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34 TPI

Clinic
Count
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KOOL SMILES TEXAS

TPI

Provider Name

Address

City

ST

Phys_Zip

Type

Procedure Number_S Number_Cl
_Cd
ervices
ients
Total_Paid

186826701
186826701
186826702
186826703
186826703
186826704
186826704
186998401
186998401
187359801
187359801
187600501
187600501
187790401
187790401
187790403
187790403
187790405
187790405
187790406
187790406
189753001
189753001
189868601
189868601
190477301
190477301
191164601
191164601
191455801
191455801
191478001
191478001

DENTISTRY OF BROWNSVILLE PC-KOOL SMILES
432 S BIBB AVE STE 300
EAGLE PASS
DENTISTRY OF BROWNSVILLE PC-KOOL SMILES
432 S BIBB AVE STE 300
EAGLE PASS
DENTISTRY OF BROWNSVILLE PC-KOOL SMILES
3111 S TEXAS AVE
BRYAN
DENTISTRY OF BROWNSVILLE PC-KOOL SMILES
5300 SAN DARIO AVE # C-2
LAREDO
DENTISTRY OF BROWNSVILLE PC-KOOL SMILES
5300 SAN DARIO AVE # C-2
LAREDO
DENTISTRY OF BROWNSVILLE PC
529 S VALLEY MILLS DR
WACO
DENTISTRY OF BROWNSVILLE PC
529 S VALLEY MILLS DR
WACO
DENTISTRY OF BROWNSVILLE PC-KOOL SMILES
1100 LOWES BLVD STE 100
KILLEEN
DENTISTRY OF BROWNSVILLE PC-KOOL SMILES
1100 LOWES BLVD STE 100
KILLEEN
DENTISTRY OF BROWNSVILLE PC-KOOL SMILES
2921 BOCA CHICA BLVD 15
BROWNSVILLE
DENTISTRY OF BROWNSVILLE PC-KOOL SMILES
2921 BOCA CHICA BLVD 15
BROWNSVILLE
DENTISTRY OF BROWNSVILLE PC-KOOL SMILES
5601 BANDERA RD STE 11
SAN ANTONIO
DENTISTRY OF BROWNSVILLE PC-KOOL SMILES
5601 BANDERA RD STE 11
SAN ANTONIO
KS2 TX PC-KOOL SMILES
2539 JUDSON RD
LONGVIEW
KS2 TX PC-KOOL SMILES
2539 JUDSON RD
LONGVIEW
KS2 TX PC-KOOL SMILES
6065 MONTANA AVE STE B5
EL PASO
KS2 TX PC-KOOL SMILES
6065 MONTANA AVE STE B5
EL PASO
KS2 TX PC-KOOL SMILES
615 N ZARAGOZA ROAD STE 88
EL PASO
KS2 TX PC-KOOL SMILES
615 N ZARAGOZA ROAD STE 88
EL PASO
KS2 TX PC
1932 E SOUTHEAST LOOP STE 323 TYLER
KS2 TX PC
1932 E SOUTHEAST LOOP STE 323 TYLER
DENTISTRY OF BROWNSVILLE PC-KOOL SMILES
1301 E US HWY 83
MCALLEN
DENTISTRY OF BROWNSVILLE PC-KOOL SMILES
1301 E US HWY 83
MCALLEN
DENTISTRY OF BROWNSVILLE PC-KOOL SMILES
213 E EXPRESSWAY 83
MISSION
DENTISTRY OF BROWNSVILLE PC-KOOL SMILES
213 E EXPRESSWAY 83
MISSION
KS2 TX PC
1923 MARSHA SHARP FWY STE 103LUBBOCK
KS2 TX PC
1923 MARSHA SHARP FWY STE 103LUBBOCK
KS2 TX PC
1000 N MIDKIFF RD STE B-6
MIDLAND
KS2 TX PC
1000 N MIDKIFF RD STE B-6
MIDLAND
KS2 TX PC
3711 GREGORY STREET
WICHITA FALLS
KS2 TX PC
3711 GREGORY STREET
WICHITA FALLS
KS2 TX PC
2210 BELL STREET
AMARILLO
KS2 TX PC
2210 BELL STREET
AMARILLO

TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX

78852
78852
77802
78041
78041
76711
76711
76542
76542
78521
78521
78238
78238
75605
75605
79925
79925
79907
79907
75711
75711
78501
78501
78572
78572
79415
79415
79701
79701
76308
76308
79106
79106

Primary
Permanent
Primary
Primary
Permanent
Primary
Permanent
Primary
Permanent
Primary
Permanent
Primary
Permanent
Primary
Permanent
Primary
Permanent
Primary
Permanent
Primary
Permanent
Primary
Permanent
Primary
Permanent
Primary
Permanent
Primary
Permanent
Primary
Permanent
Primary
Permanent

D2930
D2931
D2930
D2930
D2931
D2930
D2931
D2930
D2931
D2930
D2931
D2930
D2931
D2930
D2931
D2930
D2931
D2930
D2931
D2930
D2931
D2930
D2931
D2930
D2931
D2930
D2931
D2930
D2931
D2930
D2931
D2930
D2931

191997901

KS2 TX PC

4754 S 14TH STREET

ABILENE

TX

79605

Primary

D2930

847

477

$130,079

191997901

KS2 TX PC

4754 S 14TH STREET

ABILENE

TX

79605

Permanent D2931

53

42

$8,490

194873901
194873901
194984401
194984401
197577301
197577301
198538401

KS2 TX PC
KS2 TX PC
KS2 TX PC
KS2 TX PC
DENTISTRY OF BROWNSVILLE PC
DENTISTRY OF BROWNSVILLE PC
DENTISTRY OF BROWNSVILLE PC

