15/2020 5/15/2025 INTERNAL MEDICINE HOSPITALIST ACTIVE 5/18/2020 None N/A HERNANDEZ, RICARDO JAVIER, Q5668 MD 8/14/2015 8/14/2020 INTERNAL MEDICINE ACTIVE 8/20/2015 None N/A R2619 HERZIK, MICHAEL ANTHONY, MD 4/20/2017 4/20/2022 INTERNAL MEDICINE ACTIVE 4/24/2017 None N/A R3860 HIBBERT, CASTEL BRADLEY, MD 7/17/2017 7/17/2022 INTERNAL MEDICINE HOSPITALIST ACTIVE 7/19/2017 None N/A S4782 HIEBERT, MICHAEL, DO 1/24/2020 1/24/2025 INTERNAL MEDICINE ACTIVE 1/27/2020 None N/A S6210 HOANG, HUNG HUU, MD 4/17/2020 4/17/2025 INTERNAL MEDICINE ACTIVE 4/24/2020 None N/A R2127 HOSSIN, MD SHAKHAWAT, MD 3/20/2017 3/20/2022 INTERNAL MEDICINE ACTIVE 4/3/2017 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 R5135 HUSSEIN, ALI , MD 11/3/2017 11/3/2022 INTERNAL MEDICINE ACTIVE 12/26/2017 None N/A R3684 IBEKWE, CHIMA OKWUDIRI, MD 6/30/2017 6/30/2022 INTERNAL MEDICINE ACTIVE 7/25/2017 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 LICENSE S6646 IKRAM, FARUKH GABRIEL, MD 5/15/2020 5/15/2025 INTERNAL MEDICINE ISSUED 5/15/2020 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 LICENSE Q5436 ISKANDAR, SANDIA , MD 8/3/2015 8/3/2020 INTERNAL MEDICINE ISSUED 8/3/2015 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 HEMATOLOGY/ONCO LICENSE Q8514 ITWARU, SANDY ANN, MD 6/1/2016 6/1/2021 INTERNAL MEDICINE LOGY ISSUED 6/1/2016 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 Q6034 JAIN, RUBY, MD 9/15/2015 9/15/2020 INTERNAL MEDICINE ACTIVE 9/24/2015 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 R0028 JAMIL, MUHAMMAD OMAR, MD 9/15/2016 9/15/2021 INTERNAL MEDICINE HOSPITALIST ACTIVE 11/7/2016 None N/A

Page 36 of 332 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 S6418 JEYAKUMAR, NIKESHAN , MD 5/1/2020 5/1/2025 INTERNAL MEDICINE ISSUED 5/1/2020 None N/A 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 HEMATOLOGY/ONCO R2136 JONES, JESSICA TREVINO, MD 3/20/2017 3/20/2022 INTERNAL MEDICINE LOGY ACTIVE 3/23/2017 None N/A LICENSE Q4780 JYOTHINAGARAM, PRAVEENA, MD 6/12/2015 6/12/2020 INTERNAL MEDICINE NEPHROLOGY 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 LICENSE R6214 KAUR, RATINDER JIT, MD 3/2/2018 3/2/2023 INTERNAL MEDICINE RHEUMATOLOGY ISSUED 3/2/2018 None N/A LICENSE Q5833 KAURA, ABHIMANYU, MD 8/28/2015 8/28/2020 INTERNAL MEDICINE ISSUED 8/28/2015 None N/A R5752 KAZIM, MOHAMMAD TALHA, DO 1/19/2018 1/19/2023 INTERNAL MEDICINE HOSPITALIST ACTIVE 2/8/2018 None N/A 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 LICENSE Q5837 KHALID, MONA, MD 8/28/2015 8/28/2020 INTERNAL MEDICINE HOSPITALIST ISSUED 8/28/2015 None N/A Q7901 KHALIL, ANDREW, DO 4/15/2016 4/15/2021 INTERNAL MEDICINE ACTIVE 5/4/2016 None N/A

PH00004 KHAN, ADNAN , MD 3/4/2016 3/4/2021 INTERNAL MEDICINE ACTIVE 3/14/2016 None N/A S5947 KHAN, AHMED SHEZAD ALI, MD 4/3/2020 4/3/2025 INTERNAL MEDICINE ACTIVE 5/29/2020 None N/A LICENSE Q6339 KHAN, FAISAL RASHID, MD 10/15/2015 10/15/2020 INTERNAL MEDICINE ISSUED 10/15/2015 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 R6215 KHAN, SAMIRA, MD 3/2/2018 3/2/2023 INTERNAL MEDICINE ACTIVE 3/13/2018 None N/A R0042 KHAN, SARAH, MD 9/15/2016 9/15/2021 INTERNAL MEDICINE ACTIVE 9/27/2016 None N/A LICENSE S7079 KHANDELWAL, NUVNEET , MD 6/12/2020 6/12/2025 INTERNAL MEDICINE HOSPITALIST ISSUED 6/12/2020 None N/A S5952 KHUWAJA, SAMREEN, MD 4/3/2020 4/3/2025 INTERNAL MEDICINE ACTIVE 4/6/2020 None N/A S6661 KITIASHVILI, VLADIMER, MD 5/15/2020 5/15/2025 INTERNAL MEDICINE ACTIVE 5/18/2020 None N/A LICENSE Q8274 KOBRIN, JONATHAN ALLEN, MD 5/16/2016 5/16/2021 INTERNAL MEDICINE ISSUED 5/16/2016 None N/A LICENSE Q4792 KOTHANDARAMAN, SRILATHA, MD 6/12/2015 6/12/2020 INTERNAL MEDICINE RHEUMATOLOGY ISSUED 6/12/2015 None N/A

Page 37 of 332 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 R1401 KOVACS, ADRIENN , DO 1/20/2017 1/20/2022 INTERNAL MEDICINE ACTIVE 2/13/2017 None N/A R5585 KUMAR, ANEEL, MD 1/5/2018 1/5/2023 INTERNAL MEDICINE ACTIVE 1/10/2018 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 LICENSE Q5849 LAWAL, NURUDEEN AKANBI, MD 8/28/2015 8/28/2020 INTERNAL MEDICINE ISSUED 8/28/2015 None N/A Q5017 LE, MY DUYEN, MD 7/1/2015 7/1/2020 INTERNAL MEDICINE ACTIVE 7/8/2015 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 R5591 LI, DONGMING , MD 1/5/2018 1/5/2023 INTERNAL MEDICINE ACTIVE 1/19/2018 None N/A Q6957 LINDEMAN, TRACEY EINEM, MD 1/15/2016 1/15/2021 INTERNAL MEDICINE ACTIVE 1/22/2016 None N/A LICENSE S6441 LWANGA, JULIET, MD 5/1/2020 5/1/2025 INTERNAL MEDICINE ISSUED 5/1/2020 None N/A LICENSE S6882 MAHAR, JAMAL HUSSAIN, MD 5/29/2020 5/29/2025 INTERNAL MEDICINE ISSUED 5/29/2020 None N/A LICENSE Q6649 MALI, RAJESH, MD 12/4/2015 12/4/2020 INTERNAL MEDICINE ISSUED 12/4/2015 None N/A LICENSE S6443 MALIK, REHAN AHMED, MD 5/1/2020 5/1/2025 INTERNAL MEDICINE ISSUED 5/1/2020 None N/A Q5029 MANI, PREETHI , MD 7/1/2015 7/1/2020 INTERNAL MEDICINE ACTIVE 7/6/2015 None N/A LICENSE Q6063 MANSOUR, RANA, MD 9/15/2015 9/15/2020 INTERNAL MEDICINE HOSPITALIST ISSUED 9/15/2015 None N/A Q7230 MAPAKSHI, SRIKAR REDDY, MD 2/16/2016 2/16/2021 INTERNAL MEDICINE ACTIVE 4/21/2016 None N/A 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 Q6445 MARIONI, NOE , MD 11/2/2015 11/2/2020 INTERNAL MEDICINE ACTIVE 11/13/2015 None N/A CARDIOVASCULAR Q5696 MASUD, ALI, MD 8/14/2015 8/14/2020 INTERNAL MEDICINE DISEASES ACTIVE 9/1/2015 None N/A LICENSE Q5865 MATHEW, TEENA, MD 8/28/2015 8/28/2020 INTERNAL MEDICINE ISSUED 8/28/2015 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 MCCOY, RODERICK LAWRENCE, LICENSE S5015 MD 2/7/2020 2/7/2025 INTERNAL MEDICINE ISSUED 2/7/2020 None N/A OCCUPATIONAL S4819 MCKNIGHT, SYLVIA, MD 1/24/2020 1/24/2025 INTERNAL MEDICINE MEDICINE ACTIVE 3/3/2020 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 S4350 MILLER, LAUREN, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE ACTIVE 1/8/2020 None N/A

Page 38 of 332 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 S4350 MILLER, LAUREN, MD 12/6/2019 12/6/2024 INTERNAL MEDICINE ACTIVE 1/8/2020 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 R1421 MIRZA, SAIYADA, MD 1/20/2017 1/20/2022 INTERNAL MEDICINE ACTIVE 1/30/2017 None N/A S4532 MOUSA, SARA HASHIM, MD 12/20/2019 12/20/2024 INTERNAL MEDICINE ACTIVE 2/19/2020 None N/A R4287 MUJEEB, MEHRUKH, MD 8/15/2017 8/15/2022 INTERNAL MEDICINE NEPHROLOGY ACTIVE 8/21/2017 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 R3720 NAEEM, SARAH , MD 6/30/2017 6/30/2022 INTERNAL MEDICINE HOSPITALIST ACTIVE 7/19/2017 None N/A Q6246 NAGARAJ, ALAKANANDA, MD 10/1/2015 10/1/2020 INTERNAL MEDICINE ACTIVE 10/9/2015 None N/A NASSAR, TAREQ ISSA MICHAEL, Q6884 MD 1/6/2016 1/6/2021 INTERNAL MEDICINE NEPHROLOGY ACTIVE 1/19/2016 None N/A LICENSE R5909 NAVEED, JAVERIA, MD 2/2/2018 2/2/2023 INTERNAL MEDICINE ISSUED 2/2/2018 None N/A

R1089 NEZAMABADI, ARYAN ALIREZA, MD 12/16/2016 12/16/2021 INTERNAL MEDICINE INTERNAL MEDICINE ACTIVE 2/9/2017 None N/A LICENSE Q8112 NGUYEN, MARY CECILIA, DO 5/2/2016 5/2/2021 INTERNAL MEDICINE UNSPECIFIED ISSUED 5/2/2016 None N/A S4537 NIETO, ELIZABETH ANN, MD 12/20/2019 12/20/2024 INTERNAL MEDICINE ACTIVE 1/1/2020 None N/A Q4655 NOLEN, PATRICK RYAN, DO 6/1/2015 6/1/2020 INTERNAL MEDICINE ACTIVE 6/4/2015 None N/A NWADIKE, VINCENTIA CHINEME, LICENSE Q6673 MD 12/4/2015 12/4/2020 INTERNAL MEDICINE ISSUED 12/4/2015 None N/A LICENSE Q5236 NWAOGWUGWU, UCHEOMA, MD 7/15/2015 7/15/2020 INTERNAL MEDICINE ISSUED 7/15/2015 None N/A R4441 NWEKE, CHINEDU PATRICK, MD 8/25/2017 8/25/2022 INTERNAL MEDICINE NEPHROLOGY ACTIVE 9/11/2017 None N/A LICENSE S7110 ODEH, OSAYAWE NOSAYABA, MD 6/12/2020 6/12/2025 INTERNAL MEDICINE ISSUED 6/12/2020 None N/A R4297 OGUAYO, CHRISTOPHER , MD 8/15/2017 8/15/2022 INTERNAL MEDICINE ACTIVE 9/4/2017 None N/A OKUNDAYE, ETINOSASERE S4833 OSAYONAME, MD 1/24/2020 1/24/2025 INTERNAL MEDICINE UNSPECIFIED ACTIVE 3/13/2020 None N/A OLUGBODI, AKINTOMI AKINYEMI, S4362 MD 12/6/2019 12/6/2024 INTERNAL MEDICINE PAIN MEDICINE ACTIVE 12/23/2019 None N/A OLUGBODI, AKINTOMI AKINYEMI, S4362 MD 12/6/2019 12/6/2024 INTERNAL MEDICINE PAIN MEDICINE ACTIVE 12/23/2019 None N/A LICENSE Q8766 OLUSANYA, YETUNDE , MD 6/10/2016 6/10/2021 INTERNAL MEDICINE ISSUED 6/10/2016 None N/A R0470 PADILLA, ADRIAN, MD 10/14/2016 10/14/2021 INTERNAL MEDICINE HOSPITALIST ACTIVE 11/3/2016 None N/A PALAKURTHI, LAKSHMI LICENSE Q8319 CHARUSEELA, MD 5/16/2016 5/16/2021 INTERNAL MEDICINE ISSUED 5/16/2016 None N/A

Page 39 of 332 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 PAMERLA, MOHAN RAMKUMAR, LICENSE Q6355 MD 10/15/2015 10/15/2020 INTERNAL MEDICINE ISSUED 10/15/2015 None N/A CRITICAL CARE R1267 PANCRUDO, JACKLYN REYES, DO 1/6/2017 1/6/2022 INTERNAL MEDICINE MEDICINE (IM) ACTIVE 1/20/2017 None N/A R3732 PATEL, APURVA, MD 6/30/2017 6/30/2022 INTERNAL MEDICINE CARDIOLOGY ACTIVE 8/14/2017 None N/A Q8325 PATEL, NAPOLEON, MD 5/16/2016 5/16/2021 INTERNAL MEDICINE ACTIVE 5/23/2016 None N/A Q7767 PATEL, NEERAJ M, MD 4/1/2016 4/1/2021 INTERNAL MEDICINE ACTIVE 4/21/2016 None N/A Q7589 PATEL, NIRAV DILIPBHAI, MD 3/15/2016 3/15/2021 INTERNAL MEDICINE ACTIVE 3/17/2016 None N/A LICENSE Q6357 PATEL, NIYATI MITAL, MD 10/15/2015 10/15/2020 INTERNAL MEDICINE ISSUED 10/15/2015 None N/A PULMONARY PATEL, PURVESH RAJENDRABHAI, CRITICAL CARE Q5246 MD 7/15/2015 7/15/2020 INTERNAL MEDICINE MEDICINE ACTIVE 7/21/2015 None N/A LICENSE S6915 PATEL, RUPA, MD 5/29/2020 5/29/2025 INTERNAL MEDICINE ISSUED 5/29/2020 None N/A PATEL, SANDIPKUMAR CANC NON- R0097 HASMUKHBHAI, MD 9/15/2016 9/15/2021 INTERNAL MEDICINE PAYMENT 3/5/2018 None N/A LICENSE Q8770 PATEL, UMANGI , MD 6/10/2016 6/10/2021 INTERNAL MEDICINE ISSUED 6/10/2016 None N/A DELINQUEN T-NON R0295 PATHAK, BASANTA, MD 9/30/2016 9/30/2021 INTERNAL MEDICINE PAYMENT 12/30/2017 None N/A AEROSPACE LICENSE R6073 PAVELA, JAMES HAROLD, MD 2/16/2018 2/16/2023 INTERNAL MEDICINE MEDICINE ISSUED 2/16/2018 None N/A S6013 PERAM, INDEEVAR, MD 4/3/2020 4/3/2025 INTERNAL MEDICINE HOSPITALIST ACTIVE 4/20/2020 None N/A K9869 PETERS, DAVID WILLIAM, MD 4/3/2020 4/3/2025 INTERNAL MEDICINE GERIATRICS ACTIVE 4/7/2020 None N/A LICENSE S7117 PHIRIPES, CONSTANTINE E, MD 6/12/2020 6/12/2025 INTERNAL MEDICINE ISSUED 6/12/2020 None N/A S5469 POLAMRAJU, TANMAYEE, DO 3/6/2020 3/6/2025 INTERNAL MEDICINE ACTIVE 4/28/2020 None N/A CANC NON- R0302 QADEER, ATIF , MD 9/30/2016 9/30/2021 INTERNAL MEDICINE HOSPITALIST PAYMENT 3/5/2018 None N/A R3189 QUADRI, MIR M, MD 5/22/2017 5/22/2022 INTERNAL MEDICINE HOSPITALIST ACTIVE 7/19/2017 None N/A GASTROENTEROLOG Q8611 RAHIMI NAINI, SOHRAB, MD 6/1/2016 6/1/2021 INTERNAL MEDICINE Y ACTIVE 6/6/2016 None N/A R3738 RAJASHEKARA, SHRUTHI, MD 6/30/2017 6/30/2022 INTERNAL MEDICINE ACTIVE 7/3/2017 None N/A RAMPURE, RITESH JANARDHAN, LICENSE R5799 MD 1/19/2018 1/19/2023 INTERNAL MEDICINE HOSPITALIST ISSUED 1/19/2018 None N/A S4554 RAVURI, SURESH KUMAR, MD 12/20/2019 12/20/2024 INTERNAL MEDICINE INTERNAL MEDICINE ACTIVE 1/15/2020 None N/A

Page 40 of 332 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 REDDY, CHANAKYARAM AYYADAP, GASTROENTEROLOG LICENSE S7124 MD 6/12/2020 6/12/2025 INTERNAL MEDICINE Y ISSUED 6/12/2020 None N/A REDDY, DEREDDI RAJA SHEKAR, CRITICAL CARE LICENSE Q5255 MD 7/15/2015 7/15/2020 INTERNAL MEDICINE MEDICINE ISSUED 7/15/2015 None N/A R2453 REDDY, SOWMYA K, MD 4/4/2017 4/4/2022 INTERNAL MEDICINE GERIATRICS ACTIVE 4/6/2017 None N/A LICENSE Q8781 RIZVI, RABA, MD 6/10/2016 6/10/2021 INTERNAL MEDICINE ISSUED 6/10/2016 None N/A Q6364 ROCHELIN, FLEURGIN, MD 10/15/2015 10/15/2020 INTERNAL MEDICINE INTERNAL MEDICINE ACTIVE 12/2/2015 None N/A RODRIGUEZ VARGAS, FELIX R4463 MARIA, MD 8/25/2017 8/25/2022 INTERNAL MEDICINE ACTIVE 9/8/2017 None N/A R5928 ROSALES, EDMUNDO , MD 2/2/2018 2/2/2023 INTERNAL MEDICINE ACTIVE 2/12/2018 None N/A S6501 RUBANO, JUDITH ESTELLE, MD 5/1/2020 5/1/2025 INTERNAL MEDICINE ACTIVE 5/18/2020 None N/A S5760 RUCK, LELA, MD 3/20/2020 3/20/2025 INTERNAL MEDICINE ACTIVE 3/31/2020 None N/A DELINQUEN T-NON R2463 SAAD, SYED MUHAMMAD ALI, MD 4/4/2017 4/4/2022 INTERNAL MEDICINE PAYMENT 7/3/2017 None N/A S4561 SAHORE SALWAN, ANU, MD 12/20/2019 12/20/2024 INTERNAL MEDICINE ACTIVE 1/1/2020 None N/A LICENSE Q5087 SALMAN, TAYYABA, MD 7/1/2015 7/1/2020 INTERNAL MEDICINE ISSUED 7/1/2015 None N/A ENDOCRINOLOGY, SANDIFER KUM-NJI, JULIETTE L, DIABETES AND R2964 MD 5/5/2017 5/5/2022 INTERNAL MEDICINE METABOLISM ACTIVE 10/30/2017 None N/A SANTIAGO MORALES, PAOLA R0316 EDMEE, MD 9/30/2016 9/30/2021 INTERNAL MEDICINE ACTIVE 10/4/2016 None N/A LICENSE Q4840 SATTAR, SHARIQ, MD 6/12/2015 6/12/2020 INTERNAL MEDICINE ISSUED 6/12/2015 None N/A

R3427 SCHNEIDER, SARAH LAUREN, MD 6/2/2017 6/2/2022 INTERNAL MEDICINE ACTIVE 6/7/2017 None N/A CARDIOVASCULAR LICENSE S6936 SEY, ALBERT ATTAH-KOFI, MD 5/29/2020 5/29/2025 INTERNAL MEDICINE DISEASES ISSUED 5/29/2020 None N/A LICENSE Q4691 SHAH, BHUMIK, MD 6/1/2015 6/1/2020 INTERNAL MEDICINE ISSUED 6/1/2015 None N/A R1871 SHAH, MEHUL P, DO 2/22/2017 2/22/2022 INTERNAL MEDICINE ACTIVE 5/19/2017 None N/A PULMONARY CRITICAL CARE LICENSE Q5566 SHAH, SHENIL SHRENIK, MD 8/3/2015 8/3/2020 INTERNAL MEDICINE MEDICINE ISSUED 8/3/2015 None N/A LICENSE Q4844 SHEN, MIN, MD 6/12/2015 6/12/2020 INTERNAL MEDICINE ISSUED 6/12/2015 None N/A

Page 41 of 332 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 LICENSE S6303 SHENOY, AKHIL VIJAY, MD 4/17/2020 4/17/2025 INTERNAL MEDICINE METABOLISM ISSUED 4/17/2020 None N/A INFECTIOUS LICENSE Q5930 SHETH, ARPITA ASHWINBHAI, MD 8/28/2015 8/28/2020 INTERNAL MEDICINE DISEASES ISSUED 8/28/2015 None N/A PALLIATIVE Q5572 SHOUKAT, SANA, MD 8/3/2015 8/3/2020 INTERNAL MEDICINE MEDICINE ACTIVE 8/5/2015 None N/A GASTROENTEROLOG LICENSE S7142 SIDDIQ, MUHAMMAD SOHAIL, MD 6/12/2020 6/12/2025 INTERNAL MEDICINE Y ISSUED 6/12/2020 None N/A INFECTIOUS LICENSE Q6572 SIDDIQUI, BAZGHA, MD 11/16/2015 11/16/2020 INTERNAL MEDICINE DISEASES ISSUED 11/16/2015 None N/A Q7476 SIDDIQUI, BEENISH , MD 3/4/2016 3/4/2021 INTERNAL MEDICINE ACTIVE 3/14/2016 None N/A SIDDIQUI, SALAAH MOHAMMED, LICENSE S7143 DO 6/12/2020 6/12/2025 INTERNAL MEDICINE ISSUED 6/12/2020 None N/A S6739 SIFUENTES, JOSHUA DAVID, MD 5/15/2020 5/15/2025 INTERNAL MEDICINE ACTIVE 5/25/2020 None N/A Q6288 SIVARAMAN, PADMAPRIYA, MD 10/1/2015 10/1/2020 INTERNAL MEDICINE RHEUMATOLOGY ACTIVE 10/16/2015 None N/A GASTROENTEROLOG Q9515 SMITH, AVERY LEE, MD 8/1/2016 8/1/2021 INTERNAL MEDICINE Y ACTIVE 8/12/2016 None N/A SNYDER, CHRISTOPHER MYERS, OCCUPATIONAL S4691 DO 1/10/2020 1/10/2025 INTERNAL MEDICINE MEDICINE ACTIVE 1/15/2020 None N/A PALLIATIVE Q9522 SRAN, MANPREET SINGH, MD 8/1/2016 8/1/2021 INTERNAL MEDICINE MEDICINE ACTIVE 8/10/2016 None N/A CARDIOVASCULAR R4476 STATHOPOULOS, TOM K, MD 8/25/2017 8/25/2022 INTERNAL MEDICINE DISEASES ACTIVE 9/6/2017 None N/A R3762 STUBBS, BROOKE VEITH, MD 6/30/2017 6/30/2022 INTERNAL MEDICINE ACTIVE 7/6/2017 None N/A R2984 SUDHAKAR, DEEPTHI , MD 5/5/2017 5/5/2022 INTERNAL MEDICINE ACTIVE 6/26/2017 None N/A LICENSE S6953 SUN, JIESU LEE, MD 5/29/2020 5/29/2025 INTERNAL MEDICINE ISSUED 5/29/2020 None N/A Q8656 TARAPASADE, SANDRA, MD 6/1/2016 6/1/2021 INTERNAL MEDICINE ACTIVE 6/2/2016 None N/A R4786 TATA, SUNITHA, MD 9/22/2017 9/22/2022 INTERNAL MEDICINE ACTIVE 12/8/2017 None N/A THATISHETTY, AMEET VENKAT, R5944 MD 2/2/2018 2/2/2023 INTERNAL MEDICINE HOSPITALIST ACTIVE 2/7/2018 None N/A Q6116 THI, VU HOANG, MD 9/15/2015 9/15/2020 INTERNAL MEDICINE ACTIVE 9/17/2015 None N/A LICENSE R6120 THOMAS, NITHIN GEORGEY, MD 2/16/2018 2/16/2023 INTERNAL MEDICINE ISSUED 2/16/2018 None N/A LICENSE R6303 TRAN, THAO P, DO 3/2/2018 3/2/2023 INTERNAL MEDICINE ISSUED 3/2/2018 None N/A R4336 TRIVEDI, RIDDHI, MD 8/15/2017 8/15/2022 INTERNAL MEDICINE ACTIVE 9/15/2017 None N/A R0336 UNNIKRISHNAN, MADHU, MD 9/30/2016 9/30/2021 INTERNAL MEDICINE ONCOLOGY ACTIVE 10/13/2016 None N/A

Page 42 of 332 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 Q8802 VADIVELU, ARUNPRIYA, MD 6/10/2016 6/10/2021 INTERNAL MEDICINE ACTIVE 6/20/2016 None N/A S7154 VARGHESE, NEVIN ANTONY, MD 6/12/2020 6/12/2025 INTERNAL MEDICINE ACTIVE 6/16/2020 None N/A LICENSE Q4871 VERMA, PRAKASH, MD 6/12/2015 6/12/2020 INTERNAL MEDICINE ISSUED 6/12/2015 None N/A Q5951 WEDIN, KYLE EDWARD, MD 8/28/2015 8/28/2020 INTERNAL MEDICINE ACTIVE 9/14/2015 None N/A WEERAKOON, NILUKA SHYAMALIE, LICENSE Q5603 MD 8/3/2015 8/3/2020 INTERNAL MEDICINE ISSUED 8/3/2015 None N/A LICENSE Q5952 WEISBRUCH, MICHAEL ADAM, MD 8/28/2015 8/28/2020 INTERNAL MEDICINE ISSUED 8/28/2015 None N/A WONDIMAGEGNEHU, NEBIYOU Q7305 ESAYAS, MD 2/16/2016 2/16/2021 INTERNAL MEDICINE ACTIVE 2/19/2016 None N/A LICENSE Q4709 WU, RICHARD CHENGHAN, MD 6/1/2015 6/1/2020 INTERNAL MEDICINE ISSUED 6/1/2015 None N/A

Q7989 YANAMANDRA, SUDHA RANI , MD 4/15/2016 4/15/2021 INTERNAL MEDICINE ACTIVE 4/25/2016 None N/A Q9925 YARLAGADDA, NAVEEN K, MD 8/26/2016 8/26/2021 INTERNAL MEDICINE ACTIVE 9/14/2016 None N/A LICENSE Q8683 YENDLURI, PRASOON KUMAR, MD 6/1/2016 6/1/2021 INTERNAL MEDICINE ISSUED 6/1/2016 None N/A S5529 ZIA, HAFSA, MD 3/6/2020 3/6/2025 INTERNAL MEDICINE HOSPITALIST ACTIVE 6/2/2020 None N/A R6322 ZIA, SUNNA SYED, MD 3/2/2018 3/2/2023 INTERNAL MEDICINE ACTIVE 3/19/2018 None N/A LICENSE Q6593 ZUO, YU , MD 11/16/2015 11/16/2020 INTERNAL MEDICINE RHEUMATOLOGY ISSUED 11/16/2015 None N/A BOYELLA, RAVICHANDRA REDDY, INTERVENTIONAL LICENSE Q6395 MD 11/2/2015 11/2/2020 CARDIOLOGY ISSUED 11/2/2015 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 INTERVENTIONAL CARDIOVASCULAR R0717 GADGIL, JAY YESHAWANT, MD 11/15/2016 11/15/2021 CARDIOLOGY DISEASES ACTIVE 11/17/2016 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 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 INTERVENTIONAL S6458 MOTIWALA, AFAQ, MD 5/1/2020 5/1/2025 CARDIOLOGY CARDIOLOGY ACTIVE 6/15/2020 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 INTERVENTIONAL DIAGNOSTIC S6484 QURESHI, JAWAD MAHMOOD, MD 5/1/2020 5/1/2025 RADIOLOGY RADIOLOGY ACTIVE 5/5/2020 None N/A

Page 43 of 332 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 INTERVENTIONAL DIAGNOSTIC T-NON R5477 TAHIR, OSMAN MANZOOR, DO 12/8/2017 12/8/2022 RADIOLOGY RADIOLOGY PAYMENT 3/8/2018 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 Q6202 HAREL, TAMAR , MD 10/1/2015 10/1/2020 MEDICAL GENETICS ACTIVE 10/7/2015 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 MUSCULOSKELETAL MUSCULOSKELETAL S5127 BOWKER, HAROLD DEAN III, MD 2/21/2020 2/21/2025 IMAGING IMAGING ACTIVE 2/25/2020 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

NEONATAL- LICENSE R6219 KONA, SASHI KUMAR, MD 3/2/2018 3/2/2023 PERINATAL MEDICINE PEDIATRICS ISSUED 3/2/2018 None N/A

NEONATAL- LICENSE Q6456 PATEL, JIGNESH, MD 11/2/2015 11/2/2020 PERINATAL MEDICINE PEDIATRICS ISSUED 11/2/2015 None N/A

NEONATAL- Q9924 YALLAPRAGADA, SUSHMITA G, MD 8/26/2016 8/26/2021 PERINATAL MEDICINE ACTIVE 8/31/2016 None N/A LICENSE Q5270 RUBIN, LEWIS PHILLIP, MD 7/15/2015 7/15/2020 NEONATOLOGY PEDIATRICS ISSUED 7/15/2015 None N/A LICENSE S7153 TRYZMEL, JOHNY, MD 6/12/2020 6/12/2025 NEONATOLOGY PEDIATRICS ISSUED 6/12/2020 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 LICENSE Q5840 KHAN, SADAF SANA, MD 8/28/2015 8/28/2020 NEPHROLOGY INTERNAL MEDICINE ISSUED 8/28/2015 None N/A S4867 SHAH, ANITA , MD 1/24/2020 1/24/2025 NEPHROLOGY INTERNAL MEDICINE ACTIVE 2/4/2020 None N/A NEUROLOGICAL LICENSE R5566 HRUSKA, ROB THOMAS, MD 1/5/2018 1/5/2023 SURGERY ISSUED 1/5/2018 None N/A NEUROLOGICAL LICENSE Q8759 NDUKU, VALENTINE T, DO 6/10/2016 6/10/2021 SURGERY ISSUED 6/10/2016 None N/A NEUROLOGICAL R4302 PATEL, ACHAL , MD 8/15/2017 8/15/2022 SURGERY ACTIVE 10/25/2017 None N/A

Page 44 of 332 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 RAJU, MURALIDHARA RUDHRA, NEUROLOGICAL R2946 MD 5/5/2017 5/5/2022 SURGERY ACTIVE 5/11/2017 None N/A NEUROLOGICAL LICENSE S7122 RAPER, DANIEL, MD 6/12/2020 6/12/2025 SURGERY ISSUED 6/12/2020 None N/A NEUROLOGICAL LICENSE Q8615 RASKIN, JEFFREY STEVEN, MD 6/1/2016 6/1/2021 SURGERY ISSUED 6/1/2016 None N/A

NEURO-PHYSIOLOGY R1163 ANDREWS, WEGDAN, MD 1/6/2017 1/6/2022 NEUROLOGY (NEUROLOGY) ACTIVE 3/30/2017 None N/A CAJAVILCA, CHRISTIAN EDUARDO, R5983 MD 2/16/2018 2/16/2023 NEUROLOGY ACTIVE 3/14/2018 None N/A Q8044 DAVE, HINA , MD 5/2/2016 5/2/2021 NEUROLOGY ACTIVE 5/18/2016 None N/A

NEURO-PHYSIOLOGY Q5395 DURGAM, PREETHI , DO 8/3/2015 8/3/2020 NEUROLOGY (NEUROLOGY) ACTIVE 8/5/2015 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

NEURO-PHYSIOLOGY R5878 KESARI, NAVIN KUMAR, MD 2/2/2018 2/2/2023 NEUROLOGY (NEUROLOGY) ACTIVE 2/19/2018 None N/A VASCULAR R0601 KHANDELWAL, PRIYANK, MD 10/31/2016 10/31/2021 NEUROLOGY NEUROLOGY ACTIVE 1/16/2017 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 S6879 LINDQUIST, JUSTIN KYLE, MD 5/29/2020 5/29/2025 NEUROLOGY ISSUED 5/29/2020 None N/A R5163 MADEY, JASON , MD 11/3/2017 11/3/2022 NEUROLOGY ACTIVE 2/5/2018 None N/A LICENSE Q4810 MILLER, SPENCER OWEN, MD 6/12/2015 6/12/2020 NEUROLOGY HOSPITALIST ISSUED 6/12/2015 None N/A LICENSE S5712 MURALIDHARA, ARTI RENATA, MD 3/20/2020 3/20/2025 NEUROLOGY ISSUED 3/20/2020 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 NANDIGAM, RAM NARAYAN CANC NON- Q8975 KAVEER, MD 7/1/2016 7/1/2021 NEUROLOGY PAYMENT 12/11/2017 None N/A VASCULAR LICENSE S7105 NEAL, JASON BENNETT, MD 6/12/2020 6/12/2025 NEUROLOGY NEUROLOGY ISSUED 6/12/2020 None N/A

Page 45 of 332 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 S7109 NOVA, ALAN STEVEN, DO 6/12/2020 6/12/2025 NEUROLOGY MEDICINE ISSUED 6/12/2020 None N/A

CLINICAL LICENSE Q6679 PALAC, SUSAN MARY, MD 12/4/2015 12/4/2020 NEUROLOGY NEUROPHYSIOLOGY ISSUED 12/4/2015 None N/A

CLINICAL R2937 PATEL, KULDEEP VINODBHAI, MD 5/5/2017 5/5/2022 NEUROLOGY NEUROPHYSIOLOGY ACTIVE 7/31/2017 None N/A R5455 PILLAI, MOHAN AIYASWAMI, MD 12/8/2017 12/8/2022 NEUROLOGY ACTIVE 12/20/2017 None N/A

NEURO-PHYSIOLOGY LICENSE Q4668 PORTO, MARIANO JR, MD 6/1/2015 6/1/2020 NEUROLOGY (NEUROLOGY) ISSUED 6/1/2015 None N/A LICENSE Q8616 RASTOGI, KOMAL , MD 6/1/2016 6/1/2021 NEUROLOGY ISSUED 6/1/2016 None N/A R2961 SALEH, SAMER, MD 5/5/2017 5/5/2022 NEUROLOGY INTERNAL MEDICINE ACTIVE 8/1/2017 None N/A LICENSE Q8632 SEBASIGARI, DENISE , DO 6/1/2016 6/1/2021 NEUROLOGY ISSUED 6/1/2016 None N/A LICENSE S4681 SEGURA, ENRIQUE, MD 1/10/2020 1/10/2025 NEUROLOGY ISSUED 1/10/2020 None N/A LICENSE R6298 SUN, LINQUAN, MD 3/2/2018 3/2/2023 NEUROLOGY ISSUED 3/2/2018 None N/A

TM00860 STANTON, CHRISTIAN LORE, MD 1/24/2020 1/24/2025 NEURO-RADIOLOGY ACTIVE 3/19/2020 None N/A LICENSE Q6196 GOEL, SUMINA, MD 10/1/2015 10/1/2020 NUCLEAR MEDICINE ISSUED 10/1/2015 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 PARCHEM, JACQUELINE GILMORE, LICENSE Q6554 MD 11/16/2015 11/16/2020 OBSTETRICS ISSUED 11/16/2015 None N/A OBSTETRICS & GYNECOLOGICAL OBSTETRICS AND R5473 SINGH, SIMRAT KAUR, DO 12/8/2017 12/8/2022 SURGERY GYNECOLOGY ACTIVE 2/14/2018 None N/A OBSTETRICS & GYNECOLOGICAL LICENSE Q8668 VONG, JENNIFER, DO 6/1/2016 6/1/2021 SURGERY ISSUED 6/1/2016 None N/A OBSTETRICS AND R4353 ADOMAKO, ANGELA ASIEDUA, MD 8/25/2017 8/25/2022 GYNECOLOGY ACTIVE 9/7/2017 None N/A OBSTETRICS AND LICENSE Q4885 AKAJAGBOR, EDESIRI, MD 7/1/2015 7/1/2020 GYNECOLOGY ISSUED 7/1/2015 None N/A

Page 46 of 332 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 Q4886 ALIFONSO-AMADOR, YAMINÉS, MD 7/1/2015 7/1/2020 GYNECOLOGY ACTIVE 7/27/2015 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 LICENSE Q6142 ANDERSON, CHARMAINE, MD 10/1/2015 10/1/2020 GYNECOLOGY ISSUED 10/1/2015 None N/A OBSTETRICS AND Q8243 BAKER, NOELLE AISSA, MD 5/16/2016 5/16/2021 GYNECOLOGY ACTIVE 5/17/2016 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 OBSTETRICS AND LICENSE Q4723 BELLOWS, PATRICIA HARRIS, MD 6/12/2015 6/12/2020 GYNECOLOGY ISSUED 6/12/2015 None N/A OBSTETRICS AND R2539 BELTRAN, FRANS, MD 4/20/2017 4/20/2022 GYNECOLOGY ACTIVE 4/27/2017 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 DE LA GARZA, ELIZABETH MARIE, OBSTETRICS AND R2568 MD 4/20/2017 4/20/2022 GYNECOLOGY ACTIVE 5/18/2017 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 OBSTETRICS AND R2084 DODARD, CINDY , MD 3/20/2017 3/20/2022 GYNECOLOGY ACTIVE 5/17/2017 None N/A OBSTETRICS AND R3066 DONNA, CYNTHIA , MD 5/22/2017 5/22/2022 GYNECOLOGY ACTIVE 5/31/2017 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 OBSTETRICS AND P9425 FAPOHUNDA, TEMITOPE, MD 9/15/2016 9/15/2021 GYNECOLOGY ACTIVE 9/22/2016 None N/A OBSTETRICS AND R0231 FEKRY, SAMUEL, MD 9/30/2016 9/30/2021 GYNECOLOGY ACTIVE 1/30/2018 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 OBSTETRICS AND GYNECOLOGIC LICENSE Q8482 GARZA, ERICA CELINA, MD 6/1/2016 6/1/2021 GYNECOLOGY SURGERY ISSUED 6/1/2016 None N/A OBSTETRICS AND S5376 GRIFFIN, PHOEBE GISELE, MD 3/6/2020 3/6/2025 GYNECOLOGY ACTIVE 3/30/2020 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

Page 47 of 332 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 R3856 HATEM, HATEM, MD 7/17/2017 7/17/2022 GYNECOLOGY ACTIVE 7/19/2017 None N/A OBSTETRICS AND LICENSE Q5667 HERNANDEZ, OSCAR, MD 8/14/2015 8/14/2020 GYNECOLOGY ISSUED 8/14/2015 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 IBE, ARMSTRONG OBSTETRICS AND S6415 CHUKWUNONSO, MD 5/1/2020 5/1/2025 GYNECOLOGY ACTIVE 6/8/2020 None N/A OBSTETRICS AND LICENSE Q5437 IVANOV, GENNADIY, MD 8/3/2015 8/3/2020 GYNECOLOGY ISSUED 8/3/2015 None N/A OBSTETRICS AND R0592 JENKINS, ANN, MD 10/31/2016 10/31/2021 GYNECOLOGY ACTIVE 3/28/2017 None N/A JOHNS, MONTGOMERY NEWMAN, OBSTETRICS AND Q7396 MD 3/4/2016 3/4/2021 GYNECOLOGY ACTIVE 3/14/2016 None N/A OBSTETRICS AND Q5826 JONES, ANGELA, DO 8/28/2015 8/28/2020 GYNECOLOGY ACTIVE 9/9/2015 None N/A OBSTETRICS AND D8301 KELLY, JOHN BARRY, MD 10/14/2016 10/14/2021 GYNECOLOGY ACTIVE 10/26/2016 None N/A OBSTETRICS AND LICENSE Q5680 KINDRED, ROBIN, MD 8/14/2015 8/14/2020 GYNECOLOGY ISSUED 8/14/2015 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 LEE-OSTERMAYER, KATHY OBSTETRICS AND LICENSE Q8739 KAISEE, MD 6/10/2016 6/10/2021 GYNECOLOGY ISSUED 6/10/2016 None N/A OBSTETRICS AND Q5023 LYNCH, BERNARD ANDREW, MD 7/1/2015 7/1/2020 GYNECOLOGY ACTIVE 7/10/2015 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 MEANS, JACQUELYN MICHELLE, OBSTETRICS AND Q6448 MD 11/2/2015 11/2/2020 GYNECOLOGY ACTIVE 11/9/2015 None N/A OBSTETRICS AND LICENSE Q4635 MELLO, LEAH , MD 6/1/2015 6/1/2020 GYNECOLOGY ISSUED 6/1/2015 None N/A OBSTETRICS AND R3715 MORALES, KRISTY, MD 6/30/2017 6/30/2022 GYNECOLOGY ACTIVE 7/11/2017 None N/A OBSTETRICS AND S5709 MORGAN, NURAH M, MD 3/20/2020 3/20/2025 GYNECOLOGY ACTIVE 5/20/2020 None N/A

Page 48 of 332 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 Q6677 OGBURN, JOSEPH ANTHONY, MD 12/4/2015 12/4/2020 GYNECOLOGY ISSUED 12/4/2015 None N/A PAGADALA, PADMAVATHI OBSTETRICS AND R3930 VENKATA, MD 7/17/2017 7/17/2022 GYNECOLOGY ACTIVE 8/21/2017 None N/A OBSTETRICS AND R3179 PEREZ-COSIO, CARLOS, MD 5/22/2017 5/22/2022 GYNECOLOGY ACTIVE 5/23/2017 None N/A OBSTETRICS AND R2202 QADRI, NADIA SYEDA, DO 3/20/2017 3/20/2022 GYNECOLOGY ACTIVE 4/5/2017 None N/A OBSTETRICS AND Q8128 RAMIREZ GOMEZ, FERNANDO, MD 5/2/2016 5/2/2021 GYNECOLOGY ACTIVE 5/6/2016 None N/A OBSTETRICS AND LICENSE Q6365 RODRIGO, GILBERTO, MD 10/15/2015 10/15/2020 GYNECOLOGY ISSUED 10/15/2015 None N/A OBSTETRICS AND LICENSE R6274 RUPLEY, DEVON MADEYLN, MD 3/2/2018 3/2/2023 GYNECOLOGY OBSTETRICS ISSUED 3/2/2018 None N/A SANTIAGO-MATOS, CHRISTIAN OBSTETRICS AND Q8789 JAVIER, MD 6/10/2016 6/10/2021 GYNECOLOGY ACTIVE 6/13/2016 None N/A OBSTETRICS AND S4876 SUMNER, JESSICA, DO 1/24/2020 1/24/2025 GYNECOLOGY ACTIVE 3/16/2020 None N/A OBSTETRICS AND S5088 TAPPY, ERRYN ESTHER, MD 2/7/2020 2/7/2025 GYNECOLOGY UROGYNECOLOGY ACTIVE 2/12/2020 None N/A THOMPSON, NORRIS BERNARD, OBSTETRICS AND LICENSE S6962 MD 5/29/2020 5/29/2025 GYNECOLOGY ISSUED 5/29/2020 None N/A OBSTETRICS AND LICENSE R5945 TILFORD, SARAH , MD 2/2/2018 2/2/2023 GYNECOLOGY ISSUED 2/2/2018 None N/A VITERI MOLINA, OSCAR ANDRES, OBSTETRICS AND LICENSE Q8665 MD 6/1/2016 6/1/2021 GYNECOLOGY ISSUED 6/1/2016 None N/A OBSTETRICS AND R2780 WAINWRIGHT, ALEXANDER , MD 4/20/2017 4/20/2022 GYNECOLOGY ACTIVE 5/5/2017 None N/A WARD-MOORE, ALLISON MARIE, OBSTETRICS AND S4414 MD 12/6/2019 12/6/2024 GYNECOLOGY OTHER SPECIALTY ACTIVE 3/18/2020 None N/A WARD-MOORE, ALLISON MARIE, OBSTETRICS AND S4414 MD 12/6/2019 12/6/2024 GYNECOLOGY OTHER SPECIALTY ACTIVE 3/18/2020 None N/A OBSTETRICS AND Q9082 WEIDNER, JENNIFER LYNN, MD 7/1/2016 7/1/2021 GYNECOLOGY ACTIVE 7/6/2016 None N/A OBSTETRICS AND LICENSE Q5605 WHITEHOUSE, KATHERINE , DO 8/3/2015 8/3/2020 GYNECOLOGY ISSUED 8/3/2015 None N/A LICENSE S7025 CHIHARA, DAI, MD 6/12/2020 6/12/2025 ONCOLOGY ISSUED 6/12/2020 None N/A

Page 49 of 332 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

Q7912 LAYMAN, RACHEL MICHELLE, MD 4/15/2016 4/15/2021 ONCOLOGY INTERNAL MEDICINE ACTIVE 5/30/2016 None N/A LICENSE R6323 WILDING, GEORGE, MD 3/2/2018 3/2/2023 ONCOLOGY INTERNAL MEDICINE ISSUED 3/2/2018 None N/A S6332 YU, IRENE SOU WAI, MD 4/17/2020 4/17/2025 ONCOLOGY INTERNAL MEDICINE ACTIVE 4/22/2020 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 R0180 AMBATI, BALAMURALI K, MD 9/30/2016 9/30/2021 OPHTHALMOLOGY ACTIVE 10/10/2016 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 Q5762 BICKNELL, KENDALL , MD 8/28/2015 8/28/2020 OPHTHALMOLOGY ACTIVE 9/1/2015 None N/A LICENSE S7013 BOHONOS, MELISSA AJUNWA, MD 6/12/2020 6/12/2025 OPHTHALMOLOGY ISSUED 6/12/2020 None N/A LICENSE Q8230 COLEMAN, WYCHE T III, MD 5/16/2016 5/16/2021 OPHTHALMOLOGY ISSUED 5/16/2016 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 S4964 HARBIE, KHALIL ANTONIO, MD 2/7/2020 2/7/2025 OPHTHALMOLOGY ACTIVE 2/25/2020 None N/A

OPHTHALMOLOGY - LICENSE TM00608 LENG, THEODORE, MD 7/15/2015 7/15/2020 OPHTHALMOLOGY VITREOUS SURGERY ISSUED 7/15/2015 None N/A Q9203 MENEES, AARIKA LESLIE, MD 7/15/2016 7/15/2021 OPHTHALMOLOGY ACTIVE 7/19/2016 None N/A Q7088 NAIDS, STEVEN, MD 2/1/2016 2/1/2021 OPHTHALMOLOGY ACTIVE 3/28/2016 None N/A PEDIATRIC Q4675 RAM, RADHA, MD 6/1/2015 6/1/2020 OPHTHALMOLOGY OPHTHALMOLOGY ACTIVE 6/2/2015 None N/A CORNEA REFRACTIVE LICENSE Q4683 ROSENBLAT, ELAN AARON, MD 6/1/2015 6/1/2020 OPHTHALMOLOGY SURGERY ISSUED 6/1/2015 None N/A S4566 SHEKOH, NOOR UL AIN, MD 12/20/2019 12/20/2024 OPHTHALMOLOGY OPHTHALMOLOGY ACTIVE 1/8/2020 None N/A LICENSE R6310 WEST, DEVIN M, MD 3/2/2018 3/2/2023 OPHTHALMOLOGY ISSUED 3/2/2018 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 OPHTHALMOLOGY - S6120 ATTIA, HOSAM, MD 4/17/2020 4/17/2025 VITREOUS SURGERY OPHTHALMOLOGY ACTIVE 5/21/2020 None N/A

Page 50 of 332 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 - R4937 BANKER, TANUJ PARENDRA, MD 10/20/2017 10/20/2022 VITREOUS SURGERY ACTIVE 10/30/2017 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 OPHTHALMOLOGY - LICENSE S6844 GEORGE, ROSHAN THOMAS, MD 5/29/2020 5/29/2025 VITREOUS SURGERY ISSUED 5/29/2020 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 OPHTHALMOLOGY - LICENSE S6684 MARSHALL, BRIGID KATHLEEN, MD 5/15/2020 5/15/2025 VITREOUS SURGERY ISSUED 5/15/2020 None N/A PERKINS, JONATHAN MORGAN, OPHTHALMOLOGY - LICENSE Q8772 MD 6/10/2016 6/10/2021 VITREOUS SURGERY OPHTHALMOLOGY ISSUED 6/10/2016 None N/A OPHTHALMOLOGY - R2723 ROSTAMIZADEH, MAHDI, MD 4/20/2017 4/20/2022 VITREOUS SURGERY ACTIVE 6/5/2017 None N/A SOEKAMTO, CHRISTA DANIELLE, OPHTHALMOLOGY - S5502 MD 3/6/2020 3/6/2025 VITREOUS SURGERY ACTIVE 3/25/2020 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 ORTHOPEDIC S5313 ANIGHORO, KENOMA, MD 3/6/2020 3/6/2025 SURGERY ACTIVE 3/19/2020 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 ORTHOPEDIC R5700 BHATT, SHIV S, MD 1/19/2018 1/19/2023 SURGERY ACTIVE 2/1/2018 None N/A ORTHOPEDIC S4608 BRITTEN, TYLER ANDREW, MD 1/10/2020 1/10/2025 SURGERY ACTIVE 3/20/2020 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 ORTHOPEDIC SPORTS MEDICINE Q7681 EILERS, MARK AARON, MD 4/1/2016 4/1/2021 SURGERY (ORTH SURG) ACTIVE 4/11/2016 None N/A ORTHOPEDIC LICENSE Q4587 GOTHA, HEATHER ELIZABETH, MD 6/1/2015 6/1/2020 SURGERY ISSUED 6/1/2015 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 ORTHOPEDIC S5377 GUEVARA, JONATHAN, MD 3/6/2020 3/6/2025 SURGERY ACTIVE 3/12/2020 None N/A

Page 51 of 332 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 LICENSE S6856 ILYAS, HAARISS BIN, MD 5/29/2020 5/29/2025 SURGERY ISSUED 5/29/2020 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 KONOPKA, GEOFFREY ORTHOPEDIC R3360 NEWCOMER, MD 6/2/2017 6/2/2022 SURGERY HAND SURGERY ACTIVE 6/7/2017 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 ORTHOPEDIC ADULT LICENSE Q7748 MILLER, DOUGLAS MICHAEL, DO 4/1/2016 4/1/2021 SURGERY RECONSTRUCTION ISSUED 4/1/2016 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 ADULT ORTHOPEDIC RECONSTRUCTIVE S5247 PATEL, MITAL SUMANKUMAR, MD 2/21/2020 2/21/2025 SURGERY ORTHOPEDICS ACTIVE 2/24/2020 None N/A ORTHOPEDIC S6278 PATEL, VIKAS VISHNUBHAI, MD 4/17/2020 4/17/2025 SURGERY ACTIVE 5/5/2020 None N/A ORTHOPEDIC FOOT AND ANKLE, R0126 SEIDMAN, DANIEL , MD 9/15/2016 9/15/2021 SURGERY ORTHOPEDICS ACTIVE 9/20/2016 None N/A ORTHOPEDIC R6105 SMITH, RYAN STEVEN, MD 2/16/2018 2/16/2023 SURGERY ACTIVE 2/27/2018 None N/A ORTHOPEDIC Q9742 SOMERSON, JEREMY SAMUEL, MD 8/15/2016 8/15/2021 SURGERY ACTIVE 8/23/2016 None N/A HAND SURGERY - ORTHOPEDIC ORTHOPEDIC LICENSE R6107 SOMOGYI, JASON ROBERT, MD 2/16/2018 2/16/2023 SURGERY SURGERY ISSUED 2/16/2018 None N/A ORTHOPEDIC R2019 SONNTAG, JEFFREY ROBERT, DO 3/3/2017 3/3/2022 SURGERY ACTIVE 4/10/2017 None N/A HAND SURGERY - ORTHOPEDIC ORTHOPEDIC R6117 TAVAKOLIAN, PAUL , MD 2/16/2018 2/16/2023 SURGERY SURGERY ACTIVE 2/20/2018 None N/A ORTHOPEDIC LICENSE R6130 WEBB, ANTONIO JEROME, MD 2/16/2018 2/16/2023 SURGERY ISSUED 2/16/2018 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

Page 52 of 332 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 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 ORTHOPEDIC SURGERY OF THE LICENSE S7129 SAMPATH, VIKRAM MAYURAN, MD 6/12/2020 6/12/2025 SPINE ISSUED 6/12/2020 None N/A ORTHOPEDIC R2989 TISSUE, CAMDEN MICHAEL, MD 5/5/2017 5/5/2022 TRAUMA ORTHOPEDICS ACTIVE 5/22/2017 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 PEDIATRIC LICENSE R6179 DUXBURY, GILBERT SHAWN, MD 3/2/2018 3/2/2023 ORTHOPEDICS ORTHOPEDICS ISSUED 3/2/2018 None N/A DELINQUEN T-NON R5387 EXTINE, JAMES HARLEY, DO 12/8/2017 12/8/2022 ORTHOPEDICS PAYMENT 3/8/2018 None N/A R2235 TAVAKOLI, EVAN MATTHEW, MD 3/20/2017 3/20/2022 ORTHOPEDICS ACTIVE 4/14/2017 None N/A

R1475 WALLSKOG, JOEL ANTHONY, MD 1/20/2017 1/20/2022 ORTHOPEDICS ACTIVE 2/22/2017 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 DELINQUEN T-NON R5231 ZAIDI, ALI, DO 11/3/2017 11/3/2022 OTHER SPECIALTY PAYMENT 2/1/2018 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 OTOLARYN & FACIAL LICENSE Q6666 MOURAD, MOUSTAFA WALID, MD 12/4/2015 12/4/2020 PLASTIC SURGERY ISSUED 12/4/2015 None N/A CANC NON- Q9951 BEASLEY, MICHAEL SCOTT, MD 9/15/2016 9/15/2021 OTOLARYNGOLOGY PAYMENT 3/5/2018 None N/A S5351 DANIYAN, OPEOLUWA, MD 3/6/2020 3/6/2025 OTOLARYNGOLOGY ACTIVE 4/6/2020 None N/A LICENSE S7096 MCCOUL, EDWARD DAVID, MD 6/12/2020 6/12/2025 OTOLARYNGOLOGY ISSUED 6/12/2020 None N/A R1607 PATEL, RAMYA SRINIVASAN, MD 2/6/2017 2/6/2022 OTOLARYNGOLOGY ACTIVE 2/14/2017 None N/A PLASTIC SURGERY WITHIN THE HEAD LICENSE R6106 SOKOYA, MOFIYINFOLU, MD 2/16/2018 2/16/2023 OTOLARYNGOLOGY AND NECK ISSUED 2/16/2018 None N/A HEAD AND NECK LICENSE R6308 WANG, RUI , MD 3/2/2018 3/2/2023 OTOLARYNGOLOGY SURGERY ISSUED 3/2/2018 None N/A

Page 53 of 332 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 OTORHINOLARYNGOL Q6353 NWOJO, RAPHAEL EZERA, MD 10/15/2015 10/15/2020 OGY ACTIVE 10/16/2015 None N/A OTORHINOLARYNGOL OTOLOGY/NEUTOTO LICENSE Q6566 SANA, SAID SHOIB, DO 11/16/2015 11/16/2020 OGY LOGY ISSUED 11/16/2015 None N/A ANESTHESIOLOGY - R1467 TUCKER, DOUGLAS ALAN, MD 1/20/2017 1/20/2022 PAIN & SPINE PAIN MANAGEMENT ACTIVE 2/13/2017 None N/A