5130 FAIRBANKS RD
5130 FAIRBANKS RD
2916 N US HIGHWAY 75 STE 900
2916 N US HIGHWAY 75 STE 900
290
290

EL PASO
EL PASO
SHERMAN
SHERMAN
Marietta
Marietta

TX
TX
TX
TX
GA
GA
TX

79924
79924
75090
75090
30067
30067
78223

Primary
Permanent
Primary
Permanent
Primary
Permanent
Primary

1,012
11
842
5
2,439
19
1,664

511
9
406
4
1,053
16
679

$155,284
$1,760
$129,039
$803
$374,233
$3,039
$255,533

3850 S NEW BRAUNFELS AVE STE 101
SAN ANTONIO

D2930
D2931
D2930
D2931
D2930
D2931
D2930

2,071
1
2,391
4,936
3
1,661
17
1,299
14
2,821
10
1,466
1
1,961
6
1,568
24
2,277
25
1,511
10
3,548
7
4,362
17
1,244
23
1,059
21
893
7
960
1

767
1
1,096
2,010
3
813
16
550
12
1,219
7
666
1
927
6
725
20
1,002
20
714
10
1,471
6
1,401
11
639
20
518
18
473
7
599
1

$317,329
$159
$366,247
$757,225
$478
$254,788
$2,722
$199,413
$2,136
$433,105
$1,527
$224,776
$159
$299,982
$962
$240,741
$3,838
$349,961
$3,996
$231,635
$1,602
$544,522
$1,116
$669,356
$2,727
$190,841
$3,692
$162,302
$3,259
$137,015
$1,126
$147,160
$159

23
24
25
26
27
28
29
30
31
32
33
34

198538401
198792701
198792701
205933901
205933901
207594701
207594701
209177901
209177901
209353601
209353601
209519201
209519201
213676401
213676401
213830701
213830701
213872901
213872901
214339801
284609901
284656001
284656001

DENTISTRY OF BROWNSVILLE PC
KS2 TX PC-KOOL SMILES
KS2 TX PC-KOOL SMILES
DENTISTRY OF BROWNSVILLE PCDENTISTRY OF BROWNSVILLE PCKS2 TX PCKS2 TX PCKS2 TX PCKS2 TX PCKS2 TX PCKS2 TX PCKS2 TX PCKS2 TX PCKS2 TX PCKS2 TX PCDENTISTRY OF BROWNSVILLE PCDENTISTRY OF BROWNSVILLE PCDENTISTRY OF BROWNSVILLE PCDENTISTRY OF BROWNSVILLE PCKS2 TX PCKS2 TX, PCKS2 TX PCKS2 TX PC-

3850 S NEW BRAUNFELS AVE STE 101
SAN ANTONIO
1613 N WEST COUNTY RD C
ODESSA
1613 N WEST COUNTY RD C
ODESSA
2400 RICHMOND RD STE 133
TEXARKANA
2400 RICHMOND RD STE 133
TEXARKANA
400 N TIMBERLAND DR # 100
LUFKIN
400 N TIMBERLAND DR # 100
LUFKIN
2903 50TH ST
LUBBOCK
2903 50TH ST
LUBBOCK
6910 N MESA ST
EL PASO
6910 N MESA ST
EL PASO
1840 N LEE TREVINO DR STE 405 EL PASO
1840 N LEE TREVINO DR STE 405 EL PASO
710 ESTES DR STE 105
LONGVIEW
710 ESTES DR STE 105
LONGVIEW
1004 N TEXAS BLVD STE B1
WESLACO
1004 N TEXAS BLVD STE B1
WESLACO
2316 S ZAPATA HWY STE 190
LAREDO
2316 S ZAPATA HWY STE 190
LAREDO
4403 SHERWOOD WAY
SAN ANGELO
3864 STATE HIGHWAY 64 W
TYLER
1784 STATE HIGHWAY 351
ABILENE
1784 STATE HIGHWAY 351
ABILENE

Total Primary 58357
Total Permanent 457
128:1

TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX
TX

78223
79763
79763
75503
75503
75901
75901
79413
79413
79912
79912
79936
79936
75602
75602
78596
78596
78046
78046
76901
75704
79601
79601

Permanent
Primary
Permanent
Primary
Permanent
Primary
Permanent
Primary
Permanent
Primary
Permanent
Primary
Permanent
Primary
Permanent
Primary
Permanent
Primary
Permanent
Primary
Primary
Primary
Permanent

D2931
D2930
D2931
D2930
D2931
D2930
D2931
D2930
D2931
D2930
D2931
D2930
D2931
D2930
D2931
D2930
D2931
D2930
D2931
D2930
D2930
D2930
D2931

8
2,133
29
844
25
2,640
41
723
38
769
13
1,305
7
769
1
2,970
14
2,851
5
478
1
42
1

6
910
24
415
18
992
34
390
28
389
10
584
6
353
1
1,210
13
1,127
5
206
1
22
1

$1,276
$326,864
$4,651
$129,703
$3,994
$404,743
$6,427
$110,883
$5,904
$117,965
$2,083
$200,168
$1,124
$117,902
$159
$455,265
$2,231
$436,957
$796
$73,105
$153
$6,423
$159

58,814

25,691

$9,023,253