S4901 WILLIAMSON, JOSEPH JAMES, DO 1/24/2020 1/24/2025 PAIN & SPINE ACTIVE 2/3/2020 None N/A PAIN DELINQUEN MANAGEMENT/REHAB T-NON R3752 SHEIKH, NAUREEN JAFFERY, MD 6/30/2017 6/30/2022 MED PAYMENT 12/4/2017 None N/A R5530 CHI, MICHELLE, MD 1/5/2018 1/5/2023 PAIN MEDICINE PAIN MEDICINE ACTIVE 1/15/2018 None N/A GERIATRICS - LICENSE Q5276 SAWEY, KATHRYN ANN , DO 7/15/2015 7/15/2020 PALLIATIVE MEDICINE INTERNAL MEDICINE ISSUED 7/15/2015 None N/A LICENSE Q6151 BEST, ANNA MOORHEAD, MD 10/1/2015 10/1/2020 PATHOLOGY ISSUED 10/1/2015 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 LICENSE S6822 DINARVAND, PEYMAN , MD 5/29/2020 5/29/2025 PATHOLOGY ISSUED 5/29/2020 None N/A LICENSE S6250 MILLER, DANIEL LEE, MD 4/17/2020 4/17/2025 PATHOLOGY CYTOPATHOLOGY ISSUED 4/17/2020 None N/A PEDIATRIC R0620 MILLINGTON, KARMAINE , MD 10/31/2016 10/31/2021 PATHOLOGY PATHOLOGY ACTIVE 11/7/2016 None N/A R2685 MURTHY, STACEY LYNN, MD 4/20/2017 4/20/2022 PATHOLOGY ACTIVE 5/9/2017 None N/A R0949 SCHOCKER, JASON, MD 12/2/2016 12/2/2021 PATHOLOGY ACTIVE 1/5/2017 None N/A LICENSE Q4696 SHEN, JEANNE, MD 6/1/2015 6/1/2020 PATHOLOGY ISSUED 6/1/2015 None N/A S6768 VYAS, SHIKHAR GAUTAM, MD 5/15/2020 5/15/2025 PATHOLOGY CYTOPATHOLOGY ACTIVE 5/18/2020 None N/A HEMATOLOGY LICENSE Q6479 WEI, ERIC XUEYING, MD 11/2/2015 11/2/2020 PATHOLOGY (PATHOLOGY) ISSUED 11/2/2015 None N/A R5343 ZHANG, HAIYAN , MD 11/17/2017 11/17/2022 PATHOLOGY ACTIVE 12/5/2017 None N/A PEDIATRIC ANESTHESIOLOGY S5772 SESHACHELLAM, VISHWAS , DO 3/20/2020 3/20/2025 (PEDS) ANESTHESIOLOGY ACTIVE 3/24/2020 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

Page 54 of 332 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 CRITICAL R3825 DAVIS, KASEY ILENE, MD 7/17/2017 7/17/2022 CARE MEDICINE ACTIVE 7/19/2017 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 PEDIATRIC EMERGENCY LICENSE Q6721 WHITEFIELD, JULIA SABINE, MD 12/4/2015 12/4/2020 MEDICINE (EM) ISSUED 12/4/2015 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 EMERGENCY LICENSE S6668 LANG, BENJAMIN ANDREW, MD 5/15/2020 5/15/2025 MEDICINE (PEDS) ISSUED 5/15/2020 None N/A PEDIATRIC EMERGENCY LICENSE Q8740 LEVINE, MARLA CASEY, MD 6/10/2016 6/10/2021 MEDICINE (PEDS) ISSUED 6/10/2016 None N/A PEDIATRIC EMERGENCY LICENSE Q8609 QUINN, KELLIE, DO 6/1/2016 6/1/2021 MEDICINE (PEDS) PEDIATRICS ISSUED 6/1/2016 None N/A PEDIATRIC LICENSE Q8624 ROY, SANI ANN MATHEW, MD 6/1/2016 6/1/2021 ENDOCRINOLOGY ISSUED 6/1/2016 None N/A PEDIATRIC R5232 ZERAH, MICHELE MATHILDE, MD 11/3/2017 11/3/2022 ENDOCRINOLOGY PEDIATRICS ACTIVE 11/14/2017 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 PEDIATRIC GASTROENTEROLOG R0460 NAIR, SUPRIYA , MD 10/14/2016 10/14/2021 Y ACTIVE 10/18/2016 None N/A PEDIATRIC GASTROENTEROLOG LICENSE Q4842 SEBASTIAN, TEENA, MD 6/12/2015 6/12/2020 Y PEDIATRICS ISSUED 6/12/2015 None N/A PEDIATRIC GASTROENTEROLOG LICENSE Q8378 VAUGHAN, JULIANA FREM, MD 5/16/2016 5/16/2021 Y ISSUED 5/16/2016 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

Page 55 of 332 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 PEDIATRIC Q5096 SHAH, SHWETA SHILPAN, MD 7/1/2015 7/1/2020 NEPHROLOGY PEDIATRICS ACTIVE 7/7/2015 None N/A

PEDIATRIC CLINICAL LICENSE R6275 SALIM, MUHAMMAD FAISAL, MD 3/2/2018 3/2/2023 NEUROLOGY NEUROPHYSIOLOGY ISSUED 3/2/2018 None N/A PEDIATRIC SPORTS MEDICINE - R3493 CLINE, KELLY ELIZABETH, MD 6/16/2017 6/16/2022 ORTHOPEDICS ORTHOPEDICS ACTIVE 7/19/2017 None N/A PEDIATRIC R0933 POWERS, JENIFER NICOLE, MD 12/2/2016 12/2/2021 ORTHOPEDICS ACTIVE 12/21/2016 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 PEDIATRIC LICENSE R5658 SZEREMETA, WASYL , MD 1/5/2018 1/5/2023 OTOLARYNGOLOGY ISSUED 1/5/2018 None N/A GATCLIFFE, CHELSEA ANN MARY, PEDIATRIC S4763 MD 1/24/2020 1/24/2025 PULMONOLOGY ACTIVE 2/3/2020 None N/A PEDIATRIC LICENSE Q8614 RAMMEL, JENNIFER LEIGH , MD 6/1/2016 6/1/2021 RHEUMATOLOGY ISSUED 6/1/2016 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 LICENSE S6028 RUSCHER, KIMBERLY ANN, MD 4/3/2020 4/3/2025 PEDIATRIC SURGERY ISSUED 4/3/2020 None N/A S6586 CHAN, YVONNE YUH-RU, MD 5/15/2020 5/15/2025 PEDIATRIC UROLOGY ACTIVE 5/25/2020 None N/A LICENSE S6232 LEVY, JAY BERRY, MD 4/17/2020 4/17/2025 PEDIATRIC UROLOGY ISSUED 4/17/2020 None N/A CHILD AND ADOLESCENT R3193 REINER, WILLIAM GEORGE, MD 5/22/2017 5/22/2022 PEDIATRIC UROLOGY PSYCHIATRY ACTIVE 5/29/2017 None N/A R2258 ABDALLA, KHUZAM, MD 4/4/2017 4/4/2022 PEDIATRICS ACTIVE 4/5/2017 None N/A S5304 ABDERRAHMAN, YEZAN , MD 3/6/2020 3/6/2025 PEDIATRICS ACTIVE 4/30/2020 None N/A Q7125 ABU SULB, AHMAD, MD 2/16/2016 2/16/2021 PEDIATRICS ACTIVE 2/19/2016 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 S6564 AMEEN, NAUREEN WASIF, MD 5/15/2020 5/15/2025 PEDIATRICS ACTIVE 5/18/2020 None N/A S6350 ANNOR, STEPHANIE YAA, MD 5/1/2020 5/1/2025 PEDIATRICS ACTIVE 5/18/2020 None N/A R0530 ANSARI, SAEMA, MD 10/31/2016 10/31/2021 PEDIATRICS ACTIVE 6/23/2017 None N/A

Page 56 of 332 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 Q5145 ARMSTRONG, MIA, MD 7/15/2015 7/15/2020 PEDIATRICS ISSUED 7/15/2015 None N/A Q9116 ATIF, MUZNA, MD 7/15/2016 7/15/2021 PEDIATRICS ACTIVE 9/29/2016 None N/A BENJAMIN, JENNIFER CHRISTINA, Q9954 MD 9/15/2016 9/15/2021 PEDIATRICS PEDIATRICS ACTIVE 10/3/2016 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 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 LICENSE S6802 BODAGALA, HIMA, MD 5/29/2020 5/29/2025 PEDIATRICS ISSUED 5/29/2020 None N/A R6151 BOGAN, SHANNON TRICHEL, MD 3/2/2018 3/2/2023 PEDIATRICS ACTIVE 3/7/2018 None N/A BRATHWAITE-DINGLE, NICHOLE R3040 RENEE, MD 5/22/2017 5/22/2022 PEDIATRICS ACTIVE 6/7/2017 None N/A R2298 CAMOSY, CAROLINE , MD 4/4/2017 4/4/2022 PEDIATRICS ACTIVE 4/11/2017 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 R2301 CEBRIAN, YVETTE DIANA, MD 4/4/2017 4/4/2022 PEDIATRICS ACTIVE 4/11/2017 None N/A LICENSE Q5369 CHINNAIYAN, PREMNATH, MD 8/3/2015 8/3/2020 PEDIATRICS ISSUED 8/3/2015 None N/A R0847 CLEE, MARK STEVENS, MD 12/2/2016 12/2/2021 PEDIATRICS ACTIVE 1/11/2017 None N/A LICENSE R6168 COSTELLO, KATHLEEN , MD 3/2/2018 3/2/2023 PEDIATRICS ISSUED 3/2/2018 None N/A

R4203 COZIER ROSS, DIONNE LEAH, MD 8/15/2017 8/15/2022 PEDIATRICS ACTIVE 9/14/2017 None N/A R2564 DAVID, SHERLINE RACHEL, DO 4/20/2017 4/20/2022 PEDIATRICS ACTIVE 5/29/2017 None N/A LICENSE Q6316 DOSSUL, AMENA, MD 10/15/2015 10/15/2020 PEDIATRICS ISSUED 10/15/2015 None N/A R3837 ESCOBAR, CASEY , MD 7/17/2017 7/17/2022 PEDIATRICS ACTIVE 8/21/2017 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 PEDIATRIC CRITICAL R3508 FARHAT, ABDELAZIZ , MD 6/16/2017 6/16/2022 PEDIATRICS CARE MEDICINE ACTIVE 8/1/2017 None N/A S5618 FLORIO, DAVID FRANCIS, MD 3/20/2020 3/20/2025 PEDIATRICS ACTIVE 3/26/2020 None N/A

Page 57 of 332 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 ALLERGY AND R0398 FREEDLE, KAREN ANN, MD 10/14/2016 10/14/2021 PEDIATRICS IMMUNOLOGY ACTIVE 10/24/2016 None N/A

S6399 GARLAND, MYRIAM ANDREA, MD 5/1/2020 5/1/2025 PEDIATRICS ACTIVE 5/13/2020 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 GELLMAN BISKAMP, SARAH ROSE, S5168 MD 2/21/2020 2/21/2025 PEDIATRICS ACTIVE 3/23/2020 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 S6623 GONZALEZ, JAZMIN, MD 5/15/2020 5/15/2025 PEDIATRICS ACTIVE 5/20/2020 None N/A GOOLSBAY, LAUREN ALEXANDRA, R2345 DO 4/4/2017 4/4/2022 PEDIATRICS ACTIVE 4/13/2017 None N/A Q6201 HABIB, FAROOQ, MD 10/1/2015 10/1/2020 PEDIATRICS PEDIATRICS ACTIVE 10/22/2015 None N/A PEDIATRIC LICENSE R5735 HAMDAN, HISHAM , MD 1/19/2018 1/19/2023 PEDIATRICS PULMONOLOGY ISSUED 1/19/2018 None N/A HAMMOND, JAMES DOUGLAS II, LICENSE S6199 MD 4/17/2020 4/17/2025 PEDIATRICS ISSUED 4/17/2020 None N/A LICENSE Q7702 HAUGHTON, NICOLE, MD 4/1/2016 4/1/2021 PEDIATRICS ISSUED 4/1/2016 None N/A HIDALGO ARMENTA, GRACE S6207 IVETH, MD 4/17/2020 4/17/2025 PEDIATRICS ACTIVE 4/20/2020 None N/A R0248 HIPPELI, ANGELA NICOLE, MD 9/30/2016 9/30/2021 PEDIATRICS ACTIVE 10/6/2016 None N/A Q6847 HOANG, CHRISTINE , MD 1/6/2016 1/6/2021 PEDIATRICS ACTIVE 2/15/2016 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 S6643 HOUSTON, SARA, MD 5/15/2020 5/15/2025 PEDIATRICS ACTIVE 5/27/2020 None N/A Q6945 HUANG, ERYONG, MD 1/15/2016 1/15/2021 PEDIATRICS ACTIVE 1/28/2016 None N/A LICENSE Q4769 HUMPHREY, JENNA, MD 6/12/2015 6/12/2020 PEDIATRICS ISSUED 6/12/2015 None N/A LICENSE Q5198 JALAL, ZULEKHA, MD 7/15/2015 7/15/2020 PEDIATRICS ISSUED 7/15/2015 None N/A JAYARAMASWAMY SULOCHANA, S5193 SHILPA, MD 2/21/2020 2/21/2025 PEDIATRICS PEDIATRICS ACTIVE 2/25/2020 None N/A LICENSE Q5825 JIMENEZ RAMOS, FARRAH, MD 8/28/2015 8/28/2020 PEDIATRICS ISSUED 8/28/2015 None N/A

Page 58 of 332 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 S5669 JURAK, JADE , MD 3/20/2020 3/20/2025 PEDIATRICS ACTIVE 4/14/2020 None N/A S5672 KADAPURAM, BETSY MARY, DO 3/20/2020 3/20/2025 PEDIATRICS ACTIVE 4/1/2020 None N/A KATIKANENI, RAO Q6756 MURALIKRISHNA, MD 12/15/2015 12/15/2020 PEDIATRICS ACTIVE 12/28/2015 None N/A LICENSE R6028 KEYBURN, HANH, DO 2/16/2018 2/16/2023 PEDIATRICS ISSUED 2/16/2018 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 Q5681 KOEHLER, BRUCE ERIC II, MD 8/14/2015 8/14/2020 PEDIATRICS ACTIVE 8/18/2015 None N/A LICENSE Q6530 LANERIE, JESSICA ANN, MD 11/16/2015 11/16/2020 PEDIATRICS ISSUED 11/16/2015 None N/A LLUBERES GORDO, KARLA R6229 MICHELLE, MD 3/2/2018 3/2/2023 PEDIATRICS ACTIVE 3/9/2018 None N/A Q5691 MAHESHWARI, SURBHI, MD 8/14/2015 8/14/2020 PEDIATRICS ACTIVE 8/19/2015 None N/A Q7739 MALIK, FAHAD MUBARIK, MD 4/1/2016 4/1/2021 PEDIATRICS ACTIVE 4/6/2016 None N/A Q6062 MANCIA, EDUARDO , MD 9/15/2015 9/15/2020 PEDIATRICS ACTIVE 9/17/2015 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 S5992 MILAD, MOHEB , MD 4/3/2020 4/3/2025 PEDIATRICS ACTIVE 5/20/2020 None N/A Q4638 MILLER, KYLE SCOTT, DO 6/1/2015 6/1/2020 PEDIATRICS ACTIVE 6/17/2015 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 Q9448 MORENO, ITTAY ORLANDO, MD 8/1/2016 8/1/2021 PEDIATRICS ACTIVE 8/3/2016 None N/A R1835 MURTHY, APOORVA , MD 2/22/2017 2/22/2022 PEDIATRICS ACTIVE 2/28/2017 None N/A LICENSE Q5506 NABI, NEELOFAR , MD 8/3/2015 8/3/2020 PEDIATRICS ISSUED 8/3/2015 None N/A Q8585 NIETO, ZEINA , MD 6/1/2016 6/1/2021 PEDIATRICS ACTIVE 6/7/2016 None N/A LICENSE Q6674 NWANERI, MICHAEL OSITA, MD 12/4/2015 12/4/2020 PEDIATRICS ISSUED 12/4/2015 None N/A Q6674 NWANERI, MICHAEL OSITA, MD 12/4/2015 12/4/2020 PEDIATRICS ACTIVE 12/31/2015 None N/A Q6674 NWANERI, MICHAEL OSITA, MD 12/4/2015 12/4/2020 PEDIATRICS ACTIVE 12/31/2015 None N/A LICENSE Q5518 ODUMUSI, KOLAWOLE, MD 8/3/2015 8/3/2020 PEDIATRICS ISSUED 8/3/2015 None N/A OQUENDO RINCON, MARCIAL LICENSE Q8590 ANDRES, MD 6/1/2016 6/1/2021 PEDIATRICS ISSUED 6/1/2016 None N/A S4664 ORONTI, OMORINSOLA, MD 1/10/2020 1/10/2025 PEDIATRICS ACTIVE 2/28/2020 None N/A LICENSE S7121 PRYOR, GRACE , MD 6/12/2020 6/12/2025 PEDIATRICS ISSUED 6/12/2020 None N/A

Page 59 of 332 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 S6019 QUINTANILLA, ALEXANDRA , MD 4/3/2020 4/3/2025 PEDIATRICS ACTIVE 4/14/2020 None N/A LICENSE Q4673 RAJAGOPAL, SHILPA, MD 6/1/2015 6/1/2020 PEDIATRICS ISSUED 6/1/2015 None N/A R0937 RAJASEKARAN, SHANTHI, MD 12/2/2016 12/2/2021 PEDIATRICS ACTIVE 12/19/2016 None N/A LICENSE Q6688 RAMAKRISHNAN, SREEMDEVI, MD 12/4/2015 12/4/2020 PEDIATRICS ISSUED 12/4/2015 None N/A G2004 RAO, SWARAJYALAXMI B, MD 2/1/2016 2/1/2021 PEDIATRICS ACTIVE 2/9/2016 None N/A LICENSE Q5718 RUDERFER, DANIEL , MD 8/14/2015 8/14/2020 PEDIATRICS ISSUED 8/14/2015 None N/A Q9504 RUIZ, VANESSA , MD 8/1/2016 8/1/2021 PEDIATRICS ACTIVE 8/3/2016 None N/A PEDIATRIC HEMATOLOGY/ONCO LICENSE Q5923 SANCHEZ, DIMARYS , MD 8/28/2015 8/28/2020 PEDIATRICS LOGY ISSUED 8/28/2015 None N/A R2468 SANDHU, SANJEET SINGH, DO 4/4/2017 4/4/2022 PEDIATRICS ACTIVE 4/6/2017 None N/A SHAREEF, MOHAMMED RASHED, LICENSE Q8148 MD 5/2/2016 5/2/2021 PEDIATRICS NEONATOLOGY ISSUED 5/2/2016 None N/A LICENSE S7140 SHEHZAD, IRFAN, MD 6/12/2020 6/12/2025 PEDIATRICS ISSUED 6/12/2020 None N/A LICENSE S6043 SHEIKH, IRTIZA NASEER, DO 4/3/2020 4/3/2025 PEDIATRICS ISSUED 4/3/2020 None N/A LICENSE Q5929 SHERIF, ALI M, MD 8/28/2015 8/28/2020 PEDIATRICS ISSUED 8/28/2015 None N/A Q6469 SILVA, ERICA CLAUDETTE, MD 11/2/2015 11/2/2020 PEDIATRICS ACTIVE 11/10/2015 None N/A S6052 SOLORZANO, SARINA, MD 4/3/2020 4/3/2025 PEDIATRICS ACTIVE 4/7/2020 None N/A R3225 STORM, JOY SUNSHINE, MD 5/22/2017 5/22/2022 PEDIATRICS ACTIVE 5/24/2017 None N/A STROBEL, CHELSEA ELIZABETH, R6297 MD 3/2/2018 3/2/2023 PEDIATRICS ACTIVE 3/12/2018 None N/A LICENSE S6954 SWORDS, DARDEN CARROLL, MD 5/29/2020 5/29/2025 PEDIATRICS ISSUED 5/29/2020 None N/A

Q4701 TANTOUSH, MANAL YOUSEF, MD 6/1/2015 6/1/2020 PEDIATRICS ACTIVE 6/17/2015 None N/A LICENSE S7151 TARDIEU, GABRIELLE GLORIA, MD 6/12/2020 6/12/2025 PEDIATRICS ISSUED 6/12/2020 None N/A LICENSE Q5581 THUET, CHRISTINA, MD 8/3/2015 8/3/2020 PEDIATRICS ISSUED 8/3/2015 None N/A VARGAS-WHALE, RAQUEL ANN, LICENSE Q4870 MD 6/12/2015 6/12/2020 PEDIATRICS ISSUED 6/12/2015 None N/A VARGHESE, JENNIFER MAUREEN, LICENSE R5671 MD 1/5/2018 1/5/2023 PEDIATRICS ISSUED 1/5/2018 None N/A

Page 60 of 332 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 Q6917 VARGHESE, SIBI SARAH, MD 1/6/2016 1/6/2021 PEDIATRICS PEDIATRICS ACTIVE 2/1/2016 None N/A R3240 VEGA, KARY, MD 5/22/2017 5/22/2022 PEDIATRICS ACTIVE 7/17/2017 None N/A LICENSE Q6718 WALCZAK, ROSE M, MD 12/4/2015 12/4/2020 PEDIATRICS ISSUED 12/4/2015 None N/A LICENSE S4580 WALKER, ROLAND HAYES, MD 12/20/2019 12/20/2024 PEDIATRICS GENERAL PRACTICE ISSUED 12/19/2020 None N/A WAWER-CHUBB, ALLISON R4165 KRISTEN, DO 8/1/2017 8/1/2022 PEDIATRICS ACTIVE 8/9/2017 None N/A LICENSE Q8809 WHITE, BERNADETTE , MD 6/10/2016 6/10/2021 PEDIATRICS ISSUED 6/10/2016 None N/A S6336 ZAKIRYENOK, ELENA, MD 4/17/2020 4/17/2025 PEDIATRICS ACTIVE 5/28/2020 None N/A DELINQUEN PEDIATRICS, T-NON R0127 SHAH, ANKUR BHARAT, MD 9/15/2016 9/15/2021 CARDIOLOGY PEDIATRICS PAYMENT 12/30/2017 None N/A PEDIATRICS, LICENSE Q4852 SUBRAMANIAN, SARADHA, MD 6/12/2015 6/12/2020 CARDIOLOGY ISSUED 6/12/2015 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 PHYSICAL MED. & Q7631 ARANKE, SIDDHARTH VIJAY, MD 4/1/2016 4/1/2021 REHABILITATION ACTIVE 4/7/2016 None N/A PHYSICAL MED. & S5546 ARCURE, JOHN DAVID, MD 3/20/2020 3/20/2025 REHABILITATION ACTIVE 4/3/2020 None N/A 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 BARADIA, MOHAMED HUSSEIN , PHYSICAL MED. & LICENSE S6356 DO 5/1/2020 5/1/2025 REHABILITATION PAIN MANAGEMENT ISSUED 5/1/2020 None N/A BARSHIKAR, SURENDRA PHYSICAL MED. & Q8019 SHRIKRISHNA, MD 5/2/2016 5/2/2021 REHABILITATION ACTIVE 5/9/2016 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 PHYSICAL MED. & R1515 CONNOR, JOSEPH LUKE JR, MD 2/6/2017 2/6/2022 REHABILITATION ACTIVE 3/20/2017 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 DHAMDHERE, SAYLEE SHIRISH, PHYSICAL MED. & LICENSE R6171 MD 3/2/2018 3/2/2023 REHABILITATION ISSUED 3/2/2018 None N/A

Page 61 of 332 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. & R2324 EDGE, DARSHE CHENEL, MD 4/4/2017 4/4/2022 REHABILITATION ACTIVE 4/14/2017 None N/A PHYSICAL MED. & LICENSE Q4755 GARCIA, OMAR , MD 6/12/2015 6/12/2020 REHABILITATION ISSUED 6/12/2015 None N/A PEDIATRIC PHYSICAL MED. & REHABILITATION Q8500 HARDEN, JEANNIE K, MD 6/1/2016 6/1/2021 REHABILITATION MEDICINE ACTIVE 6/3/2016 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 PHYSICAL MED. & R4719 HOU, SAIYUN , MD 9/22/2017 9/22/2022 REHABILITATION ACTIVE 12/4/2017 None N/A PHYSICAL MED. & S5930 HUA, JASON , DO 4/3/2020 4/3/2025 REHABILITATION ACTIVE 6/8/2020 None N/A PHYSICAL MED. & R1563 KHAN, SAMAIRA, DO 2/6/2017 2/6/2022 REHABILITATION ACTIVE 3/13/2017 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 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 PHYSICAL MED. & Q6978 PUROHIT, MAULIK PRAFULL, MD 1/15/2016 1/15/2021 REHABILITATION PUBLIC HEALTH ACTIVE 4/7/2016 None N/A PHYSICAL MED. & LICENSE S6530 SMITH, JENNY ALYCE, MD 5/1/2020 5/1/2025 REHABILITATION ISSUED 5/1/2020 None N/A DELINQUEN PHYSICAL MED. & T-NON Q9747 SUBBARAO, BRUNO SHANKAR, DO 8/15/2016 8/15/2021 REHABILITATION PAYMENT 12/30/2017 None N/A PHYSICAL MED. & S5277 TIAN, IRIS XIAO, DO 2/21/2020 2/21/2025 REHABILITATION ACTIVE 3/9/2020 None N/A PHYSICAL MED. & Q8662 VELA, OCTAVIO , MD 6/1/2016 6/1/2021 REHABILITATION ACTIVE 6/16/2016 None N/A VILLACORTA, JENNIFER MAY PHYSICAL MED. & SPINAL CORD Q7500 MADRID, MD 3/4/2016 3/4/2021 REHABILITATION INJURY MEDICINE ACTIVE 4/4/2016 None N/A PHYSICAL MED. & LICENSE R5954 WILLIAMS, KORIAND'R, MD 2/2/2018 2/2/2023 REHABILITATION ISSUED 2/2/2018 None N/A INTERNAL PHYSICAL MED. & MED/REHABILITATIO Q7516 YARROZU, ARUNA L, MD 3/4/2016 3/4/2021 REHABILITATION N ACTIVE 3/31/2016 None N/A

Page 62 of 332 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. & R0818 ZHANG, TRISTAN , MD 11/15/2016 11/15/2021 REHABILITATION GENERAL PRACTICE ACTIVE 11/21/2016 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 PLASTIC & RECONSTRUCTIVE Q6933 BRIDGE, KEVIN ALAN, MD 1/15/2016 1/15/2021 SURGERY GENERAL SURGERY ACTIVE 1/20/2016 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 PLASTIC & RECONSTRUCTIVE S4982 KALARIA, SHANA SUBODH, MD 2/7/2020 2/7/2025 SURGERY ACTIVE 5/1/2020 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 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 PLASTIC & RECONSTRUCTIVE LICENSE Q4808 MCKEE, DANIEL, MD 6/12/2015 6/12/2020 SURGERY ISSUED 6/12/2015 None N/A PLASTIC & DELINQUEN RECONSTRUCTIVE T-NON R5467 SAWA, KATHRYN, MD 12/8/2017 12/8/2022 SURGERY PAYMENT 3/8/2018 None N/A PLASTIC & RECONSTRUCTIVE CRANIOFACIAL S4584 XUE, AMY SHENGNAN, MD 12/20/2019 12/20/2024 SURGERY SURGERY ACTIVE 1/13/2020 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 PREVENTIVE LICENSE R5729 GRIEGER, DARA , MD 1/19/2018 1/19/2023 MEDICINE GENERAL PRACTICE ISSUED 1/19/2018 None N/A ADDICTION Q7008 AVILA, JORGE N, MD 2/1/2016 2/1/2021 PSYCHIATRY MEDICINE ACTIVE 4/21/2016 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

Page 63 of 332 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 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 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 CHILD AND ADOLESCENT Q9148 DESAI, MUKESH INDUBHAI, MD 7/15/2016 7/15/2021 PSYCHIATRY PSYCHIATRY ACTIVE 9/26/2016 None N/A DONTHI REDDY, SRINIVASA LICENSE Q6179 REDDY, MD 10/1/2015 10/1/2020 PSYCHIATRY ISSUED 10/1/2015 None N/A Q7682 ELKHATIB, RANIA , MD 4/1/2016 4/1/2021 PSYCHIATRY ACTIVE 4/4/2016 None N/A GERIATRIC Q5797 FLOYD, CARALYN JEAN, DO 8/28/2015 8/28/2020 PSYCHIATRY PSYCHIATRY ACTIVE 9/1/2015 None N/A Q7562 HUSSAIN, SHAHID, MD 3/15/2016 3/15/2021 PSYCHIATRY ACTIVE 6/14/2016 None N/A LICENSE Q7711 IBRAHIM, SYED TARIQ, MD 4/1/2016 4/1/2021 PSYCHIATRY INTERNAL MEDICINE ISSUED 4/1/2016 None N/A Q6436 KELLER, BRADLY J, MD 11/2/2015 11/2/2020 PSYCHIATRY ACTIVE 11/4/2015 None N/A LICENSE Q7906 KREIN, STUART, MD 4/15/2016 4/15/2021 PSYCHIATRY ISSUED 4/15/2016 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 R2920 MILLS, CHRISTINA SHANTE, MD 5/5/2017 5/5/2022 PSYCHIATRY ACTIVE 6/7/2017 None N/A LICENSE Q5494 MILTON, ROBERT MICHAEL, MD 8/3/2015 8/3/2020 PSYCHIATRY ISSUED 8/3/2015 None N/A

R2179 MOTSINGER, CHARLES DUKE, MD 3/20/2017 3/20/2022 PSYCHIATRY FAMILY PRACTICE ACTIVE 3/28/2017 None N/A CHILD AND ADOLESCENT LICENSE S7107 NIBRAS, SOHAIL AMAR, MD 6/12/2020 6/12/2025 PSYCHIATRY PSYCHIATRY ISSUED 6/12/2020 None N/A NOTTAGE-MURPHY, LATOYA Q5882 CHRISTAL, MD 8/28/2015 8/28/2020 PSYCHIATRY ACTIVE 9/7/2015 None N/A FORENSIC LICENSE S6911 ORTIZ, PATRICIA, MD 5/29/2020 5/29/2025 PSYCHIATRY PSYCHIATRY ISSUED 5/29/2020 None N/A LICENSE Q4829 QUINONES, MARLON P, MD 6/12/2015 6/12/2020 PSYCHIATRY ISSUED 6/12/2015 None N/A

Page 64 of 332 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 RAGAB, SHERIF ALY MOHAMED Q4671 ALY, MD 6/1/2015 6/1/2020 PSYCHIATRY ACTIVE 6/2/2015 None N/A LICENSE Q4831 RAWLS, STACEY LAWRENCE, MD 6/12/2015 6/12/2020 PSYCHIATRY ISSUED 6/12/2015 None N/A ADDICTION R3205 SAVINO, ADRIA CLAUDIA, MD 5/22/2017 5/22/2022 PSYCHIATRY PSYCHIATRY ACTIVE 6/21/2017 None N/A DELINQUEN FORENSIC T-NON R5337 VYAS, SANKET ASHWIN, MD 11/17/2017 11/17/2022 PSYCHIATRY PSYCHIATRY PAYMENT 2/15/2018 None N/A LICENSE Q6722 YAHAGI, KEISHA , MD 12/4/2015 12/4/2020 PSYCHIATRY ISSUED 12/4/2015 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 PULMONARY CRITICAL CARE Q7400 KAMATHAM, MADHURI, MD 3/4/2016 3/4/2021 MEDICINE SLEEP MEDICINE ACTIVE 3/9/2016 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 PULMONARY SANTIAGO-BELLEDONNE, HECTOR CRITICAL CARE S4382 EDUARDO , MD 12/6/2019 12/6/2024 MEDICINE INTERNAL MEDICINE ACTIVE 12/16/2019 None N/A PULMONARY SANTIAGO-BELLEDONNE, HECTOR CRITICAL CARE S4382 EDUARDO , MD 12/6/2019 12/6/2024 MEDICINE INTERNAL MEDICINE ACTIVE 12/16/2019 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 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 RADIATION S5120 BECKHAM, THOMAS HENDRIX, MD 2/21/2020 2/21/2025 ONCOLOGY ACTIVE 2/27/2020 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 RADIATION LICENSE Q6199 GREENFIELD, BRAD JOSEPH, MD 10/1/2015 10/1/2020 ONCOLOGY ISSUED 10/1/2015 None N/A RADIATION LICENSE S6679 LUDMIR, ETHAN BERNARD, MD 5/15/2020 5/15/2025 ONCOLOGY ISSUED 5/15/2020 None N/A

Page 65 of 332 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 RADIATION Q6259 PATEL, UMANG HASMUKH, MD 10/1/2015 10/1/2020 ONCOLOGY ACTIVE 10/5/2015 None N/A RADIATION Q8379 VERMA, JONATHAN A, MD 5/16/2016 5/16/2021 ONCOLOGY ACTIVE 5/17/2016 None N/A

TM00646 ABRAHAM, RALPH LEE III, MD 9/30/2016 9/30/2021 RADIOLOGY ACTIVE 1/30/2017 None N/A Q6004 ALIAN, ALI, MD 9/15/2015 9/15/2020 RADIOLOGY INTERNAL MEDICINE ACTIVE 9/17/2015 None N/A Q7140 BAINS, PAVIT , MD 2/16/2016 2/16/2021 RADIOLOGY ACTIVE 3/23/2016 None N/A MUSCULOSKELETAL R1499 BAWA, PRITISH, MD 2/6/2017 2/6/2022 RADIOLOGY RADIOLOGY ACTIVE 2/8/2017 None N/A LICENSE S7008 BERGMANN, LIISA LOUISE, MD 6/12/2020 6/12/2025 RADIOLOGY ISSUED 6/12/2020 None N/A CLOWER, MATTHEW SIMPSON, LICENSE Q4736 MD 6/12/2015 6/12/2020 RADIOLOGY ISSUED 6/12/2015 None N/A LICENSE Q5672 HWANG, WILLY, MD 8/14/2015 8/14/2020 RADIOLOGY ISSUED 8/14/2015 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

Q7398 JUAN-RAMIREZ, JUAN PABLO, MD 3/4/2016 3/4/2021 RADIOLOGY ACTIVE 3/14/2016 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 LICENSE Q5844 KRAUSE, ROBERT WILLIAM, MD 8/28/2015 8/28/2020 RADIOLOGY ISSUED 8/28/2015 None N/A LICENSE TM00885 KUMAR, PRASANNA G, MD 6/12/2020 6/12/2025 RADIOLOGY MAMMOGRAPHY ISSUED 6/12/2020 None N/A LICENSE Q6531 LEDFORD, JAMIE R, MD 11/16/2015 11/16/2020 RADIOLOGY ISSUED 11/16/2015 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 LICENSE Q4820 NGUYEN, DUSTIN DUY, DO 6/12/2015 6/12/2020 RADIOLOGY ISSUED 6/12/2015 None N/A LICENSE R6066 ODEGHE, JOHN KALU, MD 2/16/2018 2/16/2023 RADIOLOGY ISSUED 2/16/2018 None N/A LICENSE Q8769 PATEL, NIMESH, MD 6/10/2016 6/10/2021 RADIOLOGY ISSUED 6/10/2016 None N/A

Page 66 of 332 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 Q5542 RAVI, ANANTH KUMAR, MD 8/3/2015 8/3/2020 RADIOLOGY ISSUED 8/3/2015 None N/A LICENSE Q5271 RUSS, EDMOND VINCENT III, MD 7/15/2015 7/15/2020 RADIOLOGY ISSUED 7/15/2015 None N/A LICENSE R6277 SAMARDZIC, DEJAN, MD 3/2/2018 3/2/2023 RADIOLOGY NEURO-RADIOLOGY ISSUED 3/2/2018 None N/A LICENSE Q5564 SHAH, BAIJU , MD 8/3/2015 8/3/2020 RADIOLOGY ISSUED 8/3/2015 None N/A R0130 SIDDIQUI, PERVEZ, MD 9/15/2016 9/15/2021 RADIOLOGY ACTIVE 9/23/2016 None N/A PEDIATRIC LICENSE S4884 THAKRAR, DARSHIT, MD 1/24/2020 1/24/2025 RADIOLOGY RADIOLOGY ISSUED 1/24/2020 None N/A LICENSE S6781 ALAM, SYED, MD 5/29/2020 5/29/2025 RHEUMATOLOGY INTERNAL MEDICINE ISSUED 5/29/2020 None N/A Q5346 BATHULA, SRIKANTH, MD 8/3/2015 8/3/2020 RHEUMATOLOGY INTERNAL MEDICINE ACTIVE 8/31/2015 None N/A Q6159 CAMPBELL, CARMEN MARIE, MD 10/1/2015 10/1/2020 RHEUMATOLOGY INTERNAL MEDICINE ACTIVE 10/23/2015 None N/A R1783 JALANDHARA, PRIYANKA, MD 2/22/2017 2/22/2022 RHEUMATOLOGY ACTIVE 5/12/2017 None N/A

Q7236 MEISSNER, MARISSA NICOLE, MD 2/16/2016 2/16/2021 RHEUMATOLOGY INTERNAL MEDICINE ACTIVE 3/8/2016 None N/A LICENSE S6557 ZINN, WILLIAM, MD 5/1/2020 5/1/2025 ROENTGENOLOGY ISSUED 5/1/2020 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 SPORTS MEDICINE- Q9868 MOONEY, CAITLYN CHRISTINE, MD 8/26/2016 8/26/2021 PEDS PEDIATRICS ACTIVE 11/24/2016 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 SURGICAL CRITICAL TRAUMATIC LICENSE S7077 KEITH, STACEY LYN, MD 6/12/2020 6/12/2025 CARE SURGERY 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 THORACIC CARDIOVASCULAR CARDIOVASCULAR LICENSE Q4628 LYTLE, BRUCE WHITNEY, MD 6/1/2015 6/1/2020 SURGERY SURGERY ISSUED 6/1/2015 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

Page 67 of 332 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 SURGICAL CRITICAL LICENSE Q8618 REA, FRANCO R, MD 6/1/2016 6/1/2021 SURGERY CARE ISSUED 6/1/2016 None N/A THORACIC CARDIOVASCULAR LICENSE Q6713 TABE, CYRIL ETTA, MD 12/4/2015 12/4/2020 SURGERY GENERAL SURGERY ISSUED 12/4/2015 None N/A S4748 COOPER, WILLIAM, MD 1/24/2020 1/24/2025 THORACIC SURGERY ACTIVE 1/28/2020 None N/A TRANSPLANT LICENSE Q6705 SHEIKH, SAMIA SAJID, MD 12/4/2015 12/4/2020 SURGERY ISSUED 12/4/2015 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

R2527 BALINGER, KATHRYN JULIA, MD 4/20/2017 4/20/2022 TRAUMATIC SURGERY GENERAL SURGERY ACTIVE 5/19/2017 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 R0442 LARSON, NICHOLAS, MD 10/14/2016 10/14/2021 UNSPECIFIED ACTIVE 10/19/2016 None N/A URGENT CARE Q6208 JAVAID, SIMRA, DO 10/1/2015 10/1/2020 MEDICINE ACTIVE 10/19/2015 None N/A LICENSE Q4933 DANFORD, JILL MCHENRY, MD 7/1/2015 7/1/2020 UROGYNECOLOGY GYNECOLOGY ISSUED 7/1/2015 None N/A S5157 DERISAVIFARD, SAMIR, MD 2/21/2020 2/21/2025 UROLOGIC SURGERY UROGYNECOLOGY ACTIVE 3/9/2020 None N/A R2605 GREGG, JUSTIN ROBERT, MD 4/20/2017 4/20/2022 UROLOGIC SURGERY ACTIVE 4/24/2017 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

Q6734 BIGGS, GRACE ANNE YANG, MD 12/15/2015 12/15/2020 UROLOGY UROLOGIC SURGERY ACTIVE 1/12/2016 None N/A

S4934 COCKERILL, KATHERINE JEAN, MD 2/7/2020 2/7/2025 UROLOGY UROLOGIC SURGERY ACTIVE 2/17/2020 None N/A HARRIS, STEPHANIE ELIZABETH, R0410 MD 10/14/2016 10/14/2021 UROLOGY ACTIVE 10/25/2016 None N/A UROLOGIC S4781 HENSLEY, PATRICK JOSEPH, MD 1/24/2020 1/24/2025 UROLOGY ONCOLOGY ACTIVE 2/25/2020 None N/A R2185 NELSON, JONATHAN SCOTT, MD 3/20/2017 3/20/2022 UROLOGY ACTIVE 5/24/2017 None N/A PEDIATRIC LICENSE Q5901 PETERS, CRAIG ANDREW, MD 8/28/2015 8/28/2020 UROLOGY UROLOGY ISSUED 8/28/2015 None N/A DELINQUEN T-NON R5457 QURAISHI, TANYA, MD 12/8/2017 12/8/2022 UROLOGY UROGYNECOLOGY PAYMENT 3/8/2018 None N/A

Page 68 of 332 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

R6086 RODRIGUEZ, DAYRON, MD 2/16/2018 2/16/2023 UROLOGY UROLOGIC SURGERY ACTIVE 2/19/2018 None N/A TRANSPLANT Q4702 TREAT, ERIC GLENN, MD 6/1/2015 6/1/2020 UROLOGY SURGERY ACTIVE 6/4/2015 None N/A VILLARREAL, HUMBERTO LICENSE Q5118 GUADALUPE, MD 7/1/2015 7/1/2020 UROLOGY ISSUED 7/1/2015 None N/A Q5296 VILLEGAS, GUSTAVO V, MD 7/15/2015 7/15/2020 UROLOGY ACTIVE 7/22/2015 None N/A WILLIAMS, RONALD MURPH SR, Q6800 MD 12/15/2015 12/15/2020 UROLOGY ACTIVE 12/17/2015 None N/A UROLOGIC Q8389 WOLDU, SOLOMON LUKASZ, MD 5/16/2016 5/16/2021 UROLOGY ONCOLOGY ACTIVE 5/25/2016 None N/A LICENSE R6316 YI, YOONI, MD 3/2/2018 3/2/2023 UROLOGY ISSUED 3/2/2018 None N/A VASCULAR AND INTERVENTIONAL S4886 THOMPSON, CHAD GLENN, MD 1/24/2020 1/24/2025 RADIOLOGY ACTIVE 2/4/2020 None N/A VASCULAR AND INTERVENTIONAL LICENSE Q5309 ZHANG, KAN, MD 7/15/2015 7/15/2020 RADIOLOGY RADIOLOGY ISSUED 7/15/2015 None N/A DELINQUEN VASCULAR T-NON Q8991 PAR, GEORGE JAMES, MD 7/1/2016 7/1/2021 NEUROLOGY OPHTHALMOLOGY PAYMENT 12/30/2017 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 PRATT, BABAFEMI BABAWANDE , LICENSE Q5072 MD 7/1/2015 7/1/2020 VASCULAR SURGERY ISSUED 7/1/2015 None N/A

R3947 RAHIMI, MAHAM, MD 7/17/2017 7/17/2022 VASCULAR SURGERY ACTIVE 7/24/2017 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 4TH FLOOR, R3745 SALINAS, MEAGEN REBECCA, MD 6/30/2017 6/30/2022 NEUROLOGY SUITE 108 TX ACTIVE 8/14/2017 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 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 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

Page 69 of 332 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 R0381 CROSS, WILLIAM IAN, DO 10/14/2016 10/14/2021 MEDICINE ABILENE TX ACTIVE 10/21/2016 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 EMERGENCY EMERGENCY Q7917 LYON, STEPHEN MICHAEL, DO 4/15/2016 4/15/2021 MEDICINE MEDICINE ABILENE TX ACTIVE 4/26/2016 None N/A OHLENDORF, KATHERINE MARIE, EMERGENCY R0087 MD 9/15/2016 9/15/2021 MEDICINE ABILENE TX ACTIVE 10/3/2016 None N/A EMERGENCY EMERGENCY Q9471 PATEL, PRATIK SHASHIKANT, MD 8/1/2016 8/1/2021 MEDICINE MEDICINE ABILENE TX ACTIVE 8/9/2016 None N/A EMERGENCY Q7458 ROSSETTIE, ANTHONY S, MD 3/4/2016 3/4/2021 MEDICINE ABILENE TX ACTIVE 3/14/2016 None N/A EMERGENCY R1675 WREN, DALE LEE, MD 2/6/2017 2/6/2022 MEDICINE ABILENE TX ACTIVE 2/15/2017 None N/A EMERGENCY R0584 HARPER, LEVI KEITH, MD 10/31/2016 10/31/2021 FAMILY MEDICINE MEDICINE ABILENE TX ACTIVE 1/18/2017 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 HEMATOLOGY/ONCOL R6067 ODO, UGOCHUKWU ADA, MD 2/16/2018 2/16/2023 OGY INTERNAL MEDICINE ABILENE TX ACTIVE 2/19/2018 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 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 R2870 HASSAN, RASHEED , DO 5/5/2017 5/5/2022 INTERNAL MEDICINE HOSPITALIST ABILENE TX ACTIVE 5/24/2017 None N/A R2271 AREITER, ERIC, MD 4/4/2017 4/4/2022 OPHTHALMOLOGY ABILENE TX ACTIVE 6/6/2017 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

CRAWFORD, COURTNEY OPHTHALMOLOGY - Q7173 MAURICE, MD 2/16/2016 2/16/2021 OPHTHALMOLOGY VITREOUS SURGERY ABILENE TX ACTIVE 2/29/2016 None N/A HACOPIAN, ALEXANDER GARNICK, S4962 MD 2/7/2020 2/7/2025 OPHTHALMOLOGY ABILENE TX ACTIVE 2/10/2020 None N/A

OPHTHALMOLOGY - R2020 STEVENS, CLAYTON A, MD 3/3/2017 3/3/2022 OPHTHALMOLOGY ANTERIOR SURGERY ABILENE TX ACTIVE 3/7/2017 None N/A ORTHOPEDIC R2707 PITTS, TODD CHRISTOPHER, MD 4/20/2017 4/20/2022 SURGERY ABILENE TX ACTIVE 6/2/2017 None N/A PHYSICAL MED. & R5226 WICHNER, MONICA HEIDI, DO 11/3/2017 11/3/2022 REHABILITATION ABILENE TX ACTIVE 11/10/2017 None N/A R2766 TIPU, ALI, MD 4/20/2017 4/20/2022 INTERNAL MEDICINE HOSPITALIST ADA OK ACTIVE 5/2/2017 None N/A

Page 70 of 332 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 - R1544 HESS, CHRISTOPHER AARON, MD 2/6/2017 2/6/2022 ANESTHESIOLOGY PAIN MANAGEMENT ADDISON TX ACTIVE 2/13/2017 None N/A UBESIE, KANENECHUKWU Q6716 VIRGINIA, MD 12/4/2015 12/4/2020 GENERAL SURGERY OTHER SPECIALTY ADDISON TX ACTIVE 12/8/2015 None N/A UBESIE, KANENECHUKWU Q6716 VIRGINIA, MD 12/4/2015 12/4/2020 GENERAL SURGERY OTHER SPECIALTY ADDISON TX ACTIVE 12/8/2015 None N/A UBESIE, KANENECHUKWU Q6716 VIRGINIA, MD 12/4/2015 12/4/2020 GENERAL SURGERY OTHER SPECIALTY ADDISON TX ACTIVE 12/8/2015 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 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 N7294 KOLI, ABHIJEET VIJAY, MD 1/5/2018 1/5/2023 CARDIOLOGY INTERNAL MEDICINE AIEA HI ACTIVE 1/19/2018 None N/A EMERGENCY R3584 QUAN, PERRI KAY, MD 6/16/2017 6/16/2022 MEDICINE AIEA HI ACTIVE 7/11/2017 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 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 PEDIATRIC ANESTHESIOLOGY R4748 MISHRA, PRAGNYADIPTA, MD 9/22/2017 9/22/2022 ANESTHESIOLOGY (PEDS) ALBANY NY ACTIVE 9/27/2017 None N/A CARDIOTHORACIC Q7776 RAJA, ASIM-NAZIR, MD 4/1/2016 4/1/2021 ANESTHESIOLOGY ANESTHESIOLOGY ALBANY NY ACTIVE 4/5/2016 None N/A EMERGENCY S5319 BARKLEY, TASHA, MD 3/6/2020 3/6/2025 MEDICINE ALBANY OR ACTIVE 3/25/2020 None N/A EMERGENCY R1638 SEMEIKS, JEREMY RAYMOND, MD 2/6/2017 2/6/2022 MEDICINE ALBANY NY ACTIVE 2/13/2017 None N/A EMERGENCY EMERGENCY Q6715 TAROKH, SAEED, MD 12/4/2015 12/4/2020 MEDICINE MEDICINE ALBANY NY ACTIVE 12/14/2015 None N/A EMERGENCY EMERGENCY Q6715 TAROKH, SAEED, MD 12/4/2015 12/4/2020 MEDICINE MEDICINE ALBANY NY ACTIVE 12/14/2015 None N/A

Q6700 SANUSI, MONISOLA MODUPE, MD 12/4/2015 12/4/2020 FAMILY MEDICINE ALBANY GA ACTIVE 2/11/2016 None N/A

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Q6700 SANUSI, MONISOLA MODUPE, MD 12/4/2015 12/4/2020 FAMILY MEDICINE ALBANY GA ACTIVE 2/11/2016 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 ALLERGY AND ALBUQUERQU R2247 WACHS, RICHARD ALAN, MD 3/20/2017 3/20/2022 IMMUNOLOGY E NM ACTIVE 3/28/2017 None N/A ALBUQUERQU S5057 SAADATZADEH, TIRAJEH, MD 2/7/2020 2/7/2025 HOSPITALIST E NM ACTIVE 3/9/2020 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 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 ALBUQUERQU M4695 ALAS, EDUARDO ARTURO, MD 8/15/2017 8/15/2022 NEPHROLOGY INTERNAL MEDICINE E NM ACTIVE 8/22/2017 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 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 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 R4638 SOTO, NICOLE MARIE, MD 9/8/2017 9/8/2022 DERMATOLOGY ALCOA TN ACTIVE 12/18/2017 None N/A R0436 KODURU, SRILATHA, MD 10/14/2016 10/14/2021 INTERNAL MEDICINE ALEXANDIRA LA ACTIVE 10/26/2016 None N/A SHAKHATREH, MOHAMMED R1291 IBRAHIM, MD 1/6/2017 1/6/2022 INTERNAL MEDICINE ALEXANDRIA LA ACTIVE 1/19/2017 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 NEONATAL- PERINATAL R0417 HUDA, SHEHZAD A, MD 10/14/2016 10/14/2021 PEDIATRICS MEDICINE ALEXANDRIA LA ACTIVE 10/18/2016 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 EMERGENCY EMERGENCY Q5004 KENNY, COLIN MATTHEW, DO 7/1/2015 7/1/2020 MEDICINE MEDICINE ALICE TX ACTIVE 7/3/2015 None N/A EMERGENCY Q8993 PASILLAS, ALBERTO , MD 7/1/2016 7/1/2021 FAMILY MEDICINE MEDICINE ALICE TX ACTIVE 8/11/2016 None N/A EMERGENCY R3012 YU, JAMES ZHENG, MD 5/5/2017 5/5/2022 INTERNAL MEDICINE MEDICINE ALICE TX ACTIVE 5/16/2017 None N/A

Page 72 of 332 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 Q7124 ZHAO, GUOHUA, MD 2/1/2016 2/1/2021 PATHOLOGY (PATHOLOGY) ALISO VIEJO CA ACTIVE 2/3/2016 None N/A Q9552 WHITE, ANDREA M, MD 8/1/2016 8/1/2021 ANESTHESIOLOGY ALLEN TX ACTIVE 8/3/2016 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 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 R3176 PATEL, KSHITIJ, MD 5/22/2017 5/22/2022 ANESTHESIOLOGY PAIN MEDICINE ALLENTOWN PA ACTIVE 8/14/2017 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 OBSTETRICS AND Q7226 LEE, EUNICE, MD 2/16/2016 2/16/2021 GYNECOLOGY ALLENTOWN PA ACTIVE 4/7/2016 None N/A OBSTETRICS AND Q4868 UXER, JENNIFER BETH, DO 6/12/2015 6/12/2020 GYNECOLOGY ALLENTOWN PA ACTIVE 6/18/2015 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 ANATOMIC/CLINICAL Q7082 MILLS, KYLE CHARLES, MD 2/1/2016 2/1/2021 PATHOLOGY DERMOPATHOLOGY ALPHARETTA GA ACTIVE 2/24/2016 None N/A PREVENTIVE K2605 THOMPSON, DONALD, MD 1/5/2018 1/5/2023 FAMILY PRACTICE MEDICINE ALPHARETTA GA ACTIVE 1/23/2018 None N/A R4701 GAROFALO, JAMES H, MD 9/22/2017 9/22/2022 ANESTHESIOLOGY ALTOONA PA ACTIVE 9/28/2017 None N/A Q6483 ZAKY, MAGED MONIR, MD 11/2/2015 11/2/2020 INTERNAL MEDICINE INTERNAL MEDICINE ALTOONA PA ACTIVE 11/4/2015 None N/A R1432 PACHECO, ALEJANDRO, MD 1/20/2017 1/20/2022 FAMILY MEDICINE FAMILY MEDICINE ALTUS OK ACTIVE 2/8/2017 None N/A R2305 CHEN, EUGENE, MD 4/4/2017 4/4/2022 GENERAL SURGERY ALTUS OK ACTIVE 4/10/2017 None N/A MARTINEZ, PRISCILA EMMANUEL, Q9431 MD 8/1/2016 8/1/2021 PEDIATRICS ALVIN TX ACTIVE 8/4/2016 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 R3911 MCKENNY, JAMES ROBERT, MD 7/17/2017 7/17/2022 ANESTHESIOLOGY AMARILLO TX ACTIVE 7/18/2017 None N/A EMERGENCY Q5349 BERRY, MIKE P JR, MD 8/3/2015 8/3/2020 MEDICINE AMARILLO TX ACTIVE 8/14/2015 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 EMERGENCY R3667 FAILES, LORI ELIZABETH, DO 6/30/2017 6/30/2022 MEDICINE AMARILLO TX ACTIVE 7/25/2017 None N/A

Page 73 of 332 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 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 EMERGENCY R3614 VU, THOMAS KHOA, MD 6/16/2017 6/16/2022 MEDICINE AMARILLO TX ACTIVE 6/21/2017 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 Q8008 ANDERSON, SEAN DANIEL, MD 5/2/2016 5/2/2021 FAMILY MEDICINE AMARILLO TX ACTIVE 5/24/2016 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 Q5656 GOMEZ, LAURA , MD 8/14/2015 8/14/2020 FAMILY MEDICINE AMARILLO TX ACTIVE 8/25/2015 None N/A R1846 PEARSON, DAVID M, MD 2/22/2017 2/22/2022 FAMILY MEDICINE AMARILLO TX ACTIVE 3/2/2017 None N/A Q6086 POAGE, FREDERICK DEAN, DO 9/15/2015 9/15/2020 FAMILY MEDICINE AMARILLO TX ACTIVE 9/17/2015 None N/A Q9751 TAUTE, BRITTANY NICOLE, MD 8/15/2016 8/15/2021 FAMILY MEDICINE FAMILY PRACTICE AMARILLO TX ACTIVE 8/17/2016 None N/A R4163 WANG, GRACE CHRISTINE, MD 8/1/2017 8/1/2022 FAMILY MEDICINE AMARILLO TX ACTIVE 8/21/2017 None N/A Q6127 WILHELM, SETH FRANCIS, MD 9/15/2015 9/15/2020 FAMILY MEDICINE AMARILLO TX ACTIVE 9/16/2015 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 GASTROENTEROLOG Q7601 SHEAR, WILLIAM SCOVELL, MD 3/15/2016 3/15/2021 Y INTERNAL MEDICINE AMARILLO TX ACTIVE 3/30/2016 None N/A SEE PREVIOUS Q6687 QUIGLEY, LAJOHN BRADFORD, MD 12/4/2015 12/4/2020 GENERAL SURGERY AMARILLO TX ACTIVE 12/31/2015 ORDER 12/7/2015 SEE PREVIOUS Q6687 QUIGLEY, LAJOHN BRADFORD, MD 12/4/2015 12/4/2020 GENERAL SURGERY AMARILLO TX ACTIVE 12/31/2015 ORDER 12/7/2015 CRITICAL CARE Q6277 SANTOS, ARIEL PABLO, MD 10/1/2015 10/1/2020 GENERAL SURGERY (TRAUMA) AMARILLO TX ACTIVE 10/5/2015 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 R3033 BAZZAZ, OMAR H, MD 5/22/2017 5/22/2022 INTERNAL MEDICINE HOSPITALIST AMARILLO TX ACTIVE 5/29/2017 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 GARRIDO MORALES, JUAN PABLO, Q9613 MD 8/15/2016 8/15/2021 INTERNAL MEDICINE AMARILLO TX ACTIVE 8/16/2016 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 OMER, ABDEL RAHMAN Q8984 ABUOBIEDA, MD 7/1/2016 7/1/2021 INTERNAL MEDICINE AMARILLO TX ACTIVE 7/11/2016 None N/A

Page 74 of 332 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 SULIMAN, ABDELRAZIG BABIKER R5941 SIRAG, MD 2/2/2018 2/2/2023 INTERNAL MEDICINE AMARILLO TX ACTIVE 2/12/2018 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 ORTHOPEDIC SPORTS MEDICINE - R3726 OBROCK, BLAKE ROBERT, DO 6/30/2017 6/30/2022 SURGERY ORTHOPEDICS AMARILLO TX ACTIVE 7/3/2017 None N/A

Q9675 MCLEAN, ROBERT COCHRANE, MD 8/15/2016 8/15/2021 OTOLARYNGOLOGY AMARILLO TX ACTIVE 9/1/2016 None N/A 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

R6140 ABUHANTESH, ALYA HAKAM, MD 3/2/2018 3/2/2023 PEDIATRICS AMARILLO TX ACTIVE 3/13/2018 None N/A Q7831 ANDERSON, RACHEL MAY, MD 4/15/2016 4/15/2021 PEDIATRICS AMARILLO TX ACTIVE 4/21/2016 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 R4092 MATTAMAL, RAPHAEL JOSY, MD 8/1/2017 8/1/2022 PEDIATRICS AMARILLO TX ACTIVE 1/24/2018 None N/A R0518 TURRIE, MATTHEW ROBERT, MD 10/14/2016 10/14/2021 PEDIATRICS AMARILLO TX ACTIVE 10/21/2016 None N/A PEDIATRIC HEMATOLOGY/ONCO R1915 ZAID KAYLANI, SAMER, MD 2/22/2017 2/22/2022 PEDIATRICS LOGY AMARILLO TX ACTIVE 3/2/2017 None N/A PULMONARY CRITICAL CARE Q5530 PATEL, MANISH LALJIBHAI, MD 8/3/2015 8/3/2020 MEDICINE SLEEP MEDICINE AMARILLO TX ACTIVE 8/5/2015 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 SURGICAL Q8465 DOUGHTIE, CATHRYN ANNE, MD 6/1/2016 6/1/2021 ONCOLOGY GENERAL SURGERY AMARILLO TX ACTIVE 6/2/2016 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 THORACIC CARDIOVASCULAR Q6713 TABE, CYRIL ETTA, MD 12/4/2015 12/4/2020 SURGERY GENERAL SURGERY AMARILLO TX ACTIVE 1/4/2016 None N/A THORACIC CARDIOVASCULAR Q6713 TABE, CYRIL ETTA, MD 12/4/2015 12/4/2020 SURGERY GENERAL SURGERY AMARILLO TX ACTIVE 1/4/2016 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

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S5937 JIANG, RUIYANG, MD 4/3/2020 4/3/2025 UROLOGY UROLOGIC SURGERY AMARILLO TX ACTIVE 5/4/2020 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 DIAGNOSTIC S5739 POWERS, KELLY JOHNSON, MD 3/20/2020 3/20/2025 RADIOLOGY ANCHORAGE AK ACTIVE 3/26/2020 None N/A R0376 CHUDHARY, AMARA S, MD 10/14/2016 10/14/2021 PSYCHIATRY ANDERSON SC ACTIVE 10/31/2016 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 EMERGENCY Q9257 TOLES, KARA, MD 7/15/2016 7/15/2021 MEDICINE ANGLETON TX ACTIVE 7/21/2016 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 R1233 LAKHANI, ADNAN, MD 1/6/2017 1/6/2022 INTERNAL MEDICINE HOSPITALIST ANGLETON TX ACTIVE 1/11/2017 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 INTERVENTIONAL Q4685 SAHA, ARNOLD, MD 6/1/2015 6/1/2020 RADIOLOGY RADIOLOGY ANN ARBOR MI ACTIVE 6/2/2015 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 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

Q4708 WILLCOX, NEVENA PAVLOVIC, MD 6/1/2015 6/1/2020 FAMILY MEDICINE ANTIOCH CA ACTIVE 6/16/2015 None N/A HEMATOLOGY/ONCOL R2206 RANDHAWA, JASLEEN KAUR, MD 3/20/2017 3/20/2022 OGY INTERNAL MEDICINE APPLETON WI ACTIVE 3/22/2017 None N/A R1287 SALEM, YASSER SALAH, MD 1/6/2017 1/6/2022 INTERNAL MEDICINE CARDIOLOGY APPLETON WI ACTIVE 1/27/2017 None N/A PULMONARY CRITICAL CARE ARANSAS Q7803 VAKIL, ABHAY, MD 4/1/2016 4/1/2021 INTERNAL MEDICINE MEDICINE PASS TX ACTIVE 5/13/2016 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 PULMONARY CRITICAL CARE ARANSAS R2972 SHERANI, KHALID, MD 5/5/2017 5/5/2022 MEDICINE INTERNAL MEDICINE PASS TX ACTIVE 5/30/2017 None N/A

Page 76 of 332 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

Q8782 ROBERTS, COURTNEY ROME, MD 6/10/2016 6/10/2021 ANESTHESIOLOGY ARDMORE OK ACTIVE 6/20/2016 None N/A INFECTIOUS R3007 WILLIS, JASON LLOYD, MD 5/5/2017 5/5/2022 INTERNAL MEDICINE DISEASES ARDMORE OK ACTIVE 5/9/2017 None N/A CRITICAL CARE AM00146 RIES, MARIANNE CLARE, MD 1/10/2020 1/10/2025 ANESTHESIOLOGY MEDICINE ARLINGTON TX ACTIVE 1/15/2020 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 Q7575 LEE, KIE YUNG, MD 3/15/2016 3/15/2021 MEDICINE ARLINGTON TX ACTIVE 4/1/2016 None N/A EMERGENCY EMERGENCY R2771 TREVIAS, BENJAMIN , MD 4/20/2017 4/20/2022 MEDICINE MEDICINE ARLINGTON TX ACTIVE 4/25/2017 None N/A ENDOCRINOLOGY, SULLER, MARIA RENELA GAMBITO, DIABETES AND Q8651 MD 6/1/2016 6/1/2021 METABOLISM INTERNAL MEDICINE ARLINGTON TX ACTIVE 6/3/2016 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 FOOT AND ANKLE, ORTHOPEDIC S5783 STAL, DREW NATHANIEL, MD 3/20/2020 3/20/2025 ORTHOPEDICS SURGERY ARLINGTON TX ACTIVE 3/30/2020 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 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 S4431 ALI, MONSUR , DO 12/20/2019 12/20/2024 INTERNAL MEDICINE HOSPITALIST ARLINGTON TX ACTIVE 2/6/2020 None N/A Q5363 CAZZANIGA, STEFANO, MD 8/3/2015 8/3/2020 INTERNAL MEDICINE ARLINGTON TX ACTIVE 8/4/2015 None N/A GANGANI, KISHORBHAI R1208 JADAVBHAI, MD 1/6/2017 1/6/2022 INTERNAL MEDICINE ARLINGTON TX ACTIVE 1/27/2017 None N/A S6302 SHARMA, NIPUN, MD 4/17/2020 4/17/2025 INTERNAL MEDICINE ARLINGTON VA ACTIVE 4/21/2020 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

NEONATAL- R3567 NOVAK, ZUZANA EVA, MD 6/16/2017 6/16/2022 PERINATAL MEDICINE ARLINGTON TX ACTIVE 6/20/2017 None N/A R1542 HEIPLE, DREW COURTNEY, MD 2/6/2017 2/6/2022 NEPHROLOGY INTERNAL MEDICINE ARLINGTON TX ACTIVE 2/23/2017 None N/A R1302 SUBEI, ADNAN M, DO 1/6/2017 1/6/2022 NEUROLOGY ARLINGTON TX ACTIVE 3/27/2017 None N/A REPRODUCTIVE RAJ, RENJU SARATHCHANDRA, OBSTETRICS AND ENDOCRINOLOGY R1110 MD 12/16/2016 12/16/2021 GYNECOLOGY AND INFERTILITY ARLINGTON TX ACTIVE 12/21/2016 None N/A

Page 77 of 332 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

S5579 CHINICHIAN, SAHMON DANIEL, DO 3/20/2020 3/20/2025 OPHTHALMOLOGY ARLINGTON TX ACTIVE 3/26/2020 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 ADULT ORTHOPEDIC RECONSTRUCTIVE R0646 RAPURI, VENKAT R, MD 10/31/2016 10/31/2021 SURGERY ORTHOPEDICS ARLINGTON TX ACTIVE 11/4/2016 None N/A PHYSICAL MED. & Q9212 NGUYEN, KENNETH XUAN, DO 7/15/2016 7/15/2021 REHABILITATION PAIN MEDICINE ARLINGTON TX ACTIVE 7/19/2016 None N/A PHYSICAL MED. & R0657 SINGH, RANJEET, MD 10/31/2016 10/31/2021 REHABILITATION ARLINGTON TX ACTIVE 11/1/2016 None N/A S5933 IQBAL, ADNAN, MD 4/3/2020 4/3/2025 PSYCHIATRY ARLINGTON TX ACTIVE 4/6/2020 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 HEMATOLOGY/ONCOL S5666 JAFRI, MOHAMMAD ALI SYED, MD 3/20/2020 3/20/2025 OGY ASHLAND KY ACTIVE 3/31/2020 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 Q7594 PHILLIPS, ALEXIS MICHELE, DO 3/15/2016 3/15/2021 PEDIATRICS ATASCOCITA TX ACTIVE 4/28/2016 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 EMERGENCY Q6605 BATEMAN, JOHN BRIAN, MD 12/4/2015 12/4/2020 MEDICINE ATHENS TX ACTIVE 1/8/2016 None N/A EMERGENCY Q6689 REAVES, JASON SCOTT, MD 12/4/2015 12/4/2020 MEDICINE ATHENS TX ACTIVE 1/28/2016 None N/A EMERGENCY Q6689 REAVES, JASON SCOTT, MD 12/4/2015 12/4/2020 MEDICINE ATHENS TX ACTIVE 1/28/2016 None N/A EMERGENCY H5207 STONER, RICHARD SWOPE, MD 10/15/2015 10/15/2020 MEDICINE ATHENS TX ACTIVE 11/24/2015 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 DIAGNOSTIC S6431 LALAJI, ANAND PANKAJ, MD 5/1/2020 5/1/2025 RADIOLOGY ATLANTA GA ACTIVE 5/14/2020 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 EMERGENCY R3914 MELOY, PATRICK, MD 7/17/2017 7/17/2022 MEDICINE ATLANTA GA ACTIVE 7/27/2017 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 BERNARD, FOLASHADE MODUPE, Q8025 MD 5/2/2016 5/2/2021 INTERNAL MEDICINE ATLANTA GA ACTIVE 5/3/2016 None N/A

Page 78 of 332 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 CRITICAL S5625 GIL, DANNY VELA, MD 3/20/2020 3/20/2025 CARE MEDICINE ATLANTA GA ACTIVE 5/4/2020 None N/A R2009 REZWAN, ANM, MD 3/3/2017 3/3/2022 INTERNAL MEDICINE ATLANTIS FL ACTIVE 3/14/2017 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 R5052 VARGHESE, JASON, MD 10/20/2017 10/20/2022 FAMILY MEDICINE AUGUSTA GA ACTIVE 11/6/2017 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 OBSTETRICS AND S6292 ROSS, MEGAN ELIZABETH, MD 4/17/2020 4/17/2025 GYNECOLOGY AURORA CO ACTIVE 4/24/2020 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 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 R5960 ALVARADO, DAVID EARL, MD 2/16/2018 2/16/2023 ANESTHESIOLOGY PAIN MEDICINE AUSTIN TX ACTIVE 2/22/2018 None N/A 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 CARDIOTHORACIC R1948 EOH, EUN JEONG, MD 3/3/2017 3/3/2022 ANESTHESIOLOGY ANESTHESIOLOGY AUSTIN TX ACTIVE 3/7/2017 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 ANESTHESIOLOGY - S6218 JENG, JEFFREY, MD 4/17/2020 4/17/2025 ANESTHESIOLOGY PAIN MANAGEMENT AUSTIN TX ACTIVE 4/20/2020 None N/A PEDIATRIC ANESTHESIOLOGY S6057 SPECKS, SEBASTIAN, MD 4/3/2020 4/3/2025 ANESTHESIOLOGY (PEDS) AUSTIN TX ACTIVE 4/7/2020 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 S6358 BENZING, TRAVIS ROBERT, MD 5/1/2020 5/1/2025 CARDIOLOGY INTERNAL MEDICINE AUSTIN TX ACTIVE 5/22/2020 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 Q7972 THOMAS, JEROME MATHEW, MD 4/15/2016 4/15/2021 CARDIOLOGY INTERNAL MEDICINE AUSTIN TX ACTIVE 4/22/2016 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

Page 79 of 332 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 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 THORACIC YANG, JONATHAN ALEXANDER, CARDIOVASCULAR CARDIOVASCULAR Q6801 MD 12/15/2015 12/15/2020 SURGERY SURGERY AUSTIN TX ACTIVE 12/21/2015 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

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 S5147 CORREA, MARK ARNOLD, MD 2/21/2020 2/21/2025 DERMATOLOGY AUSTIN TX ACTIVE 3/3/2020 None N/A OBAYAN, OLUBUSAYO KEHINDE, Q5053 MD 7/1/2015 7/1/2020 DERMATOLOGY AUSTIN TX ACTIVE 7/13/2015 None N/A DIAGNOSTIC Q7587 ONYEACHOLEM, IFEANYI C, MD 3/15/2016 3/15/2021 RADIOLOGY BREAST IMAGING AUSTIN TX ACTIVE 3/17/2016 None N/A DIAGNOSTIC R3591 SARAVANAN, ARTHY, MD 6/16/2017 6/16/2022 RADIOLOGY BREAST IMAGING AUSTIN TX ACTIVE 6/20/2017 None N/A DIAGNOSTIC S4685 SHARMA, NIDHI, MD 1/10/2020 1/10/2025 RADIOLOGY AUSTIN TX ACTIVE 1/13/2020 None N/A DIAGNOSTIC R1654 SPIRIDONOV, STANISLAV I, MD 2/6/2017 2/6/2022 RADIOLOGY AUSTIN TX ACTIVE 2/8/2017 None N/A DIAGNOSTIC INTERVENTIONAL R1656 STAHL, COSETTE MARIE, DO 2/6/2017 2/6/2022 RADIOLOGY RADIOLOGY AUSTIN TX ACTIVE 2/9/2017 None N/A DIAGNOSTIC NUCLEAR Q6378 TOBY, JAMES, MD 10/15/2015 10/15/2020 RADIOLOGY RADIOLOGY AUSTIN TX ACTIVE 10/26/2015 None N/A EMERGENCY Q9108 ALDAZ, SEBASTIAN, MD 7/15/2016 7/15/2021 MEDICINE AUSTIN TX ACTIVE 10/4/2016 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 EMERGENCY Q5353 BIRNBAUM, GLENN, MD 8/3/2015 8/3/2020 MEDICINE AUSTIN TX ACTIVE 8/6/2015 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 EMERGENCY R1512 CHERIAN, JUSTIN KORAH, DO 2/6/2017 2/6/2022 MEDICINE AUSTIN TX ACTIVE 3/2/2017 None N/A

Page 80 of 332 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 Q5790 DILLE, RENEE , MD 8/28/2015 8/28/2020 MEDICINE AUSTIN TX ACTIVE 9/3/2015 None N/A EMERGENCY Q4747 DRAGANN, BRENDAN, DO 6/12/2015 6/12/2020 MEDICINE AUSTIN TX ACTIVE 6/17/2015 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 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 EMERGENCY R0017 HAVLICK, JOHN, DO 9/15/2016 9/15/2021 MEDICINE AUSTIN TX ACTIVE 9/16/2016 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 EMERGENCY Q7390 HORTON, RYAN , MD 3/4/2016 3/4/2021 MEDICINE AUSTIN TX ACTIVE 4/4/2016 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 EMERGENCY Q5010 KULP, KARI ANN, MD 7/1/2015 7/1/2020 MEDICINE AUSTIN TX ACTIVE 7/6/2015 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 EMERGENCY R0618 MILLER, AMANDA BARBARA, MD 10/31/2016 10/31/2021 MEDICINE AUSTIN TX ACTIVE 11/3/2016 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 EMERGENCY R0770 NGUYEN, PHUC UYEN, MD 11/15/2016 11/15/2021 MEDICINE AUSTIN TX ACTIVE 11/23/2016 None N/A EMERGENCY EMERGENCY R4766 PICKETT, JASON RAINE, MD 9/22/2017 9/22/2022 MEDICINE MEDICAL SERVICES AUSTIN TX ACTIVE 9/27/2017 None N/A EMERGENCY R0106 RANKIN, JOHN, MD 9/15/2016 9/15/2021 MEDICINE AUSTIN TX ACTIVE 9/27/2016 None N/A EMERGENCY R0311 RIZVI, SABA, MD 9/30/2016 9/30/2021 MEDICINE AUSTIN TX ACTIVE 10/4/2016 None N/A EMERGENCY Q9532 TRUX, CHRISTIAN LEIGH, MD 8/1/2016 8/1/2021 MEDICINE AUSTIN TX ACTIVE 8/22/2016 None N/A

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

Page 81 of 332 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 R1690 ANDAYA, MARO STEPHANIE, MD 2/22/2017 2/22/2022 FAMILY MEDICINE AUSTIN TX ACTIVE 3/7/2017 None N/A Q9117 ATORE, CARLOS , MD 7/15/2016 7/15/2021 FAMILY MEDICINE AUSTIN TX ACTIVE 7/18/2016 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 Q5649 FARDAL, JOHN PATRICK, DO 8/14/2015 8/14/2020 FAMILY MEDICINE AUSTIN TX ACTIVE 8/27/2015 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 S4473 GAO, HUI, MD 12/20/2019 12/20/2024 FAMILY MEDICINE AUSTIN TX ACTIVE 2/3/2020 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 R0775 PALLA, SWAPNA, MD 11/15/2016 11/15/2021 FAMILY MEDICINE AUSTIN TX ACTIVE 12/8/2016 None N/A

R3932 PAPENDIECK, ANDREW DEAN, MD 7/17/2017 7/17/2022 FAMILY MEDICINE FAMILY MEDICINE AUSTIN TX ACTIVE 7/19/2017 None N/A S6275 PARSONS, KAZIA LUCILLE, MD 4/17/2020 4/17/2025 FAMILY MEDICINE AUSTIN TX ACTIVE 5/7/2020 None N/A LICENSE Q5905 PRATT, ADRIANA AZAR, MD 8/28/2015 8/28/2020 FAMILY MEDICINE AUSTIN TX ISSUED 8/28/2015 None N/A

R0494 SCHALSCHA, ALAN GEORGE, DO 10/14/2016 10/14/2021 FAMILY MEDICINE AUSTIN TX ACTIVE 11/21/2016 None N/A STEFANOWICZ, MICHAEL R6294 CHRISTOPHER, DO 3/2/2018 3/2/2023 FAMILY MEDICINE AUSTIN TX ACTIVE 3/7/2018 None N/A R0966 THOMPSON, HEIDI MARIE, MD 12/2/2016 12/2/2021 FAMILY MEDICINE AUSTIN TX ACTIVE 12/9/2016 None N/A S6971 WARTENBERG, DAVID IRA, MD 5/29/2020 5/29/2025 FAMILY MEDICINE AUSTIN TX ACTIVE 6/1/2020 None N/A S6771 WEBB, KACI MARIE, MD 5/15/2020 5/15/2025 FAMILY MEDICINE AUSTIN TX ACTIVE 5/20/2020 None N/A

R4653 ZARNDT, DARLA JEAN ALEACE, DO 9/8/2017 9/8/2022 FAMILY MEDICINE AUSTIN TX ACTIVE 9/18/2017 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 GASTROENTEROLOG R4710 GUNN, NADEGE TACHA, MD 9/22/2017 9/22/2022 Y HEPATOLOGY AUSTIN TX ACTIVE 9/25/2017 None N/A GASTROENTEROLOG S6477 PATEL, RUPAL, MD 5/1/2020 5/1/2025 Y AUSTIN TX ACTIVE 5/5/2020 None N/A GASTROENTEROLOG R1466 TSAI, JOHN KAI-LING, MD 1/20/2017 1/20/2022 Y AUSTIN TX ACTIVE 1/31/2017 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 TRAUMATIC Q6744 DELEON, ASHLEY NICOLE, MD 12/15/2015 12/15/2020 GENERAL SURGERY SURGERY AUSTIN TX ACTIVE 1/19/2016 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

Page 82 of 332 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 R3371 LIROV, ROY, MD 6/2/2017 6/2/2022 GENERAL SURGERY METABOLISM AUSTIN TX ACTIVE 6/8/2017 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

S4361 OLSON, KRISTOFOR AKSAMIT, MD 12/6/2019 12/6/2024 GENERAL SURGERY AUSTIN TX ACTIVE 12/16/2019 None N/A

S4361 OLSON, KRISTOFOR AKSAMIT, MD 12/6/2019 12/6/2024 GENERAL SURGERY AUSTIN TX ACTIVE 12/16/2019 None N/A S5521 WELL, ANDREW MICHAEL, MD 3/6/2020 3/6/2025 GENERAL SURGERY AUSTIN TX ACTIVE 3/9/2020 None N/A 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 GRZANKOWSKI, KASSONDRA GYNECOLOGIC LICENSE S5634 SUZANNE, MD 3/20/2020 3/20/2025 ONCOLOGY GYNECOLOGY AUSTIN TX ISSUED 3/20/2020 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 GYNECOLOGIC Q7907 KUECK, ANGELA, MD 4/15/2016 4/15/2021 ONCOLOGY AUSTIN TX ACTIVE 4/19/2016 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 HUDSON, KATHRYN ELIZABETH, HEMATOLOGY/ONCOL Q7561 MD 3/15/2016 3/15/2021 OGY AUSTIN TX ACTIVE 3/21/2016 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 CHAUDHARY, NABEEL YOUSAF, R0549 MD 10/31/2016 10/31/2021 HOSPITALIST INTERNAL MEDICINE AUSTIN TX ACTIVE 12/8/2016 None N/A MORIATES, CHRISTOPHER PAUL, Q8308 MD 5/16/2016 5/16/2021 HOSPITALIST AUSTIN TX ACTIVE 5/19/2016 None N/A DELINQUEN T-NON R0519 VESTAL, RICHARD ALLEN II, MD 10/14/2016 10/14/2021 HOSPITALIST INTERNAL MEDICINE AUSTIN TX PAYMENT 12/30/2017 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 ADAMS-KRUEGER, ANDREA Q6386 JANENE, MD 11/2/2015 11/2/2020 INTERNAL MEDICINE AUSTIN TX ACTIVE 11/17/2015 None N/A

Page 83 of 332 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 Q6387 AGUIAR, RUDXANDRA, MD 11/2/2015 11/2/2020 INTERNAL MEDICINE AUSTIN TX ACTIVE 11/10/2015 None N/A Q9275 ALEX, ASHA, MD 8/1/2016 8/1/2021 INTERNAL MEDICINE AUSTIN TX ACTIVE 8/10/2016 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 R0194 BHAMA, SAMEEKSHA , MD 9/30/2016 9/30/2021 INTERNAL MEDICINE AUSTIN TX ACTIVE 10/4/2016 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 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 R3650 CIOLETTI, ANNE CARROLL, MD 6/30/2017 6/30/2022 INTERNAL MEDICINE AUSTIN TX ACTIVE 7/18/2017 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 Q6012 GADGIL, MEGHANA, MD 9/15/2015 9/15/2020 INTERNAL MEDICINE HOSPITALIST AUSTIN TX ACTIVE 9/16/2015 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 R5742 HUSSAIN, SAAD YOUSUF, MD 1/19/2018 1/19/2023 INTERNAL MEDICINE AUSTIN TX ACTIVE 3/19/2018 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 R0424 KAHN, ERNEST JAMES, DO 10/14/2016 10/14/2021 INTERNAL MEDICINE AUSTIN TX ACTIVE 10/17/2016 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 R0745 KUANG, AUDREY, MD 11/15/2016 11/15/2021 INTERNAL MEDICINE AUSTIN TX ACTIVE 12/22/2016 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 R1817 MABRY CANTU, CARLYE, MD 2/22/2017 2/22/2022 INTERNAL MEDICINE INTERNAL MEDICINE AUSTIN TX ACTIVE 3/13/2017 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 Q7072 MANN, MICAH DAVID, MD 2/1/2016 2/1/2021 INTERNAL MEDICINE HOSPITALIST AUSTIN TX ACTIVE 2/26/2016 None N/A Q5052 NGUYEN, DUNG DUC-TIEN, MD 7/1/2015 7/1/2020 INTERNAL MEDICINE AUSTIN TX ACTIVE 7/2/2015 None N/A PUBLIC HEALTH/PREVENTIVE MEDICINE R5610 NORWOOD, ALIZA STEINBERG, MD 1/5/2018 1/5/2023 INTERNAL MEDICINE (GENERAL) AUSTIN TX ACTIVE 1/18/2018 None N/A Q8600 PAULSON, QIWEI , MD 6/1/2016 6/1/2021 INTERNAL MEDICINE HOSPITALIST AUSTIN TX ACTIVE 6/13/2016 None N/A

R4620 PIGNONE, MICHAEL PATRICK, MD 9/8/2017 9/8/2022 INTERNAL MEDICINE AUSTIN TX ACTIVE 9/18/2017 None N/A S6288 RAMESH, JANANIE , MD 4/17/2020 4/17/2025 INTERNAL MEDICINE AUSTIN TX ACTIVE 4/29/2020 None N/A R5635 RIAR, JASNEET, MD 1/5/2018 1/5/2023 INTERNAL MEDICINE AUSTIN TX ACTIVE 1/15/2018 None N/A R6270 ROBKIN, ZACHARY, DO 3/2/2018 3/2/2023 INTERNAL MEDICINE AUSTIN TX ACTIVE 3/14/2018 None N/A R1863 SALAZAR, RENE, MD 2/22/2017 2/22/2022 INTERNAL MEDICINE AUSTIN TX ACTIVE 3/6/2017 None N/A R2218 SCLAFANI, JOSEPH JAMES, MD 3/20/2017 3/20/2022 INTERNAL MEDICINE AUSTIN TX ACTIVE 3/28/2017 None N/A S4682 SELINGER, SCOTT, MD 1/10/2020 1/10/2025 INTERNAL MEDICINE AUSTIN TX ACTIVE 3/4/2020 None N/A Q5094 SHAH, NEIL NAYAN, MD 7/1/2015 7/1/2020 INTERNAL MEDICINE HOSPITALIST AUSTIN TX ACTIVE 7/15/2015 None N/A R3750 SHAH, VIVEK, MD 6/30/2017 6/30/2022 INTERNAL MEDICINE AUSTIN TX ACTIVE 9/29/2017 None N/A Q5122 WAIGANJO, NANCY W, MD 7/1/2015 7/1/2020 INTERNAL MEDICINE AUSTIN TX ACTIVE 7/10/2015 None N/A

Page 84 of 332 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 R3253 ZITO, PAUL DAVID, MD 5/22/2017 5/22/2022 INTERNAL MEDICINE AUSTIN TX ACTIVE 6/9/2017 None N/A INTERVENTIONAL S6457 MOSCONA, JOHN, MD 5/1/2020 5/1/2025 CARDIOLOGY AUSTIN TX ACTIVE 5/6/2020 None N/A 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 PASSANANTE, GIOVANNI JAMES, INTERVENTIONAL DIAGNOSTIC R2000 MD 3/3/2017 3/3/2022 RADIOLOGY RADIOLOGY AUSTIN TX ACTIVE 3/8/2017 None N/A MUSCULOSKELETAL DIAGNOSTIC R3009 WOOD, JEFFREY PARK, MD 5/5/2017 5/5/2022 RADIOLOGY RADIOLOGY AUSTIN TX ACTIVE 5/10/2017 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 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

TYLER-KABARA, ELIZABETH NEUROLOGICAL PEDIATRIC SURGERY S5284 CHRISTINE, MD 2/21/2020 2/21/2025 SURGERY (NEUROLOGY) AUSTIN TX ACTIVE 2/27/2020 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 S4931 CHOUCAIR, ALI K, MD 2/7/2020 2/7/2025 NEUROLOGY NEURO-ONCOLOGY AUSTIN TX ACTIVE 2/11/2020 None N/A Q8508 HOAK, DAVID ARNOLD, DO 6/1/2016 6/1/2021 NEUROLOGY AUSTIN TX ACTIVE 6/16/2016 None N/A R2912 LUDT, CAMERON, DO 5/5/2017 5/5/2022 NEUROLOGY AUSTIN TX ACTIVE 5/10/2017 None N/A ROUSSEAU, JUSTIN FREDERICK, R0314 MD 9/30/2016 9/30/2021 NEUROLOGY AUSTIN TX ACTIVE 10/13/2016 None N/A STEFFENSEN, STEPHAN LEWIS II, S6313 MD 4/17/2020 4/17/2025 NEUROLOGY AUSTIN TX ACTIVE 5/1/2020 None N/A

TOVAR QUIROGA, DIEGO FELIPE, CLINICAL Q9061 MD 7/1/2016 7/1/2021 NEUROLOGY NEUROPHYSIOLOGY AUSTIN TX ACTIVE 7/12/2016 None N/A Q8676 WERCHAN, WALTER PAUL, MD 6/1/2016 6/1/2021 NEUROLOGY AUSTIN TX ACTIVE 6/7/2016 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 EMERGENCY/TRAUM R0325 SIMONDS, JUSTIN SCOTT, MD 9/30/2016 9/30/2021 NEURO-RADIOLOGY A RADIOLOGY AUSTIN TX ACTIVE 10/4/2016 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

Page 85 of 332 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 OBSTETRICS AND R1738 DISARRO, AMANDA LYNN, DO 2/22/2017 2/22/2022 SURGERY GYNECOLOGY AUSTIN TX ACTIVE 3/9/2017 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 OBSTETRICS & GYNECOLOGICAL Q7729 KUECK, KATHLEEN DEAN, MD 4/1/2016 4/1/2021 SURGERY AUSTIN TX ACTIVE 4/5/2016 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 OBSTETRICS AND R5865 HALDER, GABRIELA EUGENIA, MD 2/2/2018 2/2/2023 GYNECOLOGY AUSTIN TX ACTIVE 2/12/2018 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 OBSTETRICS AND R2457 ROGERS, REBECCA GLENN, MD 4/4/2017 4/4/2022 GYNECOLOGY UROGYNECOLOGY AUSTIN TX ACTIVE 4/14/2017 None N/A OBSTETRICS AND GYNECOLOGIC R3423 SALAZAR, CHRISTINA ALICIA, MD 6/2/2017 6/2/2022 GYNECOLOGY SURGERY AUSTIN TX ACTIVE 6/6/2017 None N/A OBSTETRICS AND R4918 WHITNEY, MARGARET L, MD 10/6/2017 10/6/2022 GYNECOLOGY AUSTIN TX ACTIVE 11/22/2017 None N/A OPHTHALMOLOGY - R3422 RYG, PETER, MD 6/2/2017 6/2/2022 OPHTHALMOLOGY CORNEA AUSTIN TX ACTIVE 6/28/2017 None N/A

SAULNY, STANLEY MICHAEL JR, OPHTHALMOLOGY - R2216 MD 3/20/2017 3/20/2022 OPHTHALMOLOGY RECONST SURGERY AUSTIN TX ACTIVE 4/5/2017 None N/A OPHTHALMOLOGY - R0432 KHAN, TANYA TABASSUM, MD 10/14/2016 10/14/2021 RECONST SURGERY OPHTHALMOLOGY AUSTIN TX ACTIVE 10/19/2016 None N/A OPHTHALMOLOGY - Q6988 SOMOGYI, MARIE BRENNER, MD 1/15/2016 1/15/2021 RECONST SURGERY AUSTIN TX ACTIVE 1/18/2016 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 ORTHOPEDIC R1692 ANDRAWIS, JOHN PHILIP, MD 2/22/2017 2/22/2022 SURGERY AUSTIN TX ACTIVE 2/28/2017 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 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

Page 86 of 332 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 ORTHOPEDIC RECONSTRUCTIVE Q6953 KOENIG, KARL MARC, MD 1/15/2016 1/15/2021 SURGERY ORTHOPEDICS AUSTIN TX ACTIVE 1/20/2016 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 ORTHOPEDIC Q9501 RODRIGUEZ, JOHN PAUL, MD 8/1/2016 8/1/2021 SURGERY AUSTIN TX ACTIVE 8/12/2016 None N/A ORTHOPEDIC ORTHOPEDIC Q7462 SALDANHA, VILAS, MD 3/4/2016 3/4/2021 TRAUMA SURGERY AUSTIN NV ACTIVE 3/7/2016 None N/A OTOLARYN & FACIAL Q6786 ROY, SUDEEP, MD 12/15/2015 12/15/2020 PLASTIC SURGERY AUSTIN TX ACTIVE 12/17/2015 None N/A R1736 DHARAMSI, LATIF M, MD 2/22/2017 2/22/2022 OTOLARYNGOLOGY AUSTIN TX ACTIVE 5/16/2017 None N/A R2469 SCHWAB, BRIAN, MD 4/4/2017 4/4/2022 OTOLARYNGOLOGY AUSTIN TX ACTIVE 4/12/2017 None N/A OTOLARYNGIC Q5106 TAHERI, KEVIN, MD 7/1/2015 7/1/2020 OTOLARYNGOLOGY ALLERGY AUSTIN TX ACTIVE 7/3/2015 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 NEUHAUSER, THOMAS STEPHAN, HEMATOLOGY R0289 MD 9/30/2016 9/30/2021 PATHOLOGY (PATHOLOGY) AUSTIN TX ACTIVE 4/7/2017 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 PEDIATRIC EMERGENCY Q5972 BAHLING, JOHN, MD 9/15/2015 9/15/2020 MEDICINE (PEDS) AUSTIN TX ACTIVE 12/7/2015 None N/A 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 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 PEDIATRIC EMERGENCY Q8913 IRWIN, WHITNEY WELLBORN, MD 7/1/2016 7/1/2021 MEDICINE (PEDS) AUSTIN TX ACTIVE 7/7/2016 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

Page 87 of 332 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 K2108 REEVES, JOHN JOSEPH, MD 4/15/2016 4/15/2021 MEDICINE (PEDS) PEDIATRICS AUSTIN TX ACTIVE 4/18/2016 None N/A PEDIATRIC FORENSIC R5648 SNYDER, KATHERINE ROSS, MD 1/5/2018 1/5/2023 MEDICINE PEDIATRICS AUSTIN TX ACTIVE 1/29/2018 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 PEDIATRIC Q9809 FENTON, AMBER STURGES, MD 8/26/2016 8/26/2021 OPHTHALMOLOGY AUSTIN TX ACTIVE 11/22/2016 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 PEDIATRIC Q7633 ATTRA, JAMES JOHNATHAN, MD 4/1/2016 4/1/2021 OTOLARYNGOLOGY OTOLARYNGOLOGY AUSTIN TX ACTIVE 4/14/2016 None N/A PEDIATRIC S6310 SMITH, DANIELLE PATRICE, MD 4/17/2020 4/17/2025 OTOLARYNGOLOGY AUSTIN TX ACTIVE 5/20/2020 None N/A PEDIATRIC S5589 COSTE, FERDINAND LOUIS III, DO 3/20/2020 3/20/2025 PULMONOLOGY PEDIATRICS AUSTIN TX ACTIVE 3/27/2020 None N/A PEDIATRIC R4901 SHISHOV, MICHAEL, MD 10/6/2017 10/6/2022 RHEUMATOLOGY AUSTIN TX ACTIVE 10/11/2017 None N/A R1088 NAST, KELLY, MD 12/16/2016 12/16/2021 PEDIATRIC UROLOGY UROLOGY AUSTIN TX ACTIVE 12/26/2016 None N/A

R2272 ARREDONDO, ANTHONY RAY, DO 4/4/2017 4/4/2022 PEDIATRICS AUSTIN TX ACTIVE 6/23/2017 None N/A Q5761 BERNARD, NICOLE LOUISE, MD 8/28/2015 8/28/2020 PEDIATRICS AUSTIN TX ACTIVE 8/31/2015 None N/A S5122 BICKI, ALEXANDRA , MD 2/21/2020 2/21/2025 PEDIATRICS AUSTIN TX ACTIVE 3/6/2020 None N/A S6366 BRAND, KATHRYN ESTHER, MD 5/1/2020 5/1/2025 PEDIATRICS AUSTIN TX ACTIVE 5/18/2020 None N/A S5865 CLARK, BRANDI , MD 4/3/2020 4/3/2025 PEDIATRICS AUSTIN TX ACTIVE 4/16/2020 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 Q7194 GAVVALA, SHEELA LAXMI, DO 2/16/2016 2/16/2021 PEDIATRICS AUSTIN TX ACTIVE 3/2/2016 None N/A R1531 GIBSON, SARA , MD 2/6/2017 2/6/2022 PEDIATRICS AUSTIN TX ACTIVE 2/17/2017 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 R6035 LEBOEUF, BRITNI CENE, MD 2/16/2018 2/16/2023 PEDIATRICS AUSTIN TX ACTIVE 2/19/2018 None N/A R6233 MACLEOD, ERIN CROWLEY, DO 3/2/2018 3/2/2023 PEDIATRICS AUSTIN TX ACTIVE 3/7/2018 None N/A Q7925 MCCLUNG, MEGAN, MD 4/15/2016 4/15/2021 PEDIATRICS AUSTIN TX ACTIVE 4/25/2016 None N/A S5716 NG, CHRISTOPHER , MD 3/20/2020 3/20/2025 PEDIATRICS AUSTIN TX ACTIVE 4/1/2020 None N/A R5796 PETERSON, RYAN PAUL, MD 1/19/2018 1/19/2023 PEDIATRICS AUSTIN TX ACTIVE 3/6/2018 None N/A

Page 88 of 332 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 Q7260 PILLAI, CHANTHU , MD 2/16/2016 2/16/2021 PEDIATRICS METABOLISM AUSTIN TX ACTIVE 2/29/2016 None N/A S5047 PORTER, TIMOTHY JAMES, MD 2/7/2020 2/7/2025 PEDIATRICS AUSTIN TX ACTIVE 2/11/2020 None N/A NEONATAL- PERINATAL R1285 RUDINE, ANTHONY CLARK, MD 1/6/2017 1/6/2022 PEDIATRICS MEDICINE AUSTIN TX ACTIVE 1/11/2017 None N/A Q9020 SANDLIN, KRYSTINE BYRD, MD 7/1/2016 7/1/2021 PEDIATRICS AUSTIN TX ACTIVE 7/7/2016 None N/A Q9027 SCHWARZ, WHITNEY WROE, MD 7/1/2016 7/1/2021 PEDIATRICS AUSTIN TX ACTIVE 7/14/2016 None N/A R0967 TIDWELL, TYSON JENSEN, DO 12/2/2016 12/2/2021 PEDIATRICS AUSTIN TX ACTIVE 12/7/2016 None N/A WITTENBURG, KAREN TORRES, R1910 MD 2/22/2017 2/22/2022 PEDIATRICS AUSTIN TX ACTIVE 3/1/2017 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 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

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 ONG, JON MICHAEL PHYSICAL MED. & S6909 RESURRECCION, MD 5/29/2020 5/29/2025 REHABILITATION AUSTIN TX ACTIVE 6/9/2020 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 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 R4178 ALMEIDA, JORGE, MD 8/15/2017 8/15/2022 PSYCHIATRY AUSTIN TX ACTIVE 8/17/2017 None N/A R1701 BARRON, GRACE CAROLINE, MD 2/22/2017 2/22/2022 PSYCHIATRY AUSTIN TX ACTIVE 3/3/2017 None N/A PEDIATRIC Q5765 BOSE, KINSHUK, MD 8/28/2015 8/28/2020 PSYCHIATRY PSYCHIATRY AUSTIN TX ACTIVE 9/10/2015 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 Q9311 CHAPEL, KATHERINE MARIE, MD 8/1/2016 8/1/2021 PSYCHIATRY AUSTIN TX ACTIVE 10/4/2016 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

Page 89 of 332 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 S4275 CHERLOPALLE, SUNEELA, MD 12/6/2019 12/6/2024 PSYCHIATRY PSYCHIATRY AUSTIN TX ACTIVE 12/23/2019 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 GONZALEZ, VICTOR MANUEL JR, R4707 MD 9/22/2017 9/22/2022 PSYCHIATRY AUSTIN TX ACTIVE 10/9/2017 None N/A R5275 INANO, HEATHER LEE, MD 11/17/2017 11/17/2022 PSYCHIATRY AUSTIN TX ACTIVE 1/9/2018 None N/A PSYCHOSOMATIC Q5201 KEY, RICHARD GARRETT, MD 7/15/2015 7/15/2020 PSYCHIATRY MEDICINE AUSTIN TX ACTIVE 7/17/2015 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 LAWSON, WILLIAM BRADFORD, ADDICTION Q9183 MD 7/15/2016 7/15/2021 PSYCHIATRY PSYCHIATRY AUSTIN TX ACTIVE 7/28/2016 None N/A R3132 LOPEZ, PAMELA ANN, MD 5/22/2017 5/22/2022 PSYCHIATRY AUSTIN TX ACTIVE 6/7/2017 None N/A 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 ADDICTION R0769 NGUYEN, LONG HOANG, MD 11/15/2016 11/15/2021 PSYCHIATRY PSYCHIATRY AUSTIN TX ACTIVE 11/16/2016 None N/A S4390 SHARP, STEVEN JAMES, MD 12/6/2019 12/6/2024 PSYCHIATRY AUSTIN TX ACTIVE 2/6/2020 None N/A S4390 SHARP, STEVEN JAMES, MD 12/6/2019 12/6/2024 PSYCHIATRY AUSTIN TX ACTIVE 2/6/2020 None N/A Q6480 WERCHAN, ISELA ARRIETA, MD 11/2/2015 11/2/2020 PSYCHIATRY AUSTIN TX ACTIVE 11/3/2015 None N/A PULMONARY CRITICAL CARE Q8672 WARNER, MICHAEL BEERS, MD 6/1/2016 6/1/2021 MEDICINE AUSTIN TX ACTIVE 6/22/2016 None N/A R2291 BRUS-RAMER, MARCEL, MD 4/4/2017 4/4/2022 RADIOLOGY AUSTIN TX ACTIVE 4/6/2017 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 REPRODUCTIVE ENDOCRINOLOGY S6714 PROKAI, DAVID , MD 5/15/2020 5/15/2025 AND INFERTILITY AUSTIN TX ACTIVE 6/3/2020 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 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 SURGICAL CRITICAL Q6576 STRONG, MICHELLE LYNNE, MD 11/16/2015 11/16/2020 TRAUMATIC SURGERY CARE AUSTIN TX ACTIVE 11/19/2015 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 Q9222 OSTERBERG, E CHARLES III, MD 7/15/2016 7/15/2021 UROLOGIC SURGERY UROLOGY AUSTIN TX ACTIVE 7/19/2016 None N/A

Page 90 of 332 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 MAZZARELLA, BRIAN CONFREY, R5008 MD 10/20/2017 10/20/2022 UROLOGY AUSTIN TX ACTIVE 11/2/2017 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 SANTUCCI, RICHARD ANTHONY, R5205 MD 11/3/2017 11/3/2022 UROLOGY AUSTIN TX ACTIVE 11/6/2017 None N/A R0159 WOLF, JAMES STUART JR, MD 9/15/2016 9/15/2021 UROLOGY AUSTIN TX ACTIVE 9/19/2016 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 EMERGENCY R2106 GILIBERTO, BRIANNE, DO 3/20/2017 3/20/2022 MEDICINE AZLE TX ACTIVE 3/28/2017 None N/A EMERGENCY S4834 OLESKY, KAYLA, DO 1/24/2020 1/24/2025 MEDICINE AZLE TX ACTIVE 2/3/2020 None N/A DIAGNOSTIC S6515 SHAH, MANJUL, MD 5/1/2020 5/1/2025 RADIOLOGY NEURO-RADIOLOGY BAKERSFIELD CA ACTIVE 5/6/2020 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 BANKOLE, OMOLABAKE R0186 OLORUNTOBILOBA, MD 9/30/2016 9/30/2021 FAMILY MEDICINE BAKERSFIELD CA ACTIVE 10/27/2016 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 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 N2980 CASTILLO KONTAK, LETICIA, MD 8/14/2015 8/14/2020 CARDIOLOGY INTERNAL MEDICINE BALLWIN MO ACTIVE 8/18/2015 None N/A 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 CARDIOVASCULAR R6223 KWON, CHRISTOPHER C, MD 3/2/2018 3/2/2023 SURGERY BALTIMORE MD ACTIVE 3/9/2018 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 RADIATION R5241 BADIYAN, SHAHED NICOLAS, MD 11/17/2017 11/17/2022 ONCOLOGY BALTIMORE MD ACTIVE 1/31/2018 None N/A R1628 ROEHR, JOANNE, DO 2/6/2017 2/6/2022 FAMILY PRACTICE OBSTETRICS BARROW AK ACTIVE 2/8/2017 None N/A HEMATOLOGY/ONCOL S4844 POSNIK, BARTLOMIEJ, MD 1/24/2020 1/24/2025 OGY ONCOLOGY BASTROP TX ACTIVE 1/29/2020 None N/A

Page 91 of 332 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 - R5039 SIDDIQUI, MERAJ, MD 10/20/2017 10/20/2022 PAIN MANAGEMENT PAIN MANAGEMENT BATESVILLE AR ACTIVE 11/2/2017 None N/A

CLINICAL Q6679 PALAC, SUSAN MARY, MD 12/4/2015 12/4/2020 NEUROLOGY NEUROPHYSIOLOGY BATH MI ACTIVE 3/3/2016 None N/A

CLINICAL Q6679 PALAC, SUSAN MARY, MD 12/4/2015 12/4/2020 NEUROLOGY NEUROPHYSIOLOGY BATH MI ACTIVE 3/3/2016 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 EMERGENCY BATON Q9876 PAUL, DILLON WILLIAM, MD 8/26/2016 8/26/2021 MEDICINE ROUGE LA ACTIVE 11/2/2016 None N/A BATON R3247 WILLIAMS, DUSTYN ERIK, MD 5/22/2017 5/22/2022 INTERNAL MEDICINE ROUGE LA ACTIVE 7/27/2017 None N/A S4861 SATTAR, ABDUL, MD 1/24/2020 1/24/2025 HOSPITALIST INTERNAL MEDICINE BAY SHORE NY ACTIVE 3/30/2020 None N/A CRITICAL CARE R2960 SAFIYEH, MAJED FATHI, MD 5/5/2017 5/5/2022 INTERNAL MEDICINE MEDICINE (IM) BAY TOWN TX ACTIVE 5/8/2017 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 EMERGENCY Q9456 NORINSKY, ALEXANDER, DO 8/1/2016 8/1/2021 MEDICINE BAYTOWN TX ACTIVE 8/3/2016 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 Q5964 ANABOR, OMEGIE LINDA, MD 9/15/2015 9/15/2020 FAMILY MEDICINE BAYTOWN TX ACTIVE 11/2/2015 None N/A Q9994 FLORES, ELEAZAR , MD 9/15/2016 9/15/2021 FAMILY MEDICINE BAYTOWN TX ACTIVE 9/16/2016 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 R0209 CHOI, LAURA HARGIE, MD 9/30/2016 9/30/2021 GENERAL SURGERY BAYTOWN TX ACTIVE 10/5/2016 None N/A Q8368 THALER, KLAUS, MD 5/16/2016 5/16/2021 GENERAL SURGERY BAYTOWN TX ACTIVE 5/25/2016 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 R0333 GANDHIR, ANKITA, MD 9/30/2016 9/30/2021 NEPHROLOGY INTERNAL MEDICINE BAYTOWN TX ACTIVE 10/3/2016 None N/A WAGNER, JENNIFER KATHLEEN, ORTHOPEDIC R2248 MD 3/20/2017 3/20/2022 SURGERY HAND SURGERY BAYTOWN TX ACTIVE 4/11/2017 None N/A Q6906 SHAH, ARPITA, MD 1/6/2016 1/6/2021 PEDIATRICS PEDIATRICS BAYTOWN TX ACTIVE 1/7/2016 None N/A PULMONARY CRITICAL CARE Q9696 NGUYEN, THIEN AN, MD 8/15/2016 8/15/2021 MEDICINE INTERNAL MEDICINE BAYTOWN TX ACTIVE 8/31/2016 None N/A R0798 TITTLE, SHAWN, MD 11/15/2016 11/15/2021 THORACIC SURGERY BAYTOWN TX ACTIVE 12/8/2016 None N/A Q6119 TOJUOLA, OLUBAYO D, MD 9/15/2015 9/15/2020 UROLOGY BAYTOWN TX ACTIVE 9/17/2015 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 R2873 HINES, CLAYTON ROBERT, MD 5/5/2017 5/5/2022 ANESTHESIOLOGY BEAUMONT TX ACTIVE 5/8/2017 None N/A

Page 92 of 332 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 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 EMERGENCY S6568 AUGILLARD, ALLAN, MD 5/15/2020 5/15/2025 MEDICINE BEAUMONT TX ACTIVE 5/18/2020 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 EMERGENCY Q8845 CARINO, CHARLES, DO 7/1/2016 7/1/2021 MEDICINE BEAUMONT TX ACTIVE 7/7/2016 None N/A EMERGENCY Q9807 ELLIS, NICOLAS, MD 8/26/2016 8/26/2021 MEDICINE BEAUMONT TX ACTIVE 9/19/2016 None N/A EMERGENCY Q7191 FLEMING, MICHAEL JAMES, MD 2/16/2016 2/16/2021 MEDICINE BEAUMONT TX ACTIVE 3/14/2016 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 EMERGENCY ADDICTION R4627 ROGALA, CAROL ANN, DO 9/8/2017 9/8/2022 MEDICINE MEDICINE BEAUMONT CA ACTIVE 9/13/2017 None N/A R2491 TASNEEM, NUZHATH, MD 4/4/2017 4/4/2022 FAMILY PRACTICE BEAUMONT TX ACTIVE 6/27/2017 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 OBSTETRICS AND Q5511 NESBITT, SHAYLA, MD 8/3/2015 8/3/2020 GYNECOLOGY BEAUMONT TX ACTIVE 8/14/2015 None N/A SEE OBSTETRICS AND PREVIOUS R4498 WEST, HENRY EARL, MD 8/25/2017 8/25/2022 GYNECOLOGY BEAUMONT TN ACTIVE 9/14/2017 ORDER 2/19/2018 Q9196 MEAUX, CRAIG JR, MD 7/15/2016 7/15/2021 OPHTHALMOLOGY BEAUMONT TX ACTIVE 7/25/2016 None N/A 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 CARDIAC ELECTROPHYSIOLOG M5696 EIFLING, MICHAEL DENNIS, MD 1/19/2018 1/19/2023 Y CARDIOLOGY BEDFORD TX ACTIVE 1/29/2018 None N/A GERIATRIC MEDICINE (FAMILY R2228 SIRAM, RAMCHANDRA, MD 3/20/2017 3/20/2022 FAMILY MEDICINE PRACTICE) BEDFORD TX ACTIVE 4/10/2017 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 INTERVENTIONAL Q5948 VIDI, VENKATESAN DYANESH, MD 8/28/2015 8/28/2020 CARDIOLOGY CARDIOLOGY BEDFORD TX ACTIVE 8/31/2015 None N/A Q5550 ROJAS, ANA MARIA, MD 8/3/2015 8/3/2020 ONCOLOGY BEDFORD TX ACTIVE 8/5/2015 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

Page 93 of 332 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 Q9414 LEE, YVONNE, MD 8/1/2016 8/1/2021 OTOLARYNGOLOGY BEDFORD TX ACTIVE 8/11/2016 None N/A PULMONARY CRITICAL CARE R0167 ZAIZAFOUN, MANAF , MD 9/15/2016 9/15/2021 MEDICINE INTERNAL MEDICINE BEDFORD OH ACTIVE 10/3/2016 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 EMERGENCY R5886 LEE, PHOEBE, MD 2/2/2018 2/2/2023 MEDICINE BELLAIRE TX ACTIVE 2/6/2018 None N/A EMERGENCY Q7800 TOWNS, JACOB SCOTT, MD 4/1/2016 4/1/2021 MEDICINE BELLAIRE TX ACTIVE 4/26/2016 None N/A R2231 SOWARDS, KENDELL , MD 3/20/2017 3/20/2022 GENERAL SURGERY BELLAIRE TX ACTIVE 3/24/2017 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 MERCHANT, DELWIN SHELDON, EMERGENCY Q7747 MD 4/1/2016 4/1/2021 MEDICINE BELLEVILLE IL ACTIVE 4/13/2016 None N/A R4043 FRENCH, TRACI, MD 8/1/2017 8/1/2022 FAMILY PRACTICE BELTON TX ACTIVE 8/9/2017 None N/A R3988 AHUJA, SHONA, MD 8/1/2017 8/1/2022 INTERNAL MEDICINE BELTON TX ACTIVE 8/9/2017 None N/A SCHWINDT, MITCHEL GERARD, EMERGENCY R0123 MD 9/15/2016 9/15/2021 MEDICINE BEMIDJI MN ACTIVE 9/20/2016 None N/A EMERGENCY R4913 TREUER, MICAH RICHARD, MD 10/6/2017 10/6/2022 MEDICINE BEMIDJI MN ACTIVE 12/18/2017 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 R4392 GEORGIEV, ANTON L, DO 8/25/2017 8/25/2022 GENERAL SURGERY BERWICK PA ACTIVE 9/11/2017 None N/A Q7977 VATHIKULAM, JENCY PAULY, DO 4/15/2016 4/15/2021 FAMILY MEDICINE BERWYN IL ACTIVE 4/26/2016 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 S5009 MANI, ANNE ELIZABETH, MD 2/7/2020 2/7/2025 CARDIOLOGY INTERNAL MEDICINE BETHLEHEM PA ACTIVE 2/17/2020 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 R5605 NAMBIAR, UMA EDAYLLAM, MD 1/5/2018 1/5/2023 PEDIATRICS BETHLEHEM PA ACTIVE 1/8/2018 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 JOSEPH, RACHAEL ANN MELISSA, R1228 MD 1/6/2017 1/6/2022 INTERNAL MEDICINE HOSPITALIST BIDDESFORD ME ACTIVE 1/9/2017 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

Page 94 of 332 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

Q7214 JOSEPH, GEORGE MALIAKKAL, MD 2/16/2016 2/16/2021 OPHTHALMOLOGY BIG SPRING TX ACTIVE 3/8/2016 None N/A BIG STONE R0973 VU, EDMUND , DO 12/2/2016 12/2/2021 FAMILY MEDICINE GAP VA ACTIVE 12/5/2016 None N/A WILLIAMS, CHRISTOPHER DIRK, GASTROENTEROLOG R1321 MD 1/6/2017 1/6/2022 Y BILLINGS MT ACTIVE 1/12/2017 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

Q6807 ASIKAIWE, CHIMA NATHANIEL, MD 1/6/2016 1/6/2021 PSYCHIATRY BINGHAMTON NY ACTIVE 1/18/2016 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 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 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 DIAGNOSTIC S4438 AZIZ, MUHAMMAD USMAN, MD 12/20/2019 12/20/2024 RADIOLOGY BIRMINGHAM AL ACTIVE 1/21/2020 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 EMERGENCY Q8297 MANGEL, RYAN SEAN, MD 5/16/2016 5/16/2021 MEDICINE FAMILY MEDICINE BIRMINGHAM AL ACTIVE 5/19/2016 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 Q8335 RICKERT, PAUL J, MD 5/16/2016 5/16/2021 INTERNAL MEDICINE BIRMINGHAM AL ACTIVE 5/23/2016 None N/A Q8639 SHIRAH, WILLIAM BRADLEY, MD 6/1/2016 6/1/2021 INTERNAL MEDICINE BIRMINGHAM AL ACTIVE 6/10/2016 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 R2214 SANCHES, MARSAL , MD 3/20/2017 3/20/2022 PSYCHIATRY BISMARCK ND ACTIVE 4/3/2017 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 INTERVENTIONAL BLOOMINGTO R0496 SENAPATHI, MURALI KRISHNA, MD 10/14/2016 10/14/2021 INTERNAL MEDICINE CARDIOLOGY N IN ACTIVE 4/13/2017 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 Q6045 KHAN, RAO ALI HASHIM, MD 9/15/2015 9/15/2020 NEPHROLOGY INTERNAL MEDICINE BLUEFIELD WV ACTIVE 11/16/2015 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 95 of 332 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 R1012 DEAKTER, DANIEL ROBERT, MD 12/16/2016 12/16/2021 MEDICINE BOCA RATON FL ACTIVE 12/21/2016 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 Q5487 MCINTOSH, G ANDREW, MD 8/3/2015 8/3/2020 FAMILY MEDICINE BOERNE TX ACTIVE 8/4/2015 None N/A R3411 RIOJAS, LARISSA NYVIA, DO 6/2/2017 6/2/2022 FAMILY MEDICINE BOERNE TX ACTIVE 7/17/2017 None N/A RODRIGUEZ PEREZ, VIRGEN M, Q9015 MD 7/1/2016 7/1/2021 FAMILY PRACTICE BOERNE TX ACTIVE 7/28/2016 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 Q7401 KAMPE, DORIS, MD 3/4/2016 3/4/2021 INTERNAL MEDICINE BOLIVIA NC ACTIVE 4/20/2016 None N/A Q9816 GARAY, RAUL, MD 8/26/2016 8/26/2021 FAMILY MEDICINE BONHAM TX ACTIVE 9/13/2016 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 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 OBSTETRICS AND R0071 MARK, ALICE GRACE, MD 9/15/2016 9/15/2021 GYNECOLOGY BOSTON MA ACTIVE 9/26/2016 None N/A S5223 MCADAMS, JILLIAN, MD 2/21/2020 2/21/2025 PEDIATRICS BOSTON MA ACTIVE 2/26/2020 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 DIAGNOSTIC S7157 WILLIS, ANTHONY J, MD 6/12/2020 6/12/2025 RADIOLOGY BOTHELL WA ACTIVE 6/16/2020 None N/A S5289 WALLEN, JARED JOHN, MD 2/21/2020 2/21/2025 UROLOGIC SURGERY BRANDON FL ACTIVE 3/11/2020 None N/A ENDOCRINOLOGY, TIRUMALASETTY, NAGA NALINI, DIABETES AND R5048 MD 10/20/2017 10/20/2022 METABOLISM INTERNAL MEDICINE BRANSON MO ACTIVE 10/30/2017 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 BRECKENRID R4651 WINDSOR, KELLI ANN, DO 9/8/2017 9/8/2022 FAMILY MEDICINE GE TX ACTIVE 9/11/2017 None N/A P8671 GRAY, CHRISTOPHER, MD 3/20/2020 3/20/2025 FAMILY PRACTICE BRENHAM TX ACTIVE 4/16/2020 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 INTERNAL MED - INTERNAL MED - R1154 YABUT, EDMOND PALACIOS, MD 12/16/2016 12/16/2021 EMERGENCY MED PEDS BRENTWOOD TN ACTIVE 12/26/2016 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

Page 96 of 332 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 R1250 MISRA, SUTANU, MD 1/6/2017 1/6/2022 ANESTHESIOLOGY BRIDGEPORT WV ACTIVE 1/17/2017 None N/A NWADIKE, VINCENTIA CHINEME, Q6673 MD 12/4/2015 12/4/2020 INTERNAL MEDICINE BRIDGEPORT CT ACTIVE 12/17/2015 None N/A NWADIKE, VINCENTIA CHINEME, Q6673 MD 12/4/2015 12/4/2020 INTERNAL MEDICINE BRIDGEPORT CT ACTIVE 12/17/2015 None N/A R1640 SEYE, ASTOU, MD 2/6/2017 2/6/2022 INTERNAL MEDICINE BRIDGEPORT CT ACTIVE 3/1/2017 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 Q6140 ALI, SYED IRFAN QASIM, MD 10/1/2015 10/1/2020 ANESTHESIOLOGY FAMILY MEDICINE BROCKTON MA ACTIVE 10/5/2015 None N/A EMERGENCY R0299 PLANTE, TROILUS ANTHONY, MD 9/30/2016 9/30/2021 MEDICINE BROCKTON MA ACTIVE 10/4/2016 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 S5308 ALI, NISHA NIZAR, MD 3/6/2020 3/6/2025 INTERNAL MEDICINE BRONX NY ACTIVE 3/18/2020 None N/A Q7553 GARREPALLI, SWAPNA, MD 3/15/2016 3/15/2021 INTERNAL MEDICINE BRONX NY ACTIVE 3/21/2016 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 OBSTETRICS & GYNECOLOGICAL S4879 TAKO, ERNEST AYUK, MD 1/24/2020 1/24/2025 SURGERY BRONX NY ACTIVE 2/20/2020 None N/A PEDIATRIC PEDIATRIC GASTROENTEROLOG GASTROENTEROLOG Q4672 RAJ, PRIYA, MD 6/1/2015 6/1/2020 Y Y BRONX NY ACTIVE 6/4/2015 None N/A NAVARRO GARZA, EDGAR NOE, R2688 MD 4/20/2017 4/20/2022 PEDIATRICS BRONX NY ACTIVE 4/25/2017 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 PULMONARY CRITICAL CARE R2037 ADRISH, MUHAMMAD, MD 3/20/2017 3/20/2022 MEDICINE BRONX NY ACTIVE 3/21/2017 None N/A TAWADROUS, ZAKARIA SOLIMAN, R2759 MD 4/20/2017 4/20/2022 INTERNAL MEDICINE BROOKFIELD WI ACTIVE 5/15/2017 None N/A EMERGENCY R5179 PATEL, KETAN HASMUKHLAL, MD 11/3/2017 11/3/2022 MEDICINE BROOKLYN NY ACTIVE 11/6/2017 None N/A EMERGENCY S4674 ROCKOFF, BRADLEY IAN, MD 1/10/2020 1/10/2025 MEDICINE BROOKLYN NY ACTIVE 2/6/2020 None N/A EMERGENCY Q8183 WEN, WENDY, MD 5/2/2016 5/2/2021 MEDICINE BROOKLYN NY ACTIVE 5/9/2016 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

Page 97 of 332 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

R3258 AL-LAMI, MUSTAFA S KHODER, MD 6/2/2017 6/2/2022 INTERNAL MEDICINE BROOKLYN NY ACTIVE 6/26/2017 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 R5709 CHEMTOB, JOSEF, MD 1/19/2018 1/19/2023 INTERNAL MEDICINE HOSPITALIST BROOKLYN NY ACTIVE 1/25/2018 None N/A S6178 FORSON, JENIFFER, MD 4/17/2020 4/17/2025 PEDIATRICS BROOKLYN NY ACTIVE 5/11/2020 None N/A RADIATION S4594 ANSARI, SOBIYA, MD 1/10/2020 1/10/2025 ONCOLOGY BROOKLYN NY ACTIVE 1/22/2020 None N/A

S6445 MANGINANI, SRIDEVI, MD 5/1/2020 5/1/2025 INTERNAL MEDICINE BROOKSVILLE FL ACTIVE 5/6/2020 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 BROWNSVILL R4080 KU, CHRISTINE W, DO 8/1/2017 8/1/2022 DERMATOLOGY E TX ACTIVE 8/3/2017 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 NEUROMUSCULOSK FAMILY ELETAL BROWNSVILL Q5555 SAAVEDRA, TERESA GAIL, DO 8/3/2015 8/3/2020 PRACTICE/OMM MEDICINE/OMT E TX ACTIVE 8/6/2015 None N/A BROWNSVILL R0326 SIYANBADE, OYETUNDE, MD 9/30/2016 9/30/2021 GENERAL SURGERY E TX ACTIVE 12/29/2016 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 BROWNSVILL R0040 KELLEY, SALLY ANN, MD 9/15/2016 9/15/2021 PALLIATIVE MEDICINE E TX ACTIVE 10/11/2016 None N/A BROWNSVILL R6026 JAVAID, SHAHID, MD 2/16/2018 2/16/2023 PEDIATRICS E TX ACTIVE 2/26/2018 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 ANATOMIC/CLINICAL R5261 FAJARDO, DANIEL ADRIAN, MD 11/17/2017 11/17/2022 PATHOLOGY BRUNSWICK GA ACTIVE 11/21/2017 None N/A DERMATOPATHOLO R5029 RADU, OANA MIHAELA, MD 10/20/2017 10/20/2022 PATHOLOGY GY BRUNSWICK GA ACTIVE 11/10/2017 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 EMERGENCY R5561 GRIGORYAN, GAYANA, DO 1/5/2018 1/5/2023 MEDICINE BRYAN TX ACTIVE 1/16/2018 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 Q9324 COTTER, JILL , DO 8/1/2016 8/1/2021 FAMILY MEDICINE OBSTETRICS BRYAN TX ACTIVE 8/9/2016 None N/A

Page 98 of 332 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 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 R4221 FRAKES, MARK WAYNE, MD 8/15/2017 8/15/2022 FAMILY MEDICINE BRYAN TX ACTIVE 8/24/2017 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 R0244 HANSEN, LAURA WORTH, DO 9/30/2016 9/30/2021 FAMILY MEDICINE BRYAN TX ACTIVE 10/4/2016 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 Q6049 KNAPP, ERIC FARQUIS, MD 9/15/2015 9/15/2020 FAMILY MEDICINE BRYAN TX ACTIVE 9/17/2015 None N/A KRAUSE-CASTANEDA, JULIA R0050 SHAE, MD 9/15/2016 9/15/2021 FAMILY MEDICINE OBSTETRICS BRYAN TX ACTIVE 9/28/2016 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 S4655 MCGEHEE, HANNA BRADEN, MD 1/10/2020 1/10/2025 FAMILY MEDICINE OBSTETRICS BRYAN TX ACTIVE 1/13/2020 None N/A Q5916 REINKE, TESSA , MD 8/28/2015 8/28/2020 FAMILY MEDICINE BRYAN TX ACTIVE 9/2/2015 None N/A Q8642 SIRUCEK, JOSH KENNETH, DO 6/1/2016 6/1/2021 FAMILY MEDICINE BRYAN TX ACTIVE 6/7/2016 None N/A SPORTS MEDICINE Q5286 STATLER, ROBERT DOUGLAS, DO 7/15/2015 7/15/2020 FAMILY MEDICINE (FAMILY PRACTICE) BRYAN TX ACTIVE 7/27/2015 None N/A R4331 TAYLOR, BRANDON KYLE, MD 8/15/2017 8/15/2022 FAMILY MEDICINE BRYAN TX ACTIVE 8/16/2017 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 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 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 ORTHOPEDIC R2461 ROWLAND, GRANT MARSHALL, MD 4/4/2017 4/4/2022 SURGERY SPORTS MEDICINE BRYAN TX ACTIVE 4/28/2017 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 ROLAND, RANDALL KWARTENG, R5637 DO 1/5/2018 1/5/2023 INTERNAL MEDICINE BRYANT TX ACTIVE 1/16/2018 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 R0840 BHALLA, AMARPREET, MD 12/2/2016 12/2/2021 PATHOLOGY CYTOPATHOLOGY BUFFALO NY ACTIVE 2/27/2017 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 Q5048 MURTHY, KENTON KUMAR, DO 7/1/2015 7/1/2020 FAMILY MEDICINE BURLESON TX ACTIVE 7/7/2015 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 OLINDE, ALLISON ELISABETH Q8765 TATUM, MD 6/10/2016 6/10/2021 INTERNAL MEDICINE HOSPITALIST BURLESON TX ACTIVE 6/13/2016 None N/A Q8315 OLINDE, JUSTIN BRANDT, MD 5/16/2016 5/16/2021 INTERNAL MEDICINE HOSPITALIST BURLESON TX ACTIVE 5/18/2016 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

Page 99 of 332 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 R5043 SUNGUROV, MAXIM, MD 10/20/2017 10/20/2022 INTERNAL MEDICINE HOSPITALIST CAMDEN NJ PAYMENT 1/18/2018 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 DINASARAPU, CHANDRASEKHAR Q6409 REDDY, MD 11/2/2015 11/2/2020 INTERNAL MEDICINE HOSPITALIST CAMP HILL PA ACTIVE 11/9/2015 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 ORTHOPEDIC CAMP R5612 OFOBIKE, EMEKA OKEY JR, MD 1/5/2018 1/5/2023 SURGERY PENDLETON CA ACTIVE 1/8/2018 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 THORACIC CARDIOVASCULAR R2760 TAWIL, MARK T, MD 4/20/2017 4/20/2022 SURGERY CANTON OH ACTIVE 4/24/2017 None N/A S5016 MCGILVERY, TARYN NICOLE, MD 2/7/2020 2/7/2025 FAMILY MEDICINE CANYON TX ACTIVE 4/6/2020 None N/A CAPE Q6584 THOMAS, REENA, MD 11/16/2015 11/16/2020 INTERNAL MEDICINE GIRARDEAU MO ACTIVE 11/17/2015 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 FALEBITA, OLUWATOYIN TOLANI, CARRIZO Q5648 MD 8/14/2015 8/14/2020 FAMILY MEDICINE SPRING TX ACTIVE 8/24/2015 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 BHUVA, DARPAN GIRISHKUMAR, S5324 MD 3/6/2020 3/6/2025 HOSPITALIST CARROLLTON GA ACTIVE 5/15/2020 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 CARTERSVILL Q9262 VEGIRAJU, THAMMI RAJU, MD 7/15/2016 7/15/2021 INTERNAL MEDICINE E GA ACTIVE 7/25/2016 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 S6490 RANGEL, JOSEPH , DO 5/1/2020 5/1/2025 PEDIATRICS CASTROVILLE TX ACTIVE 6/5/2020 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 R2428 NOBLE, WILLIAM PAUL II, MD 4/4/2017 4/4/2022 FAMILY MEDICINE CEDAR PARK TX ACTIVE 5/15/2017 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 Q8487 GODARA, POOJA, MD 6/1/2016 6/1/2021 OPHTHALMOLOGY CEDAR PARK TX ACTIVE 6/6/2016 None N/A

Page 100 of 332 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 R4968 GIVNER, SARAH, MD 10/20/2017 10/20/2022 PEDIATRICS CEDAR PARK TX ACTIVE 12/7/2017 None N/A Q8978 NICK, BRENT GERARD, MD 7/1/2016 7/1/2021 PEDIATRICS CEDAR PARK TX ACTIVE 7/6/2016 None N/A SURGICAL BREAST SURGICAL BREAST R3390 OBRIEN, BRIDGET ANNE, DO 6/2/2017 6/2/2022 ONCOLOGY ONCOLOGY CEDAR PARK TX ACTIVE 6/7/2017 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 CEDAR Q6804 ADEPOJU, OLUWAROTIMI , MD 1/6/2016 1/6/2021 PEDIATRICS RAPIDS IA ACTIVE 3/3/2016 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 ANESTHESIOLOGY - CHAMBERSBU Q8893 GLINIANSKI, MICHAL, MD 7/1/2016 7/1/2021 ANESTHESIOLOGY PAIN MANAGEMENT RG PA ACTIVE 8/31/2016 None N/A ANESTHESIOLOGY - CHAMBERSBU Q9041 SIDOR, MALGORZATA, MD 7/1/2016 7/1/2021 ANESTHESIOLOGY PAIN MANAGEMENT RG PA ACTIVE 8/31/2016 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

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 R5977 BOYARS, LISA MAE, MD 2/16/2018 2/16/2023 PSYCHIATRY CHARLESTON SC ACTIVE 2/20/2018 None N/A WOODARD, WILLIAM LEICESTER Q6481 JR, MD 11/2/2015 11/2/2020 RADIOLOGY NEURO-RADIOLOGY CHARLESTON SC ACTIVE 11/4/2015 None N/A EMERGENCY R0809 WATSON, LEONYSIA, MD 11/15/2016 11/15/2021 MEDICINE CHARLOTTE NC ACTIVE 11/18/2016 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

NEURO-PHYSIOLOGY R5321 SINGH, RAJDEEP, MD 11/17/2017 11/17/2022 NEUROLOGY (NEUROLOGY) CHARLOTTE NC ACTIVE 12/11/2017 None N/A 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 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 CHATTANOOG R5432 MICHAELIS, NANCY GADAMS, MD 12/8/2017 12/8/2022 INTERNAL MEDICINE HOSPITALIST A TN ACTIVE 1/1/2018 None N/A

Page 101 of 332 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 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 S5171 GOLI, HIMAN, MD 2/21/2020 2/21/2025 INTERNAL MEDICINE HOSPITALIST CHEVERLY MD ACTIVE 6/8/2020 None N/A PEDIATRIC ANESTHESIOLOGY Q7096 PANJWANI, ANJANA SAHANI, MD 2/1/2016 2/1/2021 ANESTHESIOLOGY (PEDS) CHICAGO IL ACTIVE 2/9/2016 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 S5231 MYERS, GRIFFIN ROBERT, MD 2/21/2020 2/21/2025 MEDICINE CHICAGO IL ACTIVE 3/5/2020 None N/A EMERGENCY R2777 VILLALBA, MARTHA, MD 4/20/2017 4/20/2022 MEDICINE CHICAGO IL ACTIVE 4/28/2017 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 R6139 ABDELSALAM, AHMED, MD 3/2/2018 3/2/2023 INTERNAL MEDICINE OPHTHALMOLOGY CHICAGO IL ACTIVE 3/9/2018 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 R3101 HINES, VALERIE CRISTINA, MD 5/22/2017 5/22/2022 PEDIATRICS CHICAGO IL ACTIVE 6/2/2017 None N/A PHYSICAL MED. & S6485 RABI, JOSEPH, MD 5/1/2020 5/1/2025 REHABILITATION PAIN MANAGEMENT CHICAGO IL ACTIVE 5/22/2020 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 VASCULAR AND INTERVENTIONAL R1116 REZAI, PEDRAM, MD 12/16/2016 12/16/2021 RADIOLOGY RADIOLOGY CHICAGO IL ACTIVE 12/28/2016 None N/A R1295 SIDDIQUI, MARIAM AYSHA, MD 1/6/2017 1/6/2022 RHEUMATOLOGY CHICAGO IL ACTIVE 3/20/2017 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 H0333 ESSEX, THOMAS W, DO 2/21/2020 2/21/2025 INTERNAL MEDICINE CHICKASHA OK ACTIVE 2/25/2020 None N/A CARDIO- INTERVENTIONAL N4863 YHIP, JAMES PETER ANDREW, MD 5/1/2020 5/1/2025 RADIOLOGY CARDIOLOGY CHICO CA ACTIVE 5/4/2020 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 CARDIO- INTERVENTIONAL R0527 AHMAD, SAAD SAIFUDDIN, MD 10/31/2016 10/31/2021 RADIOLOGY CARDIOLOGY CINCINNATI OH ACTIVE 11/21/2016 None N/A

Page 102 of 332 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 Q9892 REHAN, ARSHAD, MD 8/26/2016 8/26/2021 CARDIOLOGY CARDIOLOGY CINCINNATI OH ACTIVE 11/24/2016 None N/A EMERGENCY R4172 ZAYAC, CARL, DO 8/1/2017 8/1/2022 MEDICINE CINCINNATI OH ACTIVE 8/24/2017 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 TRANSPLANT M4472 REZNICHENKO, ALEKSANDR A, MD 9/22/2017 9/22/2022 GENERAL SURGERY SURGERY CINCINNATI OH ACTIVE 10/2/2017 None N/A Q7577 LEUNG, SAMSON, MD 3/15/2016 3/15/2021 ANESTHESIOLOGY CLAREMONT CA ACTIVE 3/21/2016 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 Q6556 PARMAR, AMIT, MD 11/16/2015 11/16/2020 HOSPITALIST FAMILY MEDICINE CLARKSVILLE TN ACTIVE 11/18/2015 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 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 EMERGENCY R3082 FLOWERS, DAMIAN M, MD 5/22/2017 5/22/2022 MEDICINE CLEARWATER FL ACTIVE 6/2/2017 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

Q6108 SINGH, RAHULKUMAR GULAB, MD 9/15/2015 9/15/2020 INTERNAL MEDICINE CLEBURNE TX ACTIVE 9/22/2015 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

R0915 NAIK, PRATIK SUDHIRKUMAR, MD 12/2/2016 12/2/2021 INTERNAL MEDICINE INTERNAL MEDICINE CLERMONT FL ACTIVE 2/28/2017 None N/A INTERVENTIONAL R1924 AGGARWAL, BHUVNESH, MD 3/3/2017 3/3/2022 CARDIOLOGY CARDIOLOGY CLEVELAND OH ACTIVE 3/15/2017 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

H2761 SCHAUER, PHILIP RAYMOND, MD 8/1/2016 8/1/2021 GENERAL SURGERY CLEVELAND OH ACTIVE 9/19/2016 None N/A HEMATOLOGY/ONCOL Q6352 NWIZU, TOBENNA IGWEONU, MD 10/15/2015 10/15/2020 OGY INTERNAL MEDICINE CLEVELAND OH ACTIVE 10/19/2015 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 Q7078 MERJANEH, ZAHI, MD 2/1/2016 2/1/2021 INTERNAL MEDICINE CLEVELAND OH ACTIVE 3/17/2016 None N/A R0719 GHORI, ABDULLA KHAN, MD 11/15/2016 11/15/2021 PEDIATRICS CLEVELAND OH ACTIVE 1/19/2017 None N/A

Page 103 of 332 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 R0070 MANSOOR, RABEEA, MD 9/15/2016 9/15/2021 PSYCHIATRY PSYCHIATRY CLEVELAND OH ACTIVE 9/20/2016 None N/A PULMONARY CRITICAL CARE S6022 RAZA, MUHAMMAD ALI, MD 4/3/2020 4/3/2025 MEDICINE SLEEP MEDICINE CLEVELAND OH ACTIVE 4/20/2020 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 ANESTHESIOLOGY - TM00696 NAIK, RAVI, MD 1/19/2018 1/19/2023 ANESTHESIOLOGY PAIN MANAGEMENT CLIFTON NJ ACTIVE 1/30/2018 None N/A R1902 WANER, LACI DESIRAE, MD 2/22/2017 2/22/2022 FAMILY MEDICINE CLIFTON TX ACTIVE 2/28/2017 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 OBSTETRICS AND Q5686 KRIG, MARIE, MD 8/14/2015 8/14/2020 GYNECOLOGY CLINTON MD ACTIVE 8/28/2015 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 R0272 LINDO, ROLANDO JOSÉ SR, MD 9/30/2016 9/30/2021 FAMILY MEDICINE CLOVIS NM ACTIVE 10/5/2016 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 R1567 KOKORICHA, TOBORE, MD 2/6/2017 2/6/2022 INTERNAL MEDICINE HOSPITALIST CLOVIS NM ACTIVE 3/2/2017 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 Q5846 KUMAR, DEEPAK, MD 8/28/2015 8/28/2020 PSYCHIATRY COALINGA CA ACTIVE 9/1/2015 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 EMERGENCY COCONUT R1834 MONTOYA, DENNIS, MD 2/22/2017 2/22/2022 MEDICINE CREEK FL ACTIVE 3/7/2017 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 COLLEGE Q5287 STEFFEN, LAUREN, MD 7/15/2015 7/15/2020 FAMILY MEDICINE STATION TX ACTIVE 7/22/2015 None N/A SEE FAMILY PRACTICE - COLLEGE PREVIOUS Q6682 PATTON, HEATHER TILL, MD 12/4/2015 12/4/2020 EMERGENCY MED STATION TX ACTIVE 1/7/2016 ORDER 12/4/2015 SEE FAMILY PRACTICE - COLLEGE PREVIOUS Q6682 PATTON, HEATHER TILL, MD 12/4/2015 12/4/2020 EMERGENCY MED STATION TX ACTIVE 1/7/2016 ORDER 12/4/2015 OBSTETRICS AND COLLEGE Q7335 CARLTON, SHARREL MARIE, MD 3/4/2016 3/4/2021 GYNECOLOGY STATION TX ACTIVE 3/8/2016 None N/A

Page 104 of 332 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 COLLEGE R3353 JONES, DANIELLE NICOLE, MD 6/2/2017 6/2/2022 GYNECOLOGY SURGERY STATION TX ACTIVE 6/7/2017 None N/A ORTHOPEDIC COLLEGE K3391 PETERSON, DARRYL WAYNE, MD 5/5/2017 5/5/2022 SURGERY HAND SURGERY STATION TX ACTIVE 5/9/2017 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 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 COLLEGE S5969 LINDSEY, CODY CLAYTON, MD 4/3/2020 4/3/2025 PSYCHIATRY STATION TX ACTIVE 4/20/2020 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 R5575 KAGWIMA, RUTH, MD 1/5/2018 1/5/2023 FAMILY MEDICINE COLLEYVILLE TX ACTIVE 2/6/2018 None N/A EMERGENCY URGENT CARE COLORADO R5826 ZAREMBA, JOSEPH ANTHONY, MD 1/19/2018 1/19/2023 MEDICINE MEDICINE SPRINGS CO ACTIVE 1/22/2018 None N/A THORACIC CARDIOVASCULAR COLORADO S6746 SPATA, TYLER COOLEY, MD 5/15/2020 5/15/2025 SURGERY THORACIC SURGERY SPRINGS CO ACTIVE 5/20/2020 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

S6017 POWERS, RICHARD REAMS JR, MD 4/3/2020 4/3/2025 FAMILY MEDICINE COLUMBIA TN ACTIVE 4/7/2020 None N/A R3201 SABATH, CHARISSE, MD 5/22/2017 5/22/2022 INTERNAL MEDICINE COLUMBIA MD ACTIVE 7/10/2017 None N/A VASCULAR Q7289 TARLOV, NICHOLAS EDWARD, MD 2/16/2016 2/16/2021 NEUROLOGY NEUROLOGY COLUMBIA MO ACTIVE 3/15/2016 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 CHILD AND SALAU, MUSKINNI OLANREWAJU, ADOLESCENT R1635 MD 2/6/2017 2/6/2022 PSYCHIATRY PSYCHIATRY COLUMBIA MO ACTIVE 4/10/2017 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 COLUMBIA R4648 VAIDYA, ANJALI SUDHAKAR, MD 9/8/2017 9/8/2022 FAMILY MEDICINE HEIGHTS MN ACTIVE 9/27/2017 None N/A EMERGENCY R5437 NAGARAJ, LALITHA, MD 12/8/2017 12/8/2022 MEDICINE COLUMBUS OH ACTIVE 12/20/2017 None N/A

Page 105 of 332 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 Q5000 KATZ, ROBERT MICHAEL, MD 7/1/2015 7/1/2020 FAMILY PRACTICE OBSTETRICS COLUMBUS TX ACTIVE 7/3/2015 None N/A PULMONARY NOBARI, MATTHEW MOHAMMAD, CRITICAL CARE R2190 MD 3/20/2017 3/20/2022 INTERNAL MEDICINE MEDICINE COLUMBUS IN ACTIVE 5/25/2017 None N/A Q6705 SHEIKH, SAMIA SAJID, MD 12/4/2015 12/4/2020 NEPHROLOGY INTERNAL MEDICINE COLUMBUS IN ACTIVE 2/25/2016 None N/A Q6705 SHEIKH, SAMIA SAJID, MD 12/4/2015 12/4/2020 NEPHROLOGY INTERNAL MEDICINE COLUMBUS IN ACTIVE 2/25/2016 None N/A VASCULAR S6295 SAFDAR, ADNAN, MD 4/17/2020 4/17/2025 NEUROLOGY NEUROLOGY COLUMBUS OH ACTIVE 4/28/2020 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 PEDIATRIC R1965 HONSINGER, KRISTEN LYNN, MD 3/3/2017 3/3/2022 OTOLARYNGOLOGY OTOLARYNGOLOGY COLUMBUS OH ACTIVE 3/14/2017 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 AMINI-VAUGHAN, ZHALEH R4356 JACQUELINE, MD 8/25/2017 8/25/2022 FAMILY MEDICINE CONROE TX ACTIVE 9/18/2017 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 R0568 FARLEY, DANNY JR, MD 10/31/2016 10/31/2021 FAMILY MEDICINE CONROE TX ACTIVE 12/15/2016 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 Q4985 HUNTER, NOTA, MD 7/1/2015 7/1/2020 FAMILY MEDICINE CONROE TX ACTIVE 7/3/2015 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 R4728 KIEFFER, HILARY JANE, MD 9/22/2017 9/22/2022 FAMILY MEDICINE CONROE TX ACTIVE 9/27/2017 None N/A SONNIER, CHRISTIAN MICHAEL, Q9045 MD 7/1/2016 7/1/2021 FAMILY MEDICINE HOSPITALIST CONROE TX ACTIVE 9/7/2016 None N/A LICENSE Q4851 STONE, SHANE , MD 6/12/2015 6/12/2020 FAMILY MEDICINE CONROE TX ISSUED 6/12/2015 None N/A R0682 ALI, YASER, MD 11/15/2016 11/15/2021 INTERNAL MEDICINE CONROE TX ACTIVE 11/16/2016 None N/A INTERVENTIONAL CARDIOVASCULAR S6423 KETRON, LOWELL LANE, MD 5/1/2020 5/1/2025 CARDIOLOGY DISEASES CONROE TX ACTIVE 5/18/2020 None N/A R1870 SHAH, JAECEL OSHAY, MD 2/22/2017 2/22/2022 OTOLARYNGOLOGY CONROE TX ACTIVE 2/23/2017 None N/A WILLIAMSON, MARY ELIZABETH, R3248 MD 5/22/2017 5/22/2022 OTOLARYNGOLOGY CONROE TX ACTIVE 6/21/2017 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 R4932 ALAKSHAR, HASSAN, MD 10/20/2017 10/20/2022 FAMILY MEDICINE FAMILY MEDICINE CONWAY AR ACTIVE 10/27/2017 None N/A

Page 106 of 332 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 S6577 BOYD, CURTIS JAMES III, DO 5/15/2020 5/15/2025 GYNECOLOGY CONWAY AR ACTIVE 5/26/2020 None N/A PSYCHOSOMATIC COOPERSTO LICENSE Q5904 PRADHAN, AMIT PRAKASH, MD 8/28/2015 8/28/2020 PSYCHIATRY MEDICINE WN NY ISSUED 8/28/2015 None N/A R4299 ONGOLE, BHASKAR, MD 8/15/2017 8/15/2022 INTERNAL MEDICINE HOSPITALIST COOS BAY OR ACTIVE 10/17/2017 None N/A GERIATRIC MEDICINE (INTERNAL R4125 PEDDAGOVINDU, BHAVANI, MD 8/1/2017 8/1/2022 INTERNAL MEDICINE MED) COOS BAY OR ACTIVE 10/3/2017 None N/A

R5196 ROBERTS, KRYSTLE JEANEEN, MD 11/3/2017 11/3/2022 FAMILY MEDICINE COPPELL TX ACTIVE 11/13/2017 None N/A URGENT CARE R1658 SYKES, JOYA KERRISE, DO 2/6/2017 2/6/2022 MEDICINE FAMILY PRACTICE COPPELL TX ACTIVE 3/30/2017 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 R3560 MORSY, AMR SAYED, MD 6/16/2017 6/16/2022 ANESTHESIOLOGY PAIN MANAGEMENT CORONA CA ACTIVE 6/27/2017 None N/A R3265 ARSHAD, SAAIMA, MD 6/2/2017 6/2/2022 INTERNAL MEDICINE CORONA CA ACTIVE 9/11/2017 None N/A EMERGENCY R5851 COWNE, CAMILLE KATHERINE, MD 2/2/2018 2/2/2023 MEDICINE CORONADO CA ACTIVE 3/19/2018 None N/A CORPUS R5805 SALAZAR, ANA VELIA, MD 1/19/2018 1/19/2023 PEDIATRICS CHRIST TX ACTIVE 1/22/2018 None N/A PEDIATRIC ANESTHESIOLOGY CORPUS S6475 PATEL, AYAN, DO 5/1/2020 5/1/2025 ANESTHESIOLOGY (PEDS) CHRISTI TX ACTIVE 5/20/2020 None N/A PEDIATRIC ANESTHESIOLOGY CORPUS S5504 SOMAIYA, ANIE VASANT, DO 3/6/2020 3/6/2025 ANESTHESIOLOGY (PEDS) CHRISTI TX ACTIVE 3/9/2020 None N/A CORPUS Q7937 NORMAN, ROY EDWARD JR, DO 4/15/2016 4/15/2021 CARDIOLOGY INTERNAL MEDICINE CHRISTI TX ACTIVE 4/26/2016 None N/A INTERVENTIONAL CORPUS R1892 TAYLOR, TRAVIS PAUL, MD 2/22/2017 2/22/2022 CARDIOLOGY CARDIOLOGY CHRISTI TX ACTIVE 3/2/2017 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 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 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

Page 107 of 332 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 R0984 ADAMSON, AARON KENNETH, DO 12/16/2016 12/16/2021 MEDICINE CHRISTI TX ACTIVE 1/20/2017 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 EMERGENCY CORPUS Q9343 ERIKSSON, HANS OLOF, MD 8/1/2016 8/1/2021 MEDICINE CHRISTI TX ACTIVE 8/2/2016 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 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 CORPUS Q4998 KANE, EVAN DANIEL, MD 7/1/2015 7/1/2020 MEDICINE CHRISTI TX ACTIVE 7/6/2015 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 EMERGENCY CORPUS S5031 NEUGEBAUER, AMBER LEE, DO 2/7/2020 2/7/2025 MEDICINE CHRISTI TX ACTIVE 2/25/2020 None N/A EMERGENCY CORPUS Q7770 PRICE, BRANDON MICHAEL, MD 4/1/2016 4/1/2021 MEDICINE CHRISTI TX ACTIVE 4/21/2016 None N/A EMERGENCY CORPUS S5770 SEATON, COLE , DO 3/20/2020 3/20/2025 MEDICINE CHRISTI TX ACTIVE 3/23/2020 None N/A EMERGENCY EMERGENCY CORPUS Q9549 WENTLING, JESSICA , DO 8/1/2016 8/1/2021 MEDICINE MEDICINE CHRISTI TX ACTIVE 8/2/2016 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 CORPUS R2287 BHULA, JITEN JAYANTILAL, MD 4/4/2017 4/4/2022 FAMILY MEDICINE CHRISTI TX ACTIVE 6/22/2017 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 CORPUS Q8247 GARZA, ERIK , MD 5/16/2016 5/16/2021 FAMILY MEDICINE CHRISTI TX ACTIVE 5/24/2016 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 CORPUS S5647 HART, MAURENE ELIZABETH, DO 3/20/2020 3/20/2025 FAMILY MEDICINE CHRISTI TX ACTIVE 4/6/2020 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 CORPUS R0869 HEUSNER BANKS, KYLA, MD 12/2/2016 12/2/2021 FAMILY MEDICINE CHRISTI TX ACTIVE 1/2/2017 None N/A

Page 108 of 332 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 S6411 HOEFERLIN, KATIE MARIE, MD 5/1/2020 5/1/2025 FAMILY MEDICINE CHRISTI TX ACTIVE 5/5/2020 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 LAMARTINE, NORA ELIZABETH , CORPUS R5761 MD 1/19/2018 1/19/2023 FAMILY MEDICINE OBSTETRICS CHRISTI TX ACTIVE 1/22/2018 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 CORPUS Q5229 MITCHELL, ROBERT BYRON, DO 7/15/2015 7/15/2020 FAMILY MEDICINE CHRISTI TX ACTIVE 7/20/2015 None N/A CORPUS S6264 NOCHE, RAMY LEONILL, MD 4/17/2020 4/17/2025 FAMILY MEDICINE CHRISTI TX ACTIVE 4/20/2020 None N/A EMERGENCY CORPUS Q6675 O'CONNELL, ETHAN, MD 12/4/2015 12/4/2020 FAMILY MEDICINE MEDICINE CHRISTI TX ACTIVE 12/21/2015 None N/A EMERGENCY CORPUS Q6675 O'CONNELL, ETHAN, MD 12/4/2015 12/4/2020 FAMILY MEDICINE MEDICINE CHRISTI TX ACTIVE 12/21/2015 None N/A EMERGENCY CORPUS R1263 ONUFRAK, KIM THUY NGUYEN, DO 1/6/2017 1/6/2022 FAMILY MEDICINE MEDICINE CHRISTI TX ACTIVE 1/19/2017 None N/A SCHWARZKOPF, HEINZ-DIETER , CORPUS R5206 DO 11/3/2017 11/3/2022 FAMILY MEDICINE CHRISTI TX ACTIVE 11/6/2017 None N/A CORPUS R6121 TOVAR-CAMARGO, JOSE I, MD 2/16/2018 2/16/2023 FAMILY MEDICINE CHRISTI TX ACTIVE 2/22/2018 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 CORPUS Q6183 ELIZONDO, CARLOS , MD 10/1/2015 10/1/2020 FAMILY PRACTICE CHRISTI TX ACTIVE 10/8/2015 None N/A SCHEBLER POULOS, ALLISON CORPUS Q6102 KEELER, DO 9/15/2015 9/15/2020 FAMILY PRACTICE CHRISTI TX ACTIVE 9/25/2015 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 CORPUS Q9656 KODAK, PAVLO, MD 8/15/2016 8/15/2021 HOSPITALIST CHRISTI TX ACTIVE 8/25/2016 None N/A CORPUS R2744 SHIPOTKO, MIKHAIL, MD 4/20/2017 4/20/2022 HOSPITALIST CHRISTI TX ACTIVE 4/24/2017 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

Page 109 of 332 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 R2292 BUI, CHRISTINE KIM, DO 4/4/2017 4/4/2022 INTERNAL MEDICINE CHRISTI TX ACTIVE 6/7/2017 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 CORPUS R1772 HLAING, KYIN, MD 2/22/2017 2/22/2022 INTERNAL MEDICINE CHRISTI TX ACTIVE 3/3/2017 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 CORPUS Q7416 MALIE, PATRICK MICHAEL, DO 3/4/2016 3/4/2021 INTERNAL MEDICINE CHRISTI TX ACTIVE 3/23/2016 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 CORPUS R0624 MURPHY, TIMOTHY JOSEPH, DO 10/31/2016 10/31/2021 INTERNAL MEDICINE CHRISTI TX ACTIVE 1/23/2017 None N/A CORPUS R5441 NGUYEN, BRIAN , DO 12/8/2017 12/8/2022 INTERNAL MEDICINE CHRISTI TX ACTIVE 12/11/2017 None N/A SEE CORPUS PREVIOUS R3936 PEARCE, RANDY RIC, DO 7/17/2017 7/17/2022 INTERNAL MEDICINE CHRISTI TX ACTIVE 7/25/2017 ORDER 10/12/2015 EMERGENCY CORPUS R3180 PERKINS, SHANE HAYWARD, DO 5/22/2017 5/22/2022 INTERNAL MEDICINE MEDICINE CHRISTI TX ACTIVE 7/27/2017 None N/A SANCHEZ, DARLENE MICHELLE, CORPUS R3746 DO 6/30/2017 6/30/2022 INTERNAL MEDICINE CHRISTI TX ACTIVE 7/6/2017 None N/A CORPUS Q8629 SANCHEZ, RICHARD, DO 6/1/2016 6/1/2021 INTERNAL MEDICINE CARDIOLOGY CHRISTI TX ACTIVE 6/2/2016 None N/A CORPUS R0947 SASS, ERIC MATTHEW, DO 12/2/2016 12/2/2021 INTERNAL MEDICINE CHRISTI TX ACTIVE 12/5/2016 None N/A CORPUS Q8641 SINGH, PRABHAT, MD 6/1/2016 6/1/2021 INTERNAL MEDICINE NEPHROLOGY CHRISTI TX ACTIVE 6/21/2016 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 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 OBSTETRICS AND CORPUS Q5946 VASQUEZ, LINDSEY ROSE, MD 8/28/2015 8/28/2020 GYNECOLOGY CHRISTI TX ACTIVE 9/1/2015 None N/A CORPUS Q6114 TAFOYA, LAWRENCE CECILIO, MD 9/15/2015 9/15/2020 OPHTHALMOLOGY CHRISTI TX ACTIVE 10/9/2015 None N/A ORTHOPEDIC SPORTS MEDICINE - CORPUS S5999 NEFF, PETER CHRISTOPHER, MD 4/3/2020 4/3/2025 SURGERY ORTHOPEDICS CHRISTI TX ACTIVE 4/7/2020 None N/A

Page 110 of 332 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 ORTHOPEDIC CORPUS S6853 HODGES, BRIAN NEIL, DO 5/29/2020 5/29/2025 TRAUMA SURGERY CHRISTI TX ACTIVE 6/5/2020 None N/A 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 CRITICAL INTERNAL MED - CORPUS S4423 ZEBRACK, CELIA MICHELLE, MD 12/6/2019 12/6/2024 CARE MEDICINE PEDS CHRISTI TX ACTIVE 12/17/2019 None N/A PEDIATRIC CRITICAL INTERNAL MED - CORPUS S4423 ZEBRACK, CELIA MICHELLE, MD 12/6/2019 12/6/2024 CARE MEDICINE PEDS CHRISTI TX ACTIVE 12/17/2019 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 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 PEDIATRIC HEMATOLOGY/ONCOL CORPUS R4144 SHERANI, FARHA, MD 8/1/2017 8/1/2022 OGY CHRISTI TX ACTIVE 8/3/2017 None N/A PEDIATRIC CORPUS S4378 ROMERO OLVERA, MAURICIO, MD 12/6/2019 12/6/2024 NEPHROLOGY PEDIATRICS CHRISTI TX ACTIVE 12/17/2019 None N/A PEDIATRIC CORPUS S4378 ROMERO OLVERA, MAURICIO, MD 12/6/2019 12/6/2024 NEPHROLOGY PEDIATRICS CHRISTI TX ACTIVE 12/17/2019 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 ENCALADA, SANTIAGO ENRIQUE, PEDIATRIC CORPUS R4834 MD 10/6/2017 10/6/2022 PULMONOLOGY PEDIATRICS CHRISTI TX ACTIVE 10/27/2017 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 CABRERA GONCALVES, AGUSTIN CORPUS S4740 JOSE, MD 1/24/2020 1/24/2025 PEDIATRICS CHRISTI TX ACTIVE 2/5/2020 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 CORPUS Q9164 GOITIA SERPA, VERONICA , MD 7/15/2016 7/15/2021 PEDIATRICS CHRISTI TX ACTIVE 8/11/2016 None N/A NUNES MONTIEL, ZAINETH MARIA, CORPUS R0772 MD 11/15/2016 11/15/2021 PEDIATRICS CHRISTI TX ACTIVE 2/8/2017 None N/A CORPUS R4298 OKOYE, MEKAM TOCHUKWU, MD 5/29/2020 5/29/2025 PEDIATRICS PUBLIC HEALTH CHRISTI TX ACTIVE 6/2/2020 None N/A PEDIATRICS, CORPUS Q9483 PORAYETTE, PRASHOB, MD 8/1/2016 8/1/2021 PEDIATRICS CARDIOLOGY CHRISTI TX ACTIVE 8/25/2016 None N/A

Page 111 of 332 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 CORPUS Q6579 SYED, SABEEN ASLAM, MD 11/16/2015 11/16/2020 PEDIATRICS Y CHRISTI TX ACTIVE 11/18/2015 None N/A CORPUS S5296 WU, SHANG-CHEN , MD 2/21/2020 2/21/2025 PEDIATRICS CHRISTI TX ACTIVE 2/24/2020 None N/A PEDIATRICS, CORPUS Q6082 PARIS, GABRIEL, MD 9/15/2015 9/15/2020 CARDIOLOGY PEDIATRICS CHRISTI TX ACTIVE 9/17/2015 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 RADIATION CORPUS R3618 WATTS, WALTER EDWIN IV, MD 6/16/2017 6/16/2022 ONCOLOGY CHRISTI TX ACTIVE 7/25/2017 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 CORPUS S6185 GANDHI, ARPIT HARSHAD, MD 4/17/2020 4/17/2025 RADIOLOGY NEURO-RADIOLOGY CHRISTI TX ACTIVE 4/30/2020 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 THORACIC CARDIOVASCULAR VASCULAR CORPUS Q7261 PUSCA, SORIN VLADIMIR, MD 2/16/2016 2/16/2021 SURGERY SURGERY CHRISTI TX ACTIVE 2/18/2016 None N/A INFECTIOUS CORPUS P3662 RAMACHANDRUNI, SRIKANTH, MD 8/25/2017 8/25/2022 DISEASES INTERNAL MEDICINE CHRISTIE TX ACTIVE 8/30/2017 None N/A Q6754 HOLINEJ, SHARISSE, MD 12/15/2015 12/15/2020 FAMILY MEDICINE CORSICANA TX ACTIVE 12/24/2015 None N/A POLKAMPALLI, NANDAKISHORE, R0643 MD 10/31/2016 10/31/2021 HOSPITALIST CORSICANA TX ACTIVE 11/14/2016 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 NEUROLOGY & R4934 ALVA, GUSTAVO, MD 10/20/2017 10/20/2022 NEURO-PSYCHIATRY PSYCHIATRY COSTA MESA CA ACTIVE 11/1/2017 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 ANESTHESIOLOGY - COUDERSPOR Q9695 NGUYEN, PHONG, DO 8/15/2016 8/15/2021 ANESTHESIOLOGY PAIN MANAGEMENT T PA ACTIVE 9/7/2016 None N/A ANESTHESIOLOGY - S6305 SHIH, LOWELL BENJAMIN, MD 4/17/2020 4/17/2025 PAIN MANAGEMENT COVINGTON LA ACTIVE 5/27/2020 None N/A

Page 112 of 332 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

Q7996 AGBOOLA, SUNDAY ABIODUN, MD 5/2/2016 5/2/2021 INTERNAL MEDICINE CRANBERRY PA ACTIVE 5/4/2016 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 CROSS R3928 NUTTING, WILLIAM JAMES II, MD 7/17/2017 7/17/2022 FAMILY MEDICINE ROADS TX ACTIVE 7/20/2017 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 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 Q4631 MCDANIEL, RENNY, MD 6/1/2015 6/1/2020 FAMILY MEDICINE CUERO TX ACTIVE 6/15/2015 None N/A Q7749 MILLS, SHERYL, MD 4/1/2016 4/1/2021 FAMILY PRACTICE CUERO TX ACTIVE 5/10/2016 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 Q5520 OKAFOR, KANAYO KEVIN, MD 8/3/2015 8/3/2020 ANESTHESIOLOGY CYPRESS TX ACTIVE 8/4/2015 None N/A EMERGENCY EMERGENCY R2025 THOMAS, JACOB, MD 3/3/2017 3/3/2022 MEDICINE MEDICINE CYPRESS TX ACTIVE 3/23/2017 None N/A Q8949 MAHMOODUDDIN, FAISAL , MD 7/1/2016 7/1/2021 FAMILY MEDICINE CYPRESS TX ACTIVE 7/18/2016 None N/A Q9055 TAQI, TABASSUM, MD 7/1/2016 7/1/2021 FAMILY MEDICINE CYPRESS TX ACTIVE 9/16/2016 None N/A R4493 VENKATESH, RATI, DO 8/25/2017 8/25/2022 FAMILY MEDICINE CYPRESS TX ACTIVE 8/28/2017 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 TEKETEL, TEWODROS Q9058 WOLDEMARIAM, MD 7/1/2016 7/1/2021 INTERNAL MEDICINE CYPRESS TX ACTIVE 7/5/2016 None N/A ORTHOPEDIC SPORTS MEDICINE R0155 WILLIAMS, PHILLIP NYAMEKYE, MD 9/15/2016 9/15/2021 SURGERY (ORTH SURG) CYPRESS TX ACTIVE 9/19/2016 None N/A Q6024 HALLMARK, CHRISTOPHER, MD 9/15/2015 9/15/2020 RADIOLOGY CYPRESS TX ACTIVE 9/17/2015 None N/A Q7595 PICKERING, MELANIE RAE, DO 3/15/2016 3/15/2021 RADIOLOGY BREAST IMAGING CYPRESS TX ACTIVE 3/18/2016 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 VASCULAR AND INTERVENTIONAL R4907 SUWAN, TARIQ ZIAD, MD 10/6/2017 10/6/2022 RADIOLOGY RADIOLOGY CYPRESS, TX TX ACTIVE 10/16/2017 None N/A DAKOTA R5808 SIDDIQUI, SHAHEER, MD 1/19/2018 1/19/2023 INTERNAL MEDICINE HOSPITALIST DUNES SD ACTIVE 1/29/2018 None N/A DIAGNOSTIC Q5291 SYED, ALMAS, MD 7/15/2015 7/15/2020 RADIOLOGY DALALS TX ACTIVE 7/24/2015 None N/A

Page 113 of 332 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 S4449 CANTWAY, CATHERINE, MD 12/20/2019 12/20/2024 FAMILY MEDICINE PRACTICE) DALHART TX ACTIVE 1/2/2020 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 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 CRITICAL CARE Q5146 ASIMI, NTESI ANASTASIOS, MD 7/15/2015 7/15/2020 ANESTHESIOLOGY ANESTHESIOLOGY DALLAS TX ACTIVE 7/16/2015 None N/A Q4562 AZIZAD, OMAIRA , MD 6/1/2015 6/1/2020 ANESTHESIOLOGY DALLAS TX ACTIVE 6/15/2015 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 S5549 BAGWELL, THOMAS JAMES, MD 3/20/2020 3/20/2025 ANESTHESIOLOGY DALLAS TX ACTIVE 3/26/2020 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 CARDIOTHORACIC R1352 CHOI, SIMON , MD 1/20/2017 1/20/2022 ANESTHESIOLOGY ANESTHESIOLOGY DALLAS TX ACTIVE 1/26/2017 None N/A Q7670 CLINE, MALLORIE TAYLOR, MD 4/1/2016 4/1/2021 ANESTHESIOLOGY DALLAS TX ACTIVE 4/11/2016 None N/A CARDIOTHORACIC Q7170 COUCH, MICHAEL CHRISTIAN, MD 2/16/2016 2/16/2021 ANESTHESIOLOGY ANESTHESIOLOGY DALLAS TX ACTIVE 2/17/2016 None N/A Q7864 EDWARDS, JASON TRAVIS, MD 4/15/2016 4/15/2021 ANESTHESIOLOGY DALLAS TX ACTIVE 4/25/2016 None N/A S5367 FARTHING, JOSHUA, MD 3/6/2020 3/6/2025 ANESTHESIOLOGY DALLAS TX ACTIVE 3/12/2020 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

S6181 FUBARA, DEBORAH SOTONYE, MD 4/17/2020 4/17/2025 ANESTHESIOLOGY DALLAS TX ACTIVE 5/4/2020 None N/A

Q4965 GREWAL, GAGANPREET KAUR, MD 7/1/2015 7/1/2020 ANESTHESIOLOGY DALLAS TX ACTIVE 7/3/2015 None N/A R4054 HARDMAN, BAILOR L, MD 8/1/2017 8/1/2022 ANESTHESIOLOGY DALLAS TX ACTIVE 8/2/2017 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 R0729 HONG, SUK , MD 11/15/2016 11/15/2021 ANESTHESIOLOGY DALLAS TX ACTIVE 1/9/2017 None N/A S4975 HOYE, DOUGLAS JOSEPH, MD 2/7/2020 2/7/2025 ANESTHESIOLOGY DALLAS TX ACTIVE 2/13/2020 None N/A R3345 HUANG, CHIENYAO, MD 6/2/2017 6/2/2022 ANESTHESIOLOGY DALLAS TX ACTIVE 6/9/2017 None N/A R2361 HULSEY, MATTHEW W, MD 4/4/2017 4/4/2022 ANESTHESIOLOGY DALLAS TX ACTIVE 4/10/2017 None N/A

Page 114 of 332 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 R0421 ISKANDER, INGY, MD 10/14/2016 10/14/2021 ANESTHESIOLOGY (PEDS) DALLAS TX ACTIVE 10/17/2016 None N/A Q6209 JENNINGS, AMY KIRSTEN, DO 10/1/2015 10/1/2020 ANESTHESIOLOGY DALLAS TX ACTIVE 10/12/2015 None N/A R4569 JOSEPH, ASHLEY MERRIN, MD 9/8/2017 9/8/2022 ANESTHESIOLOGY PEDIATRICS DALLAS TX ACTIVE 11/9/2017 None N/A R3879 KAESBERG, JULIE LOUISE, MD 7/17/2017 7/17/2022 ANESTHESIOLOGY DALLAS TX ACTIVE 9/1/2017 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 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 R3127 LAHSAEI, PEIMAN, MD 5/22/2017 5/22/2022 ANESTHESIOLOGY ANESTHESIOLOGY DALLAS TX ACTIVE 5/24/2017 None N/A Q9664 LIN, MITCHELL, MD 8/15/2016 8/15/2021 ANESTHESIOLOGY DALLAS TX ACTIVE 8/25/2016 None N/A Q6648 LIN, PETER CHARLIE, MD 12/4/2015 12/4/2020 ANESTHESIOLOGY DALLAS TX ACTIVE 2/3/2016 None N/A Q6648 LIN, PETER CHARLIE, MD 12/4/2015 12/4/2020 ANESTHESIOLOGY DALLAS TX ACTIVE 2/3/2016 None N/A R2408 MATTHEWS, VARGHESE , MD 4/4/2017 4/4/2022 ANESTHESIOLOGY DALLAS TX ACTIVE 4/13/2017 None N/A R2918 MEEK, CAMERON ALAN, MD 5/5/2017 5/5/2022 ANESTHESIOLOGY DALLAS TX ACTIVE 5/15/2017 None N/A

R2678 MIDDLETON JONES, JAMELA, MD 4/20/2017 4/20/2022 ANESTHESIOLOGY DALLAS TX ACTIVE 7/10/2017 None N/A S4826 MUSAU, PATRICK , MD 1/24/2020 1/24/2025 ANESTHESIOLOGY DALLAS TX ACTIVE 1/27/2020 None N/A R1429 OGUNKUA, OLUTOYOSI , MD 1/20/2017 1/20/2022 ANESTHESIOLOGY DALLAS TX ACTIVE 2/3/2017 None N/A Q6463 REBAL, BRETT ALLEN, MD 11/2/2015 11/2/2020 ANESTHESIOLOGY DALLAS TX ACTIVE 11/6/2015 None N/A

S4849 REMSTER, JEFFREY ANDREW, MD 1/24/2020 1/24/2025 ANESTHESIOLOGY DALLAS TX ACTIVE 2/3/2020 None N/A CRITICAL CARE - R3418 ROMITO, JIA WANG, MD 6/2/2017 6/2/2022 ANESTHESIOLOGY NEUROSURGERY DALLAS TX ACTIVE 6/5/2017 None N/A

R3426 SCHLEGEL, LEVI J, MD 6/2/2017 6/2/2022 ANESTHESIOLOGY GENERAL PRACTICE DALLAS TX ACTIVE 6/5/2017 None N/A OBSTETRICAL Q9507 SENG, DAVID LEE, DO 8/1/2016 8/1/2021 ANESTHESIOLOGY ANESTHESIA DALLAS TX ACTIVE 8/22/2016 None N/A R0791 SMITH, MIAKKA NICOLE, MD 11/15/2016 11/15/2021 ANESTHESIOLOGY DALLAS TX ACTIVE 2/8/2017 None N/A ANESTHESIOLOGY - R4154 TO, LISA , MD 8/1/2017 8/1/2022 ANESTHESIOLOGY PAIN MANAGEMENT DALLAS TX ACTIVE 8/2/2017 None N/A WILKERSON, MATTHEW HARRY CRITICAL CARE R4649 LEE , MD 9/8/2017 9/8/2022 ANESTHESIOLOGY ANESTHESIOLOGY DALLAS TX ACTIVE 10/2/2017 None N/A R4923 WONG, JEREMY MUN-HING, MD 10/6/2017 10/6/2022 ANESTHESIOLOGY DALLAS TX ACTIVE 10/9/2017 None N/A S5107 XIAO, CINDY YUBIN, MD 2/7/2020 2/7/2025 ANESTHESIOLOGY DALLAS TX ACTIVE 2/17/2020 None N/A

Page 115 of 332 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 - L0868 MEYER, JEFFREY PAUL, MD 8/25/2017 8/25/2022 PAIN MANAGEMENT DALLAS TX ACTIVE 9/4/2017 None N/A ANESTHESIOLOGY - R3922 NELSON, GEOFFREY , DO 7/17/2017 7/17/2022 PAIN MANAGEMENT DALLAS TX ACTIVE 7/21/2017 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 CARDIAC ELECTROPHYSIOLOG Q8743 LINK, MARK STEVEN, MD 6/10/2016 6/10/2021 Y CARDIOLOGY DALLAS TX ACTIVE 6/21/2016 None N/A CARDIAC ELECTROPHYSIOLOG R2451 RAO, PRAVEEN KALIPATNAM, MD 4/4/2017 4/4/2022 Y CARDIOLOGY DALLAS TX ACTIVE 4/11/2017 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 Q5981 CAIN, MATTHEW A, MD 9/15/2015 9/15/2020 CARDIOLOGY INTERNAL MEDICINE DALLAS TX ACTIVE 9/17/2015 None N/A Q5634 CEDARS, ARI MICHAEL, MD 8/14/2015 8/14/2020 CARDIOLOGY DALLAS TX ACTIVE 8/17/2015 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 S5623 GEURINK, KYLE ROBERT, MD 3/20/2020 3/20/2025 CARDIOLOGY INTERNAL MEDICINE DALLAS TX ACTIVE 3/27/2020 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 PATERICK, TIMOTHY EDWARD SR, CARDIOVASCULAR Q8327 MD 5/16/2016 5/16/2021 CARDIOLOGY IMAGING DALLAS TX ACTIVE 6/13/2016 None N/A R2227 SILVA, JOSE MANUEL, MD 3/20/2017 3/20/2022 CARDIOLOGY INTERNAL MEDICINE DALLAS TX ACTIVE 3/22/2017 None N/A Q5117 VIGEN, REBECCA , MD 7/1/2015 7/1/2020 CARDIOLOGY INTERNAL MEDICINE DALLAS TX ACTIVE 7/3/2015 None N/A Q6723 ZAHA, VLAD GABRIEL, MD 12/4/2015 12/4/2020 CARDIOLOGY INTERNAL MEDICINE DALLAS TX ACTIVE 12/7/2015 None N/A Q6723 ZAHA, VLAD GABRIEL, MD 12/4/2015 12/4/2020 CARDIOLOGY INTERNAL MEDICINE DALLAS TX ACTIVE 12/7/2015 None N/A Q6723 ZAHA, VLAD GABRIEL, MD 12/4/2015 12/4/2020 CARDIOLOGY INTERNAL MEDICINE DALLAS TX ACTIVE 12/7/2015 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 CARDIOVASCULAR R1373 GONG, TIMOTHY ALLAN, MD 1/20/2017 1/20/2022 DISEASES INTERNAL MEDICINE DALLAS TX ACTIVE 1/23/2017 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 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 CARDIOVASCULAR S6718 RAYGOR, VIRAJ , MD 5/15/2020 5/15/2025 DISEASES DALLAS TX ACTIVE 5/20/2020 None N/A CARDIOVASCULAR TRANSPLANT R4343 WENCKER, DETLEF, MD 8/15/2017 8/15/2022 DISEASES SURGERY DALLAS TX ACTIVE 10/3/2017 None N/A

Page 116 of 332 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 CARDIOVASCULAR Q9783 BAJONA, PIETRO , MD 8/26/2016 8/26/2021 SURGERY SURGERY DALLAS TX ACTIVE 8/30/2016 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 CARDIOVASCULAR Q8182 WATERS, JOHN KEENE, MD 5/2/2016 5/2/2021 SURGERY GENERAL SURGERY DALLAS TX ACTIVE 5/9/2016 None N/A PEDIATRIC R3703 LABINER, KATHERINE STACY , MD 6/30/2017 6/30/2022 CHILD NEUROLOGY NEUROLOGY DALLAS TX ACTIVE 7/26/2017 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 R6296 STOKES, MATHEW , MD 3/2/2018 3/2/2023 CHILD NEUROLOGY DALLAS TX ACTIVE 3/6/2018 None N/A

NEURO-PHYSIOLOGY S6067 TALAI, AFSANEH, MD 4/3/2020 4/3/2025 CHILD NEUROLOGY (NEUROLOGY) DALLAS TX ACTIVE 4/9/2020 None N/A R0974 WANG, CYNTHIA XINZI , MD 12/2/2016 12/2/2021 CHILD NEUROLOGY NEUROLOGY DALLAS TX ACTIVE 12/6/2016 None N/A MOVEMENT R5488 WAUGH, JEFFREY LYNN, MD 12/8/2017 12/8/2022 CHILD NEUROLOGY DISORDERS DALLAS TX ACTIVE 12/20/2017 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 CRITICAL CARE Q9621 GRANT, JENNIFER, MD 8/15/2016 8/15/2021 (SURGERY) DALLAS TX ACTIVE 9/12/2016 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 CRITICAL CARE R1661 THANGUDU, PAVAN KUMAR, MD 2/6/2017 2/6/2022 MEDICINE INTERNAL MEDICINE DALLAS TX ACTIVE 3/8/2017 None N/A DERMATOLOGIC S6751 TATE, JESALYN AUTUMN, MD 5/15/2020 5/15/2025 SURGERY DERMATOLOGY DALLAS TX ACTIVE 5/20/2020 None N/A R4021 CHEN, SEAN , MD 8/1/2017 8/1/2022 DERMATOLOGY DALLAS TX ACTIVE 10/3/2017 None N/A Q5989 CIZENSKI, JEFFREY DAVID, MD 9/15/2015 9/15/2020 DERMATOLOGY DALLAS TX ACTIVE 9/17/2015 None N/A R4683 CURRIMBHOY, SHARIF , MD 9/22/2017 9/22/2022 DERMATOLOGY DALLAS TX ACTIVE 9/27/2017 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 R2162 MA, LIQIAO , MD 3/20/2017 3/20/2022 DERMATOLOGY DALLAS TX ACTIVE 3/28/2017 None N/A NGUYEN, ROSELYNN HONGLAM, Q5879 MD 8/28/2015 8/28/2020 DERMATOLOGY DALLAS TX ACTIVE 9/8/2015 None N/A R3394 ORSETH, MEREDITH LEE, MD 6/2/2017 6/2/2022 DERMATOLOGY DALLAS TX ACTIVE 6/6/2017 None N/A R3729 PAEK, SO YEON, MD 6/30/2017 6/30/2022 DERMATOLOGY DALLAS TX ACTIVE 7/6/2017 None N/A

Page 117 of 332 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 DERMATOPATHOLO S5781 SODE, TITILOLA TEMITOPE , MD 3/20/2020 3/20/2025 DERMATOLOGY GY DALLAS TX ACTIVE 4/24/2020 None N/A R2789 WILDER, ELIZABETH GRACE, MD 4/20/2017 4/20/2022 DERMATOLOGY DALLAS TX ACTIVE 5/1/2017 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 DIAGNOSTIC Q7663 CHANG, I-YUAN JOSEPH, MD 4/1/2016 4/1/2021 RADIOLOGY DALLAS TX ACTIVE 6/2/2016 None N/A DIAGNOSTIC Q7544 COLLARD, MICHAEL DAVID, MD 3/15/2016 3/15/2021 RADIOLOGY DALLAS TX ACTIVE 3/17/2016 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 DIAGNOSTIC R4848 HARRIS, MERISSA GARVEY, MD 10/6/2017 10/6/2022 RADIOLOGY INTERNAL MEDICINE DALLAS TX ACTIVE 12/28/2017 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 DIAGNOSTIC Q8099 LICHLITER, ANDREW H, MD 5/2/2016 5/2/2021 RADIOLOGY DALLAS TX ACTIVE 5/4/2016 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 MOREDOCK, ELISABETH PARISH, DIAGNOSTIC Q8964 MD 7/1/2016 7/1/2021 RADIOLOGY DALLAS TX ACTIVE 7/4/2016 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 DIAGNOSTIC INTERVENTIONAL Q9704 PALUMBO, ALISON, MD 8/15/2016 8/15/2021 RADIOLOGY RADIOLOGY DALLAS TX ACTIVE 8/16/2016 None N/A DIAGNOSTIC R1129 SHURAFA, MAHMUD , MD 12/16/2016 12/16/2021 RADIOLOGY DALLAS TX ACTIVE 12/19/2016 None N/A DIAGNOSTIC S6309 SLEPICKA, CHENELLE JOY, MD 4/17/2020 4/17/2025 RADIOLOGY DALLAS TX ACTIVE 4/20/2020 None N/A DIAGNOSTIC Q7967 SMITH, JASON GREGORY, MD 4/15/2016 4/15/2021 RADIOLOGY DALLAS TX ACTIVE 6/20/2016 None N/A SUBRAMANIAM, RATHAN DIAGNOSTIC Q6990 MARKANDAN, MD 1/15/2016 1/15/2021 RADIOLOGY NUCLEAR MEDICINE DALLAS TX ACTIVE 1/18/2016 None N/A DIAGNOSTIC Q5586 TOLIYAT, MOHAMMAD , MD 8/3/2015 8/3/2020 RADIOLOGY DALLAS TX ACTIVE 8/7/2015 None N/A EMERGENCY Q6146 BALASUBRAMANIAN, DIVYA, DO 10/1/2015 10/1/2020 MEDICINE DALLAS TX ACTIVE 10/14/2015 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

Page 118 of 332 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 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 EMERGENCY Q7659 BUSTI, ANTHONY, MD 4/1/2016 4/1/2021 MEDICINE DALLAS TX ACTIVE 4/5/2016 None N/A EMERGENCY Q8862 COLE, SADIE , MD 7/1/2016 7/1/2021 MEDICINE DALLAS TX ACTIVE 7/11/2016 None N/A EMERGENCY R2837 COOPER, JOHN K , DO 5/5/2017 5/5/2022 MEDICINE PEDIATRICS DALLAS TX ACTIVE 5/16/2017 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 CRANE, STEPHANIE MICHELLE, EMERGENCY Q7172 MD 2/16/2016 2/16/2021 MEDICINE DALLAS TX ACTIVE 3/14/2016 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 EMERGENCY R1013 DEHNING, MEAGHAN , MD 12/16/2016 12/16/2021 MEDICINE DALLAS TX ACTIVE 1/9/2017 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 EMERGENCY R1018 DOYLE, DAVID ANTHONY, MD 12/16/2016 12/16/2021 MEDICINE DALLAS TX ACTIVE 1/5/2017 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 EMERGENCY R0572 FOX, WILLIAM RICHARD, MD 10/31/2016 10/31/2021 MEDICINE DALLAS TX ACTIVE 11/4/2016 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 EMERGENCY S5919 HASHMI, MOHAMMEDALI, DO 4/3/2020 4/3/2025 MEDICINE DALLAS TX ACTIVE 4/6/2020 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 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 HUMMEL, CHRISTOPHER EMERGENCY Q4984 JONATHAN, DO 7/1/2015 7/1/2020 MEDICINE DALLAS TX ACTIVE 7/8/2015 None N/A EMERGENCY Q7722 KENNEDY, CHRISTOPHER, MD 4/1/2016 4/1/2021 MEDICINE DALLAS TX ACTIVE 4/11/2016 None N/A EMERGENCY R1063 KIM, ANGELO, MD 12/16/2016 12/16/2021 MEDICINE DALLAS TX ACTIVE 1/2/2017 None N/A

Page 119 of 332 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 Q9407 KULSTAD, CHRISTINE E, MD 8/1/2016 8/1/2021 MEDICINE DALLAS TX ACTIVE 8/5/2016 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 EMERGENCY S5217 LULLA, ADITYA, MD 2/21/2020 2/21/2025 MEDICINE DALLAS TX ACTIVE 5/13/2020 None N/A EMERGENCY Q5861 MARANTO, LISMAIDA, DO 8/28/2015 8/28/2020 MEDICINE DALLAS TX ACTIVE 9/1/2015 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 EMERGENCY R0076 MCHUGH, MARY C, MD 9/15/2016 9/15/2021 MEDICINE DALLAS TX ACTIVE 9/20/2016 None N/A 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 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 EMERGENCY R3151 MIKKILINENI, MONICA, MD 5/22/2017 5/22/2022 MEDICINE DALLAS TX ACTIVE 5/29/2017 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 EMERGENCY Q5698 MORSHEDI, BRANDON , MD 8/14/2015 8/14/2020 MEDICINE DALLAS TX ACTIVE 8/31/2015 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 EMERGENCY Q6885 NAZEER, OMER, MD 1/6/2016 1/6/2021 MEDICINE DALLAS TX ACTIVE 1/7/2016 None N/A EMERGENCY R4757 OPFER, AMANDA ELIZABETH, DO 9/22/2017 9/22/2022 MEDICINE DALLAS TX ACTIVE 10/11/2017 None N/A EMERGENCY S5042 PARNELL, SAMUEL THOMAS, MD 2/7/2020 2/7/2025 MEDICINE DALLAS TX ACTIVE 2/10/2020 None N/A EMERGENCY EMERGENCY R1274 PETROSIAN, ALEX, MD 1/6/2017 1/6/2022 MEDICINE MEDICINE DALLAS TX ACTIVE 2/7/2017 None N/A EMERGENCY Q9234 QUAYSON, ESI, MD 7/15/2016 7/15/2021 MEDICINE DALLAS TX ACTIVE 7/18/2016 None N/A EMERGENCY R2947 RALL, NICOLE B, DO 5/5/2017 5/5/2022 MEDICINE DALLAS TX ACTIVE 5/8/2017 None N/A EMERGENCY R5030 REEVES, CROMWELL KEITH, MD 10/20/2017 10/20/2022 MEDICINE DALLAS TX ACTIVE 10/27/2017 None N/A

Page 120 of 332 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 Q8620 RITTER, SAMUEL ISAAC, MD 6/1/2016 6/1/2021 MEDICINE DALLAS TX ACTIVE 6/2/2016 None N/A EMERGENCY Q5084 RUCINSKI, MARIA C, MD 7/1/2015 7/1/2020 MEDICINE DALLAS TX ACTIVE 7/13/2015 None N/A EMERGENCY Q6986 SHINNEMAN, DREW WAYNE, MD 1/15/2016 1/15/2021 MEDICINE DALLAS TX ACTIVE 1/26/2016 None N/A SPRUELL, CHRISTOPHER EMERGENCY R4781 WILLIAM, MD 9/22/2017 9/22/2022 MEDICINE DALLAS TX ACTIVE 9/28/2017 None N/A EMERGENCY S4572 STANNARD, TYLER , MD 12/20/2019 12/20/2024 MEDICINE DALLAS TX ACTIVE 12/23/2019 None N/A EMERGENCY R3443 THORNTON, JONATHAN, MD 6/2/2017 6/2/2022 MEDICINE DALLAS TX ACTIVE 6/6/2017 None N/A EMERGENCY EMERGENCY Q8371 TICE, MATTHEW, MD 5/16/2016 5/16/2021 MEDICINE MEDICAL SERVICES DALLAS TX ACTIVE 5/17/2016 None N/A EMERGENCY R3444 TILLMAN, RYAN, MD 6/2/2017 6/2/2022 MEDICINE DALLAS TX ACTIVE 6/20/2017 None N/A EMERGENCY R3002 WALKER, KARA, MD 5/5/2017 5/5/2022 MEDICINE DALLAS TX ACTIVE 5/31/2017 None N/A MEDICAL TOXICOLOGY EMERGENCY (EMERGENCY R1907 WEISS, STEPHANIE TARA, MD 2/22/2017 2/22/2022 MEDICINE MEDICINE) DALLAS TX ACTIVE 3/21/2017 None N/A EMERGENCY R5823 WILLMANN, DAVIS, MD 1/19/2018 1/19/2023 MEDICINE DALLAS TX ACTIVE 2/2/2018 None N/A EMERGENCY Q9092 WILTSE, RICHARD JACOB, MD 7/1/2016 7/1/2021 MEDICINE DALLAS TX ACTIVE 7/4/2016 None N/A EMERGENCY Q7815 YAVORCIK, KEVIN JAMES, MD 4/1/2016 4/1/2021 MEDICINE DALLAS TX ACTIVE 4/8/2016 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 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 ENDOCRINOLOGY, DIABETES AND S5935 JACKSON, KRISTEN, MD 4/3/2020 4/3/2025 METABOLISM DALLAS TX ACTIVE 4/24/2020 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

Page 121 of 332 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 AMBALONG, MARIA PHARAH Q9277 PAGUSARA, MD 8/1/2016 8/1/2021 FAMILY MEDICINE GERIATRICS DALLAS TX ACTIVE 8/9/2016 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 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 Q5632 CASEY, CHRISTINA VU, DO 8/14/2015 8/14/2020 FAMILY MEDICINE DALLAS TX ACTIVE 8/31/2015 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 ESQUIVEL, HEATHER MICHELE, Q7362 MD 3/4/2016 3/4/2021 FAMILY MEDICINE DALLAS TX ACTIVE 4/4/2016 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 R5000 LI, LIN, MD 10/20/2017 10/20/2022 FAMILY MEDICINE FAMILY PRACTICE DALLAS TX ACTIVE 10/31/2017 None N/A R4275 MARROQUIN, OKSANA , MD 8/15/2017 8/15/2022 FAMILY MEDICINE DALLAS TX ACTIVE 8/16/2017 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 R4123 PATEL, MAHEEN , DO 8/1/2017 8/1/2022 FAMILY MEDICINE DALLAS TX ACTIVE 8/28/2017 None N/A Q9502 ROY, VIBIN , MD 8/1/2016 8/1/2021 FAMILY MEDICINE DALLAS TX ACTIVE 8/8/2016 None N/A J2783 SCHNEIDER, FRANK DAVID, MD 5/22/2017 5/22/2022 FAMILY MEDICINE DALLAS TX ACTIVE 5/24/2017 None N/A R3959 SHIVASHANKAR, SANDYA, MD 7/17/2017 7/17/2022 FAMILY MEDICINE DALLAS TX ACTIVE 7/24/2017 None N/A Q6290 ST JOHN, JAY , MD 10/1/2015 10/1/2020 FAMILY MEDICINE GERIATRICS DALLAS TX ACTIVE 10/12/2015 None N/A Q7120 TRAN, KIM , MD 2/1/2016 2/1/2021 FAMILY MEDICINE DALLAS TX ACTIVE 2/8/2016 None N/A WEISS, CHRISTOPHER JOSEPH, R0810 MD 11/15/2016 11/15/2021 FAMILY MEDICINE DALLAS TX ACTIVE 11/17/2016 None N/A R0343 WILEY, BRIAN ARNELL, MD 9/30/2016 9/30/2021 FAMILY PRACTICE PAIN MANAGEMENT DALLAS TX ACTIVE 10/7/2016 None N/A PAIN FAMILY PRACTICE - MANAGEMENT/REHA Q9070 VERMA, NEIL, MD 7/1/2016 7/1/2021 EMERGENCY MED B MED DALLAS TX ACTIVE 7/8/2016 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 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 GASTROENTEROLOG R2573 DESAI, AMIT P, MD 4/20/2017 4/20/2022 Y INTERNAL MEDICINE DALLAS TX ACTIVE 7/4/2017 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 GASTROENTEROLOG R5461 ROBBINS, RICHARD , MD 12/8/2017 12/8/2022 Y DALLAS TX ACTIVE 1/12/2018 None N/A GASTROENTEROLOG R2229 SOAPE, MATTHEW PHILLIP , MD 3/20/2017 3/20/2022 Y INTERNAL MEDICINE DALLAS TX ACTIVE 3/27/2017 None N/A

Page 122 of 332 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 R0138 SOUZA, RHONDA FRANCES, MD 9/15/2016 9/15/2021 Y INTERNAL MEDICINE DALLAS TX ACTIVE 9/21/2016 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 S5123 BLASINGAME, JAY MICHAEL, MD 2/21/2020 2/21/2025 GENERAL SURGERY DALLAS TX ACTIVE 3/9/2020 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 Q5782 CLARKE, NICHOLAS , MD 8/28/2015 8/28/2020 GENERAL SURGERY DALLAS TX ACTIVE 9/1/2015 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 S4761 FLOYD, MORGAN , MD 1/24/2020 1/24/2025 GENERAL SURGERY DALLAS TX ACTIVE 1/30/2020 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 THORACIC CARDIOVASCULAR S6637 HEID, CHRISTOPHER , MD 5/15/2020 5/15/2025 GENERAL SURGERY SURGERY DALLAS TX ACTIVE 5/18/2020 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 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 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 MALEKPOUR GHORBANI, VASCULAR R0611 FATEMEH, MD 10/31/2016 10/31/2021 GENERAL SURGERY SURGERY DALLAS TX ACTIVE 11/14/2016 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 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 SURGICAL Q6068 MINTER, REBECCA MANGET, MD 9/15/2015 9/15/2020 GENERAL SURGERY ONCOLOGY DALLAS TX ACTIVE 9/16/2015 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 TRANSPLANT R1109 PURI, VICHIN CHANDER, MD 12/16/2016 12/16/2021 GENERAL SURGERY SURGERY DALLAS TX ACTIVE 12/20/2016 None N/A TRAUMATIC R2958 ROSS, SAMUEL WADE, MD 5/5/2017 5/5/2022 GENERAL SURGERY SURGERY DALLAS TX ACTIVE 5/12/2017 None N/A SCHNEIDER, BENJAMIN EDWARD, L4697 MD 10/20/2017 10/20/2022 GENERAL SURGERY DALLAS TX ACTIVE 11/6/2017 None N/A

Page 123 of 332 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 SPALDING, MARSHALL CHANCE, TRAUMATIC Q5283 DO 7/15/2015 7/15/2020 GENERAL SURGERY SURGERY DALLAS TX ACTIVE 7/16/2015 None N/A CRITICAL CARE Q9064 TSENG, ESTHER SOPHIA, MD 7/1/2016 7/1/2021 GENERAL SURGERY (TRAUMA) DALLAS TX ACTIVE 7/7/2016 None N/A

Q5592 VAUGHAN, NATHAN ANDREW , MD 8/3/2015 8/3/2020 GENERAL SURGERY DALLAS TX ACTIVE 8/18/2015 None N/A R4497 WEIS, JOSHUA JOHN, MD 8/25/2017 8/25/2022 GENERAL SURGERY DALLAS TX ACTIVE 9/1/2017 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 GERIATRICS - R5675 VOIT, JESSICA HARPHAM, MD 1/5/2018 1/5/2023 INTERNAL MEDICINE INTERNAL MEDICINE DALLAS TX ACTIVE 1/8/2018 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 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 HINCHCLIFF, KATHARINE MOSS, S5386 MD 3/6/2020 3/6/2025 HAND SURGERY DALLAS TX ACTIVE 4/30/2020 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 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 HEMATOLOGY - S6793 BAT, TAHA, MD 5/29/2020 5/29/2025 INTERNAL MEDICINE ONCOLOGY DALLAS TX ACTIVE 6/5/2020 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 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 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 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 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

Page 124 of 332 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 HEMATOLOGY/ONCOL MEDICINE (INTERNAL R0113 RIZVI, SYED MUJTABA, MD 9/15/2016 9/15/2021 OGY MED) DALLAS TX ACTIVE 10/3/2016 None N/A HEMATOLOGY/ONCOL S4894 VANDROSS, ANDRAE, MD 1/24/2020 1/24/2025 OGY DALLAS TX ACTIVE 1/27/2020 None N/A Q5318 AGHAROKH, LADAN, MD 8/3/2015 8/3/2020 HOSPITALIST PEDIATRICS DALLAS TX ACTIVE 8/4/2015 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 R5101 CHU, EUGENE, MD 11/3/2017 11/3/2022 HOSPITALIST DALLAS TX ACTIVE 11/29/2017 None N/A S4949 FLEMING, RYAN, MD 2/7/2020 2/7/2025 HOSPITALIST DALLAS TX ACTIVE 2/26/2020 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 TEXAS LICENSE P3903 JONES, CHRISTINA , MD 11/16/2015 11/16/2020 HOSPITALIST DALLAS TX ISSUED 11/16/2015 None N/A Q7216 KALRA, NEERAJ KUMAR, MD 2/16/2016 2/16/2021 HOSPITALIST DALLAS TX ACTIVE 2/26/2016 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

Q5238 OLISA, CHARLES ONWUMERE, MD 7/15/2015 7/15/2020 HOSPITALIST INTERNAL MEDICINE DALLAS TX ACTIVE 7/17/2015 None N/A Q5716 RIZWAN, ATIF, MD 8/14/2015 8/14/2020 HOSPITALIST INTERNAL MEDICINE DALLAS TX ACTIVE 8/17/2015 None N/A S5271 SORRELL, LUKE PAINE, MD 2/21/2020 2/21/2025 HOSPITALIST INTERNAL MEDICINE DALLAS TX ACTIVE 3/2/2020 None N/A R4905 STONE, LANGDON GUNDRY, MD 10/6/2017 10/6/2022 HOSPITALIST DALLAS TX ACTIVE 10/10/2017 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 INFECTIOUS R5112 ESTELLE, CAROLEE D, MD 11/3/2017 11/3/2022 DISEASES INTERNAL MEDICINE DALLAS TX ACTIVE 11/7/2017 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 INFECTIOUS MEDICAL Q9373 HILL, EMILIE VERONICA, MD 8/1/2016 8/1/2021 DISEASES MICROBIOLOGY DALLAS TX ACTIVE 8/11/2016 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 INFECTIOUS R1409 LUQUE, AMNERIS ESTHER, MD 1/20/2017 1/20/2022 DISEASES INTERNAL MEDICINE DALLAS TX ACTIVE 1/30/2017 None N/A INFECTIOUS R2705 PERL, TRISH MARIE, MD 4/20/2017 4/20/2022 DISEASES INTERNAL MEDICINE DALLAS TX ACTIVE 4/24/2017 None N/A SANDKOVSKY, URIEL SEBASTIAN, INFECTIOUS R5933 MD 2/2/2018 2/2/2023 DISEASES INTERNAL MEDICINE DALLAS TX ACTIVE 2/5/2018 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

Page 125 of 332 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 Q8813 ADESINA, JOYCE, MD 7/1/2016 7/1/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 7/6/2016 None N/A R2516 ADUBA, IFEOMA , MD 4/20/2017 4/20/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 5/8/2017 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

R5346 AGGARWAL, MANIK NARAYAN, MD 12/8/2017 12/8/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 12/11/2017 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 AHMED TAHA, RIHAB ELAMEEN , Q4882 MD 7/1/2015 7/1/2020 INTERNAL MEDICINE NEPHROLOGY DALLAS TX ACTIVE 8/5/2015 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

R2799 AKINSEYE-AFFUM, NOVLETTE, MD 5/5/2017 5/5/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 5/26/2017 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 R0989 ALI, SHAH RUKH, MD 12/16/2016 12/16/2021 INTERNAL MEDICINE CARDIOLOGY DALLAS TX ACTIVE 12/20/2016 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 R3792 ANSHASI, AHMAD, MD 7/17/2017 7/17/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 7/19/2017 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 BAYSSA, EYERUSALEM ENGIDA, R2053 MD 3/20/2017 3/20/2022 INTERNAL MEDICINE NEPHROLOGY DALLAS TX ACTIVE 3/30/2017 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 R0538 BENNETT, DANIEL NOALL, MD 10/31/2016 10/31/2021 INTERNAL MEDICINE CARDIOLOGY DALLAS TX ACTIVE 11/7/2016 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

R5370 BREWER, ELIZABETH CAITLIN, MD 12/8/2017 12/8/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 2/15/2018 None N/A R3803 BRICKEY, MARK, MD 7/17/2017 7/17/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 8/1/2017 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

Q6160 CARDENAS, CARLOS PATRICK, MD 10/1/2015 10/1/2020 INTERNAL MEDICINE DALLAS TX ACTIVE 10/6/2015 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 S5343 CHIDESTER, JEFFREY PAUL, MD 3/6/2020 3/6/2025 INTERNAL MEDICINE DALLAS TX ACTIVE 3/17/2020 None N/A R4199 CHINDHY, SHAHZAD , MD 8/15/2017 8/15/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 8/17/2017 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

Page 126 of 332 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 DAVIES JONES, OLUBUKOLA Q6407 ADUKE, MD 11/2/2015 11/2/2020 INTERNAL MEDICINE DALLAS TX ACTIVE 11/9/2015 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 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 S6164 DUNCAN, RACHEL LYNN, MD 4/17/2020 4/17/2025 INTERNAL MEDICINE DALLAS TX ACTIVE 4/29/2020 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 ELSBERND, BENJAMIN R2092 LAWRENCE, MD 3/20/2017 3/20/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 4/25/2017 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 Q9837 ESEDDI, JOAD, MD 8/26/2016 8/26/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 8/29/2016 None N/A FALLAHZADEH ABARGHOUEI, R4039 MOHAMMAD KAZEM , MD 8/1/2017 8/1/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 8/3/2017 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 Q7364 FEINGOLD, WILLIAM ISAAC, DO 3/4/2016 3/4/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 3/16/2016 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 Q9354 GEHI, DIVYA , MD 8/1/2016 8/1/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 8/3/2016 None N/A R0722 GUPTA, ARJUN , MD 11/15/2016 11/15/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 11/22/2016 None N/A R2863 HALAWI, RACHA, MD 5/5/2017 5/5/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 5/25/2017 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 HENDREN, NICHOLAS STEPHEN, R0726 MD 11/15/2016 11/15/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 11/28/2016 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 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 Q4602 HOSSAIN, SHABBIR MAJID, MD 6/1/2015 6/1/2020 INTERNAL MEDICINE DALLAS TX ACTIVE 6/2/2015 None N/A R3867 HOYER, AIMEE, MD 7/17/2017 7/17/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 8/9/2017 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 R4241 ISRAEL, KATHERINE ANNE, MD 8/15/2017 8/15/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 8/17/2017 None N/A Q9833 JAVED, SAIMA, MD 8/26/2016 8/26/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 9/7/2016 None N/A R2372 JOSHI, SHYAM , MD 4/4/2017 4/4/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 4/14/2017 None N/A R3694 KARMEGAM, SATHISH , MD 6/30/2017 6/30/2022 INTERNAL MEDICINE HOSPITALIST DALLAS TX ACTIVE 7/11/2017 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

Page 127 of 332 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 R0045 KHERA, ROHAN, MD 9/15/2016 9/15/2021 INTERNAL MEDICINE CARDIOLOGY DALLAS TX ACTIVE 9/21/2016 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 R1400 KOTLA, SUMAN KRISHNA , MD 1/20/2017 1/20/2022 INTERNAL MEDICINE INTERNAL MEDICINE DALLAS TX ACTIVE 4/13/2017 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 R1069 LE, TRI CAO, MD 12/16/2016 12/16/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 12/20/2016 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 R6228 LINZAY, CATHERINE DOWNS, MD 3/2/2018 3/2/2023 INTERNAL MEDICINE DALLAS TX ACTIVE 3/19/2018 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 R3903 LITTLE, LANNA , MD 7/17/2017 7/17/2022 INTERNAL MEDICINE INTERNAL MEDICINE DALLAS TX ACTIVE 7/24/2017 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 R4090 MAHAVESH, AMTUL K, MD 8/1/2017 8/1/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 8/24/2017 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 S6887 MAURICIO, RINA , MD 5/29/2020 5/29/2025 INTERNAL MEDICINE CARDIOLOGY DALLAS 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 Q9204 MENON, INDU, MD 7/15/2016 7/15/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 7/22/2016 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 Q9449 MUTUA, MARY KAVENGI, MD 8/1/2016 8/1/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 8/25/2016 None N/A R5014 NANDIVADA, SRIJNA , MD 10/20/2017 10/20/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 10/23/2017 None N/A Q9691 NAYAK, SATYAM, MD 8/15/2016 8/15/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 9/2/2016 None N/A NIETO MERAZ, ARIANNA MARIOTT, Q9698 MD 8/15/2016 8/15/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 8/18/2016 None N/A

S6470 OLIVER, KELVIN BERNARD JR, MD 5/1/2020 5/1/2025 INTERNAL MEDICINE DALLAS TX ACTIVE 5/8/2020 None N/A PAGADALA, MANGESH RAJARAM, GASTROENTEROLOG Q6256 MD 10/1/2015 10/1/2020 INTERNAL MEDICINE Y DALLAS TX ACTIVE 10/20/2015 None N/A PAMULAPARTHY, SMITHA REDDY, R0091 MD 9/15/2016 9/15/2021 INTERNAL MEDICINE NEPHROLOGY DALLAS TX ACTIVE 9/22/2016 None N/A R2434 PANDEY, AMBARISH , MD 4/4/2017 4/4/2022 INTERNAL MEDICINE CARDIOLOGY DALLAS TX ACTIVE 4/18/2017 None N/A PANEZAI, MUHAMMAD AJMAL R2696 KHAN, MD 4/20/2017 4/20/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 4/25/2017 None N/A Q6083 PARK, BORAM KIM, MD 9/15/2015 9/15/2020 INTERNAL MEDICINE DALLAS TX ACTIVE 9/17/2015 None N/A

Page 128 of 332 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 R3731 PATEL, AENA, MD 6/30/2017 6/30/2022 INTERNAL MEDICINE LOGY DALLAS TX ACTIVE 7/10/2017 None N/A R1099 PATEL, KERSHAW VIRAF , MD 12/16/2016 12/16/2021 INTERNAL MEDICINE CARDIOLOGY DALLAS TX ACTIVE 12/19/2016 None N/A CARDIOVASCULAR R3935 PATEL, NISHI HAMANTKUMAR , MD 7/17/2017 7/17/2022 INTERNAL MEDICINE DISEASES DALLAS TX ACTIVE 7/19/2017 None N/A Q9706 PATEL, RAVINA , DO 8/15/2016 8/15/2021 INTERNAL MEDICINE NEPHROLOGY DALLAS TX ACTIVE 8/17/2016 None N/A R1103 PATEL, TIMIL H, MD 12/16/2016 12/16/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 12/19/2016 None N/A Q6557 PERWEZ, FARIHAH BADAR, MD 11/16/2015 11/16/2020 INTERNAL MEDICINE DALLAS TX ACTIVE 11/20/2015 None N/A S4843 PHILIP, STEPHEN GEORGE, MD 1/24/2020 1/24/2025 INTERNAL MEDICINE DALLAS TX ACTIVE 1/29/2020 None N/A Q6898 POWELL, MELANIE ANN, MD 1/6/2016 1/6/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 1/25/2016 None N/A R1619 PREMACHANDRA, LALITH P, MD 2/6/2017 2/6/2022 INTERNAL MEDICINE INTERNAL MEDICINE DALLAS TX ACTIVE 2/27/2017 None N/A INFECTIOUS Q9885 PROKESCH, BONNIE CHASE, MD 8/26/2016 8/26/2021 INTERNAL MEDICINE DISEASES DALLAS TX ACTIVE 8/30/2016 None N/A R0780 RANKIN, MICHAEL BRETT, MD 11/15/2016 11/15/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 11/17/2016 None N/A R3192 RAO, SEEMA MAHALE, MD 5/22/2017 5/22/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 5/31/2017 None N/A PALLIATIVE R2953 REDDY, PADMAJA GUDURU, MD 5/5/2017 5/5/2022 INTERNAL MEDICINE MEDICINE DALLAS TX ACTIVE 5/9/2017 None N/A S6920 REZIGH, AUSTIN CAMERON, MD 5/29/2020 5/29/2025 INTERNAL MEDICINE DALLAS TX ACTIVE 6/5/2020 None N/A R2721 ROSOL, ZACHARY PAUL , MD 4/20/2017 4/20/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 5/3/2017 None N/A Q8787 RUSHI, SWATI, MD 6/10/2016 6/10/2021 INTERNAL MEDICINE HOSPITALIST DALLAS TX ACTIVE 6/13/2016 None N/A R5932 SAINI, VINAY K, MD 2/2/2018 2/2/2023 INTERNAL MEDICINE NEPHROLOGY DALLAS TX ACTIVE 2/20/2018 None N/A Q6904 SALEH, ANAS W, MD 1/6/2016 1/6/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 1/27/2016 None N/A S4381 SALEH, SAMEH , MD 12/6/2019 12/6/2024 INTERNAL MEDICINE DALLAS TX ACTIVE 12/11/2019 None N/A S4381 SALEH, SAMEH , MD 12/6/2019 12/6/2024 INTERNAL MEDICINE DALLAS TX ACTIVE 12/11/2019 None N/A S6929 SARTIN, REBECCA LEIGH, MD 5/29/2020 5/29/2025 INTERNAL MEDICINE DALLAS TX ACTIVE 6/12/2020 None N/A S5266 SHAFIEI, SCOTT , MD 2/21/2020 2/21/2025 INTERNAL MEDICINE HOSPITALIST DALLAS TX ACTIVE 3/20/2020 None N/A S7139 SHAH, SONIA , MD 6/12/2020 6/12/2025 INTERNAL MEDICINE CARDIOLOGY DALLAS TX ACTIVE 6/15/2020 None N/A PULMONARY Q8634 SHAH, TRUSHIL GAURAV, MD 6/1/2016 6/1/2021 INTERNAL MEDICINE MEDICINE DALLAS TX ACTIVE 6/6/2016 None N/A R3753 SHIE, JESSICA J, MD 6/30/2017 6/30/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 7/10/2017 None N/A PULMONARY CRITICAL CARE R2478 SINGH, ANIL, MD 4/4/2017 4/4/2022 INTERNAL MEDICINE MEDICINE DALLAS TX ACTIVE 5/22/2017 None N/A R6108 SONDHI, VARUN , MD 2/16/2018 2/16/2023 INTERNAL MEDICINE DALLAS TX ACTIVE 2/19/2018 None N/A R5475 SUKUMAR, SENTHIL , MD 12/8/2017 12/8/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 12/25/2017 None N/A Q9911 SUTARIA, JAINI MEHUL, MD 8/26/2016 8/26/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 9/26/2016 None N/A R4785 TARLOW, BRANDEN DAVID, MD 9/22/2017 9/22/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 10/9/2017 None N/A GASTROENTEROLOG R2027 TIELLEMAN, THOMAS JAMES, MD 3/3/2017 3/3/2022 INTERNAL MEDICINE Y DALLAS TX ACTIVE 3/17/2017 None N/A

Page 129 of 332 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 S6076 TRIANA, TAYLOR SUZANNE, MD 4/3/2020 4/3/2025 INTERNAL MEDICINE CARDIOLOGY DALLAS TX ACTIVE 4/15/2020 None N/A

Q9533 TSAI, THOMAS TSONG-HUSAN, MD 8/1/2016 8/1/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 8/3/2016 None N/A R3447 TSAI-NGUYEN, GINGER , MD 6/2/2017 6/2/2022 INTERNAL MEDICINE DALLAS TX ACTIVE 6/5/2017 None N/A R0804 VASUDEV, BRAHM SARUP, MD 11/15/2016 11/15/2021 INTERNAL MEDICINE NEPHROLOGY DALLAS TX ACTIVE 11/16/2016 None N/A R4159 VATANAPRADITH, ATHICA , MD 8/1/2017 8/1/2022 INTERNAL MEDICINE SLEEP MEDICINE DALLAS TX ACTIVE 8/2/2017 None N/A S6084 VENTO, JOSEPH ANTHONY, MD 4/3/2020 4/3/2025 INTERNAL MEDICINE DALLAS TX ACTIVE 4/16/2020 None N/A R5676 WAGNER, JENNIFER MARIE, MD 1/5/2018 1/5/2023 INTERNAL MEDICINE DALLAS TX ACTIVE 1/10/2018 None N/A Q6993 WANG, DAVID CHUNG WEI, MD 1/15/2016 1/15/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 1/20/2016 None N/A WARSHAUER, WILLIAM LOUIS III, Q7300 MD 2/16/2016 2/16/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 2/19/2016 None N/A R1672 WATSON, JOHN THOMAS, MD 2/6/2017 2/6/2022 INTERNAL MEDICINE INTERNAL MEDICINE DALLAS TX ACTIVE 2/8/2017 None N/A Q9553 WHITE, KATHRYN, DO 8/1/2016 8/1/2021 INTERNAL MEDICINE DALLAS TX ACTIVE 8/23/2016 None N/A Q5128 WOOD, MICHAEL ALAN, MD 7/1/2015 7/1/2020 INTERNAL MEDICINE DALLAS TX ACTIVE 7/2/2015 None N/A WROBEL, CHRISTOPHER ALLEN, R6314 MD 3/2/2018 3/2/2023 INTERNAL MEDICINE DALLAS TX ACTIVE 3/13/2018 None N/A Q5308 ZHANG, DA, MD 7/15/2015 7/15/2020 INTERNAL MEDICINE DALLAS TX ACTIVE 8/11/2015 None N/A HEMATOLOGY/ONCO R0168 ZHREBKER, LEAH , MD 9/15/2016 9/15/2021 INTERNAL MEDICINE LOGY DALLAS TX ACTIVE 10/3/2016 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 INTERVENTIONAL Q4916 CHAMARTHY, MURTHY R, MD 7/1/2015 7/1/2020 RADIOLOGY NUCLEAR MEDICINE DALLAS TX ACTIVE 7/7/2015 None N/A INTERVENTIONAL R1614 PETTIBON, KEITH DANIEL, MD 2/6/2017 2/6/2022 RADIOLOGY RADIOLOGY DALLAS TX ACTIVE 2/8/2017 None N/A INTERVENTIONAL R2967 SHAH, HRIDAY, MD 5/5/2017 5/5/2022 RADIOLOGY DALLAS TX ACTIVE 5/9/2017 None N/A NEUROLOGY/DIAGN OSTIC INTERVENTIONAL RAD/NEURORADIOLO S6750 TANG, LINNAN, MD 5/15/2020 5/15/2025 RADIOLOGY GY DALLAS TX ACTIVE 5/20/2020 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 MUSCULOSKELETAL ORTHOPEDIC R3349 ISAAC, CHRISTIAN, MD 6/2/2017 6/2/2022 ONCOLOGY SURGERY DALLAS TX ACTIVE 9/1/2017 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

Page 130 of 332 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

SMITHHART, WILLIAM ELLISON, NEONATAL- Q9249 MD 7/15/2016 7/15/2021 PERINATAL MEDICINE DALLAS TX ACTIVE 7/19/2016 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 TEXAS LICENSE N1638 GADHIA, MONIKA, MD 11/16/2015 11/16/2020 NEONATOLOGY DALLAS TX ISSUED 11/16/2015 None N/A Q7521 AL RIFAI, ANAS, MD 3/15/2016 3/15/2021 NEPHROLOGY DALLAS TX ACTIVE 4/7/2016 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 S6353 BAEZ MATOS, ELDRID, MD 5/1/2020 5/1/2025 NEPHROLOGY DALLAS TX ACTIVE 5/22/2020 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 NEUROLOGICAL Q5756 BAGLEY, CARLOS ANTONIO, MD 8/28/2015 8/28/2020 SURGERY DALLAS TX ACTIVE 9/4/2015 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 WHITTEMORE, BRETT ANTHONY, NEUROLOGICAL R0675 MD 10/31/2016 10/31/2021 SURGERY DALLAS TX ACTIVE 11/7/2016 None N/A R2534 BATES, JERRY ALAN, MD 4/20/2017 4/20/2022 NEUROLOGY DALLAS TX ACTIVE 4/27/2017 None N/A R3488 CHAMBERS, ELIZABETH J, MD 6/16/2017 6/16/2022 NEUROLOGY DALLAS TX ACTIVE 8/21/2017 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 R3327 GIBBONS, SARAH KATHRYN, DO 6/2/2017 6/2/2022 NEUROLOGY DALLAS TX ACTIVE 6/9/2017 None N/A HEINZELMANN, MORGAN S6204 MICHELLE, MD 4/17/2020 4/17/2025 NEUROLOGY DALLAS TX ACTIVE 4/20/2020 None N/A Q8908 HOMONOFF, MARK C, MD 7/1/2016 7/1/2021 NEUROLOGY DALLAS TX ACTIVE 8/23/2016 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

S4517 LAURITSEN, JONATHAN MARK, DO 12/20/2019 12/20/2024 NEUROLOGY DALLAS TX ACTIVE 2/7/2020 None N/A S5967 LI, DENISE JING, MD 4/3/2020 4/3/2025 NEUROLOGY DALLAS TX ACTIVE 4/6/2020 None N/A Q6916 VARGAS, BERT BRANDON, MD 1/6/2016 1/6/2021 NEUROLOGY DALLAS TX ACTIVE 2/11/2016 None N/A CRITICAL CARE - S6089 WALLEY, MEGAN JOYCE, MD 4/3/2020 4/3/2025 NEUROLOGY NEUROSURGERY DALLAS TX ACTIVE 4/8/2020 None N/A

NEURO-PHYSIOLOGY Q9923 XIONG, GE, MD 8/26/2016 8/26/2021 NEUROLOGY (NEUROLOGY) DALLAS TX ACTIVE 9/8/2016 None N/A

Page 131 of 332 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

CLINICAL Q9271 ZEPEDA, RODRIGO, MD 7/15/2016 7/15/2021 NEUROLOGY NEUROPHYSIOLOGY DALLAS TX ACTIVE 7/20/2016 None N/A NEUROMUSCULAR R2513 ZHOU, LAN, MD 4/4/2017 4/4/2022 NEUROLOGY DISEASE DALLAS TX ACTIVE 4/12/2017 None N/A NEUROLOGY & CRITICAL CARE - R1322 WILLIS, ADAM MATTHEW, MD 1/6/2017 1/6/2022 PSYCHIATRY NEUROSURGERY DALLAS TX ACTIVE 4/17/2017 None N/A R3432 SHAH, BHAVYA RAMESH, MD 6/2/2017 6/2/2022 NEURO-RADIOLOGY DALLAS TX ACTIVE 6/13/2017 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 OBSTETRICS AND Q8404 ACOSTA-TORRES, STEFANY , MD 6/1/2016 6/1/2021 GYNECOLOGY DALLAS TX ACTIVE 6/7/2016 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 OBSTETRICS AND R5238 ARIAS-FRANKLIN, SONIA L, MD 11/17/2017 11/17/2022 GYNECOLOGY DALLAS TX ACTIVE 11/20/2017 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 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 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 S4620 DEBNATH, PRIYANKA , MD 1/10/2020 1/10/2025 GYNECOLOGY DALLAS TX ACTIVE 1/14/2020 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 OBSTETRICS AND R3511 FLOWERS, MAUREEN E, MD 6/16/2017 6/16/2022 GYNECOLOGY DALLAS TX ACTIVE 6/19/2017 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 OBSTETRICS AND Q9388 JARIN, JASON , MD 8/1/2016 8/1/2021 GYNECOLOGY GYNECOLOGY DALLAS TX ACTIVE 10/4/2016 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 OBSTETRICS AND R4584 LAWSON, ASHLI ALYSSA, MD 9/8/2017 9/8/2022 GYNECOLOGY DALLAS TX ACTIVE 9/18/2017 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 132 of 332 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 Q7930 MILLER, PATRICIA ANN, DO 4/15/2016 4/15/2021 GYNECOLOGY DALLAS TX ACTIVE 4/18/2016 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 R3406 PORTER, ANNE , MD 6/2/2017 6/2/2022 GYNECOLOGY DALLAS TX ACTIVE 6/14/2017 None N/A OBSTETRICS AND Q8135 RODRIGUEZ, JOSE LUIS, MD 5/2/2016 5/2/2021 GYNECOLOGY DALLAS TX ACTIVE 5/4/2016 None N/A OBSTETRICS AND S6035 SCHELL, RACHEL CAROLINE, MD 4/3/2020 4/3/2025 GYNECOLOGY DALLAS TX ACTIVE 4/14/2020 None N/A OBSTETRICS AND GYNECOLOGIC R5317 SHEPHERD, JESSICA ABINA, MD 11/17/2017 11/17/2022 GYNECOLOGY SURGERY DALLAS TX ACTIVE 11/22/2017 None N/A OBSTETRICS AND GYNECOLOGIC R2224 SHIELDS, JESSICA KATHERINE, DO 3/20/2017 3/20/2022 GYNECOLOGY SURGERY DALLAS TX ACTIVE 4/3/2017 None N/A OBSTETRICS AND GYNECOLOGIC R6288 SIMS, TRAVIS T, MD 3/2/2018 3/2/2023 GYNECOLOGY ONCOLOGY DALLAS TX ACTIVE 3/5/2018 None N/A SPOONTS, KIMBERLY MICHELLE, OBSTETRICS AND R3596 MD 6/16/2017 6/16/2022 GYNECOLOGY DALLAS TX ACTIVE 7/7/2017 None N/A REPRODUCTIVE SEE OBSTETRICS AND ENDOCRINOLOGY PREVIOUS H0855 STOVALL, DALE WILLIAM, MD 6/16/2017 6/16/2022 GYNECOLOGY AND INFERTILITY DALLAS TX ACTIVE 6/28/2017 ORDER 6/19/2017 OBSTETRICS AND S6550 WANG, EMILY BRITTANY, MD 5/1/2020 5/1/2025 GYNECOLOGY DALLAS TX ACTIVE 5/11/2020 None N/A OBSTETRICS AND OBSTETRICS AND R5825 ZAPATA, HELIO ALEJANDRO, MD 1/19/2018 1/19/2023 GYNECOLOGY GYNECOLOGY DALLAS TX ACTIVE 2/2/2018 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 Q9626 HAMMERS, HANS JOERG, MD 8/15/2016 8/15/2021 ONCOLOGY DALLAS TX ACTIVE 8/17/2016 None N/A R2073 CEFALU, JEREMY, MD 3/20/2017 3/20/2022 OPHTHALMOLOGY DALLAS TX ACTIVE 3/22/2017 None N/A S5876 DAVIS, ROBERT TAYLOR, MD 4/3/2020 4/3/2025 OPHTHALMOLOGY DALLAS TX ACTIVE 4/17/2020 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

OPHTHALMOLOGY - Q8476 FONG, AMELIA ANN, MD 6/1/2016 6/1/2021 OPHTHALMOLOGY RECONST SURGERY DALLAS TX ACTIVE 6/6/2016 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 R0024 IDRIZOVIC, AZRA, DO 9/15/2016 9/15/2021 OPHTHALMOLOGY DALLAS TX ACTIVE 9/20/2016 None N/A

Page 133 of 332 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 - R2377 KHAN, RABEEA, MD 4/4/2017 4/4/2022 OPHTHALMOLOGY CORNEA DALLAS TX ACTIVE 4/12/2017 None N/A Q8541 LEE, CHRISTOPHER , MD 6/1/2016 6/1/2021 OPHTHALMOLOGY DALLAS TX ACTIVE 6/13/2016 None N/A R1610 PATEL, SAGAR YATIN, MD 2/6/2017 2/6/2022 OPHTHALMOLOGY DALLAS TX ACTIVE 2/13/2017 None N/A NEURO- Q5263 RIVERA, ENRIQUE JAVIER , MD 7/15/2015 7/15/2020 OPHTHALMOLOGY OPHTHALMOLOGY DALLAS TX ACTIVE 7/17/2015 None N/A SCHIANO, ADRIANE ELIZABETH, S5767 MD 3/20/2020 3/20/2025 OPHTHALMOLOGY DALLAS TX ACTIVE 3/27/2020 None N/A Q7114 STEPHENS, MARK THOMAS, MD 2/1/2016 2/1/2021 OPHTHALMOLOGY DALLAS TX ACTIVE 2/3/2016 None N/A R4920 WIGGINS, LAUREN, MD 10/6/2017 10/6/2022 OPHTHALMOLOGY DALLAS TX ACTIVE 11/20/2017 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

OPHTHALMOLOGY - OPHTHALMOLOGY - R3001 WALDROP, WILLIAM HATCHER, MD 5/5/2017 5/5/2022 CORNEA ANTERIOR SURGERY DALLAS TX ACTIVE 5/10/2017 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 OPHTHALMOLOGY - S4807 LIEU, PHILIP , MD 1/24/2020 1/24/2025 VITREOUS SURGERY OPHTHALMOLOGY DALLAS TX ACTIVE 2/4/2020 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 ORAL & MAXILLOFACIAL HEAD AND NECK Q6702 SCHLIEVE, THOMAS, MD 12/4/2015 12/4/2020 SURGERY SURGERY DALLAS TX ACTIVE 12/8/2015 None N/A ORAL & MAXILLOFACIAL HEAD AND NECK Q6702 SCHLIEVE, THOMAS, MD 12/4/2015 12/4/2020 SURGERY SURGERY DALLAS TX ACTIVE 12/8/2015 None N/A ORAL & MAXILLOFACIAL HEAD AND NECK Q6702 SCHLIEVE, THOMAS, MD 12/4/2015 12/4/2020 SURGERY SURGERY DALLAS TX ACTIVE 12/8/2015 None N/A ORAL & MAXILLOFACIAL R2779 VU, DAVID DAI, MD 4/20/2017 4/20/2022 SURGERY GENERAL SURGERY DALLAS TX ACTIVE 4/24/2017 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 ORTHOPEDIC PEDIATRIC R3816 CORCORAN-SCHWARTZ, IAN, MD 7/17/2017 7/17/2022 SURGERY ORTHOPEDICS DALLAS TX ACTIVE 7/19/2017 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

Page 134 of 332 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 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 ORTHOPEDIC Q7880 GIANG, ERIC LE, DO 4/15/2016 4/15/2021 SURGERY DALLAS TX ACTIVE 4/21/2016 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 ORTHOPEDIC PEDIATRIC S5671 KADADO, ALLEN ADIB, MD 3/20/2020 3/20/2025 SURGERY ORTHOPEDICS DALLAS TX ACTIVE 3/24/2020 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 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 ORTHOPEDIC Q7744 MATHEW, STEPHEN THOMAS, MD 4/1/2016 4/1/2021 SURGERY DALLAS TX ACTIVE 6/15/2016 None N/A ORTHOPEDIC S6497 RINEHART, DUSTIN BLAKE, MD 5/1/2020 5/1/2025 SURGERY DALLAS TX ACTIVE 5/14/2020 None N/A ORTHOPEDIC S5272 SUN, GRANT, MD 2/21/2020 2/21/2025 SURGERY DALLAS TX ACTIVE 3/3/2020 None N/A ORTHOPEDIC ORTHOPEDIC Q4853 SWANN, MATTHEW CHARLES, MD 6/12/2015 6/12/2020 SURGERY SURGERY DALLAS TX ACTIVE 6/15/2015 None N/A ORTHOPEDIC FOOT AND ANKLE, R0524 WUKICH, DANE K, MD 10/14/2016 10/14/2021 SURGERY ORTHOPEDICS DALLAS TX ACTIVE 10/26/2016 None N/A ORTHOPEDIC Q8402 ZMUGG, STEPHAN THOMAS, MD 5/16/2016 5/16/2021 SURGERY DALLAS TX ACTIVE 5/24/2016 None N/A ORTHOPEDIC SURGERY OF THE ORTHOPEDIC Q9068 VAN HAL, MICHAEL DAVID, MD 7/1/2016 7/1/2021 SPINE SURGERY DALLAS TX ACTIVE 7/4/2016 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 ORTHOPEDIC ORTHOPEDIC Q5558 SANDERS, DREW THOMAS, MD 8/3/2015 8/3/2020 TRAUMA SURGERY DALLAS TX ACTIVE 8/4/2015 None N/A R3783 ABEBE, ERMIAS SHAWEL , MD 7/17/2017 7/17/2022 ORTHOPEDICS DALLAS TX ACTIVE 9/25/2017 None N/A 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 PEDIATRIC R5602 MORRIS, WILLIAM ZACHARY, MD 1/5/2018 1/5/2023 ORTHOPEDICS ORTHOPEDICS DALLAS TX ACTIVE 2/6/2018 None N/A Q9931 AGAN, ASHLEY DYAN, MD 9/15/2016 9/15/2021 OTOLARYNGOLOGY DALLAS TX ACTIVE 9/23/2016 None N/A

Page 135 of 332 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 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

Q6330 JOHNSON, ANDREW KESSLER, MD 10/15/2015 10/15/2020 OTOLARYNGOLOGY DALLAS TX ACTIVE 10/19/2015 None N/A R5774 MEDINA, MELECIO JESUS, MD 1/19/2018 1/19/2023 OTOLARYNGOLOGY DALLAS TX ACTIVE 1/30/2018 None N/A HEAD AND NECK R4487 TILLMAN, BRITTNY NICOLE, MD 8/25/2017 8/25/2022 OTOLARYNGOLOGY SURGERY DALLAS TX ACTIVE 9/18/2017 None N/A Q7611 TULLY, LAURA JILL, MD 3/15/2016 3/15/2021 OTOLARYNGOLOGY DALLAS TX ACTIVE 3/21/2016 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 R3067 DOTT, DALTRY, MD 5/22/2017 5/22/2022 PAIN MANAGEMENT ANESTHESIOLOGY DALLAS TX ACTIVE 6/22/2017 None N/A

R2820 BROWN, ELIZABETH AUBREY, MD 5/5/2017 5/5/2022 PALLIATIVE MEDICINE FAMILY MEDICINE DALLAS TX ACTIVE 6/16/2017 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

Q7966 SIROPAIDES, CAITLIN HOLT, DO 4/15/2016 4/15/2021 PALLIATIVE MEDICINE INTERNAL MEDICINE DALLAS TX ACTIVE 4/18/2016 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 Q7354 DANG, DANIEL NGOC, MD 3/4/2016 3/4/2021 PATHOLOGY DALLAS TX ACTIVE 3/7/2016 None N/A R1946 DENNIS, JAKE ANDREW, MD 3/3/2017 3/3/2022 PATHOLOGY DALLAS TX ACTIVE 3/6/2017 None N/A R5858 EL-ZAYATY, SHADY AHMED, MD 2/2/2018 2/2/2023 PATHOLOGY DALLAS TX ACTIVE 2/5/2018 None N/A S4802 LANG, BENJAMIN JOSEPH, MD 1/24/2020 1/24/2025 PATHOLOGY DALLAS TX ACTIVE 1/28/2020 None N/A R6048 METTER, DAVID MATTHEW, MD 2/16/2018 2/16/2023 PATHOLOGY DALLAS TX ACTIVE 2/26/2018 None N/A MOLECULAR GENETIC S4396 SORELLE, JEFFREY ANDREW, MD 12/6/2019 12/6/2024 PATHOLOGY PATHOLOGY DALLAS TX ACTIVE 12/11/2019 None N/A MOLECULAR GENETIC S4396 SORELLE, JEFFREY ANDREW, MD 12/6/2019 12/6/2024 PATHOLOGY PATHOLOGY DALLAS TX ACTIVE 12/11/2019 None N/A PEDIATRIC R3231 THAKER, AMEET INDRAVADAN, MD 5/22/2017 5/22/2022 PATHOLOGY PATHOLOGY DALLAS TX ACTIVE 6/5/2017 None N/A R3779 ZHOU, MING, MD 6/30/2017 6/30/2022 PATHOLOGY DALLAS TX ACTIVE 7/7/2017 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

Page 136 of 332 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 JAQUISS, ROBERT DOUGLAS CARDIOTHORACIC R1549 BENJAMIN, MD 2/6/2017 2/6/2022 SURGERY DALLAS TX ACTIVE 2/8/2017 None N/A PEDIATRIC CARDIOTHORACIC Q5711 PIROLLI, TIMOTHY JOHN, MD 8/14/2015 8/14/2020 SURGERY THORACIC SURGERY DALLAS TX ACTIVE 8/27/2015 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 PEDIATRIC CRITICAL Q7038 ESANGBEDO, IVIE DORIS, MD 2/1/2016 2/1/2021 CARE MEDICINE DALLAS TX ACTIVE 2/19/2016 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 PEDIATRIC CRITICAL Q7913 LEE, AMY ELIZABETH, MD 4/15/2016 4/15/2021 CARE MEDICINE DALLAS TX ACTIVE 4/29/2016 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 PEDIATRIC CRITICAL Q9481 POOLE, ALAN MATTHEW, MD 8/1/2016 8/1/2021 CARE MEDICINE DALLAS TX ACTIVE 8/3/2016 None N/A PEDIATRIC CRITICAL R0166 YU, PRISCILLA, MD 9/15/2016 9/15/2021 CARE MEDICINE DALLAS TX ACTIVE 9/22/2016 None N/A PEDIATRIC EMERGENCY Q8118 PARIKH, RUSHI RUTESH, DO 5/2/2016 5/2/2021 MEDICINE (PEDS) PEDIATRICS DALLAS TX ACTIVE 5/9/2016 None N/A PEDIATRIC EMERGENCY R1270 PATEL, FAISALMOHEMED, MD 1/6/2017 1/6/2022 MEDICINE (PEDS) DALLAS TX ACTIVE 1/18/2017 None N/A PEDIATRIC EMERGENCY PALLIATIVE S6984 YAKLIN, CLAY WILLIAM, MD 5/29/2020 5/29/2025 MEDICINE (PEDS) MEDICINE DALLAS TX ACTIVE 6/8/2020 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 PEDIATRIC GASTROENTEROLOG R2413 MEDINA-CENTENO, RICARDO , MD 4/4/2017 4/4/2022 Y DALLAS TX ACTIVE 4/10/2017 None N/A PEDIATRIC GASTROENTEROLOG R4442 ODIASE, ELAINE , MD 8/25/2017 8/25/2022 Y PEDIATRICS DALLAS TX ACTIVE 9/5/2017 None N/A

Page 137 of 332 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 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 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 PEDIATRIC MITCHELL, MICHAEL MARSHALL, HEMATOLOGY/ONCOL R2922 DO 5/5/2017 5/5/2022 OGY DALLAS TX ACTIVE 5/8/2017 None N/A PEDIATRIC HEMATOLOGY/ONCOL R0103 PHAM, AN , MD 9/15/2016 9/15/2021 OGY DALLAS TX ACTIVE 9/23/2016 None N/A

PEDIATRIC R0510 TEKIPPE, MICHAEL JON, MD 10/14/2016 10/14/2021 INFECTIOUS DISEASE DALLAS TX ACTIVE 10/17/2016 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 PEDIATRIC R4259 KIM, ERIN D, MD 8/15/2017 8/15/2022 NEPHROLOGY DALLAS TX ACTIVE 9/4/2017 None N/A PEDIATRIC Q5947 VIDI, SMITHA RAO, MD 8/28/2015 8/28/2020 NEPHROLOGY DALLAS TX ACTIVE 9/14/2015 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 PEDIATRIC PEDIATRIC S5580 CHORNEY, STEPHEN REED, MD 3/20/2020 3/20/2025 OTOLARYNGOLOGY OTOLARYNGOLOGY DALLAS TX ACTIVE 6/3/2020 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 PEDIATRIC Q9425 MAHMOOD, BRIAN KELLY, MD 8/1/2016 8/1/2021 PULMONOLOGY PEDIATRICS DALLAS TX ACTIVE 8/16/2016 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 PEDIATRIC INTERVENTIONAL Q5829 KANG, LISA, MD 8/28/2015 8/28/2020 RADIOLOGY RADIOLOGY DALLAS TX ACTIVE 8/31/2015 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 Q4950 FIKE, FRANKIE BETH, MD 7/1/2015 7/1/2020 PEDIATRIC SURGERY DALLAS TX ACTIVE 7/9/2015 None N/A

Page 138 of 332 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 R2644 KNOD, JENNIFER LESLIE, MD 4/20/2017 4/20/2022 PEDIATRIC SURGERY DALLAS TX ACTIVE 5/18/2017 None N/A

R3572 PANDYA, SAMIR RAMESH, MD 6/16/2017 6/16/2022 PEDIATRIC SURGERY GENERAL SURGERY DALLAS TX ACTIVE 6/19/2017 None N/A R3464 AHMED, IBRAHIM M, MD 6/16/2017 6/16/2022 PEDIATRICS DALLAS TX ACTIVE 9/13/2017 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 PEDIATRIC R1703 BASORA ROVIRA, ELISA, MD 2/22/2017 2/22/2022 PEDIATRICS PULMONOLOGY DALLAS TX ACTIVE 5/11/2017 None N/A BOLT, JACQUELINE ELIZABETH, S5563 MD 3/20/2020 3/20/2025 PEDIATRICS DALLAS TX ACTIVE 4/23/2020 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 BOUTON, LAUREN KATHARINE Q8435 EBE, MD 6/1/2016 6/1/2021 PEDIATRICS DALLAS TX ACTIVE 6/10/2016 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 R2546 BYRNE, ELIZABETH ANN, MD 4/20/2017 4/20/2022 PEDIATRICS DALLAS TX ACTIVE 4/21/2017 None N/A R6163 CHOW, TIMOTHY , MD 3/2/2018 3/2/2023 PEDIATRICS DALLAS TX ACTIVE 3/19/2018 None N/A Q5639 CHU, DANIELLE DAIYUN, MD 8/14/2015 8/14/2020 PEDIATRICS DALLAS TX ACTIVE 8/21/2015 None N/A CORTELYOU, CHRISTINE R3818 MICHELLE, MD 7/17/2017 7/17/2022 PEDIATRICS DALLAS TX ACTIVE 7/20/2017 None N/A Q9138 COTTER, MICHAEL PATRICK, MD 7/15/2016 7/15/2021 PEDIATRICS DALLAS TX ACTIVE 9/22/2016 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

Q5996 DERAMO, JENNIFER SHULER, MD 9/15/2015 9/15/2020 PEDIATRICS DALLAS TX ACTIVE 9/17/2015 None N/A R3311 DETTORI, AMY B, MD 6/2/2017 6/2/2022 PEDIATRICS DALLAS TX ACTIVE 6/6/2017 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 PEDIATRIC GASTROENTEROLOG S5882 DO, PHINGA , MD 4/3/2020 4/3/2025 PEDIATRICS Y DALLAS TX ACTIVE 4/13/2020 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 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 R2338 GAMMONS, SARAH , MD 4/4/2017 4/4/2022 PEDIATRICS DALLAS TX ACTIVE 4/7/2017 None N/A R4395 GRIBBONS, MEGAN , MD 8/25/2017 8/25/2022 PEDIATRICS DALLAS TX ACTIVE 9/19/2017 None N/A

Page 139 of 332 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 GUTIERREZ BONILLA, ANALYDIA , R2609 MD 4/20/2017 4/20/2022 PEDIATRICS DALLAS TX ACTIVE 6/9/2017 None N/A

R4060 HOGE, MARGARET KATHRYN, MD 8/1/2017 8/1/2022 PEDIATRICS DALLAS TX ACTIVE 8/4/2017 None N/A R4718 HONG, PETER J, MD 9/22/2017 9/22/2022 PEDIATRICS DALLAS TX ACTIVE 10/3/2017 None N/A Q4996 JOHNSON, KATHRYN ANN, MD 7/1/2015 7/1/2020 PEDIATRICS DALLAS TX ACTIVE 7/3/2015 None N/A S5408 KIM, HEIDI , MD 3/6/2020 3/6/2025 PEDIATRICS DALLAS TX ACTIVE 3/16/2020 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 S5682 KOSKEY, GLORIA , MD 3/20/2020 3/20/2025 PEDIATRICS DALLAS TX ACTIVE 3/27/2020 None N/A R3364 LANDRY, JESSICA BOAT, MD 6/2/2017 6/2/2022 PEDIATRICS DALLAS TX ACTIVE 6/19/2017 None N/A R2151 LAZAR, LAUREN KYLIE, MD 3/20/2017 3/20/2022 PEDIATRICS DALLAS TX ACTIVE 4/3/2017 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 PEDIATRIC EMERGENCY S5010 MANUEL, MATTHIAS , MD 2/7/2020 2/7/2025 PEDIATRICS MEDICINE (PEDS) DALLAS TX ACTIVE 3/6/2020 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 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 MARTINEZ PRO, SYLVIA R6044 ALEJANDRA, MD 2/16/2018 2/16/2023 PEDIATRICS DALLAS TX ACTIVE 2/26/2018 None N/A MASHMOUSHI, AHMAD KABALAN, R5007 MD 10/20/2017 10/20/2022 PEDIATRICS DALLAS TX ACTIVE 12/12/2017 None N/A S6685 MASSERANO, BENJAMIN , MD 5/15/2020 5/15/2025 PEDIATRICS DALLAS TX ACTIVE 5/27/2020 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 MOEMEKA, ANGELA NNEBUCHI, Q5495 MD 8/3/2015 8/3/2020 PEDIATRICS DALLAS TX ACTIVE 8/7/2015 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 Q5875 NAGRA, AMRITA, DO 8/28/2015 8/28/2020 PEDIATRICS DALLAS TX ACTIVE 9/1/2015 None N/A

Page 140 of 332 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- PERINATAL R2687 NATIQUE, KIRAN RAZA, MD 4/20/2017 4/20/2022 PEDIATRICS MEDICINE DALLAS TX ACTIVE 7/10/2017 None N/A PEDIATRIC Q9216 NGUYEN, MAILAN THANH, MD 7/15/2016 7/15/2021 PEDIATRICS RHEUMATOLOGY DALLAS TX ACTIVE 8/22/2016 None N/A Q5516 NGUYEN, NAM HOANG, MD 8/3/2015 8/3/2020 PEDIATRICS DALLAS TX ACTIVE 8/5/2015 None N/A NICHOLS-VINUEZA, DIANA R0085 XIMENA, MD 9/15/2016 9/15/2021 PEDIATRICS DALLAS TX ACTIVE 9/21/2016 None N/A R4613 ODIASE, EUNICE , MD 9/8/2017 9/8/2022 PEDIATRICS DALLAS TX ACTIVE 9/18/2017 None N/A

R2196 PARTRIDGE, PAIGE HELMICK, MD 3/20/2017 3/20/2022 PEDIATRICS DALLAS TX ACTIVE 4/17/2017 None N/A PEDIATRIC EMERGENCY Q5897 PATEL, NISHIT HARISHBHAI, MD 8/28/2015 8/28/2020 PEDIATRICS MEDICINE (PEDS) DALLAS TX ACTIVE 9/14/2015 None N/A Q9007 PRENGLER, REBECCA, MD 7/1/2016 7/1/2021 PEDIATRICS DALLAS TX ACTIVE 7/8/2016 None N/A R1631 RUAN, WENLY , MD 2/6/2017 2/6/2022 PEDIATRICS DALLAS TX ACTIVE 2/15/2017 None N/A PEDIATRICS, Q9900 SAHULEE, RAJ , DO 8/26/2016 8/26/2021 PEDIATRICS CARDIOLOGY DALLAS TX ACTIVE 9/9/2016 None N/A NEONATAL- PERINATAL Q9247 SHAH, KSHITI DINESH, MD 7/15/2016 7/15/2021 PEDIATRICS MEDICINE DALLAS TX ACTIVE 7/19/2016 None N/A R2978 SIRRI, CYNTHIA, MD 5/5/2017 5/5/2022 PEDIATRICS DALLAS TX ACTIVE 6/9/2017 None N/A R1133 SMITH, TAYLOR M, MD 12/16/2016 12/16/2021 PEDIATRICS DALLAS TX ACTIVE 1/2/2017 None N/A Q6796 TING, YU, MD 12/15/2015 12/15/2020 PEDIATRICS DALLAS TX ACTIVE 12/23/2015 None N/A TOLEDANES, GIANCARLO Q5585 TIRADOR, DO 8/3/2015 8/3/2020 PEDIATRICS HOSPITALIST DALLAS TX ACTIVE 9/2/2015 None N/A PEDIATRIC CRITICAL Q5120 VOLK, ALEXANDRA PAIGE, MD 7/1/2015 7/1/2020 PEDIATRICS CARE MEDICINE DALLAS TX ACTIVE 7/7/2015 None N/A NEONATAL- PERINATAL Q6478 WAN-HUEN, PHYLLIS, MD 11/2/2015 11/2/2020 PEDIATRICS MEDICINE DALLAS TX ACTIVE 11/5/2015 None N/A

R6134 WILLIAMS, SARAH ELIZABETH, MD 2/16/2018 2/16/2023 PEDIATRICS DALLAS TX ACTIVE 3/2/2018 None N/A R2034 YU, ANDREW , MD 3/3/2017 3/3/2022 PEDIATRICS DALLAS TX ACTIVE 3/22/2017 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 PEDIATRICS, Q8353 SING, ALAN CHIN-PAO, MD 5/16/2016 5/16/2021 CARDIOLOGY DALLAS TX ACTIVE 5/18/2016 None N/A

Page 141 of 332 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 PEDIATRICS, Q5107 TANDON, ANIMESH, MD 7/1/2015 7/1/2020 CARDIOLOGY DALLAS TX ACTIVE 7/3/2015 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 PHYSICAL MED. & R4373 BUNTING, KARA LEIGH, DO 8/25/2017 8/25/2022 REHABILITATION DALLAS TX ACTIVE 9/7/2017 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 PHYSICAL MED. & Q9984 DESAI, SIMA YOGESH, MD 9/15/2016 9/15/2021 REHABILITATION DALLAS TX ACTIVE 9/21/2016 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 JOHNSON, MARIANA MURGUIA, PHYSICAL MED. & R1394 MD 1/20/2017 1/20/2022 REHABILITATION DALLAS TX ACTIVE 2/7/2017 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 PHYSICAL MED. & R3129 LEEK, DUSTIN RYAN, MD 5/22/2017 5/22/2022 REHABILITATION DALLAS TX ACTIVE 5/30/2017 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 PHYSICAL MED. & R4321 SHAHABI-AZAD, BENJAMIN , MD 8/15/2017 8/15/2022 REHABILITATION DALLAS TX ACTIVE 8/16/2017 None N/A PHYSICAL MED. & Q7981 WALTON, STEVEN , DO 4/15/2016 4/15/2021 REHABILITATION DALLAS TX ACTIVE 4/21/2016 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 PLASTIC & RECONSTRUCTIVE Q6763 LAW, HUAY-ZONG , MD 12/15/2015 12/15/2020 SURGERY DALLAS TX ACTIVE 12/17/2015 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 PLASTIC & RECONSTRUCTIVE Q5507 NAGARKAR, PURUSHOTTAM , MD 8/3/2015 8/3/2020 SURGERY DALLAS TX ACTIVE 8/5/2015 None N/A

Page 142 of 332 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 R1254 NARAM, APARAJIT, MD 1/6/2017 1/6/2022 SURGERY HAND SURGERY DALLAS TX ACTIVE 1/17/2017 None N/A PLASTIC & RECONSTRUCTIVE Q9472 PATHAK, ABRAHAM, MD 8/1/2016 8/1/2021 SURGERY GENERAL SURGERY DALLAS TX ACTIVE 9/7/2016 None N/A PLASTIC & RECONSTRUCTIVE Q6984 SHAH, NILAY RAJNIKANT, MD 1/15/2016 1/15/2021 SURGERY GENERAL SURGERY DALLAS TX ACTIVE 3/14/2016 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 CHUKWUMAH, LETITIA DANIELLE, Q8455 MD 6/1/2016 6/1/2021 PSYCHIATRY DALLAS TX ACTIVE 6/14/2016 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 ADDICTION S5601 DUNATOV, DEVIN PATRICK, MD 3/20/2020 3/20/2025 PSYCHIATRY PSYCHIATRY DALLAS TX ACTIVE 4/1/2020 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 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

Q5409 GIAMPAOLO, JENNIFER RETH, MD 8/3/2015 8/3/2020 PSYCHIATRY DALLAS TX ACTIVE 8/5/2015 None N/A GERIATRIC R1969 JOHNSON, ANNE ELIZABETH , MD 3/3/2017 3/3/2022 PSYCHIATRY PSYCHIATRY DALLAS TX ACTIVE 3/24/2017 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 S6426 KING, DARLENE RAE, MD 5/1/2020 5/1/2025 PSYCHIATRY DALLAS TX ACTIVE 5/5/2020 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 Q9855 LORD, JOSHUA , MD 8/26/2016 8/26/2021 PSYCHIATRY DALLAS TX ACTIVE 8/29/2016 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 ADDICTION R4740 MARAMBAGE, KAPILA, MD 9/22/2017 9/22/2022 PSYCHIATRY PSYCHIATRY DALLAS TX ACTIVE 9/28/2017 None N/A

Page 143 of 332 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 R1829 MILLER, DALE KATHERINE, MD 2/22/2017 2/22/2022 PSYCHIATRY DALLAS TX ACTIVE 2/23/2017 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 Q9213 NGUYEN, KHOA DANG , DO 7/15/2016 7/15/2021 PSYCHIATRY DALLAS TX ACTIVE 7/20/2016 None N/A CHILD AND ADOLESCENT Q8979 NIZAMI, SYED SAROSH, MD 7/1/2016 7/1/2021 PSYCHIATRY PSYCHIATRY DALLAS TX ACTIVE 7/6/2016 None N/A S6505 SADHU, MOHONA SNEHA, MD 5/1/2020 5/1/2025 PSYCHIATRY DALLAS TX ACTIVE 5/5/2020 None N/A R2973 SHERHART, RACHEL ALICE, MD 5/5/2017 5/5/2022 PSYCHIATRY DALLAS TX ACTIVE 5/9/2017 None N/A CHILD AND ADOLESCENT S5077 SOLTAN, ASHKAN , MD 2/7/2020 2/7/2025 PSYCHIATRY PSYCHIATRY DALLAS TX ACTIVE 2/12/2020 None N/A R2792 WOODS, JIHAN ALISON, MD 4/20/2017 4/20/2022 PSYCHIATRY DALLAS TX ACTIVE 5/1/2017 None N/A Q7515 XU, JIE , MD 3/4/2016 3/4/2021 PSYCHIATRY DALLAS TX ACTIVE 3/8/2016 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 PULMONARY CRITICAL CARE Q7343 CHISHTI, WAQAS AHMED, MD 3/4/2016 3/4/2021 MEDICINE DALLAS TX ACTIVE 3/17/2016 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 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 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 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 PULMONARY CRITICAL CARE S6079 VANDERVEST, KATHERINE, MD 4/3/2020 4/3/2025 MEDICINE DALLAS TX ACTIVE 4/8/2020 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 RADIATION R2267 ALLURI, PRASANNA G, MD 4/4/2017 4/4/2022 ONCOLOGY DALLAS TX ACTIVE 4/10/2017 None N/A

Page 144 of 332 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 RADIATION Q9981 DAN, TU DINH, MD 9/15/2016 9/15/2021 ONCOLOGY DALLAS TX ACTIVE 9/16/2016 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 RADIATION R6221 KUN, LARRY E, MD 3/2/2018 3/2/2023 ONCOLOGY DALLAS TX ACTIVE 3/14/2018 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 RADIATION Q8603 PHAM, NHAT-LONG LAM, MD 6/1/2016 6/1/2021 ONCOLOGY DALLAS TX ACTIVE 6/7/2016 None N/A RADIATION R2737 SHAH, JENNIFER LOBO, MD 4/20/2017 4/20/2022 ONCOLOGY DALLAS TX ACTIVE 4/25/2017 None N/A RADIATION Q7287 STROM, TOBIN JOEL, MD 2/16/2016 2/16/2021 ONCOLOGY DALLAS TX ACTIVE 4/4/2016 None N/A RADIATION Q9546 WARDAK, ZABIHULLAH, MD 8/1/2016 8/1/2021 ONCOLOGY DALLAS TX ACTIVE 8/3/2016 None N/A RADIATION R3455 WRAY, JUSTIN WYLIE, MD 6/2/2017 6/2/2022 ONCOLOGY DALLAS TX ACTIVE 6/6/2017 None N/A

R1185 CERANSKE, ANDREW JACOB, MD 1/6/2017 1/6/2022 RADIOLOGY DALLAS TX ACTIVE 1/24/2017 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 Q4596 HANNA, MINA FAWZI FAHIM, MD 6/1/2015 6/1/2020 RADIOLOGY DALLAS TX ACTIVE 6/10/2015 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 MUSCULOSKELETAL S7081 KOHLI, AJAY, MD 6/12/2020 6/12/2025 RADIOLOGY RADIOLOGY DALLAS TX ACTIVE 6/15/2020 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 R5283 LIU, XIAOZHOU, MD 11/17/2017 11/17/2022 RADIOLOGY DALLAS TX ACTIVE 11/21/2017 None N/A

Q7232 MARTINEZ, LAUREN CARTER, MD 2/16/2016 2/16/2021 RADIOLOGY DALLAS TX ACTIVE 2/29/2016 None N/A R4872 MATSUI, JOY TAMIKO, MD 10/6/2017 10/6/2022 RADIOLOGY DALLAS TX ACTIVE 10/9/2017 None N/A R0616 MCDEVITT, JOSEPH , MD 10/31/2016 10/31/2021 RADIOLOGY DALLAS TX ACTIVE 11/1/2016 None N/A R3157 MOORE, ALASTAIR, MD 5/22/2017 5/22/2022 RADIOLOGY DALLAS TX ACTIVE 5/24/2017 None N/A R3563 NG, TIMOTHY WEN-ZEN, MD 6/16/2017 6/16/2022 RADIOLOGY MAMMOGRAPHY DALLAS TX ACTIVE 6/21/2017 None N/A Q8581 NGUYEN, CUONG HUY, DO 6/1/2016 6/1/2021 RADIOLOGY DALLAS TX ACTIVE 6/6/2016 None N/A INTERVENTIONAL Q9470 PARK, HAROLD S, MD 8/1/2016 8/1/2021 RADIOLOGY RADIOLOGY DALLAS TX ACTIVE 8/8/2016 None N/A Q9886 QUADRI, REHAN SYED, MD 8/26/2016 8/26/2021 RADIOLOGY DALLAS TX ACTIVE 9/8/2016 None N/A

Page 145 of 332 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 SABOO, SACHIN SHYAMSUNDER, CARDIOTHORACIC R0944 MD 12/2/2016 12/2/2021 RADIOLOGY RADIOLOGY DALLAS TX ACTIVE 12/8/2016 None N/A R5644 SIBLEY, ROBERT CARSON III, MD 1/5/2018 1/5/2023 RADIOLOGY DALLAS TX ACTIVE 1/31/2018 None N/A SORRA, ENDEL ALEKSANDER II, Q7481 MD 3/4/2016 3/4/2021 RADIOLOGY DALLAS TX ACTIVE 3/7/2016 None N/A R3775 WEBER, BRIAN LOUIS , MD 6/30/2017 6/30/2022 RADIOLOGY BREAST IMAGING DALLAS TX ACTIVE 7/5/2017 None N/A Q5655 GESLANI, JOANNA LEUNG, DO 8/14/2015 8/14/2020 RHEUMATOLOGY DALLAS TX ACTIVE 8/24/2015 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 R0406 HALDERMAN, ASHLEIGH A, MD 10/14/2016 10/14/2021 RHINOLOGY DALLAS TX ACTIVE 10/18/2016 None N/A SURGICAL R3617 WANG, YI ZARN, MD 6/16/2017 6/16/2022 ONCOLOGY GENERAL SURGERY DALLAS TX ACTIVE 8/14/2017 None N/A THORACIC ROBERTS, CHARLES STEWART, CARDIOVASCULAR R6084 MD 2/16/2018 2/16/2023 SURGERY DALLAS TX ACTIVE 3/13/2018 None N/A PODGAETZ GLIKSBERG, EITAN, R0300 MD 9/30/2016 9/30/2021 THORACIC SURGERY GENERAL SURGERY DALLAS TX ACTIVE 10/24/2016 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 TRANSPLANT Q8882 FERNANDEZ, HOYLAN , MD 7/1/2016 7/1/2021 SURGERY GENERAL SURGERY DALLAS TX ACTIVE 7/12/2016 None N/A TRANSPLANT S5267 SHAH, JIGESH ATUL, DO 2/21/2020 2/21/2025 SURGERY GENERAL SURGERY DALLAS TX ACTIVE 2/24/2020 None N/A TRANSPLANT R5051 VAGEFI, PARSIA A, MD 10/20/2017 10/20/2022 SURGERY DALLAS TX ACTIVE 10/23/2017 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 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 SURGICAL CRITICAL S6871 KOHLER, CASEY , MD 5/29/2020 5/29/2025 TRAUMATIC SURGERY CARE DALLAS TX ACTIVE 6/1/2020 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 Q8899 HAMNER, JENNIFER JOY, DO 7/1/2016 7/1/2021 UROGYNECOLOGY DALLAS TX ACTIVE 7/5/2016 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 Q8833 BENSON, DANIEL GREGORY, MD 7/1/2016 7/1/2021 UROLOGY DALLAS TX ACTIVE 7/4/2016 None N/A S5398 JOICE, GREGORY ALAN, MD 3/6/2020 3/6/2025 UROLOGY DALLAS TX ACTIVE 3/12/2020 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 Q7797 SOROKIN, IGOR, MD 4/1/2016 4/1/2021 UROLOGY DALLAS TX ACTIVE 4/4/2016 None N/A

Page 146 of 332 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

S5084 SUN, ANDREW YANG, MD 2/7/2020 2/7/2025 UROLOGY UROLOGIC SURGERY DALLAS TX ACTIVE 2/10/2020 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 VASCULAR AND DELINQUEN INTERVENTIONAL ABDOMINAL T-NON Q9727 SAYYAR ROUDSARI, BAHMAN, MD 8/15/2016 8/15/2021 RADIOLOGY RADIOLOGY DALLAS TX PAYMENT 12/30/2017 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

R2852 FOLEY, LISA SUE, MD 5/5/2017 5/5/2022 VASCULAR SURGERY DALLAS TX ACTIVE 7/11/2017 None N/A

R3185 PONTIKIS, GEORGE C, MD 5/22/2017 5/22/2022 VASCULAR SURGERY GENERAL SURGERY DALLAS TX ACTIVE 5/23/2017 None N/A

Q9889 RAMANAN, BALA, MD 8/26/2016 8/26/2021 VASCULAR SURGERY GENERAL SURGERY DALLAS TX ACTIVE 8/31/2016 None N/A

Q5712 RECTENWALD, JOHN E, MD 8/14/2015 8/14/2020 VASCULAR SURGERY DALLAS TX ACTIVE 8/17/2015 None N/A R3514 GANESHAN, DEEPA, MD 6/16/2017 6/16/2022 PEDIATRICS DANBURY CT ACTIVE 6/19/2017 None N/A Q5776 CHAUDHARY, JESSICA, MD 8/28/2015 8/28/2020 PSYCHIATRY PSYCHIATRY DANBURY CT ACTIVE 9/9/2015 None N/A

S5458 OVIAWE, OSAZEE EMMANUEL, MD 3/6/2020 3/6/2025 FAMILY MEDICINE FAMILY PRACTICE DANVILLE IL ACTIVE 5/15/2020 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 MUSCULOSKELETAL R0935 QURESHI, OMAR, MD 12/2/2016 12/2/2021 RADIOLOGY RADIOLOGY DAVIE FL ACTIVE 1/11/2017 None N/A R5333 UGWU, JUSTIN KENNETH, MD 11/17/2017 11/17/2022 INTERNAL MEDICINE DAYTON OH ACTIVE 11/28/2017 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 R0405 GUPTA, NAGENDRA, MD 10/14/2016 10/14/2021 INTERNAL MEDICINE DECATUR TX ACTIVE 10/20/2016 None N/A SINGAPURI, MOHAMMED SALMAN, R0134 MD 9/15/2016 9/15/2021 INTERNAL MEDICINE NEPHROLOGY DECATUR GA ACTIVE 12/7/2016 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

R2482 SOGUNRO, OLUTAYO ABIDEMI, DO 4/4/2017 4/4/2022 GENERAL SURGERY DEL RIO TX ACTIVE 4/10/2017 None N/A R4304 PETER, JOSEPH PHILIP, MD 8/15/2017 8/15/2022 PEDIATRICS DEL RIO TX ACTIVE 9/18/2017 None N/A R1460 SYED, KHALID HUSSAIN, MD 1/20/2017 1/20/2022 PEDIATRICS DEL RIO TX ACTIVE 2/10/2017 None N/A R3451 VELASCO, ANDRES FELIPE, MD 6/2/2017 6/2/2022 FAMILY MEDICINE DELTONA FL ACTIVE 6/13/2017 None N/A

Page 147 of 332 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 S4737 BURLESON, MEGAN NICOLE, DO 1/24/2020 1/24/2025 FAMILY MEDICINE DENISON TX ACTIVE 2/19/2020 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 R2954 RIPLEY, ZACHARY SCOTT, DO 5/5/2017 5/5/2022 FAMILY MEDICINE DENISON TX ACTIVE 5/26/2017 None N/A OTOLARYN & FACIAL Q9096 YEUNG, TERRY HIU TIN, DO 7/1/2016 7/1/2021 PLASTIC SURGERY COSMETIC SURGERY DENISON TX ACTIVE 7/6/2016 None N/A R4438 NOLEN, LANG DENTON, MD 8/25/2017 8/25/2022 FAMILY MEDICINE DENTON TX ACTIVE 8/29/2017 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 Q9154 EWAIDA, NADER, MD 7/15/2016 7/15/2021 INTERNAL MEDICINE DENTON TX ACTIVE 7/19/2016 None N/A

Q6370 SARMA, REKHA REGHUNATHA, MD 10/15/2015 10/15/2020 INTERNAL MEDICINE DENTON TX ACTIVE 10/21/2015 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 R3776 WU, JAMES, DO 6/30/2017 6/30/2022 PSYCHIATRY DENTON TX ACTIVE 7/4/2017 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 R1065 KONERU, SUSHMA, MD 12/16/2016 12/16/2021 CARDIOLOGY DES MOINES IA ACTIVE 12/19/2016 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 CARDIO- INTERVENTIONAL Q9557 YALLAPRAGADA, SRINIVAS, MD 8/1/2016 8/1/2021 CARDIOLOGY RADIOLOGY DESOTO TX ACTIVE 8/2/2016 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 INFECTIOUS R5870 HUSSAIN, NOMAN AKHTAR, MD 2/2/2018 2/2/2023 DISEASES INTERNAL MEDICINE DETROIT MI ACTIVE 3/1/2018 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 Q7619 ZEHRA, NIDA, MD 3/15/2016 3/15/2021 INTERNAL MEDICINE DICKINSON ND ACTIVE 3/22/2016 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 Q7375 GHAWI, HANI, MD 3/4/2016 3/4/2021 CARDIOLOGY DOHA ACTIVE 3/11/2016 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 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

Page 148 of 332 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 DRIPPING R4733 LEE, SHELLY , MD 9/22/2017 9/22/2022 OPHTHALMOLOGY SPRINGS TX ACTIVE 10/10/2017 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 EMERGENCY R0079 MERLIS, JENNIFER KAY, MD 9/15/2016 9/15/2021 MEDICINE DULUTH MN ACTIVE 9/23/2016 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 EMERGENCY URGENT CARE R0241 GREGSTON, JAY, MD 9/30/2016 9/30/2021 MEDICINE MEDICINE DUNCAN OK ACTIVE 10/3/2016 None N/A INTERVENTIONAL R2694 OJHA, CHANDRA PRAKASH, MD 4/20/2017 4/20/2022 INTERNAL MEDICINE CARDIOLOGY DUNCAN OK ACTIVE 6/1/2017 None N/A FAMILY R1323 WOODALL, MONICA MAE, DO 1/6/2017 1/6/2022 PRACTICE/OMM DURANT OK ACTIVE 1/11/2017 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 ANATOMIC/CLINICAL R3070 EGAN, JENNIFER ANNE, MD 5/22/2017 5/22/2022 PATHOLOGY DURHAM NC ACTIVE 9/1/2017 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 R4664 BAHETI, DEEPTI RAMESH, MD 9/22/2017 9/22/2022 INTERNAL MEDICINE EAGLE PASS TX ACTIVE 10/23/2017 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 RAYA CAMPOS, RUBEN LAZARO, EAST R2452 MD 4/4/2017 4/4/2022 INTERNAL MEDICINE MEADOW NY ACTIVE 4/12/2017 None N/A OBSTETRICS AND EAST Q7089 NAZLI, YASMEEN Z, MD 2/1/2016 2/1/2021 GYNECOLOGY FAMILY PRACTICE MEADOW NY ACTIVE 2/8/2016 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 DIAGNOSTIC TM00630 BELTON, DOUGLAS JR, MD 5/16/2016 5/16/2021 RADIOLOGY EDEN PRAIRIE MN ACTIVE 6/2/2016 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 NEUROLOGY/DIAGN OSTIC DIAGNOSTIC RAD/NEURORADIOLO Q6787 RULNICK, ADAM DAVID, MD 12/15/2015 12/15/2020 RADIOLOGY GY EDEN PRAIRIE MN ACTIVE 12/16/2015 None N/A ZAHRAN, ABDURREHMAN AMIN, DIAGNOSTIC R2510 MD 4/4/2017 4/4/2022 RADIOLOGY NEURO-RADIOLOGY EDEN PRAIRIE MN ACTIVE 4/6/2017 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

Page 149 of 332 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

R5195 RIDEAU, ALECIA, MD 11/3/2017 11/3/2022 RADIOLOGY EDEN PRAIRIE MN ACTIVE 11/8/2017 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 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 EMERGENCY R5959 AKALA, OLABIYI, MD 2/16/2018 2/16/2023 MEDICINE EDINBURG TX ACTIVE 3/2/2018 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 WILKINSON, SARAH ESPINOZA, EMERGENCY Q5606 MD 8/3/2015 8/3/2020 MEDICINE EDINBURG TX ACTIVE 8/4/2015 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 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 R0560 DESAI, DIMPLE PATEL, MD 10/31/2016 10/31/2021 FAMILY MEDICINE EDINBURG TX ACTIVE 11/2/2016 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 R5449 PARIS, CARLOS ALBERTO, MD 12/8/2017 12/8/2022 INTERNAL MEDICINE EDINBURG TX ACTIVE 2/27/2018 None N/A RAPOPORT, GRIGORIY R5924 LEONIDOVICH, MD 2/2/2018 2/2/2023 INTERNAL MEDICINE EDINBURG TX ACTIVE 2/20/2018 None N/A R5204 SANTOS, HECTOR , MD 11/3/2017 11/3/2022 INTERNAL MEDICINE EDINBURG TX ACTIVE 11/24/2017 None N/A R6098 SHUAIB, OMAR NIDAL, MD 2/16/2018 2/16/2023 INTERNAL MEDICINE EDINBURG TX ACTIVE 2/22/2018 None N/A S6763 VARELA, DANIEL JR, MD 5/15/2020 5/15/2025 INTERNAL MEDICINE NEPHROLOGY EDINBURG TX ACTIVE 6/16/2020 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 OBSTETRICS AND R0360 BIGGS, KYLE ANDREW, DO 10/14/2016 10/14/2021 GYNECOLOGY EDINBURG TX ACTIVE 10/17/2016 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 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

Page 150 of 332 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 Q6677 OGBURN, JOSEPH ANTHONY, MD 12/4/2015 12/4/2020 GYNECOLOGY EDINBURG TX ACTIVE 1/6/2016 None N/A OBSTETRICS AND Q6677 OGBURN, JOSEPH ANTHONY, MD 12/4/2015 12/4/2020 GYNECOLOGY EDINBURG TX ACTIVE 1/6/2016 None N/A OBSTETRICS AND R6076 PETTLE, LUZ OLAYA, MD 2/16/2018 2/16/2023 GYNECOLOGY EDINBURG TX ACTIVE 2/26/2018 None N/A OBSTETRICS AND Q9893 RIVAS, SAUL DANIEL, MD 8/26/2016 8/26/2021 GYNECOLOGY EDINBURG TX ACTIVE 8/29/2016 None N/A OBSTETRICS AND R4137 SALCEDO, JENNIFER, MD 8/1/2017 8/1/2022 GYNECOLOGY EDINBURG TX ACTIVE 8/4/2017 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 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

Q8141 SAENZ, JENNIFER ELISABETH, MD 5/2/2016 5/2/2021 PEDIATRICS EDINBURG TX ACTIVE 5/5/2016 None N/A PEDIATRICS, R4771 ROANE, JAHEEDAH AMINAH, MD 9/22/2017 9/22/2022 CARDIOLOGY EDINBURG TX ACTIVE 11/29/2017 None N/A TORRES SANTIAGO, JOHANNA, R2769 MD 4/20/2017 4/20/2022 PSYCHIATRY EDINBURG TX ACTIVE 5/12/2017 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 R4377 CHRISTENSEN, ANGELA, MD 8/25/2017 8/25/2022 RHEUMATOLOGY EDINBURG TX ACTIVE 10/2/2017 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 MUMMERT, CATHLEEN VIRGINIA, EMERGENCY Q8966 MD 7/1/2016 7/1/2021 MEDICINE EDINBURGH TX ACTIVE 7/12/2016 None N/A Q8077 HOGUE, MICHAEL ANDREW, MD 5/2/2016 5/2/2021 OPHTHALMOLOGY EDMOND OK ACTIVE 5/12/2016 None N/A UNDER INTERVENTIONAL BOARD R4890 POWELL, DOUGLAS A, DO 10/6/2017 10/6/2022 RADIOLOGY RADIOLOGY EDMOND OK ACTIVE 1/2/2018 ORDER 9/21/2017 Q7044 GHALAMBOR, OMID, MD 2/1/2016 2/1/2021 ANESTHESIOLOGY PAIN MANAGEMENT EFFINGHAM IL ACTIVE 2/9/2016 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 GONZALEZ, JOSE ROLANDO JR, R4393 MD 8/25/2017 8/25/2022 INTERNAL MEDICINE EL CAMPO TX ACTIVE 9/4/2017 None N/A R3727 OKOYE, VIVIAN CHIOMA, MD 6/30/2017 6/30/2022 PEDIATRICS PEDIATRICS EL DORADO AR ACTIVE 7/24/2017 None N/A

Page 151 of 332 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 ANATOMIC/CLINICAL R0861 GAMEZ, ROBERTO GABRIEL, MD 12/2/2016 12/2/2021 PATHOLOGY EL PASO TX ACTIVE 12/9/2016 None N/A Q9210 NELSON, JESS THAD, MD 7/15/2016 7/15/2021 ANESTHESIOLOGY EL PASO TX ACTIVE 7/25/2016 None N/A PEDIATRIC ANESTHESIOLOGY Q9006 PORTA, KENDRA JO, MD 7/1/2016 7/1/2021 ANESTHESIOLOGY (PEDS) EL PASO TX ACTIVE 7/4/2016 None N/A Q5235 NGUYEN, TAM, MD 7/15/2015 7/15/2020 CARDIOLOGY INTERNAL MEDICINE EL PASO TX ACTIVE 7/21/2015 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 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 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 PEDIATRIC R0132 SIMPSON, BRENDA MICHELLE, MD 9/15/2016 9/15/2021 DERMATOLOGY DERMATOLOGY EL PASO TX ACTIVE 9/21/2016 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 EMERGENCY Q8422 BACA, MARSHALL G JR, DO 6/1/2016 6/1/2021 MEDICINE EL PASO TX ACTIVE 6/3/2016 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 EMERGENCY S4726 BEUERLE, JOHN ROBERT, MD 1/24/2020 1/24/2025 MEDICINE EL PASO TX ACTIVE 1/27/2020 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 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 EMERGENCY R5121 GONZALES, IRENE, MD 11/3/2017 11/3/2022 MEDICINE EL PASO TX ACTIVE 1/10/2018 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

Page 152 of 332 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 KRESTA, ALEXANDER MICHAEL, EMERGENCY S6663 MD 5/15/2020 5/15/2025 MEDICINE EL PASO TX ACTIVE 5/18/2020 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 EMERGENCY R2392 LIEVANO, KANG MEI NANCY, DO 4/4/2017 4/4/2022 MEDICINE EL PASO TX ACTIVE 4/7/2017 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 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 EMERGENCY R1868 SEHGAL, NEHA, DO 2/22/2017 2/22/2022 MEDICINE EL PASO TX ACTIVE 3/13/2017 None N/A EMERGENCY S6541 TORRES, MONICA KRISTINE, MD 5/1/2020 5/1/2025 MEDICINE EL PASO TX ACTIVE 5/5/2020 None N/A EMERGENCY S5811 YOUSEF, KARL ANDREW, MD 3/20/2020 3/20/2025 MEDICINE EL PASO TX ACTIVE 3/24/2020 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 MONTOYA, MELISSA MARGARITA, S5019 DO 2/7/2020 2/7/2025 FAMILY MEDICINE EL PASO TX ACTIVE 2/24/2020 None N/A R0100 PEREZ, EVAN DUSTIN, MD 9/15/2016 9/15/2021 FAMILY MEDICINE EL PASO TX ACTIVE 9/16/2016 None N/A RODRIGUEZ GONZALEZ, HECTOR R2212 LUCAS, MD 3/20/2017 3/20/2022 FAMILY MEDICINE EL PASO TX ACTIVE 3/28/2017 None N/A SAENZ CHAVEZ, HUMBERTO GERIATRICS - S5059 RAUL, MD 2/7/2020 2/7/2025 FAMILY MEDICINE INTERNAL MEDICINE EL PASO TX ACTIVE 3/4/2020 None N/A R5316 SHAFI, NAZISH, MD 11/17/2017 11/17/2022 FAMILY MEDICINE EL PASO TX ACTIVE 11/21/2017 None N/A Q9541 VU, LYSA P, MD 8/1/2016 8/1/2021 FAMILY MEDICINE EL PASO TX ACTIVE 10/5/2016 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 R0251 IGLESIAS, MICHELLE , MD 9/30/2016 9/30/2021 FAMILY PRACTICE EL PASO TX ACTIVE 10/4/2016 None N/A FAMILY PRACTICE - Q5066 PEREZ GARAY, ESTELA MARIA, MD 7/1/2015 7/1/2020 FAMILY PRACTICE EMERGENCY MED EL PASO TX ACTIVE 7/2/2015 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 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 GASTROENTEROLOG S6468 OKEKE, FRANCIS C, MD 5/1/2020 5/1/2025 Y INTERNAL MEDICINE EL PASO TX ACTIVE 5/25/2020 None N/A GASTROENTEROLOG R1624 RASHTAK, SHAHROOZ , MD 2/6/2017 2/6/2022 Y EL PASO TX ACTIVE 2/27/2017 None N/A

Page 153 of 332 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 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 S5256 ROCHIN, LUIS EDUARDO, MD 2/21/2020 2/21/2025 GENERAL PRACTICE EL PASO TX ACTIVE 2/24/2020 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 RIOS TOVAR, ALEJANDRO JAVIER, SURGICAL CRITICAL R5031 MD 10/20/2017 10/20/2022 GENERAL SURGERY CARE EL PASO TX ACTIVE 11/10/2017 None N/A SURGICAL CRITICAL Q7276 SHAY, ANDREW THOMAS, MD 2/16/2016 2/16/2021 GENERAL SURGERY CARE EL PASO TX ACTIVE 3/4/2016 None N/A R3214 SHIMUNOV, SERGEY, DO 5/22/2017 5/22/2022 GENERAL SURGERY EL PASO TX ACTIVE 7/14/2017 None N/A SEE TRAUMATIC LICENSE PREVIOUS Q8794 SMITH, JODY LEEANN, MD 6/10/2016 6/10/2021 GENERAL SURGERY SURGERY EL PASO TX ISSUED 6/10/2016 ORDER 8/24/2015 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 HEMATOLOGY/ONCOL Q7825 ALBINO, MIGUEL, MD 4/15/2016 4/15/2021 OGY EL PASO TX ACTIVE 4/21/2016 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 Q9113 ALVAREZ, PAOLA IVETTE, MD 7/15/2016 7/15/2021 INTERNAL MEDICINE EL PASO TX ACTIVE 7/18/2016 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 S4455 CHOUDHARY, VIVEK , MD 12/20/2019 12/20/2024 INTERNAL MEDICINE EL PASO TX ACTIVE 3/2/2020 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 R0851 DEOKER, ABHIZITH, MD 12/2/2016 12/2/2021 INTERNAL MEDICINE EL PASO TX ACTIVE 12/6/2016 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 Q9351 GAJENDRAN, MAHESH, MD 8/1/2016 8/1/2021 INTERNAL MEDICINE EL PASO TX ACTIVE 8/23/2016 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 S7066 HERLIHY, JOHN DANIEL IV, MD 6/12/2020 6/12/2025 INTERNAL MEDICINE EL PASO TX ACTIVE 6/15/2020 None N/A R1041 HINOJOSA, BARBARA ROEL, MD 12/16/2016 12/16/2021 INTERNAL MEDICINE EL PASO TX ACTIVE 12/22/2016 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 R3871 HUSSAIN, SAAD SYED, MD 7/17/2017 7/17/2022 INTERNAL MEDICINE EL PASO TX ACTIVE 7/18/2017 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

R3917 MOLINA PAREDES, SONARIS , MD 7/17/2017 7/17/2022 INTERNAL MEDICINE EL PASO TX ACTIVE 7/24/2017 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

Page 154 of 332 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 R0467 ORTEGA, LAURO IVAN, MD 10/14/2016 10/14/2021 INTERNAL MEDICINE EL PASO TX ACTIVE 10/27/2016 None N/A R5175 ORTIZ-LOPEZ, CAROLINA , MD 11/3/2017 11/3/2022 INTERNAL MEDICINE EL PASO TX ACTIVE 11/13/2017 None N/A CARDIOVASCULAR S4836 PANCHANGAM, SUBHASREE , MD 1/24/2020 1/24/2025 INTERNAL MEDICINE DISEASES EL PASO TX ACTIVE 1/27/2020 None N/A HEMATOLOGY/ONCO R0932 PHILIPOVSKIY, ALEXANDER, MD 12/2/2016 12/2/2021 INTERNAL MEDICINE LOGY EL PASO TX ACTIVE 2/6/2017 None N/A R0779 RANGEL, GABRIELA , MD 11/15/2016 11/15/2021 INTERNAL MEDICINE EL PASO TX ACTIVE 11/16/2016 None N/A

R1650 SLOVIK, JONATHAN EDWARD, MD 2/6/2017 2/6/2022 INTERNAL MEDICINE EL PASO TX ACTIVE 2/9/2017 None N/A R1138 TANO, VILMOGIL, MD 12/16/2016 12/16/2021 INTERNAL MEDICINE HOSPITALIST EL PASO TX ACTIVE 1/2/2017 None N/A R2492 TELEB, MOHAMED , MD 4/4/2017 4/4/2022 INTERNAL MEDICINE EL PASO TX ACTIVE 4/7/2017 None N/A LICENSE Q8381 VILLAGRA, MIGUEL ANGEL, MD 5/16/2016 5/16/2021 INTERNAL MEDICINE HOSPITALIST EL PASO TX ISSUED 5/16/2016 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 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 INTERVENTIONAL DIAGNOSTIC S4357 NIELSEN, NATHAN SCOTT, DO 12/6/2019 12/6/2024 RADIOLOGY RADIOLOGY EL PASO TX ACTIVE 12/12/2019 None N/A INTERVENTIONAL DIAGNOSTIC S4357 NIELSEN, NATHAN SCOTT, DO 12/6/2019 12/6/2024 RADIOLOGY RADIOLOGY EL PASO TX ACTIVE 12/12/2019 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 R1771 HECHANOVA, LISA AIMEE, MD 2/22/2017 2/22/2022 NEPHROLOGY INTERNAL MEDICINE EL PASO TX ACTIVE 2/28/2017 None N/A

Q6893 PAYAN SCHOBER, FERNANDA, MD 1/6/2016 1/6/2021 NEPHROLOGY EL PASO TX ACTIVE 1/7/2016 None N/A Q8657 THODIMA, PRADEEP REDDY, MD 6/1/2016 6/1/2021 NEPHROLOGY INTERNAL MEDICINE EL PASO TX ACTIVE 6/21/2016 None N/A NEUROLOGICAL R0777 PETTEYS, RORY JAMES, MD 11/15/2016 11/15/2021 SURGERY SPINE MEDICINE EL PASO TX ACTIVE 11/21/2016 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 NEUROMUSCULAR Q7929 MENDEZ VARGAS, KARINA, MD 4/15/2016 4/15/2021 NEUROLOGY DISEASE EL PASO TX ACTIVE 4/18/2016 None N/A S5450 NGUYEN, HUY , MD 3/6/2020 3/6/2025 NEUROLOGY EL PASO TX ACTIVE 6/1/2020 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

Page 155 of 332 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 & MISHAW, STEPHANIE MICHELE, GYNECOLOGICAL S6898 MD 5/29/2020 5/29/2025 SURGERY EL PASO TX ACTIVE 6/11/2020 None N/A 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 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 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 OBSTETRICS AND R3334 GUTIERREZ, LAURA CRISTINA, MD 6/2/2017 6/2/2022 GYNECOLOGY EL PASO TX ACTIVE 6/12/2017 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 OBSTETRICS AND Q5209 LARRAZALETA, MARIA ELENA, MD 7/15/2015 7/15/2020 GYNECOLOGY EL PASO TX ACTIVE 7/27/2015 None N/A OBSTETRICS AND R3948 RAMIREZ, DIEGO , MD 7/17/2017 7/17/2022 GYNECOLOGY EL PASO TX ACTIVE 7/18/2017 None N/A R3528 HOPEN, MICHAEL, MD 6/16/2017 6/16/2022 OPHTHALMOLOGY EL PASO TX ACTIVE 7/7/2017 None N/A

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

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

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 OPHTHALMOLOGY - S5515 VINCENT, LOGAN RUSS, MD 3/6/2020 3/6/2025 GLAUCOMA EL PASO TX ACTIVE 3/19/2020 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 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 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 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

Page 156 of 332 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 Q9648 KAFCHINSKI, LISA ANN, MD 8/15/2016 8/15/2021 SURGERY ONCOLOGY EL PASO TX ACTIVE 9/1/2016 None N/A UNDER ORTHOPEDIC SPORTS MEDICINE - LICENSE BOARD Q8803 VANDE LUNE, DANIEL WAYNE, MD 6/10/2016 6/10/2021 SURGERY ORTHOPEDICS EL PASO TX ISSUED 6/10/2016 ORDER 6/10/2016 ORTHOPEDIC Q9215 NGUYEN, MAI, MD 7/15/2016 7/15/2021 ORTHOPEDICS TRAUMA EL PASO TX ACTIVE 7/26/2016 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 ENGLAND, CHRISTOPHER RAY, OTORHINOLARYNGO Q6184 MD 10/1/2015 10/1/2020 OTOLARYNGOLOGY LOGY EL PASO TX ACTIVE 10/14/2015 None N/A WESTBROOK, BENJAMIN JAMES, Q6798 MD 12/15/2015 12/15/2020 OTOLARYNGOLOGY EL PASO TX ACTIVE 12/23/2015 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 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 PEDIATRIC EMERGENCY Q6721 WHITEFIELD, JULIA SABINE, MD 12/4/2015 12/4/2020 MEDICINE (EM) EL PASO TX ACTIVE 12/30/2015 None N/A PEDIATRIC EMERGENCY Q6721 WHITEFIELD, JULIA SABINE, MD 12/4/2015 12/4/2020 MEDICINE (EM) EL PASO TX ACTIVE 12/30/2015 None N/A PEDIATRIC EMERGENCY R6254 PARK, JOOHEE GRACE, DO 3/2/2018 3/2/2023 MEDICINE (PEDS) PEDIATRICS EL PASO TX ACTIVE 3/13/2018 None N/A PEDIATRIC GASTROENTEROLOG R4695 FRANCIS, DENEASE, MD 9/22/2017 9/22/2022 Y PEDIATRICS EL PASO TX ACTIVE 9/25/2017 None N/A ONYEDIKA, IKECHUKWU IFEANYI, PEDIATRIC ORTHOPEDIC R1096 MD 12/16/2016 12/16/2021 ORTHOPEDICS SURGERY EL PASO TX ACTIVE 12/20/2016 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

Q6934 CANALES CHAVEZ, ROBERTO, MD 1/15/2016 1/15/2021 PEDIATRICS EL PASO TX ACTIVE 2/25/2016 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

Page 157 of 332 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 DEVELOPMENTAL- BEHAVIORAL R3841 FONSECA, ANACANI, MD 7/17/2017 7/17/2022 PEDIATRICS PEDIATRICS EL PASO TX ACTIVE 9/8/2017 None N/A Q6944 HOWZE, SHERI LAKEITHA, MD 1/15/2016 1/15/2021 PEDIATRICS EL PASO TX ACTIVE 4/1/2016 None N/A Q5450 KATARIA, RAHUL , MD 8/3/2015 8/3/2020 PEDIATRICS EL PASO TX ACTIVE 8/5/2015 None N/A PEDIATRIC R3358 KHIN, EI EI, MD 6/2/2017 6/2/2022 PEDIATRICS NEPHROLOGY EL PASO TX ACTIVE 6/5/2017 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 NAVES JARDIN, CHARLENE S5447 ELIZABETH, MD 3/6/2020 3/6/2025 PEDIATRICS EL PASO TX ACTIVE 4/1/2020 None N/A NEONATAL- PERINATAL S4841 PETER-WOHL, SIGAL, MD 1/24/2020 1/24/2025 PEDIATRICS MEDICINE EL PASO TX ACTIVE 1/27/2020 None N/A NEONATAL- PERINATAL R1454 SINGH, AJAY PRATAP, MD 1/20/2017 1/20/2022 PEDIATRICS MEDICINE EL PASO TX ACTIVE 3/6/2017 None N/A PEDIATRIC EMERGENCY R4158 UPHAM, BRYAN, MD 8/1/2017 8/1/2022 PEDIATRICS MEDICINE (PEDS) EL PASO TX ACTIVE 8/14/2017 None N/A Q7992 ZEBDA, MOHAMED AWNI, DO 4/15/2016 4/15/2021 PEDIATRICS EL PASO TX ACTIVE 4/22/2016 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 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 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 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 Q9773 ADLER, LAURA ELAINE, MD 8/26/2016 8/26/2021 PSYCHIATRY EL PASO TX ACTIVE 10/31/2016 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 Q6525 KHURRAM, SOBIA K, MD 11/16/2015 11/16/2020 PSYCHIATRY EL PASO TX ACTIVE 11/18/2015 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 Q9887 RAGHEB, MOATAZ M, MD 8/26/2016 8/26/2021 PSYCHIATRY EL PASO TX ACTIVE 10/7/2016 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

Page 158 of 332 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 R0293 OMAR, FAHAD, MD 9/30/2016 9/30/2021 MEDICINE SLEEP MEDICINE EL PASO TX ACTIVE 10/10/2016 None N/A PULMONARY R1260 OMAR, ASAD, MD 1/6/2017 1/6/2022 DISEASES INTERNAL MEDICINE EL PASO TX ACTIVE 1/13/2017 None N/A R3056 COTTER, TIMOTHY, MD 5/22/2017 5/22/2022 RADIOLOGY EL PASO TX ACTIVE 6/2/2017 None N/A R3672 FISHER, IAN, MD 6/30/2017 6/30/2022 RADIOLOGY EL PASO TX ACTIVE 7/28/2017 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 INTERVENTIONAL Q5689 LOREE, ROBERT THOMAS, MD 8/14/2015 8/14/2020 RADIOLOGY RADIOLOGY EL PASO TX ACTIVE 8/21/2015 None N/A INTERVENTIONAL S5033 NWOSU, UCHENNA SAMUEL, MD 2/7/2020 2/7/2025 RADIOLOGY RADIOLOGY EL PASO TX ACTIVE 3/30/2020 None N/A INTERVENTIONAL R4143 SHARMA, AMIT KUMAR, MD 8/1/2017 8/1/2022 RADIOLOGY RADIOLOGY EL PASO TX ACTIVE 8/4/2017 None N/A R0653 SALAYANDIA, LUIS CARLOS, MD 10/31/2016 10/31/2021 RHEUMATOLOGY INTERNAL MEDICINE EL PASO TX ACTIVE 1/13/2017 None N/A ELIZABETH R0457 MULINDWA, DEO, MD 10/14/2016 10/14/2021 INTERNAL MEDICINE CITY NC ACTIVE 1/11/2017 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

NEURO-PHYSIOLOGY R2993 TSIMERINOV, EVGENY I, MD 5/5/2017 5/5/2022 NEUROLOGY (NEUROLOGY) ENCINO CA ACTIVE 5/23/2017 None N/A 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 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 R3714 MOHAN, DESH PRAKASH, MD 6/30/2017 6/30/2022 INTERNAL MEDICINE ENGLEWOOD CO ACTIVE 9/19/2017 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 R1852 PULLAMARAJU, SWATI, MD 2/22/2017 2/22/2022 FAMILY MEDICINE ENNIS TX ACTIVE 3/24/2017 None N/A S5287 VIBHUTI, VEERANNA, MD 2/21/2020 2/21/2025 HOSPITALIST ERIE PA ACTIVE 3/3/2020 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 Q9433 MASHAYEKHI, PEGAH , DO 8/1/2016 8/1/2021 INTERNAL MEDICINE SLEEP MEDICINE ESCONDIDO CA ACTIVE 10/31/2016 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

OPHTHALMOLOGY - R1055 KARTH, PETER, MD 12/16/2016 12/16/2021 OPHTHALMOLOGY VITREOUS SURGERY EUGENE OR ACTIVE 12/20/2016 None N/A R5411 JALIL, ABDUL, MD 12/8/2017 12/8/2022 NEUROLOGY EVANSTON IL ACTIVE 12/20/2017 None N/A

Page 159 of 332 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 R0030 JAZAYERLI, ROUKAN, MD 9/15/2016 9/15/2021 PSYCHIATRY SLEEP MEDICINE EVANSTON IL ACTIVE 9/20/2016 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 S4658 MEHTA, TAPAN RAJARSHI, MD 1/10/2020 1/10/2025 INTERNAL MEDICINE EVANSVILLE IN ACTIVE 1/15/2020 None N/A R2908 LIAW, WINSTON, MD 5/5/2017 5/5/2022 FAMILY MEDICINE FAIRFAX VA ACTIVE 5/12/2017 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 R2203 QURESHI, NOOR , MD 3/20/2017 3/20/2022 FAMILY MEDICINE FAIRFIELD CA ACTIVE 5/4/2017 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 FAR R1427 NDUNGU, HIRAM KAIRU, MD 1/20/2017 1/20/2022 INTERNAL MEDICINE ROCKAWAY NY ACTIVE 4/17/2017 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 FARMERS R4239 HU, TIANSHEN , MD 8/15/2017 8/15/2022 RADIOLOGY INTERNAL MEDICINE BRANCH TX ACTIVE 11/8/2017 None N/A SEE PREVIOUS Q6695 ROBISON, DENNIS J, MD 12/4/2015 12/4/2020 GENERAL SURGERY FARMINGTON NM ACTIVE 12/14/2015 ORDER 12/4/2015 SEE PREVIOUS Q6695 ROBISON, DENNIS J, MD 12/4/2015 12/4/2020 GENERAL SURGERY FARMINGTON NM ACTIVE 12/14/2015 ORDER 12/4/2015 ORTHOPEDIC R2115 HALAWI, MOHAMAD JAMAL, MD 3/20/2017 3/20/2022 SURGERY FARMINGTON CT ACTIVE 3/22/2017 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

Q9884 POUDEL, PRIMA, MD 8/26/2016 8/26/2021 INTERNAL MEDICINE HOSPITALIST FAYETTEVILLE NC ACTIVE 8/30/2016 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

R3788 ALI, ZULFIQAR, MD 7/17/2017 7/17/2022 PEDIATRICS FAYETTEVILLE NC ACTIVE 8/22/2017 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 INFECTIOUS R5402 HASAN, SAQIB IRSHAD, MD 12/8/2017 12/8/2022 DISEASES INTERNAL MEDICINE FLINT MI ACTIVE 12/25/2017 None N/A R4217 ESHENRODER, NATHAN, MD 8/15/2017 8/15/2022 FAMILY PRACTICE FLORESVILLE TX ACTIVE 9/1/2017 None N/A FLOWER R4889 PATTERSON, BOBBY R, MD 10/6/2017 10/6/2022 GENERAL PRACTICE MOUND TX ACTIVE 10/10/2017 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

Page 160 of 332 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 STANCIU, ALINA KOCHOUMIAN, OPHTHALMOLOGY - S6059 MD 4/3/2020 4/3/2025 OPHTHALMOLOGY GLAUCOMA FOREST HILLS NY ACTIVE 4/17/2020 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 EMERGENCY FORT R0269 LATHER, ROBERT KEITH, MD 9/30/2016 9/30/2021 MEDICINE BELVOIR VA ACTIVE 10/3/2016 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 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 Q6806 ANDERSON, MARK ROBERT, MD 1/6/2016 1/6/2021 UROLOGIC SURGERY FORT HOOD TX ACTIVE 2/11/2016 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 EMERGENCY FORT R3262 ARONOVICH, DANIEL MICHAEL, DO 6/2/2017 6/2/2022 MEDICINE LAUDERDALE FL ACTIVE 6/12/2017 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 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 S5243 PARK, MICHAEL, MD 2/21/2020 2/21/2025 HOSPITALIST FORT LEE NJ ACTIVE 2/28/2020 None N/A CHILD AND ADOLESCENT R3196 RICHARDS, CHRISTOPHER, MD 5/22/2017 5/22/2022 PSYCHIATRY PSYCHIATRY FORT LEE NJ ACTIVE 7/13/2017 None N/A PAPAVERO, VERONICA DERMATOPATHOLOG R3931 GENNADIEVNA, MD 7/17/2017 7/17/2022 Y PATHOLOGY FORT MYERS FL ACTIVE 7/25/2017 None N/A R4941 BENITEZ, OMAR, MD 10/20/2017 10/20/2022 UROLOGY FORT MYERS FL ACTIVE 11/17/2017 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 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 FORT SAM R0310 RITTENHOUSE, BRADLEY A, MD 9/30/2016 9/30/2021 GENERAL SURGERY HOUSTON TX ACTIVE 10/20/2016 None N/A CRITICAL CARE FORT SAM Q7264 RIZZO, JULIE ANN, MD 2/16/2016 2/16/2021 GENERAL SURGERY (TRAUMA) HOUSTON TX ACTIVE 3/1/2016 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 FORT SAM R6278 SCALZITTI, NICHOLAS JOHN, MD 3/2/2018 3/2/2023 OTOLARYNGOLOGY SLEEP MEDICINE HOUSTON TX ACTIVE 3/13/2018 None N/A

Page 161 of 332 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 R2215 SANDNESS, DORCAS JOAN, MD 3/20/2017 3/20/2022 MEDICINE MEDICAL SERVICES FORT SMITH AR ACTIVE 5/29/2017 None N/A EMERGENCY R4792 WEDDLE, JOHN PALMER, DO 9/22/2017 9/22/2022 MEDICINE FORT SMITH AR ACTIVE 9/27/2017 None N/A EMERGENCY FORT R2504 YE, YANG , MD 4/4/2017 4/4/2022 FAMILY MEDICINE MEDICINE STOCKTON TX ACTIVE 4/24/2017 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 Q6785 ROSINIA, FRANCIS, MD 12/15/2015 12/15/2020 ANESTHESIOLOGY ANESTHESIOLOGY FORT WORTH TX ACTIVE 12/21/2015 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

Q4699 SNOW, JENNIFER ANNA LEE, DO 6/1/2015 6/1/2020 BREAST ONCOLOGY GENERAL SURGERY FORT WORTH TX ACTIVE 6/3/2015 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 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 R2311 CORBIN, ELORA PATTANAIK, MD 4/4/2017 4/4/2022 CHILD NEUROLOGY FORT WORTH TX ACTIVE 6/13/2017 None N/A PIENTKA, AMANDA CATHERINE, CRITICAL CARE EMERGENCY S5735 MD 3/20/2020 3/20/2025 MEDICINE MEDICINE FORT WORTH TX ACTIVE 3/26/2020 None N/A Q8170 TOMC, CHRISTA MICHELLE, DO 5/2/2016 5/2/2021 DERMATOLOGY FORT WORTH TX ACTIVE 5/5/2016 None N/A S5800 VEMULA, SHALINI, MD 3/20/2020 3/20/2025 DERMATOLOGY FORT WORTH TX ACTIVE 4/1/2020 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 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 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 Q7653 BOYACK, DANE , DO 4/1/2016 4/1/2021 MEDICINE FORT WORTH TX ACTIVE 4/5/2016 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

Page 162 of 332 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 S4607 BREWER, MATTHEW ROBERT, MD 1/10/2020 1/10/2025 MEDICINE FORT WORTH TX ACTIVE 1/14/2020 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 EMERGENCY S4614 COHICK, CONNOR , MD 1/10/2020 1/10/2025 MEDICINE FORT WORTH TX ACTIVE 2/10/2020 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 EMERGENCY R3061 DIB, SASHA MICHAEL, MD 5/22/2017 5/22/2022 MEDICINE FORT WORTH TX ACTIVE 6/5/2017 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 EMERGENCY S5916 HARDY, JONATHAN NORMAN, DO 4/3/2020 4/3/2025 MEDICINE FORT WORTH TX ACTIVE 4/8/2020 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 EMERGENCY R5738 HIGGINS, TYSON JAY, MD 1/19/2018 1/19/2023 MEDICINE FORT WORTH TX ACTIVE 1/31/2018 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 HUDDLESTON, ASHLEY MALCOM, EMERGENCY Q4603 MD 6/1/2015 6/1/2020 MEDICINE FORT WORTH TX ACTIVE 6/4/2015 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 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 EMERGENCY Q5847 LANE, NATHANIEL GRAHAM, MD 8/28/2015 8/28/2020 MEDICINE FORT WORTH TX ACTIVE 9/4/2015 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 EMERGENCY R1083 MCLARTY, DAISHA LATOYA, MD 12/16/2016 12/16/2021 MEDICINE FORT WORTH TX ACTIVE 1/13/2017 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 NAGABHUSHAN, MEGHNA EMERGENCY R1996 PANNAGA, DO 3/3/2017 3/3/2022 MEDICINE FORT WORTH TX ACTIVE 3/14/2017 None N/A

Page 163 of 332 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 Q4679 RICHMOND, NEAL J, MD 6/1/2015 6/1/2020 MEDICINE MEDICAL SERVICES FORT WORTH TX ACTIVE 6/9/2015 None N/A EMERGENCY Q6903 RUTLEDGE, WHIT , MD 1/6/2016 1/6/2021 MEDICINE FORT WORTH TX ACTIVE 1/22/2016 None N/A EMERGENCY S4569 SMITH, KATHRYN MARIE, MD 12/20/2019 12/20/2024 MEDICINE FORT WORTH TX ACTIVE 1/14/2020 None N/A EMERGENCY Q6118 THOMAS, TREVOR KARL, DO 9/15/2015 9/15/2020 MEDICINE FORT WORTH TX ACTIVE 9/18/2015 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 Q8005 AMUDIPE, OLUBUKOLA T, MD 5/2/2016 5/2/2021 FAMILY MEDICINE FORT WORTH TX ACTIVE 5/25/2016 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 S6792 BARUCH, HILARY , MD 5/29/2020 5/29/2025 FAMILY MEDICINE FORT WORTH TX ACTIVE 6/5/2020 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 R1195 CARMICAL, KATELYN HALIE, MD 1/6/2017 1/6/2022 FAMILY MEDICINE FORT WORTH TX ACTIVE 2/6/2017 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 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 R3495 CYRIL, ELIZMARY, MD 6/16/2017 6/16/2022 FAMILY MEDICINE HOSPITALIST FORT WORTH TX ACTIVE 7/6/2017 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 S6826 EHRLICH, CODI DIANE, MD 5/29/2020 5/29/2025 FAMILY MEDICINE FORT WORTH TX ACTIVE 6/16/2020 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

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 S5981 MATTHYS, ALLYSON MARIE, DO 4/3/2020 4/3/2025 FAMILY MEDICINE FORT WORTH TX ACTIVE 4/13/2020 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 R6052 MOMIN, SONIKA HASANALI, MD 2/16/2018 2/16/2023 FAMILY MEDICINE FORT WORTH TX ACTIVE 2/19/2018 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 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 Q9211 NELSON, JOSEPH ANDREW, MD 7/15/2016 7/15/2021 FAMILY MEDICINE FORT WORTH TX ACTIVE 7/26/2016 None N/A R0767 NEWTON, REBECCA LEE, MD 11/15/2016 11/15/2021 FAMILY MEDICINE FORT WORTH TX ACTIVE 11/17/2016 None N/A Q8580 NGUYEN, CAROLINE TRINH, MD 6/1/2016 6/1/2021 FAMILY MEDICINE FORT WORTH TX ACTIVE 6/7/2016 None N/A

Page 164 of 332 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 R6062 NGUYEN, LINH THUY, MD 2/16/2018 2/16/2023 FAMILY MEDICINE FORT WORTH TX ACTIVE 2/21/2018 None N/A S5235 NORRIS, AMBER , MD 2/21/2020 2/21/2025 FAMILY MEDICINE FORT WORTH TX ACTIVE 2/24/2020 None N/A

R0088 OLOTU, OLUSESAN OLUSEUN, MD 9/15/2016 9/15/2021 FAMILY MEDICINE FORT WORTH TX ACTIVE 9/19/2016 None N/A R2702 PATTON, KYLE ANTHONY, MD 4/20/2017 4/20/2022 FAMILY MEDICINE FORT WORTH TX ACTIVE 5/1/2017 None N/A R4631 SAVERINE, ANDREW JAMES, DO 9/8/2017 9/8/2022 FAMILY MEDICINE FORT WORTH TX ACTIVE 9/11/2017 None N/A ADMINISTRATIVE Q8166 THORNSBERRY, MICHAEL D, MD 5/2/2016 5/2/2021 FAMILY MEDICINE MEDICINE FORT WORTH TX ACTIVE 5/5/2016 None N/A R2791 WINCHELL, ZHANNA , MD 4/20/2017 4/20/2022 FAMILY MEDICINE FORT WORTH TX ACTIVE 5/10/2017 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 DOLLAHITE, HENRY MATTHEW, R2846 MD 5/5/2017 5/5/2022 FAMILY PRACTICE FORT WORTH TX ACTIVE 5/8/2017 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 R4870 MANOCK, STEPHEN, MD 10/6/2017 10/6/2022 FAMILY PRACTICE FORT WORTH TX ACTIVE 10/19/2017 None N/A R4887 PATEL, UMANG, MD 10/6/2017 10/6/2022 FAMILY PRACTICE FORT WORTH TX ACTIVE 10/17/2017 None N/A

R1876 SHELMADINE, BRIAN DWIGHT, DO 2/22/2017 2/22/2022 FAMILY PRACTICE FORT WORTH TX ACTIVE 2/27/2017 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 FP/OSTEO PEDERSON, KATHERINE MANIPULATION Q7593 ADELAIDE, DO 3/15/2016 3/15/2021 MEDICINE FORT WORTH TX ACTIVE 3/18/2016 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 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 R3913 MEKALA, ASHLEY VIJAY, DO 7/17/2017 7/17/2022 GENERAL SURGERY FORT WORTH TX ACTIVE 7/26/2017 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 SEE PREVIOUS Q5895 PATEL, ARVIND CHUNIBHAI, MD 8/28/2015 8/28/2020 GENERAL SURGERY FORT WORTH TX ACTIVE 9/14/2015 ORDER 8/31/2015 HEAD AND NECK R0595 KADAKIA, SAMEEP, MD 10/31/2016 10/31/2021 SURGERY FORT WORTH TX ACTIVE 11/11/2016 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 S5630 GOPITO, BELINDA GRACE, DO 3/20/2020 3/20/2025 HOSPITALIST HOSPITALIST FORT WORTH TX ACTIVE 3/26/2020 None N/A

Page 165 of 332 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 S6416 ILINENI, VISHNU KARTHIK, MD 5/1/2020 5/1/2025 HOSPITALIST FORT WORTH TX ACTIVE 5/4/2020 None N/A Q7290 THOTA, SARITHA, MD 2/16/2016 2/16/2021 HOSPITALIST FORT WORTH TX ACTIVE 3/30/2016 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 R1486 AL HALLAK, ANAS AHMAD, MD 2/6/2017 2/6/2022 INTERNAL MEDICINE FORT WORTH TX ACTIVE 2/7/2017 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 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 R0359 BATTERTON, NICOLAS JOHN, MD 10/14/2016 10/14/2021 INTERNAL MEDICINE FORT WORTH TX ACTIVE 10/26/2016 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 Q6153 BHAT, MUSHTAQ AHMAD, MD 10/1/2015 10/1/2020 INTERNAL MEDICINE HOSPITALIST FORT WORTH TX ACTIVE 10/8/2015 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 R0553 COTA, DONNA, DO 10/31/2016 10/31/2021 INTERNAL MEDICINE FORT WORTH TX ACTIVE 1/30/2017 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 R3103 HOANG, JOHN , DO 5/22/2017 5/22/2022 INTERNAL MEDICINE FORT WORTH TX ACTIVE 6/5/2017 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

Q6037 KABIR, MOHAMMAD HUMAYUN, MD 9/15/2015 9/15/2020 INTERNAL MEDICINE NEPHROLOGY FORT WORTH tx ACTIVE 9/30/2015 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 Q5453 KAUSER, RICKY, MD 8/3/2015 8/3/2020 INTERNAL MEDICINE FORT WORTH TX ACTIVE 8/7/2015 None N/A Q5703 NJOKU, ANGELA IFEOMA, DO 8/14/2015 8/14/2020 INTERNAL MEDICINE CARDIOLOGY FORT WORTH TX ACTIVE 8/31/2015 None N/A Q8994 PATEL, AMAN , DO 7/1/2016 7/1/2021 INTERNAL MEDICINE FORT WORTH TX ACTIVE 7/15/2016 None N/A J4476 RICH, JAMES SCOTT, MD 7/1/2016 7/1/2021 INTERNAL MEDICINE HOSPITALIST FORT WORTH TX ACTIVE 8/15/2016 None N/A R3749 SENGODAN, MOHAN, MD 6/30/2017 6/30/2022 INTERNAL MEDICINE FORT WORTH TX ACTIVE 7/24/2017 None N/A R1648 SISANTE, ANTON , DO 2/6/2017 2/6/2022 INTERNAL MEDICINE FORT WORTH TX ACTIVE 2/10/2017 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 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 Q5241 PALEY, CHARLES WILLIAM, MD 7/15/2015 7/15/2020 NEONATOLOGY FORT WORTH TX ACTIVE 7/17/2015 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 MADHRIRA, MACHAIAH Q5219 MUTHANNA, MD 7/15/2015 7/15/2020 NEPHROLOGY FORT WORTH TX ACTIVE 8/26/2015 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 NEUROLOGICAL P3342 HARVEY, ADRIAN TIMOTHY, DO 12/8/2017 12/8/2022 SURGERY FORT WORTH TX ACTIVE 1/16/2018 None N/A

Page 166 of 332 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 ENDOVASCULAR NEUROLOGICAL SURGICAL Q6468 SIDDIQ, FARHAN, MD 11/2/2015 11/2/2020 SURGERY NEURORADIOLOGY FORT WORTH TX ACTIVE 11/18/2015 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 DUSHKU, PATRICIA BILLINGSLEY, OBSTETRICS AND S6165 MD 4/17/2020 4/17/2025 GYNECOLOGY FORT WORTH TX ACTIVE 4/23/2020 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 JACKSON, ANGALENE DEAPEN, OBSTETRICS AND Q9384 DO 8/1/2016 8/1/2021 GYNECOLOGY FORT WORTH TX ACTIVE 8/19/2016 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 OBSTETRICS AND R1414 MARSHALL, HAYLEY M, DO 1/20/2017 1/20/2022 GYNECOLOGY FORT WORTH TX ACTIVE 3/8/2017 None N/A OBSTETRICS AND R0924 PALMER, ANDREA BROOKE, MD 12/2/2016 12/2/2021 GYNECOLOGY FORT WORTH TX ACTIVE 1/30/2017 None N/A RIDDLE, CHRISTINE ELIZABETH, OBSTETRICS AND S6722 MD 5/15/2020 5/15/2025 GYNECOLOGY FORT WORTH TX ACTIVE 5/19/2020 None N/A OBSTETRICS AND Q9551 WESTBROOK, BRETT , MD 8/1/2016 8/1/2021 GYNECOLOGY FORT WORTH TX ACTIVE 8/3/2016 None N/A OBSTETRICS AND R0158 WILTZ KARGOU, BENISHA, MD 9/15/2016 9/15/2021 GYNECOLOGY FORT WORTH TX ACTIVE 9/28/2016 None N/A ORAL & MAXILLOFACIAL HEAD AND NECK S4567 SHUPAK, RAYMOND PATRICK, MD 12/20/2019 12/20/2024 SURGERY SURGERY FORT WORTH TX ACTIVE 1/14/2020 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 ORTHOPEDIC R4260 KIM, HANNAH HYUNHEE, MD 8/15/2017 8/15/2022 SURGERY FORT WORTH TX ACTIVE 8/28/2017 None N/A ORTHOPEDIC Q9474 PAYNE, JOSHUA MARK, DO 8/1/2016 8/1/2021 SURGERY FORT WORTH TX ACTIVE 8/4/2016 None N/A ORTHOPEDIC SURGERY OF THE ORTHOPEDIC R3234 TOY, JASON ONUR, MD 5/22/2017 5/22/2022 SPINE SURGERY FORT WORTH TX ACTIVE 5/31/2017 None N/A R3581 PATEL, SHIV PRAVIN, MD 6/16/2017 6/16/2022 ORTHOPEDICS FORT WORTH TX ACTIVE 6/20/2017 None N/A

Page 167 of 332 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 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 S5221 MARSHALL, PETER, MD 2/21/2020 2/21/2025 PAIN MEDICINE ANESTHESIOLOGY FORT WORTH TX ACTIVE 5/19/2020 None N/A

Q9703 OSENGA, KACI LYNN, MD 8/15/2016 8/15/2021 PALLIATIVE MEDICINE PEDIATRICS FORT WORTH TX ACTIVE 8/17/2016 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 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 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 PEDIATRIC EMERGENCY R3158 MOSES, STEPHANIE, DO 5/22/2017 5/22/2022 MEDICINE (PEDS) FORT WORTH TX ACTIVE 6/5/2017 None N/A PEDIATRIC R3410 RAZZOUK, RANDA, MD 6/2/2017 6/2/2022 NEPHROLOGY FORT WORTH TX ACTIVE 6/5/2017 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 Q8195 ADONIS, MICHEL JOHN, MD 5/16/2016 5/16/2021 PEDIATRICS FORT WORTH TX ACTIVE 5/20/2016 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 Q8441 BRUCE, KEELIE, DO 6/1/2016 6/1/2021 PEDIATRICS FORT WORTH TX ACTIVE 6/2/2016 None N/A R1010 DALELA, ANSHU, MD 12/16/2016 12/16/2021 PEDIATRICS FORT WORTH TX ACTIVE 12/20/2016 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 Q7980 WAGNER, BRIDGET, MD 4/15/2016 4/15/2021 PEDIATRICS FORT WORTH TX ACTIVE 4/20/2016 None N/A PEDIATRICS, S6969 VANLOOZEN, DENNIS H, MD 5/29/2020 5/29/2025 CARDIOLOGY FORT WORTH TX ACTIVE 6/1/2020 None N/A PEDIATRICS, CARDIOVASCULAR Q9093 WOLDU, KRISTAL L, MD 7/1/2016 7/1/2021 CARDIOLOGY IMAGING FORT WORTH TX ACTIVE 7/18/2016 None N/A PHYSICAL MED. & SPINE AND SPORTS R6060 NGUYEN, CHRISTINA , DO 2/16/2018 2/16/2023 REHABILITATION MEDICINE FORT WORTH TX ACTIVE 3/6/2018 None N/A 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

Page 168 of 332 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 Q9974 CARTER, KIA LASHAUN, MD 9/15/2016 9/15/2021 PSYCHIATRY PSYCHIATRY FORT WORTH TX ACTIVE 12/12/2016 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 LOPEZ CALDERON, KARLA R3372 RAQUEL, MD 6/2/2017 6/2/2022 PSYCHIATRY FORT WORTH TX ACTIVE 6/12/2017 None N/A Q6722 YAHAGI, KEISHA , MD 12/4/2015 12/4/2020 PSYCHIATRY FORT WORTH TX ACTIVE 2/29/2016 None N/A Q6722 YAHAGI, KEISHA , MD 12/4/2015 12/4/2020 PSYCHIATRY FORT WORTH TX ACTIVE 2/29/2016 None N/A PULMONARY CRITICAL CARE S5795 TRAN, LIEN KHUONG PHAM, MD 3/20/2020 3/20/2025 MEDICINE SLEEP MEDICINE FORT WORTH TX ACTIVE 3/24/2020 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 S7115 PATEL, SNEHA N, MD 6/12/2020 6/12/2025 RHEUMATOLOGY INTERNAL MEDICINE FORT WORTH TX ACTIVE 6/15/2020 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 TRANSPLANT ABDOMINAL R5193 REYAD, ASHRAF IBRAHIM, MD 11/3/2017 11/3/2022 SURGERY SURGERY FORT WORTH TX ACTIVE 11/8/2017 None N/A WILLINGHAM, JULIA MARCELLA, R5229 MD 11/3/2017 11/3/2022 UROLOGIC SURGERY FORT WORTH TX ACTIVE 11/13/2017 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 PEDIATRIC R0052 KROPP, BRADLEY PETER, MD 9/15/2016 9/15/2021 UROLOGY UROLOGY FORT WORTH TX ACTIVE 9/19/2016 None N/A PEDIATRIC R0090 PALMER, BLAKE WILEY, MD 9/15/2016 9/15/2021 UROLOGY UROLOGY FORT WORTH TX ACTIVE 9/19/2016 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 EMERGENCY S4507 KAYE, ILAN , MD 12/20/2019 12/20/2024 MEDICINE FORT WOTH TX ACTIVE 1/13/2020 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 DELINQUEN PARTHASARATHI, ARCHANA FORTHWORT T-NON R0093 PRIYADARSHINI, MD 9/15/2016 9/15/2021 INTERNAL MEDICINE H TX PAYMENT 12/30/2017 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 INTERVENTIONAL Q7340 CHANDRAPRAKASAM, SATISH, MD 3/4/2016 3/4/2021 CARDIOLOGY CARDIOLOGY FORTWORTH TX ACTIVE 4/21/2016 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

Page 169 of 332 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

R0589 HUSSEIN, MOHAMED GINAWI, MD 10/31/2016 10/31/2021 INTERNAL MEDICINE FORTWORTH TX ACTIVE 11/2/2016 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 ANESTHESIOLOGY - Q6985 SHAIKH, HARRIS, MD 1/15/2016 1/15/2021 PAIN MANAGEMENT INTERNAL MEDICINE FREDERICK MD ACTIVE 1/28/2016 None N/A ANESTHESIOLOGY - Q6907 SHAIKH, SANA, MD 1/6/2016 1/6/2021 PAIN MANAGEMENT FREDERICK MD ACTIVE 2/4/2016 None N/A EMERGENCY R4927 OCONNELL, JEANNE MARIE, MD 10/6/2017 10/6/2022 MEDICINE OTHER SPECIALTY FREDERICK MD ACTIVE 10/23/2017 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 FREDERICKSB Q9405 KLUMP, SHANNON FAITH, DO 8/1/2016 8/1/2021 FAMILY MEDICINE URG TX ACTIVE 9/27/2016 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 OBSTETRICS AND FREDERICKSB Q5424 HAWS, BLAIR , MD 8/3/2015 8/3/2020 GYNECOLOGY URG TX ACTIVE 8/4/2015 None N/A SURGICAL FREDERICKSB S4365 PELTON, JEFFREY JEROME, MD 12/6/2019 12/6/2024 ONCOLOGY GENERAL SURGERY URG VA ACTIVE 12/11/2019 None N/A SURGICAL FREDERICKSB S4365 PELTON, JEFFREY JEROME, MD 12/6/2019 12/6/2024 ONCOLOGY GENERAL SURGERY URG VA ACTIVE 12/11/2019 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 FACIAL PLASTIC Q8841 CAIN, JORDAN AUSTIN, MD 7/1/2016 7/1/2021 SURGERY OTOLARYNGOLOGY FRISCO TX ACTIVE 8/26/2016 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 R3197 ROBERTS, AARON, DO 5/22/2017 5/22/2022 GENERAL SURGERY FRISCO TX ACTIVE 8/3/2017 None N/A Q5454 KAZI, RUCHIKA, MD 8/3/2015 8/3/2020 HOSPITALIST FRISCO TX ACTIVE 8/4/2015 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 S5771 SEETHARAM, SANDHYA, MD 3/20/2020 3/20/2025 INTERNAL MEDICINE FRISCO TX ACTIVE 3/25/2020 None N/A

NEURO-PHYSIOLOGY Q5176 DIKE, NNAMDI CHIMA, DO 7/15/2015 7/15/2020 NEUROLOGY (NEUROLOGY) FRISCO TX ACTIVE 7/16/2015 None N/A

Page 170 of 332 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 ORTHOPEDIC RECONSTRUCTIVE S5597 DIBRA, FLORIAN FRANCIS, MD 3/20/2020 3/20/2025 SURGERY ORTHOPEDICS FRISCO TX ACTIVE 3/24/2020 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 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. & ANESTHESIOLOGY - R2266 ALI, RAO KAMRAN, MD 4/4/2017 4/4/2022 REHABILITATION PAIN MANAGEMENT FRISCO TX ACTIVE 4/6/2017 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 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 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 R3510 FLETCHER, MICHELLE , DO 6/16/2017 6/16/2022 MEDICINE FT WORTH TX ACTIVE 6/27/2017 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 Q4897 BALOGH, RYAN PATRICK, MD 7/1/2015 7/1/2020 GENERAL SURGERY FT WORTH TX ACTIVE 7/9/2015 None N/A NEONATAL- PERINATAL Q6093 RIVERA-LEVY, ALMA E, MD 9/15/2015 9/15/2020 PEDIATRICS MEDICINE FT. WORTH, TX ACTIVE 10/12/2015 None N/A R4992 KELLEY, RAYMOND SCOTT, MD 10/20/2017 10/20/2022 ANESTHESIOLOGY GAINESVILLE FL ACTIVE 10/26/2017 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 EMERGENCY G3647 NICHOLSON, HEIDI THERESA, MD 1/15/2016 1/15/2021 MEDICINE INTERNAL MEDICINE GAINESVILLE GA ACTIVE 1/21/2016 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 VISSERS, CHRISTIAN FRANK JR, ORTHOPEDIC SPORTS MEDICINE - R1899 MD 2/22/2017 2/22/2022 SURGERY ORTHOPEDICS GAINESVILLE TX ACTIVE 5/9/2017 None N/A S4718 ASIRVATHAM, JAYA RUTH, MD 1/24/2020 1/24/2025 PATHOLOGY GAINESVILLE FL ACTIVE 2/11/2020 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 Q7964 SHOUKIER, MAHRAN, MD 4/15/2016 4/15/2021 INTERNAL MEDICINE GALAX VA ACTIVE 4/26/2016 None N/A ALQUICIRA-MACEDO, FERNANDO , R5069 MD 11/3/2017 11/3/2022 ANESTHESIOLOGY GALVESTON TX ACTIVE 1/22/2018 None N/A

Page 171 of 332 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 R0832 ARDESHNA, RISHI , MD 12/2/2016 12/2/2021 ANESTHESIOLOGY GALVESTON TX ACTIVE 12/12/2016 None N/A Q4722 BEDNAR, GRACE , MD 6/12/2015 6/12/2020 ANESTHESIOLOGY GALVESTON TX ACTIVE 6/18/2015 None N/A Q7700 HARVEY, RYAN JOSEPH, MD 4/1/2016 4/1/2021 ANESTHESIOLOGY GALVESTON TX ACTIVE 4/7/2016 None N/A HODGES, CAMILLE MERCEDES, S5387 DO 3/6/2020 3/6/2025 ANESTHESIOLOGY GALVESTON TX ACTIVE 3/9/2020 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

R3878 JUAREZ, HERIBERTO , MD 7/17/2017 7/17/2022 ANESTHESIOLOGY GENERAL SURGERY GALVESTON TX ACTIVE 8/15/2017 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 PEDIATRIC ANESTHESIOLOGY R4428 MASEL, BRIAN DAVID, MD 8/25/2017 8/25/2022 ANESTHESIOLOGY (PEDS) GALVESTON TX ACTIVE 10/3/2017 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 S6510 SAMPLES, DARREN CLINT, MD 5/1/2020 5/1/2025 ANESTHESIOLOGY GALVESTON TX ACTIVE 6/1/2020 None N/A CARDIAC CARDIOVASCULAR ELECTROPHYSIOLO R0952 SEWANI, ASIF , MD 12/2/2016 12/2/2021 DISEASES GY GALVESTON TX ACTIVE 1/9/2017 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 COLON AND RECTAL R0485 RASHIDI, LAILA , MD 10/14/2016 10/14/2021 SURGERY GENERAL SURGERY GALVESTON TX ACTIVE 10/25/2016 None N/A COLON AND RECTAL Q9729 SENAGORE, ANTHONY, MD 8/15/2016 8/15/2021 SURGERY GENERAL SURGERY GALVESTON TX ACTIVE 8/26/2016 None N/A R3534 IKPEAMA, CHINELO , MD 6/16/2017 6/16/2022 DERMATOLOGY GALVESTON TX ACTIVE 7/26/2017 None N/A R0078 MCMAHAN, YOUNG T, MD 9/15/2016 9/15/2021 DERMATOLOGY GALVESTON TX ACTIVE 9/21/2016 None N/A R2234 TAUSEND, WILLIAM , MD 3/20/2017 3/20/2022 DERMATOLOGY GALVESTON TX ACTIVE 3/28/2017 None N/A DIAGNOSTIC INTERVENTIONAL S4562 SALEEM, ARSALAN, MD 12/20/2019 12/20/2024 RADIOLOGY RADIOLOGY GALVESTON TX ACTIVE 12/23/2019 None N/A UNDERSEA EMERGENCY HYPERBARIC MED R2942 PIPER, STEVEN MICHAEL, DO 5/5/2017 5/5/2022 MEDICINE (EMER MED) GALVESTON TX ACTIVE 7/20/2017 None N/A SCHOENSTEIN, LYNDA MITCHELL, EMERGENCY R4632 MD 9/8/2017 9/8/2022 MEDICINE GALVESTON TX ACTIVE 9/25/2017 None N/A EMERGENCY R1132 SINGER, PHILLIP LAWRENCE, DO 12/16/2016 12/16/2021 MEDICINE GALVESTON TX ACTIVE 12/19/2016 None N/A

Page 172 of 332 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 AEROSPACE R3608 THOMPSON, MORIAH SHAY, MD 6/16/2017 6/16/2022 MEDICINE MEDICINE GALVESTON TX ACTIVE 6/21/2017 None N/A ENDOCRINOLOGY, DIABETES AND R5470 SHAH, NISARG SHAILESHBHAI, MD 12/8/2017 12/8/2022 METABOLISM INTERNAL MEDICINE GALVESTON TX ACTIVE 12/15/2017 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 Q6838 GOLDSON, TOVE MARTINE, MD 1/6/2016 1/6/2021 FAMILY MEDICINE GALVESTON TX ACTIVE 1/15/2016 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 PREVENTIVE Q7212 JAMAL, NAIOMI, MD 2/16/2016 2/16/2021 FAMILY MEDICINE MEDICINE GALVESTON TX ACTIVE 2/23/2016 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 Q5005 KHAN, MADIHA AHMED, MD 7/1/2015 7/1/2020 FAMILY MEDICINE GALVESTON TX ACTIVE 7/3/2015 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 S6016 PORTER, ANDREINA ELENA, MD 4/3/2020 4/3/2025 FAMILY MEDICINE GALVESTON TX ACTIVE 4/6/2020 None N/A RODRIGUEZ-JIMENEZ, WILFREDO, AEROSPACE Q9240 MD 7/15/2016 7/15/2021 FAMILY MEDICINE MEDICINE GALVESTON TX ACTIVE 7/21/2016 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 GASTROENTEROLOG S6301 SHARMA, MANAV SEWAK, MD 4/17/2020 4/17/2025 Y GALVESTON TX ACTIVE 4/21/2020 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 R3367 LAYBA, CATHLINE JO, MD 6/2/2017 6/2/2022 GENERAL SURGERY GALVESTON TX ACTIVE 6/9/2017 None N/A NUNEZ LOPEZ, OMAR ALBERTO, S4830 MD 1/24/2020 1/24/2025 GENERAL SURGERY GALVESTON TX ACTIVE 1/31/2020 None N/A SURGICAL Q6079 OLINO, KELLY , MD 9/15/2015 9/15/2020 GENERAL SURGERY ONCOLOGY GALVESTON TX ACTIVE 9/16/2015 None N/A R2941 PEREZ, ALEXANDER, MD 5/5/2017 5/5/2022 GENERAL SURGERY GALVESTON TX ACTIVE 5/8/2017 None N/A R0817 YEH, OWEN LI-YOUNG, MD 11/15/2016 11/15/2021 HOSPITALIST INTERNAL MEDICINE GALVESTON TX ACTIVE 2/8/2017 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 ALMAHMOUD, MOHAMED FAHER , R2804 MD 5/5/2017 5/5/2022 INTERNAL MEDICINE GALVESTON TX ACTIVE 6/5/2017 None N/A Q6730 BAXTER, KHANNAH , MD 12/15/2015 12/15/2020 INTERNAL MEDICINE GALVESTON TX ACTIVE 1/25/2016 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 CAMARENA, JULIEANNA ANGEL, Q8030 DO 5/2/2016 5/2/2021 INTERNAL MEDICINE GALVESTON tx ACTIVE 5/4/2016 None N/A

Page 173 of 332 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 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 GASTROENTEROLOG R4708 GOU, ERIC , MD 9/22/2017 9/22/2022 INTERNAL MEDICINE Y GALVESTON TX ACTIVE 10/25/2017 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 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 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 Q4999 KASSEM, HANIA , MD 7/1/2015 7/1/2020 INTERNAL MEDICINE NEPHROLOGY GALVESTON TX ACTIVE 9/4/2015 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

Q9461 OMITOGUN, TUNDE OLAWALE, MD 8/1/2016 8/1/2021 INTERNAL MEDICINE GALVESTON TX ACTIVE 8/2/2016 None N/A ONOVIRAN, OLUSOLA FRANCISCA, GERIATRICS - Q8589 MD 6/1/2016 6/1/2021 INTERNAL MEDICINE INTERNAL MEDICINE GALVESTON TX ACTIVE 6/16/2016 None N/A R5023 PARK, PAUL SESUNG, MD 10/20/2017 10/20/2022 INTERNAL MEDICINE GALVESTON TX ACTIVE 10/30/2017 None N/A

S6709 PEREZ, CESAR AGUSTIN, MD 5/15/2020 5/15/2025 INTERNAL MEDICINE GENERAL PRACTICE GALVESTON TX ACTIVE 5/20/2020 None N/A S4368 PEREZ, CHRISTOPHER , MD 12/6/2019 12/6/2024 INTERNAL MEDICINE GALVESTON TX ACTIVE 2/25/2020 None N/A S4368 PEREZ, CHRISTOPHER , MD 12/6/2019 12/6/2024 INTERNAL MEDICINE GALVESTON TX ACTIVE 2/25/2020 None N/A S5086 SUTHAR, KRISHNA HEMANT, MD 2/7/2020 2/7/2025 INTERNAL MEDICINE GALVESTON TX ACTIVE 2/10/2020 None N/A Q9094 WU, GERU , MD 7/1/2016 7/1/2021 INTERNAL MEDICINE GALVESTON TX ACTIVE 7/25/2016 None N/A R1917 ZAND, ASHKAN MICHAEL, MD 2/22/2017 2/22/2022 INTERNAL MEDICINE GALVESTON TX ACTIVE 2/28/2017 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 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 H4867 BADALAMENTI, JOHN, MD 9/15/2015 9/15/2020 NEPHROLOGY INTERNAL MEDICINE GALVESTON TX ACTIVE 9/17/2015 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 OBSTETRICS AND Q8832 BAXLEY, SARAH EMILY, MD 7/1/2016 7/1/2021 GYNECOLOGY GALVESTON TX ACTIVE 7/12/2016 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 OBSTETRICS AND R1422 MONSIVAIS, LUIS ALBERTO, MD 1/20/2017 1/20/2022 GYNECOLOGY GALVESTON TX ACTIVE 2/1/2017 None N/A

Page 174 of 332 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 S6523 SHEPHERD, MEGAN CRYSTAL, MD 5/1/2020 5/1/2025 GYNECOLOGY GALVESTON TX ACTIVE 5/5/2020 None N/A OBSTETRICS AND S6330 YAKLIC, JEROME LUMETTA, MD 4/17/2020 4/17/2025 GYNECOLOGY UROGYNECOLOGY GALVESTON TX ACTIVE 4/29/2020 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 R5062 ADEBAYO, AISHAT , MD 11/3/2017 11/3/2022 OPHTHALMOLOGY GALVESTON TX ACTIVE 11/9/2017 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 CORNEA REFRACTIVE R2139 KHAN, HUMAIR , MD 3/20/2017 3/20/2022 OPHTHALMOLOGY SURGERY GALVESTON TX ACTIVE 6/2/2017 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 HEAD AND NECK R3219 SON, EUGENE LEE, MD 5/22/2017 5/22/2022 OTOLARYNGOLOGY SURGERY GALVESTON TX ACTIVE 5/29/2017 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 TRIPATHI, SHIVANI SHREEKANT, PEDIATRIC CRITICAL Q6379 MD 10/15/2015 10/15/2020 CARE MEDICINE PEDIATRICS GALVESTON TX ACTIVE 10/27/2015 None N/A

PEDIATRIC R3723 NGUYEN, DIANA KIM, DO 6/30/2017 6/30/2022 INFECTIOUS DISEASE PEDIATRICS GALVESTON TX ACTIVE 7/3/2017 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 SURGICAL CRITICAL R0801 TRAN, SIFRANCE, MD 11/15/2016 11/15/2021 PEDIATRIC SURGERY CARE GALVESTON TX ACTIVE 11/17/2016 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 O'DONOHOE, HANNAH WILSON, R2191 MD 3/20/2017 3/20/2022 PEDIATRICS GALVESTON TX ACTIVE 3/30/2017 None N/A

R1441 PROPST, MATTHEW STEPHEN, MD 1/20/2017 1/20/2022 PEDIATRICS SPORTS MEDICINE GALVESTON TX ACTIVE 1/31/2017 None N/A NEONATAL- PERINATAL S6318 TRAN, TUAN QUOC, MD 4/17/2020 4/17/2025 PEDIATRICS MEDICINE GALVESTON TX ACTIVE 4/20/2020 None N/A

Page 175 of 332 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 Q9962 BRANSKI, LUDWIK , MD 9/15/2016 9/15/2021 SURGERY GALVESTON TX ACTIVE 9/20/2016 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 PLASTIC & NORBURY, WILLIAM BENEDICT, RECONSTRUCTIVE R4439 MD 8/25/2017 8/25/2022 SURGERY GALVESTON TX ACTIVE 11/6/2017 None N/A R0236 GILLESPIE, MICHAEL , MD 9/30/2016 9/30/2021 PSYCHIATRY GALVESTON TX ACTIVE 10/5/2016 None N/A R3162 NGUYEN, LANHUONG JAMIE, DO 5/22/2017 5/22/2022 PSYCHIATRY GALVESTON TX ACTIVE 6/2/2017 None N/A CHILD AND ADOLESCENT R0094 PATEL, BIREN PRAKASH , MD 9/15/2016 9/15/2021 PSYCHIATRY PSYCHIATRY GALVESTON TX ACTIVE 9/26/2016 None N/A R5315 SELF, CHANDLER, MD 11/17/2017 11/17/2022 PSYCHIATRY GALVESTON TX ACTIVE 11/28/2017 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 RADIATION R2755 SZEJA, SEAN SIEGFRIED, MD 4/20/2017 4/20/2022 ONCOLOGY GALVESTON TX ACTIVE 4/25/2017 None N/A VERMA, TWISHA CHAKRAVARTY, RADIATION Q7295 MD 2/16/2016 2/16/2021 ONCOLOGY GALVESTON TX ACTIVE 3/16/2016 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 INTERVENTIONAL R2856 GILL, GUNVIR SINGH, MD 5/5/2017 5/5/2022 RADIOLOGY RADIOLOGY GALVESTON TX ACTIVE 6/8/2017 None N/A Q9715 RAGHURAM, KARTHIKRAM, MD 8/15/2016 8/15/2021 RADIOLOGY NEURO-RADIOLOGY GALVESTON TX ACTIVE 8/29/2016 None N/A

Q6776 OKEREKE, IKENNA CHIDUME, MD 12/15/2015 12/15/2020 THORACIC SURGERY GALVESTON TX ACTIVE 2/25/2016 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 Q6095 ROBERTS, ROBYN LIANE, MD 9/15/2015 9/15/2020 UROLOGY GALVESTON TX ACTIVE 9/23/2015 None N/A

R4924 WORSHAM, JENNIFER , MD 10/6/2017 10/6/2022 VASCULAR SURGERY GALVESTON TX ACTIVE 10/30/2017 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 EMERGENCY GARFIELD Q8919 KATIRAI, ANIS BORRAH, MD 7/1/2016 7/1/2021 MEDICINE HEIGHTS OH ACTIVE 9/16/2016 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

Page 176 of 332 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 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 R5743 IGHALO, OMONMEN OFURE, MD 1/19/2018 1/19/2023 FAMILY MEDICINE GARLAND TX ACTIVE 1/23/2018 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 Q6077 NGUYEN, HUY DUC, MD 9/15/2015 9/15/2020 FAMILY MEDICINE FAMILY MEDICINE GARLAND TX ACTIVE 9/17/2015 None N/A Q8168 TITUS, STEPHEN JAMES, MD 5/2/2016 5/2/2021 FAMILY MEDICINE GARLAND TX ACTIVE 5/3/2016 None N/A Q7297 VORA, SHAGUFTA IMTIAZ, DO 2/16/2016 2/16/2021 FAMILY MEDICINE GARLAND TX ACTIVE 4/4/2016 None N/A REDDING, COLTON REISINGER, Q7778 DO 4/1/2016 4/1/2021 FAMILY PRACTICE GARLAND TX ACTIVE 4/4/2016 None N/A GASTROENTEROLOG Q7277 SHEIKH, IMRAN, MD 2/16/2016 2/16/2021 INTERNAL MEDICINE Y GARLAND TX ACTIVE 5/3/2016 None N/A Q5135 AGRAWAL, MEGHA , MD 7/15/2015 7/15/2020 OPHTHALMOLOGY GARLAND TX ACTIVE 7/17/2015 None N/A Q8489 GOLI, NEETA MUDLAGIRI, MD 6/1/2016 6/1/2021 PEDIATRICS GARLAND TX ACTIVE 6/8/2016 None N/A R1676 YAQOOB, MUHAMMAD, MD 2/6/2017 2/6/2022 PEDIATRICS GARLAND TX ACTIVE 3/27/2017 None N/A MOHAMMED, NAZIMUDDIN TALHA, R1586 MD 2/6/2017 2/6/2022 PSYCHIATRY GARLAND TX ACTIVE 2/9/2017 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 OPHTHALMOLOGY - S6357 BEALKA, PETER JAMES, MD 5/1/2020 5/1/2025 ANTERIOR SURGERY GATESVILLE TX ACTIVE 5/29/2020 None N/A EMERGENCY R2381 KLYUY, DMITRY, MD 4/4/2017 4/4/2022 MEDICINE GENEVA OH ACTIVE 7/4/2017 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 EMERGENCY GEORGETOW S5182 HILL, MALONE VINCENT III, MD 2/21/2020 2/21/2025 MEDICINE N TX ACTIVE 3/4/2020 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 GEORGETOW Q9464 OSBORNE, RACHEL LAUREN, MD 8/1/2016 8/1/2021 INTERNAL MED - PEDS N TX ACTIVE 8/3/2016 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 RADIATION GEORGETOW R4433 MINOR, GLADYS IRENE, MD 8/25/2017 8/25/2022 ONCOLOGY N TX ACTIVE 8/29/2017 None N/A SACHANANDANI, NEIL SURESH, FACIAL PLASTIC R2465 MD 4/4/2017 4/4/2022 PLASTIC SURGERY SURGERY GILBERT AZ ACTIVE 4/5/2017 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 GASTROENTEROLOG R4065 JALA, VIKRAM R, MD 8/1/2017 8/1/2022 INTERNAL MEDICINE Y GLAVESTON TX ACTIVE 8/18/2017 None N/A

Page 177 of 332 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 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

R1660 TARAS, ANGIE ROSANNE, MD 2/6/2017 2/6/2022 GENERAL SURGERY COSMETIC SURGERY GLENVIEW IL ACTIVE 2/13/2017 None N/A TAYLOR, BRANDON DIAGNOSTIC GLENWOOD S4402 CHRISTOPHER, MD 12/6/2019 12/6/2024 RADIOLOGY SPRINGS CO ACTIVE 12/19/2019 None N/A TAYLOR, BRANDON DIAGNOSTIC GLENWOOD S4402 CHRISTOPHER, MD 12/6/2019 12/6/2024 RADIOLOGY SPRINGS CO ACTIVE 12/19/2019 None N/A ORTHOPEDIC Q9245 SEIPEL, PETER ROBERT, MD 7/15/2016 7/15/2021 SURGERY GLOBE AZ ACTIVE 7/27/2016 None N/A

TM00851 SMITH, REED KELLY, MD 12/6/2019 12/6/2024 RADIOLOGY NUCLEAR MEDICINE GOLDEN CO ACTIVE 12/30/2019 None N/A

TM00851 SMITH, REED KELLY, MD 12/6/2019 12/6/2024 RADIOLOGY NUCLEAR MEDICINE GOLDEN CO ACTIVE 12/30/2019 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 Q9181 LANDERO, MARIA EDNA, MD 7/15/2016 7/15/2021 FAMILY MEDICINE GRANBURY TX ACTIVE 7/18/2016 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 S4736 BUMP, JOHN MICHAEL, DO 1/24/2020 1/24/2025 INTERNAL MEDICINE GRANBURY TX ACTIVE 1/27/2020 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 GRAND Q6163 CHAUDHRY, AISHA BASHIR, MD 10/1/2015 10/1/2020 FAMILY MEDICINE FORKS ND ACTIVE 10/6/2015 None N/A MATERNAL AND OBSTETRICS AND GRAND R5035 SCHAEFER, ALBERT JAMES, MD 10/20/2017 10/20/2022 FETAL MEDICINE GYNECOLOGY JUNCTION CO ACTIVE 11/13/2017 None N/A OBSTETRICS AND GRAND Q5899 PEREZ, NICHOLAS JAMES, MD 8/28/2015 8/28/2020 GYNECOLOGY JUNCTION CO ACTIVE 8/31/2015 None N/A GRAND R3925 NGUYEN, THAO, MD 7/17/2017 7/17/2022 DERMATOLOGY PRAIRIE TX ACTIVE 7/20/2017 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 GRAND Q4956 GAVALDA, JUAN CARLOS, MD 7/1/2015 7/1/2020 FAMILY MEDICINE PRAIRIE TX ACTIVE 7/6/2015 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 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

Page 178 of 332 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 GRAND Q9649 KALRA, NISHANT, MD 8/15/2016 8/15/2021 INTERNAL MEDICINE DISEASES RAPIDS MI ACTIVE 8/25/2016 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 GRAND R0063 MAAN, WAJIHA, MD 9/15/2016 9/15/2021 PEDIATRICS SALINE TX ACTIVE 9/23/2016 None N/A Q8968 MUNEZ, KENNEX , MD 7/1/2016 7/1/2021 FAMILY MEDICINE GRAPEVINE TX ACTIVE 11/10/2016 None N/A 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 Q5077 RAUF, KHALIQ ABDUL, MD 7/1/2015 7/1/2020 INTERNAL MEDICINE HOSPITALIST GRAPEVINE TX ACTIVE 7/7/2015 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 OPHTHALMOLOGY - Q5641 DAVIS, LINDSAY TAYLOR, MD 8/14/2015 8/14/2020 OPHTHALMOLOGY GLAUCOMA GRAPEVINE TX ACTIVE 8/28/2015 None N/A ORTHOPEDIC Q8356 SMITH, DOUGLAS ALEXANDER, DO 5/16/2016 5/16/2021 TRAUMA GRAPEVINE TX ACTIVE 5/18/2016 None N/A ANESTHESIOLOGY - Q9731 SHAIKH, MOHAMMED USMAN, MD 8/15/2016 8/15/2021 PAIN MANAGEMENT PAIN MANAGEMENT GRAPEVINE TX ACTIVE 8/17/2016 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 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 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 OPHTHALMOLOGY - R0716 FRANKEL, RODDY A, MD 11/15/2016 11/15/2021 OPHTHALMOLOGY CORNEA GRAYSLAKE IL ACTIVE 12/9/2016 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 DAVULURI, BALA KOTESWARA R1943 RAO, MD 3/3/2017 3/3/2022 NEUROLOGY GREEN BAY WI ACTIVE 5/31/2017 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 DIAGNOSTIC TM00620 ANDERSON, ANTHONY SHANE, MD 2/1/2016 2/1/2021 RHEUMATOLOGY RADIOLOGY GREENSBORO NC ACTIVE 2/22/2016 None N/A EMERGENCY S6549 WALLACE, HANNAH RUDY, MD 5/1/2020 5/1/2025 MEDICINE GREENVILLE TX ACTIVE 5/21/2020 None N/A

Page 179 of 332 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 R1335 AGU, CHIDOZIE CHARLES, MD 1/20/2017 1/20/2022 INTERNAL MEDICINE MEDICINE GREENVILLE NC ACTIVE 4/3/2017 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 ORTHOPEDIC S6561 ALLA, SREENIVASA REDDY, MD 5/15/2020 5/15/2025 SURGERY GREENVILLE AL ACTIVE 5/25/2020 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 Q9805 ELISCO, ANTHONY JOHN III, DO 8/26/2016 8/26/2021 UROLOGY GREENVILLE TX ACTIVE 9/22/2016 None N/A Q6373 SHAH, HAIDER RAZA, MD 10/15/2015 10/15/2020 HOSPITALIST GREENWOOD IN ACTIVE 10/27/2015 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 CRITICAL CARE Q9091 WILSON, MICHAEL ANTHONY, MD 7/1/2016 7/1/2021 INTERNAL MEDICINE MEDICINE (IM) GULFPORT MS ACTIVE 8/8/2016 None N/A GUN BARREL Q7597 RAGIREDDY, KRANTHI, MD 3/15/2016 3/15/2021 FAMILY MEDICINE FAMILY MEDICINE CITY TX ACTIVE 4/6/2016 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 EMERGENCY HARKER R4686 DILLMAN, KELLY MAUREEN, DO 9/22/2017 9/22/2022 MEDICINE HEIGHTS TX ACTIVE 9/27/2017 None N/A EMERGENCY HARKER R0975 WELCH, KENNETH, MD 12/2/2016 12/2/2021 MEDICINE HEIGHTS TX ACTIVE 12/9/2016 None N/A HARKER R3553 LONGFIELD, EVAN, MD 6/16/2017 6/16/2022 OTOLARYNGOLOGY HEIGHTS TX ACTIVE 8/25/2017 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 Q7680 EHASZ, MONA, DO 4/1/2016 4/1/2021 ANESTHESIOLOGY HARLINGEN TX ACTIVE 4/4/2016 None N/A RAMOUTAR, DARREN RASHEED, INTERVENTIONAL Q9718 DO 8/15/2016 8/15/2021 CARDIOLOGY CARDIOLOGY HARLINGEN TX ACTIVE 8/24/2016 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 SULLIVAN, CHRISTOPHER JAMES, CRITICAL CARE INFECTIOUS Q9524 MD 8/1/2016 8/1/2021 MEDICINE (IM) DISEASES HARLINGEN TX ACTIVE 8/11/2016 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 WEBER, BRENNAN MARGARET, EMERGENCY S5292 DO 2/21/2020 2/21/2025 MEDICINE HARLINGEN MI ACTIVE 2/24/2020 None N/A R0279 MARTINEZ, ANTONIO , MD 9/30/2016 9/30/2021 FAMILY MEDICINE HARLINGEN TX ACTIVE 12/19/2016 None N/A

Page 180 of 332 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 PREVIOUS Q5917 REYES, RAUL JR, MD 8/28/2015 8/28/2020 FAMILY MEDICINE HARLINGEN TX ACTIVE 9/1/2015 ORDER 9/3/2013 Q6564 RODRIGUEZ, JESUS , MD 11/16/2015 11/16/2020 FAMILY MEDICINE FAMILY PRACTICE HARLINGEN TX ACTIVE 11/17/2015 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

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 HEMATOLOGY/ONCOL N4887 AHMAD, NISAR, MD 8/15/2017 8/15/2022 OGY INTERNAL MEDICINE HARLINGEN TX ACTIVE 9/6/2017 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 Q9379 HUDDLESTON, GEORGE IV, MD 8/1/2016 8/1/2021 HOSPITALIST HARLINGEN TX ACTIVE 10/12/2016 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 R5095 CANTU GARCIA, ISMAEL , MD 11/3/2017 11/3/2022 INTERNAL MEDICINE HARLINGEN TX ACTIVE 11/15/2017 None N/A R6017 HARFOUCH, BADR , MD 2/16/2018 2/16/2023 INTERNAL MEDICINE HARLINGEN TX ACTIVE 2/23/2018 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 DE ERAUSQUIN, GABRIEL R2567 ALEJANDRO, MD 4/20/2017 4/20/2022 NEUROLOGY PSYCHIATRY HARLINGEN TX ACTIVE 4/24/2017 None N/A R3216 SIMMS, GLORIA PATRICIA, MD 5/22/2017 5/22/2022 NEUROLOGY HARLINGEN TX ACTIVE 5/24/2017 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 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 PREVENTIVE R0301 PROT, EMILIE YVONNE, DO 9/30/2016 9/30/2021 MEDICINE HARLINGEN TX ACTIVE 10/6/2016 None N/A EMERGENCY S6307 SHOUKAIR, SANDRA, DO 4/17/2020 4/17/2025 MEDICINE HARLLINGEN TX ACTIVE 4/20/2020 None N/A TAYLOR, CHRISTOPHER WAYNE, GYNECOLOGIC S4696 MD 1/10/2020 1/10/2025 SURGERY HARRISON AR ACTIVE 1/16/2020 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 CHEPPALLI, NAGA SURESH ORTHOPEDIC R1511 PRASAD REDDY, MD 2/6/2017 2/6/2022 SURGERY HARTSVILLE SC ACTIVE 2/21/2017 None N/A UNDERSEA AND HYPERBARIC MED Q5894 PARKS, SARAH, MD 8/28/2015 8/28/2020 (PREV MED) HARVEY LA ACTIVE 9/7/2015 None N/A

Page 181 of 332 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 AKINWALE, ABUMERE OPHTHALMOLOGY - R4507 FOLASHADE, MD 9/8/2017 9/8/2022 VITREOUS SURGERY HATTIESBURG MS ACTIVE 9/18/2017 None N/A WATTIGNY, CHRISTOPHER NOEL, EMERGENCY R2785 MD 4/20/2017 4/20/2022 FAMILY MEDICINE MEDICINE HEMPHILL TX ACTIVE 4/24/2017 None N/A R5308 RAMSEY, KELLY MICHAEL, MD 11/17/2017 11/17/2022 FAMILY MEDICINE HEMPSTEAD TX ACTIVE 11/27/2017 None N/A G7337 SHARMA, MANJOO, MD 6/1/2015 6/1/2020 INTERNAL MEDICINE INTERNAL MEDICINE HEMPSTEAD NY ACTIVE 6/3/2015 None N/A EMERGENCY S5470 POLOGE, JONAS ISAAC, MD 3/6/2020 3/6/2025 MEDICINE HENDERSON TX ACTIVE 3/10/2020 None N/A Q4710 WYATT, LORI COLLEEN, MD 6/1/2015 6/1/2020 FAMILY MEDICINE HENDERSON TX ACTIVE 6/3/2015 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 Q5619 BERRY, BREANNA R, DO 8/14/2015 8/14/2020 FAMILY MEDICINE HEREFORD TX ACTIVE 8/18/2015 None N/A Q9296 BINDAL, SAPAN, MD 8/1/2016 8/1/2021 FAMILY MEDICINE HEREFORD TX ACTIVE 8/4/2016 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 EMERGENCY Q8594 PARDINI, RICCI STEFAN, MD 6/1/2016 6/1/2021 MEDICINE HERMISTON OR ACTIVE 6/6/2016 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 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 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 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

OPHTHALMOLOGY - S5393 JACKSON, JENELL CURNESE, MD 3/6/2020 3/6/2025 OPHTHALMOLOGY RECONST SURGERY HICKORY NC ACTIVE 3/13/2020 None N/A EMERGENCY R0419 IMANI, GLAREH, DO 10/14/2016 10/14/2021 MEDICINE HILLSBORO TX ACTIVE 10/21/2016 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 PALLIATIVE R1873 SHAMS, FARHAN, MD 2/22/2017 2/22/2022 INTERNAL MEDICINE MEDICINE HINES IL ACTIVE 4/4/2017 None N/A

CLINICAL S5252 RABI, ZEINA, MD 2/21/2020 2/21/2025 NEUROLOGY NEUROPHYSIOLOGY HINSDALE IL ACTIVE 4/17/2020 None N/A

Page 182 of 332 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 Q9666 LOVETT, PARIS BRETT, MD 8/15/2016 8/15/2021 MEDICINE HOLLYWOOD FL ACTIVE 10/24/2016 None N/A EMERGENCY F4688 WILKINSON, JOHN WALTER, DO 10/1/2015 10/1/2020 MEDICINE HONOLULU HI ACTIVE 10/16/2015 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 OBSTETRICS AND R6051 MOAYEDI, GHAZALEH , DO 2/16/2018 2/16/2023 GYNECOLOGY HONOLULU HI ACTIVE 2/22/2018 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 ANESTHESIOLOGY - R2808 ANWAR, SAEED, MD 5/5/2017 5/5/2022 PAIN MANAGEMENT PAIN & SPINE HORSEHEADS NY ACTIVE 5/15/2017 None N/A R0921 ORJI, CHRISTIAN UCHENNA, MD 12/2/2016 12/2/2021 FAMILY MEDICINE HOT SPRINGS AR ACTIVE 3/8/2017 None N/A R1644 SHARMA, MUKESH KUMAR, MD 2/6/2017 2/6/2022 NEPHROLOGY INTERNAL MEDICINE HOT SPRINGS AR ACTIVE 2/13/2017 None N/A DIAGNOSTIC Q4677 RAU, BRYAN C, MD 6/1/2015 6/1/2020 RADIOLOGY HOUMA LA ACTIVE 6/12/2015 None N/A EMERGENCY R4329 STRANEY, MICHAEL JAMES, MD 8/15/2017 8/15/2022 MEDICINE HOUMA LA ACTIVE 9/12/2017 None N/A ABDOMINAL INTERVENTIONAL S5761 RUPE, ERIC STEPHEN, MD 3/20/2020 3/20/2025 RADIOLOGY RADIOLOGY HOUSTON TX ACTIVE 3/30/2020 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 ADULT SCHRODER, STEVEN JEFFREY, RECONSTRUCTIVE ORTHOPEDIC Q6372 MD 10/15/2015 10/15/2020 ORTHOPEDICS SURGERY HOUSTON TX ACTIVE 11/17/2015 None N/A ALLERGY AND R0322 SETH, NEHA , MD 9/30/2016 9/30/2021 IMMUNOLOGY HOUSTON TX ACTIVE 10/5/2016 None N/A THAKER, HARSHWARDHAN ANATOMIC R5662 MANOHAR, MD 1/5/2018 1/5/2023 PATHOLOGY HOUSTON TX ACTIVE 1/19/2018 None N/A ANATOMIC PATHOLOGY & LAB R0169 ZHU, HUI, MD 9/15/2016 9/15/2021 MEDICINE CYTOPATHOLOGY HOUSTON TX ACTIVE 11/3/2016 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 ANATOMIC/CLINICAL R2872 HAWKINS, MONTY A, MD 5/5/2017 5/5/2022 PATHOLOGY HOUSTON TX ACTIVE 5/9/2017 None N/A

Page 183 of 332 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 - R3016 AHMED, MOUSTAFA, MD 5/22/2017 5/22/2022 ANESTHESIOLOGY PAIN MANAGEMENT HOUSTON TX ACTIVE 5/29/2017 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 PEDIATRIC ANESTHESIOLOGY R0372 CHAN, LISA, MD 10/14/2016 10/14/2021 ANESTHESIOLOGY (PEDS) HOUSTON TX ACTIVE 11/30/2016 None N/A

R2074 CLENDENINN, DALLIS JELANI, MD 3/20/2017 3/20/2022 ANESTHESIOLOGY HOUSTON TX ACTIVE 3/23/2017 None N/A CONTRERAS, VICTORIA R5990 GASCOYNE, MD 2/16/2018 2/16/2023 ANESTHESIOLOGY HOUSTON TX ACTIVE 3/6/2018 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 Q6180 DURAN, HILCIAS, MD 10/1/2015 10/1/2020 ANESTHESIOLOGY HOUSTON TX ACTIVE 10/20/2015 None N/A R2586 ELTZSCHIG, HOLGER KLAUS, MD 4/20/2017 4/20/2022 ANESTHESIOLOGY HOUSTON TX ACTIVE 5/5/2017 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 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 CRITICAL CARE R2097 FARRIS, LANDON KYLE, MD 3/20/2017 3/20/2022 ANESTHESIOLOGY ANESTHESIOLOGY HOUSTON TX ACTIVE 3/21/2017 None N/A R3849 GLUCK, DANIELLE MARIN, MD 7/17/2017 7/17/2022 ANESTHESIOLOGY HOUSTON TX ACTIVE 7/25/2017 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 Q8498 GUTIERREZ, NORA , MD 6/1/2016 6/1/2021 ANESTHESIOLOGY HOUSTON TX ACTIVE 6/13/2016 None N/A R5134 HUANG, JONATHAN , MD 11/3/2017 11/3/2022 ANESTHESIOLOGY HOUSTON TX ACTIVE 11/27/2017 None N/A Q7714 JACKSON, MAISIE LEE, MD 4/1/2016 4/1/2021 ANESTHESIOLOGY HOUSTON TX ACTIVE 4/4/2016 None N/A JOOLUKUNTLA, ADITHYA REDDY, S5942 MD 4/3/2020 4/3/2025 ANESTHESIOLOGY HOUSTON TX ACTIVE 5/4/2020 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 R6225 LEE, SAMUEL , MD 3/2/2018 3/2/2023 ANESTHESIOLOGY HOUSTON TX ACTIVE 3/13/2018 None N/A R2909 LIMA, DANIEL SAMPAIO, MD 5/5/2017 5/5/2022 ANESTHESIOLOGY HOUSTON TX ACTIVE 5/10/2017 None N/A S6673 LIN, HAW YU, MD 5/15/2020 5/15/2025 ANESTHESIOLOGY HOUSTON TX ACTIVE 5/21/2020 None N/A PEDIATRIC ANESTHESIOLOGY Q9856 LOWERY, JAMEL EDWARD, MD 8/26/2016 8/26/2021 ANESTHESIOLOGY (PEDS) HOUSTON TX ACTIVE 8/31/2016 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

Page 184 of 332 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

Q5223 MCHUGH, THOMAS MICHAEL, MD 7/15/2015 7/15/2020 ANESTHESIOLOGY HOUSTON TX ACTIVE 9/14/2015 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 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

Q8980 NWANKWO, CHIKA CHIGOZIE, MD 7/1/2016 7/1/2021 ANESTHESIOLOGY HOUSTON TX ACTIVE 7/19/2016 None N/A Q5054 OKORAFOR, NNAJA , MD 7/1/2015 7/1/2020 ANESTHESIOLOGY HOUSTON TX ACTIVE 7/3/2015 None N/A Q8997 PATEL, PURNAL A, MD 7/1/2016 7/1/2021 ANESTHESIOLOGY ANESTHESIOLOGY HOUSTON TX ACTIVE 7/8/2016 None N/A Q9473 PATHIKONDA, ANOOP , MD 8/1/2016 8/1/2021 ANESTHESIOLOGY HOUSTON TX ACTIVE 8/8/2016 None N/A CRITICAL CARE R0479 PATTERSON, VELVET MONIC, MD 10/14/2016 10/14/2021 ANESTHESIOLOGY ANESTHESIOLOGY HOUSTON TX ACTIVE 12/19/2016 None N/A ANESTHESIOLOGY - Q9475 PETERSON, ELISHA EMDERE, MD 8/1/2016 8/1/2021 ANESTHESIOLOGY PAIN MANAGEMENT HOUSTON TX ACTIVE 8/15/2016 None N/A

S4553 RASHID, MUHAMMAD JAWAD, MD 12/20/2019 12/20/2024 ANESTHESIOLOGY HOUSTON TX ACTIVE 4/1/2020 None N/A CRITICAL CARE Q5272 SAATEE, SIAVOSH, MD 7/15/2015 7/15/2020 ANESTHESIOLOGY ANESTHESIOLOGY HOUSTON TX ACTIVE 7/28/2015 None N/A Q5557 SAM, JERMALE, MD 8/3/2015 8/3/2020 ANESTHESIOLOGY HOUSTON TX ACTIVE 8/12/2015 None N/A

S7137 SENCHEREY, MAXWELL KOFI, DO 6/12/2020 6/12/2025 ANESTHESIOLOGY HOUSTON TX ACTIVE 6/15/2020 None N/A S5784 STEADMAN, RANDOLPH H, MD 3/20/2020 3/20/2025 ANESTHESIOLOGY HOUSTON TX ACTIVE 3/31/2020 None N/A ANESTHESIOLOGY - S4883 TAREEN, ALI , MD 1/24/2020 1/24/2025 ANESTHESIOLOGY PAIN MANAGEMENT HOUSTON TX ACTIVE 1/29/2020 None N/A Q5943 UPTON, ASHLEY REN'EE, MD 8/28/2015 8/28/2020 ANESTHESIOLOGY HOUSTON TX ACTIVE 9/7/2015 None N/A R3239 VAID-PINYARD, SUMREEN, MD 5/22/2017 5/22/2022 ANESTHESIOLOGY HOUSTON TX ACTIVE 7/3/2017 None N/A R2244 VANDAGRIFF, TYSON , MD 3/20/2017 3/20/2022 ANESTHESIOLOGY HOUSTON TX ACTIVE 4/10/2017 None N/A S5804 WEAVER, ROBERT L JR, MD 3/20/2020 3/20/2025 ANESTHESIOLOGY HOUSTON TX ACTIVE 3/23/2020 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 CARDIAC ELECTROPHYSIOLOG R2533 BASU RAY, INDRANILL , MD 4/20/2017 4/20/2022 Y CARDIOLOGY HOUSTON TX ACTIVE 5/3/2017 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

Page 185 of 332 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 R1168 ASSALITA, STEVEN , MD 1/6/2017 1/6/2022 CARDIOLOGY INTERNAL MEDICINE HOUSTON TX ACTIVE 3/2/2017 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 R1553 JOZWIK, BARTOSZ PAWEL, MD 2/6/2017 2/6/2022 CARDIOLOGY INTERNAL MEDICINE HOUSTON TX ACTIVE 2/8/2017 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 CARDIOVASCULAR R3545 KIM, JU HYUN, MD 6/16/2017 6/16/2022 CARDIOLOGY DISEASES HOUSTON TX ACTIVE 7/7/2017 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 Q6356 PARKER, JEFFREY RYAN, MD 10/15/2015 10/15/2020 CARDIOLOGY INTERNAL MEDICINE HOUSTON TX ACTIVE 10/16/2015 None N/A R2437 PATEL, AGAM D, MD 4/4/2017 4/4/2022 CARDIOLOGY INTERNAL MEDICINE HOUSTON TX ACTIVE 6/20/2017 None N/A Q5535 PHILLIPS, ROBERT A, MD 8/3/2015 8/3/2020 CARDIOLOGY INTERNAL MEDICINE HOUSTON TX ACTIVE 8/4/2015 None N/A INTERVENTIONAL Q5597 VOLZ, ELIZABETH MICHELLE, MD 8/3/2015 8/3/2020 CARDIOLOGY CARDIOLOGY HOUSTON TX ACTIVE 8/5/2015 None N/A S6774 XIE, LOLA , MD 5/15/2020 5/15/2025 CARDIOLOGY HOUSTON TX ACTIVE 6/15/2020 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 CARDIOVASCULAR Q9381 HUSSAIN, IMAD, MD 8/1/2016 8/1/2021 DISEASES INTERNAL MEDICINE HOUSTON TX ACTIVE 8/12/2016 None N/A CARDIOVASCULAR Q7453 POSTALIAN, ALEXANDER , MD 3/4/2016 3/4/2021 DISEASES INTERNAL MEDICINE HOUSTON TX ACTIVE 3/7/2016 None N/A CARDIOVASCULAR R0983 ADACHI, IKI , MD 12/16/2016 12/16/2021 SURGERY HOUSTON TX ACTIVE 12/23/2016 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 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 CARDIOVASCULAR VASCULAR S5037 OROZCO-SEVILLA, VICENTE , MD 2/7/2020 2/7/2025 SURGERY SURGERY HOUSTON TX ACTIVE 2/10/2020 None N/A

Page 186 of 332 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 Q5575 SINGH, STEVE KELVIN, MD 8/3/2015 8/3/2020 SURGERY HOUSTON TX ACTIVE 8/12/2015 None N/A WYLER VON BALLMOOS, MORITZ CARDIOVASCULAR R4499 C, MD 8/25/2017 8/25/2022 SURGERY THORACIC SURGERY HOUSTON TX ACTIVE 9/14/2017 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 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 LICENSE Q8509 HOUCK, KIMBERLY , MD 6/1/2016 6/1/2021 CHILD NEUROLOGY HOUSTON TX ISSUED 6/1/2016 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 Q5064 PAUL, DUSTIN JACOB, DO 7/1/2015 7/1/2020 CHILD NEUROLOGY PEDIATRICS HOUSTON TX ACTIVE 7/14/2015 None N/A R5794 PEHLIVAN, DAVUT , MD 1/19/2018 1/19/2023 CHILD NEUROLOGY HOUSTON TX ACTIVE 2/5/2018 None N/A R5458 RAO, KAVYA INDIRA, MD 12/8/2017 12/8/2022 CHILD NEUROLOGY NEUROLOGY HOUSTON TX ACTIVE 12/11/2017 None N/A NEURODEVELOPMEN TAL DISABILITIES Q5919 RISEN, SARAH RUNDELL, MD 8/28/2015 8/28/2020 CHILD NEUROLOGY (PEDIATRICS) HOUSTON TX ACTIVE 9/1/2015 None N/A Q6905 SAVATIC, MIRJANA M, MD 1/6/2016 1/6/2021 CHILD NEUROLOGY HOUSTON TX ACTIVE 1/26/2016 None N/A CLINICAL CLINICAL MOLECULAR R0508 TANG, ZHENYA, MD 10/14/2016 10/14/2021 CYTOGENICS GENETICS HOUSTON TX ACTIVE 10/27/2016 None N/A Q9099 ZHANG, LILEI, MD 7/1/2016 7/1/2021 CLINICAL GENETICS INTERNAL MEDICINE HOUSTON TX ACTIVE 7/20/2016 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

R2480 SINGH, ILA RAMNARESH, MD 4/4/2017 4/4/2022 CLINICAL PATHOLOGY HOUSTON TX ACTIVE 4/10/2017 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 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 COLON AND RECTAL Q9217 NICKERSON, TERRY PAUL, MD 7/15/2016 7/15/2021 SURGERY GENERAL SURGERY HOUSTON TX ACTIVE 7/19/2016 None N/A COLON AND RECTAL Q9019 SAMBASIVAN, CHITRA NEELA, MD 7/1/2016 7/1/2021 SURGERY GENERAL SURGERY HOUSTON TX ACTIVE 7/4/2016 None N/A

Page 187 of 332 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 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 CRITICAL CARE CARDIOVASCULAR R1188 CHATTERJEE, SUBHASIS, MD 1/6/2017 1/6/2022 (SURGERY) SURGERY HOUSTON TX ACTIVE 1/9/2017 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 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 CRITICAL CARE Q9513 SIGDEL, BINAYAK, MD 8/1/2016 8/1/2021 MEDICINE HOUSTON TX ACTIVE 8/8/2016 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 Q5758 BASSUNER, JURI, MD 8/28/2015 8/28/2020 DERMATOLOGY HOUSTON TX ACTIVE 9/11/2015 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 R4401 JACKS, STEPHANIE KARIN, MD 8/25/2017 8/25/2022 DERMATOLOGY HOUSTON TX ACTIVE 9/7/2017 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 S4550 PYE, ALLISON NICOLE, MD 12/20/2019 12/20/2024 DERMATOLOGY HOUSTON TX ACTIVE 1/9/2020 None N/A MOHS MICROGRAPHIC Q8138 ROSENBAUM, LARA, MD 5/2/2016 5/2/2021 DERMATOLOGY SURGERY HOUSTON TX ACTIVE 5/11/2016 None N/A

S4700 UKOHA, UZOAMAKA TRACEY, MD 1/10/2020 1/10/2025 DERMATOLOGY HOUSTON TX ACTIVE 1/13/2020 None N/A R1912 WRIGHT, DAVID R, MD 2/22/2017 2/22/2022 DERMATOLOGY HOUSTON TX ACTIVE 2/23/2017 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 BIRKENFELD, ELIZABETH MARY, DIAGNOSTIC Q8696 MD 6/10/2016 6/10/2021 RADIOLOGY HOUSTON TX ACTIVE 6/16/2016 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 R4951 CHONG, INSUN , MD 10/20/2017 10/20/2022 RADIOLOGY HOUSTON TX ACTIVE 10/23/2017 None N/A DIAGNOSTIC Q7678 DOMINGUEZ, MARLENE, MD 4/1/2016 4/1/2021 RADIOLOGY HOUSTON TX ACTIVE 5/2/2016 None N/A DIAGNOSTIC R2104 GHORI, SAIMA, MD 3/20/2017 3/20/2022 RADIOLOGY NEURO-RADIOLOGY HOUSTON TX ACTIVE 3/23/2017 None N/A

Page 188 of 332 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 R1219 HARVEY, HARLAN BENJAMIN, MD 1/6/2017 1/6/2022 RADIOLOGY NEURO-RADIOLOGY HOUSTON TX ACTIVE 3/17/2017 None N/A DIAGNOSTIC S5925 HILL, ERIK , MD 4/3/2020 4/3/2025 RADIOLOGY HOUSTON TX ACTIVE 4/20/2020 None N/A DIAGNOSTIC R3109 HUYNH, THACH , MD 5/22/2017 5/22/2022 RADIOLOGY HOUSTON TX ACTIVE 5/30/2017 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 DIAGNOSTIC Q8093 KNUDTSON, JOHN DAVID , MD 5/2/2016 5/2/2021 RADIOLOGY HOUSTON TX ACTIVE 5/4/2016 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 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 DIAGNOSTIC R5803 ROGERS, JASON, MD 1/19/2018 1/19/2023 RADIOLOGY NEURO-RADIOLOGY HOUSTON TX ACTIVE 1/22/2018 None N/A SAMANT, ROHAN SHAMPRASAD, DIAGNOSTIC S5263 MD 2/21/2020 2/21/2025 RADIOLOGY NEURO-RADIOLOGY HOUSTON TX ACTIVE 3/10/2020 None N/A SEWELL, AINEL BOONPRAKONG, DIAGNOSTIC Q7271 MD 2/16/2016 2/16/2021 RADIOLOGY BREAST IMAGING HOUSTON TX ACTIVE 2/23/2016 None N/A DIAGNOSTIC MUSCULOSKELETAL Q6912 TENG, MATTHEW W, MD 1/6/2016 1/6/2021 RADIOLOGY RADIOLOGY HOUSTON TX ACTIVE 1/12/2016 None N/A EMERGENCY Q9561 ADESINA, ADEDOYIN, MD 8/15/2016 8/15/2021 MEDICINE HOUSTON TX ACTIVE 8/17/2016 None N/A AIYEJORUN, AYODEJI EMERGENCY Q4883 OLUKAYODE, MD 7/1/2015 7/1/2020 MEDICINE HOUSTON TX ACTIVE 7/3/2015 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 EMERGENCY S4432 ALI, SHIHAB, MD 12/20/2019 12/20/2024 MEDICINE HOUSTON TX ACTIVE 12/24/2019 None N/A EMERGENCY R1689 ALZAHRI, MOHAMMAD , MD 2/22/2017 2/22/2022 MEDICINE HOUSTON TX ACTIVE 3/6/2017 None N/A EMERGENCY Q9569 ANAND, NISHANT, MD 8/15/2016 8/15/2021 MEDICINE HOUSTON TX ACTIVE 8/17/2016 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 EMERGENCY R2046 BADAWY, AMR, DO 3/20/2017 3/20/2022 MEDICINE HOUSTON TX ACTIVE 6/5/2017 None N/A

Page 189 of 332 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 S4918 BANALA, SRINIVAS REDDY, MD 2/7/2020 2/7/2025 MEDICINE HOUSTON TX ACTIVE 2/20/2020 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 EMERGENCY Q8216 CALLAHAN, BRYON SCOTT, MD 5/16/2016 5/16/2021 MEDICINE HOUSTON TX ACTIVE 6/6/2016 None N/A EMERGENCY S6813 CHAVEZ, SUMMER, DO 5/29/2020 5/29/2025 MEDICINE HOUSTON TX ACTIVE 6/4/2020 None N/A EMERGENCY R4376 CHONG, SAMUEL LEE, DO 8/25/2017 8/25/2022 MEDICINE HOUSTON TX ACTIVE 8/28/2017 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 EMERGENCY Q8046 DEVINE, BRENDAN PATRICK, MD 5/2/2016 5/2/2021 MEDICINE HOUSTON TX ACTIVE 5/4/2016 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 EMERGENCY Q6504 EADEH, HANNA, MD 11/16/2015 11/16/2020 MEDICINE HOUSTON TX ACTIVE 12/1/2015 None N/A EMERGENCY Q5400 FERNANDEZ, WILLIAM, MD 8/3/2015 8/3/2020 MEDICINE HOUSTON TX ACTIVE 8/20/2015 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 EMERGENCY R2108 GIORDANO, JONATHAN, DO 3/20/2017 3/20/2022 MEDICINE HOUSTON TX ACTIVE 3/22/2017 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 EMERGENCY R3866 HONG, MICHELLE, MD 7/17/2017 7/17/2022 MEDICINE HOUSTON TX ACTIVE 7/20/2017 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 EMERGENCY Q5820 HUYNH, QUYEN , MD 8/28/2015 8/28/2020 MEDICINE HOUSTON TX ACTIVE 9/7/2015 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 EMERGENCY Q6211 JOH, JAE WON , MD 10/1/2015 10/1/2020 MEDICINE HOUSTON TX ACTIVE 10/7/2015 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

Page 190 of 332 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 R1786 JOLLY, SCOTT DAVID, DO 2/22/2017 2/22/2022 MEDICINE HOUSTON TX ACTIVE 1/18/2018 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 KARFUNKLE, BENJAMIN LEWIS, EMERGENCY R3883 MD 7/17/2017 7/17/2022 MEDICINE HOUSTON TX ACTIVE 7/24/2017 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 EMERGENCY S5683 KUHL, EVAN, MD 3/20/2020 3/20/2025 MEDICINE HOUSTON TX ACTIVE 3/27/2020 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 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 R2404 MARCANTEL, DEREK LEE, MD 4/4/2017 4/4/2022 MEDICINE HOUSTON TX ACTIVE 5/15/2017 None N/A EMERGENCY Q5224 MCMILLAN, SAM, MD 7/15/2015 7/15/2020 MEDICINE HOUSTON MO ACTIVE 7/20/2015 None N/A EMERGENCY R0282 MENARD, CHRISTIAN, MD 9/30/2016 9/30/2021 MEDICINE HOUSTON TX ACTIVE 10/4/2016 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 EMERGENCY R2689 NDUM, OBINNA ANTHONY JR, MD 4/20/2017 4/20/2022 MEDICINE HOUSTON TX ACTIVE 4/27/2017 None N/A EMERGENCY R1601 NGUYEN, KHOA, MD 2/6/2017 2/6/2022 MEDICINE HOUSTON TX ACTIVE 2/17/2017 None N/A EMERGENCY S6905 NGUYEN, TINA, MD 5/29/2020 5/29/2025 MEDICINE HOUSTON TX ACTIVE 6/1/2020 None N/A EMERGENCY R5017 NICHOLS, GINA ALLISON, MD 10/20/2017 10/20/2022 MEDICINE HOUSTON TX ACTIVE 11/7/2017 None N/A EMERGENCY Q6452 OGHOGHO, EYITEMI , MD 11/2/2015 11/2/2020 MEDICINE HOUSTON TX ACTIVE 11/3/2015 None N/A EMERGENCY R0922 ORTIZ, LUIS EDUARDO, MD 12/2/2016 12/2/2021 MEDICINE INTERNAL MEDICINE HOUSTON TX ACTIVE 12/9/2016 None N/A EMERGENCY Q7441 OSBORN, LESLEY ANNE, MD 3/4/2016 3/4/2021 MEDICINE HOUSTON TX ACTIVE 3/10/2016 None N/A EMERGENCY Q9468 PANDYA, MICHAEL , MD 8/1/2016 8/1/2021 MEDICINE HOUSTON TX ACTIVE 8/8/2016 None N/A

Page 191 of 332 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 PARMAR, KARAN PRATAPSINGH, EMERGENCY Q8323 DO 5/16/2016 5/16/2021 MEDICINE INTERNAL MEDICINE HOUSTON TX ACTIVE 5/23/2016 None N/A EMERGENCY Q7448 PATEL, AMIT, MD 3/4/2016 3/4/2021 MEDICINE HOUSTON TX ACTIVE 3/8/2016 None N/A EMERGENCY EMERGENCY R4621 QASIM, MOHAMMED SAAD, MD 9/8/2017 9/8/2022 MEDICINE MEDICINE HOUSTON TX ACTIVE 10/25/2017 None N/A EMERGENCY R2211 ROBINSON, HEATHER , MD 3/20/2017 3/20/2022 MEDICINE HOUSTON TX ACTIVE 4/14/2017 None N/A EMERGENCY S4858 ROSSI, AMY , MD 1/24/2020 1/24/2025 MEDICINE HOUSTON TX ACTIVE 2/7/2020 None N/A EMERGENCY Q9739 SIMONSON, ELIZABETH ANNE, MD 8/15/2016 8/15/2021 MEDICINE HOUSTON TX ACTIVE 8/23/2016 None N/A EMERGENCY R2980 SNOW, JOSEPH HUGHES IV, DO 5/5/2017 5/5/2022 MEDICINE HOUSTON TX ACTIVE 5/11/2017 None N/A EMERGENCY Q4854 SYLVESTER, FRANCIS CRAIG, MD 6/12/2015 6/12/2020 MEDICINE HOUSTON TX ACTIVE 6/15/2015 None N/A EMERGENCY R3616 WANG, HENRY E, MD 6/16/2017 6/16/2022 MEDICINE HOUSTON TX ACTIVE 6/30/2017 None N/A EMERGENCY Q9556 WINGKUN, NEIL-JEREMY GO, MD 8/1/2016 8/1/2021 MEDICINE HOUSTON TX ACTIVE 8/8/2016 None N/A EMERGENCY R1679 ZACHARIAH, PHILIP TOMY, MD 2/6/2017 2/6/2022 MEDICINE HOUSTON TX ACTIVE 4/14/2017 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 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 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 ENDOCRINOLOGY, DIABETES AND Q7883 GUTTENBERG, KATIE BATES, MD 4/15/2016 4/15/2021 METABOLISM HOUSTON TX ACTIVE 4/25/2016 None N/A ENDOCRINOLOGY, DIABETES AND R2931 NGUYEN, HA THUY CAM, MD 5/5/2017 5/5/2022 METABOLISM INTERNAL MEDICINE HOUSTON TX ACTIVE 5/8/2017 None N/A

Page 192 of 332 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 ENDOVASCULAR SURGICAL INTERVENTIONAL Q6792 SPIEGEL, GARY RICHARD, MD 12/15/2015 12/15/2020 NEURORADIOLOGY RADIOLOGY HOUSTON TX ACTIVE 12/17/2015 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 OCCUPATIONAL R4512 AMA, IFEOMA MARGARET, MD 9/8/2017 9/8/2022 FAMILY MEDICINE MEDICINE HOUSTON TX ACTIVE 9/13/2017 None N/A Q9570 ANDERSON, SHARON, MD 8/15/2016 8/15/2021 FAMILY MEDICINE HOUSTON TX ACTIVE 8/19/2016 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 R0362 BOCANEGRA, INGRID, MD 10/14/2016 10/14/2021 FAMILY MEDICINE HOUSTON TX ACTIVE 11/1/2016 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 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 R5391 FLORES, ABEL MORENO, MD 12/8/2017 12/8/2022 FAMILY MEDICINE HOUSTON TX ACTIVE 1/15/2018 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 Q6017 GILBERT, LOUIS , DO 9/15/2015 9/15/2020 FAMILY MEDICINE HOUSTON TX ACTIVE 9/22/2015 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 Q7712 IKUGBAGBE, OLAOLUWAPO, MD 4/1/2016 4/1/2021 FAMILY MEDICINE HOUSTON TX ACTIVE 5/2/2016 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

R4570 JOSEPHS, MEREDITH SUSAN, MD 9/8/2017 9/8/2022 FAMILY MEDICINE HOUSTON TX ACTIVE 9/18/2017 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 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 PALLIATIVE Q7738 MALIGI, COURTNEY B , MD 4/1/2016 4/1/2021 FAMILY MEDICINE MEDICINE HOUSTON TX ACTIVE 4/5/2016 None N/A S5696 MANCERA, LUCIANO, MD 3/20/2020 3/20/2025 FAMILY MEDICINE HOUSTON TX ACTIVE 3/27/2020 None N/A

Q8104 MANDOLA, VINCENT JOSEPH, MD 5/2/2016 5/2/2021 FAMILY MEDICINE HOUSTON TX ACTIVE 5/6/2016 None N/A NNABUIFE, CHUKWUEMEKA S6906 CHRISTIAN, DO 5/29/2020 5/29/2025 FAMILY MEDICINE HOUSTON TX ACTIVE 6/1/2020 None N/A S6268 OKORAFOR, NGOZI ULOMA, MD 4/17/2020 4/17/2025 FAMILY MEDICINE HOUSTON TX ACTIVE 4/29/2020 None N/A R0098 PATEL, SNEHA JAGADISH, DO 9/15/2016 9/15/2021 FAMILY MEDICINE HOUSTON TX ACTIVE 9/19/2016 None N/A

Q9001 PEDROZA, RICHARD ANDRES, MD 7/1/2016 7/1/2021 FAMILY MEDICINE HOUSTON TX ACTIVE 7/4/2016 None N/A S4391 SHETH, JAYESH, MD 12/6/2019 12/6/2024 FAMILY MEDICINE HOUSTON TX ACTIVE 12/11/2019 None N/A

Page 193 of 332 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 S4391 SHETH, JAYESH, MD 12/6/2019 12/6/2024 FAMILY MEDICINE HOUSTON TX ACTIVE 12/11/2019 None N/A SILVA, DHIEKSON MELQUISEDEK, Q5574 MD 8/3/2015 8/3/2020 FAMILY MEDICINE HOUSTON TX ACTIVE 8/4/2015 None N/A R5216 TONG, BOCHEN , MD 11/3/2017 11/3/2022 FAMILY MEDICINE HOUSTON TX ACTIVE 11/10/2017 None N/A R0799 TRAN, CASEY MYLINH, DO 11/15/2016 11/15/2021 FAMILY MEDICINE HOUSTON TX ACTIVE 1/19/2017 None N/A Q5588 TRAN, SARAH LE, DO 8/3/2015 8/3/2020 FAMILY MEDICINE HOUSTON TX ACTIVE 8/6/2015 None N/A TYEBJEE, ZULEIKHA ELIZABETH, S4893 MD 1/24/2020 1/24/2025 FAMILY MEDICINE FAMILY PRACTICE HOUSTON TX ACTIVE 3/25/2020 None N/A Q6380 VELARDE, ROBERT , MD 10/15/2015 10/15/2020 FAMILY MEDICINE HOUSTON TX ACTIVE 10/16/2015 None N/A WOOLDRIDGE, GILLIAN GLENNON, R6136 DO 2/16/2018 2/16/2023 FAMILY MEDICINE SPORTS MEDICINE HOUSTON TX ACTIVE 2/26/2018 None N/A Q9112 ALVAREZ, ADAN , MD 7/15/2016 7/15/2021 FAMILY PRACTICE HOUSTON TX ACTIVE 7/21/2016 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 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 GASTROENTEROLOG Q6608 BHAKTA, DIMPAL BABU, MD 3/20/2020 3/20/2025 Y HOUSTON TX ACTIVE 3/27/2020 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 GASTROENTEROLOG Q5635 CHAN, JOHANNA LEIGH, MD 8/14/2015 8/14/2020 Y INTERNAL MEDICINE HOUSTON TX ACTIVE 8/17/2015 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 GASTROENTEROLOG R2563 DAVEE, ROY T , MD 4/20/2017 4/20/2022 Y INTERNAL MEDICINE HOUSTON TX ACTIVE 5/1/2017 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 KETWAROO, GYANPRAKASH GASTROENTEROLOG R1561 AVINASH, MD 2/6/2017 2/6/2022 Y HOUSTON TX ACTIVE 4/17/2017 None N/A GASTROENTEROLOG Q4648 NESHATIAN, LEILA, MD 6/1/2015 6/1/2020 Y HOUSTON TX ACTIVE 6/10/2015 None N/A GASTROENTEROLOG Q9495 RHIM, ANDREW D, MD 8/1/2016 8/1/2021 Y INTERNAL MEDICINE HOUSTON TX ACTIVE 9/1/2016 None N/A GASTROENTEROLOG S6939 SHIRALKAR, MALAN TARA, MD 5/29/2020 5/29/2025 Y HOUSTON TX ACTIVE 6/1/2020 None N/A GASTROENTEROLOG Q6992 USTA, YOUSEF JOSEPH, MD 1/15/2016 1/15/2021 Y INTERNAL MEDICINE HOUSTON TX ACTIVE 2/1/2016 None N/A

Page 194 of 332 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 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 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 MEDICAL S6536 TALLEY, JULIA , MD 5/1/2020 5/1/2025 GENERAL PRACTICE MANAGEMENT HOUSTON TX ACTIVE 5/6/2020 None N/A S4907 ADESOYE, TAIWO , MD 2/7/2020 2/7/2025 GENERAL SURGERY HOUSTON TX ACTIVE 2/17/2020 None N/A S6573 BARNES, BRIE , MD 5/15/2020 5/15/2025 GENERAL SURGERY HOUSTON TX ACTIVE 5/22/2020 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 BUITRAGO, WILLIAM FERNANDO, ABDOMINAL Q9305 MD 8/1/2016 8/1/2021 GENERAL SURGERY SURGERY HOUSTON TX ACTIVE 8/3/2016 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 R4953 CORSINI, ERIN M, MD 10/20/2017 10/20/2022 GENERAL SURGERY HOUSTON TX ACTIVE 10/26/2017 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 S5605 EDGCOMB, MARK, DO 3/20/2020 3/20/2025 GENERAL SURGERY HOUSTON TX ACTIVE 4/9/2020 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

R1213 HALL, JOHN JACOBS, MD 1/6/2017 1/6/2022 GENERAL SURGERY GENERAL SURGERY HOUSTON TX ACTIVE 1/25/2017 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 HUANG, ALBERT YUNG-HSIANG, Q8911 MD 7/1/2016 7/1/2021 GENERAL SURGERY HOUSTON TX ACTIVE 7/6/2016 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 Q5002 KELLER, DEBORAH SUSAN, MD 7/1/2015 7/1/2020 GENERAL SURGERY HOUSTON TX ACTIVE 7/2/2015 None N/A R4575 KIANMAJD, MAJID, DO 9/8/2017 9/8/2022 GENERAL SURGERY HOUSTON TX ACTIVE 10/9/2017 None N/A R0604 KUEHT, MICHAEL , MD 10/31/2016 10/31/2021 GENERAL SURGERY HOUSTON TX ACTIVE 11/8/2016 None N/A R4580 KUMAR, AKSHITA , MD 9/8/2017 9/8/2022 GENERAL SURGERY HOUSTON TX ACTIVE 9/11/2017 None N/A 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 TRANSPLANT Q6958 LUNSFORD, KERI ELIZABETH, MD 1/15/2016 1/15/2021 GENERAL SURGERY SURGERY HOUSTON TX ACTIVE 1/19/2016 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

Page 195 of 332 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 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

Q8578 MUECK, KRISLYNN MICHELLE, MD 6/1/2016 6/1/2021 GENERAL SURGERY HOUSTON TX ACTIVE 6/21/2016 None N/A

S5453 NWOKEDI, UGOEZE JENNIFER, MD 3/6/2020 3/6/2025 GENERAL SURGERY HOUSTON TX ACTIVE 3/12/2020 None N/A PADILLA-JONES, BRANDY TRAUMATIC R1266 BRIANNA, MD 1/6/2017 1/6/2022 GENERAL SURGERY SURGERY HOUSTON TX ACTIVE 2/3/2017 None N/A ABDOMINAL S6474 PARIKH, JANAK ATUL, MD 5/1/2020 5/1/2025 GENERAL SURGERY SURGERY HOUSTON TX ACTIVE 5/4/2020 None N/A R0481 PHAM, DANG THANH, MD 10/14/2016 10/14/2021 GENERAL SURGERY HOUSTON TX ACTIVE 1/4/2017 None N/A CRITICAL CARE S6715 QUACH, GIANG THANH, DO 5/15/2020 5/15/2025 GENERAL SURGERY (SURGERY) HOUSTON TX ACTIVE 5/20/2020 None N/A R3962 SMITH, HANNAH STARKEY, MD 7/17/2017 7/17/2022 GENERAL SURGERY HOUSTON TX ACTIVE 7/19/2017 None N/A SURGICAL CRITICAL Q5725 SOUTHARD, ROBERT ELLIS, MD 8/14/2015 8/14/2020 GENERAL SURGERY CARE HOUSTON TX ACTIVE 8/18/2015 None N/A SWORDS, DOUGLAS SAUNDERS, SURGICAL S6315 MD 4/17/2020 4/17/2025 GENERAL SURGERY ONCOLOGY HOUSTON TX ACTIVE 4/21/2020 None N/A R2998 VAN EPS, JEFFREY LUKE, MD 5/5/2017 5/5/2022 GENERAL SURGERY HOUSTON TX ACTIVE 5/10/2017 None N/A SURGICAL S5808 WITT, RUSSELL GARDNER, MD 3/20/2020 3/20/2025 GENERAL SURGERY ONCOLOGY HOUSTON TX ACTIVE 4/8/2020 None N/A REYES ORTIZ, CARLOS ALFONSO, R1115 MD 12/16/2016 12/16/2021 GERIATRICS HOUSTON TX ACTIVE 12/19/2016 None N/A R2483 SOONES, TACARA NICOLE, MD 4/4/2017 4/4/2022 GERIATRICS INTERNAL MEDICINE HOUSTON TX ACTIVE 4/7/2017 None N/A GYNECOLOGIC S4720 AVILA, MONICA , MD 1/24/2020 1/24/2025 ONCOLOGY HOUSTON TX ACTIVE 2/19/2020 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 GYNECOLOGIC OBSTETRICS AND R1869 SHAFER, AARON, MD 2/22/2017 2/22/2022 ONCOLOGY GYNECOLOGY HOUSTON TX ACTIVE 2/24/2017 None N/A GYNECOLOGIC OBSTETRICS AND R3761 STEWART, KATHERINE IKARD , MD 6/30/2017 6/30/2022 ONCOLOGY GYNECOLOGY HOUSTON TX ACTIVE 7/13/2017 None N/A GYNECOLOGIC OBSTETRICS AND H6640 SUNDE, JAN, MD 12/6/2019 12/6/2024 ONCOLOGY GYNECOLOGY HOUSTON TX ACTIVE 12/12/2019 None N/A GYNECOLOGIC OBSTETRICS AND H6640 SUNDE, JAN, MD 12/6/2019 12/6/2024 ONCOLOGY GYNECOLOGY HOUSTON TX ACTIVE 12/12/2019 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

Page 196 of 332 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 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 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 HEMATOLOGY/ONCOL S6389 ELURI, MADHULIKA, MD 5/1/2020 5/1/2025 OGY HOUSTON TX ACTIVE 5/21/2020 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 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 HEMATOLOGY/ONCOL R0037 KANAAN, ZEYAD, MD 9/15/2016 9/15/2021 OGY INTERNAL MEDICINE HOUSTON TX ACTIVE 9/21/2016 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 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 HEMATOLOGY/ONCOL S6442 MAITI, ABHISHEK , MD 5/1/2020 5/1/2025 OGY INTERNAL MEDICINE HOUSTON TX ACTIVE 5/4/2020 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 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 HEMATOLOGY/ONCOL S4548 PRATH, PATRICK ENNIUS, MD 12/20/2019 12/20/2024 OGY INTERNAL MEDICINE HOUSTON TX ACTIVE 12/23/2019 None N/A HEMATOLOGY/ONCOL S6716 RAMDIAL, JEREMY LEON, MD 5/15/2020 5/15/2025 OGY HOUSTON TX ACTIVE 5/20/2020 None N/A HEMATOLOGY/ONCOL R5462 ROME, ALISON MAE, MD 12/8/2017 12/8/2022 OGY HOUSTON TX ACTIVE 12/12/2017 None N/A HEMATOLOGY/ONCOL R3609 THOMPSON, PHILIP ALASTAIR, MD 6/16/2017 6/16/2022 OGY HOUSTON TX ACTIVE 7/3/2017 None N/A HEMATOLOGY/ONCOL Q7508 WANG, YUE , MD 3/4/2016 3/4/2021 OGY INTERNAL MEDICINE HOUSTON TX ACTIVE 3/9/2016 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 FAROOQUI, MUHAMMAD TALHA, R4691 MD 9/22/2017 9/22/2022 HOSPITALIST HOUSTON TX ACTIVE 9/26/2017 None N/A

Page 197 of 332 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 FITZGERALD, MEKESHIA Q9812 SHUNETTA, DO 8/26/2016 8/26/2021 HOSPITALIST HOUSTON TX ACTIVE 8/31/2016 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 Q7760 NGO, MICHAEL, DO 4/1/2016 4/1/2021 HOSPITALIST HOUSTON TX ACTIVE 4/4/2016 None N/A R0632 OKERE, JACQUELINE, MD 10/31/2016 10/31/2021 HOSPITALIST INTERNAL MEDICINE HOUSTON TX ACTIVE 11/14/2016 None N/A R0637 PAN, ZAN, MD 10/31/2016 10/31/2021 HOSPITALIST HOUSTON TX ACTIVE 11/11/2016 None N/A Q7490 TRAN, KIMBERLY MY LINH, DO 3/4/2016 3/4/2021 HOSPITALIST HOUSTON TX ACTIVE 3/7/2016 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 INFECTIOUS R0177 AL MOHAJER, MAYAR , MD 9/30/2016 9/30/2021 DISEASES INTERNAL MEDICINE HOUSTON TX ACTIVE 10/3/2016 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 INFECTIOUS Q5204 KHAN, NABEELA, DO 7/15/2015 7/15/2020 DISEASES INTERNAL MEDICINE HOUSTON TX ACTIVE 7/22/2015 None N/A INFECTIOUS Q6886 NIGO, MASAYUKI , MD 1/6/2016 1/6/2021 DISEASES INTERNAL MEDICINE HOUSTON TX ACTIVE 1/19/2016 None N/A PANKOW, STEPHANIE INFECTIOUS S6010 BURKHARDT, DO 4/3/2020 4/3/2025 DISEASES HOUSTON TX ACTIVE 4/8/2020 None N/A INFECTIOUS S6947 SPALLONE, AMY R, MD 5/29/2020 5/29/2025 DISEASES INTERNAL MEDICINE HOUSTON TX ACTIVE 6/5/2020 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

Q5633 CAVAZOS, ELOY JR, MD 8/14/2015 8/14/2020 INTERNAL MED - PEDS HOUSTON TX ACTIVE 8/19/2015 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 DELBECQ, ERICA STEINVORTH, R3826 MD 7/17/2017 7/17/2022 INTERNAL MED - PEDS HOUSTON TX ACTIVE 7/19/2017 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

S5631 GORDON, NADINE CYRILLA, MD 3/20/2020 3/20/2025 INTERNAL MED - PEDS HOUSTON TX ACTIVE 5/19/2020 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

S4827 MUSICK, RUTH LITWINOWICZ, MD 1/24/2020 1/24/2025 INTERNAL MED - PEDS HOUSTON TX ACTIVE 2/3/2020 None N/A

Page 198 of 332 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

R5608 NOE, ARIANA , MD 1/5/2018 1/5/2023 INTERNAL MED - PEDS HOUSTON TX ACTIVE 1/17/2018 None N/A

R0919 NWAOZO, VANESSA CHIKA, MD 12/2/2016 12/2/2021 INTERNAL MED - PEDS HOUSTON TX ACTIVE 1/4/2017 None N/A

S4370 PHAN, TUONG , MD 12/6/2019 12/6/2024 INTERNAL MED - PEDS HOUSTON TX ACTIVE 12/27/2019 None N/A

S4370 PHAN, TUONG , MD 12/6/2019 12/6/2024 INTERNAL MED - PEDS HOUSTON TX ACTIVE 12/27/2019 None N/A

Q8613 RAJAGOPAL, SELVI , MD 6/1/2016 6/1/2021 INTERNAL MED - PEDS HOUSTON TX ACTIVE 6/2/2016 None N/A

S6034 SANYAL, SHUVANI, MD 4/3/2020 4/3/2025 INTERNAL MED - PEDS HOUSTON TX ACTIVE 5/13/2020 None N/A

Q7512 WILLIARD, COCO D, MD 3/4/2016 3/4/2021 INTERNAL MED - PEDS HOUSTON TX ACTIVE 3/8/2016 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 Q9100 ADAMS, OLA , MD 7/15/2016 7/15/2021 INTERNAL MEDICINE HOUSTON TX ACTIVE 8/22/2016 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 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 Q5747 AIBANA, OMOWUNMI, MD 8/28/2015 8/28/2020 INTERNAL MEDICINE HOUSTON TX ACTIVE 8/31/2015 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 S6107 ALI, HIBA , MD 4/17/2020 4/17/2025 INTERNAL MEDICINE HOUSTON TX ACTIVE 5/4/2020 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 ATHREYA, KHANNAN Q9573 KAMESHVARAN, MD 8/15/2016 8/15/2021 INTERNAL MEDICINE HOUSTON TX ACTIVE 8/16/2016 None N/A R6145 AZIZ, HAMZA , MD 3/2/2018 3/2/2023 INTERNAL MEDICINE HOUSTON TX ACTIVE 3/5/2018 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 Q7141 BANDEALI, BARKATALI , DO 2/16/2016 2/16/2021 INTERNAL MEDICINE HOUSTON TX ACTIVE 2/18/2016 None N/A 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 R0195 BIRNBAUM, GILAD DAVID, MD 9/30/2016 9/30/2021 INTERNAL MEDICINE HOUSTON TX ACTIVE 10/4/2016 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 Q5624 BOYARS, MICHAEL EUGENE, MD 8/14/2015 8/14/2020 INTERNAL MEDICINE HOUSTON TX ACTIVE 8/17/2015 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

Page 199 of 332 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 Q4915 CHAISSON, JORDAN , MD 7/1/2015 7/1/2020 INTERNAL MEDICINE CARDIOLOGY HOUSTON TX ACTIVE 7/2/2015 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 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 Q7855 CROOMS, JAMISE , MD 4/15/2016 4/15/2021 INTERNAL MEDICINE HOUSTON TX ACTIVE 5/18/2016 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 GASTROENTEROLOG R3657 DEDANIA, BHAVTOSH KANJI, MD 6/30/2017 6/30/2022 INTERNAL MEDICINE Y HOUSTON TX ACTIVE 7/4/2017 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 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 FRANCO VEGA, MARIA CECILIA, R2590 MD 4/20/2017 4/20/2022 INTERNAL MEDICINE HOUSTON TX ACTIVE 6/23/2017 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 R0575 GARG, ANJALI, MD 10/31/2016 10/31/2021 INTERNAL MEDICINE HOUSTON TX ACTIVE 11/9/2016 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 S5627 GOATES, CHRISTOPHER, MD 3/20/2020 3/20/2025 INTERNAL MEDICINE HOUSTON TX ACTIVE 6/5/2020 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 Q9361 GONZALEZ, CELSIO , MD 8/1/2016 8/1/2021 INTERNAL MEDICINE HOUSTON TX ACTIVE 8/16/2016 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

R1536 GREIFER, KRISTYN MICHELLE, MD 2/6/2017 2/6/2022 INTERNAL MEDICINE HOSPITALIST HOUSTON TX ACTIVE 4/19/2017 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 HEMATOLOGY/ONCO R4231 GULHATI, PRATEEK , MD 8/15/2017 8/15/2022 INTERNAL MEDICINE LOGY HOUSTON TX ACTIVE 12/12/2017 None N/A 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 S5637 GUPTA, ASHISH DUSHANT, MD 3/20/2020 3/20/2025 INTERNAL MEDICINE HOSPITALIST HOUSTON TX ACTIVE 3/26/2020 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 R2866 HAMID, FATIMA, MD 5/5/2017 5/5/2022 INTERNAL MEDICINE INTERNAL MEDICINE HOUSTON TX ACTIVE 5/10/2017 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 GASTROENTEROLOG Q4975 HASSAN, SOHAIB, MD 7/1/2015 7/1/2020 INTERNAL MEDICINE Y HOUSTON TX ACTIVE 7/27/2015 None N/A R4979 HAYWARD, CHRISTIANA , MD 10/20/2017 10/20/2022 INTERNAL MEDICINE HOUSTON TX ACTIVE 10/31/2017 None N/A

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