First Name
Last Name
Home Phone
Date of Birth
MedicaidYesNo
UHC MA HMO Plan050 - AARP Secure Horizons MA TX-0021 HMO POS056 - AARP MA Patriot Plan RX TX-MA03063 - AARP MA TX-0028065 - UHC Dual Complete TX-V007053 - UHC Dual Complete TX-D005058 - UHC Complete Care TX-0024067 - AARP MA TX-0040071 - AARP MA TX-0043UHC PPO Plan#N/AAARP Medicare Advantage Patriot (H4590-029)UHC Dual Complete (H4590-022)UHC Chronic Complete (H4590-037)OUO - AARP Medicare Advantage SecureHorizons (H4590-010)AARP Medicare Advantage SecureHorizons (H4590-010)O9C - AARP Medicare Advantage (H4590-045)OUN/OI9 - UHC Dual Complete (H4590-022)OUU - UHC Chronic Complete (H4590-037)OUR - AARP Medicare Advantage Patriot (H4590-029)AARP Medicare Advantage (H4590-045)AARP Medicare Advantage SecureHorizons (H4590-010)AARP Medicare Advantage SecureHorizons (H4590-010)OUO - AARP Medicare Advantage SecureHorizons (H4590-010)
Member ID
Plan Effective Date (XX/XX/XXXX)
Primary Care Doctor/ClinicAguero MD, Claudia-Val Verde (Habla Espanol)Aguilar MD, Jesus - Highlands (Hablo Espanol)Arevalo MD, Ricardo - Leon Valley (Hablo Espanol)Bahr MD, Douglas - New BraunfelsBishop MD, Lauren-Alamo HeightsCalderon MD, Ana Maria - Wurzbach (Hablo Espanol)Casiwa MD, Mary Faith - Ingram ParkCaulfield MD, Christopher - Perrin BeitelClark MD, Kristi - WurzbachDominguez MD, Michael - Holy Cross (Hablo Espanol)Gneco MD, Cynthia - Southwest Military (Hablo Espanol)Grant MD, Andrine - San PedroHain Treviño MD, April - Alamo HeightsIndira MD, Priya - Westover HillsKonopacki MD, Michael - Hill CountryKosmatka MD, Timothy - WurzbachLim MD, John Brian - SchertzMartinez MD, Marie Mae - BlancoMcClelland MD, Tamre - Perrin BeitelMontemayor MD, Lenibet - Southwest Military (Hablo Espanol)Najera MD, Rodrigo- Highlands (Habla Espanol)Nguyen, DO, ThanhVi - Stone OaksOrtiz MD, Gabriel - Blanco (Hablo Espanol)Ortiz MD, Jose - San Pedro (Hablo Espanol)Pola DO, Bharath - Westover HillsPowell MD, Dan -Stone Oaks (Hablo Espanol)Quiñones MD, Manuel - Helotes (Hablo Espanol)Ramos MD, Steven - San PedroRodriguez MD, Orlando - Las Palmas (Hablo Espanol)Santoscoy DO, Raul - Ingram Park (Hablo Espanol)Sepulveda MD, Mae - WurzbachSoza DO, Iveth - Val Verde (Hablo Espanol)Torres MD, Francisco - Southwest Military (Hablo Espanol)Torres MD, Luis - Southwest Military (Hablo Espanol)Varma MD, Archana - Hill CountryWalter MD, James - WurzbachOrtiz MD, Gabriel - Blanco (Hablo Espanol)Garcha MD, Jasmine - Val VerdeSaunders MD, Stacey - Westover Hills
Agent Name (First Last)
Agency/Broker
Agent Phone (xxx-xxx-xxxx)
Event
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Primary Care Doctor/ClinicAguero MD, Claudia-Val Verde (Habla Espanol)Aguilar MD, Jesus - Highlands (Hablo Espanol)Arevalo MD, Ricardo - Leon Valley (Hablo Espanol)Bahr MD, Douglas - New BraunfelsBishop MD, Lauren-Alamo HeightsCalderon MD, Ana Maria - Wurzbach (Hablo Espanol)Casiwa MD, Mary Faith - Ingram ParkCaulfield MD, Christopher - Perrin BeitelClark MD, Kristi - WurzbachCruz MD, Max - Las PalmasDominguez MD, Michael - Holy Cross (Hablo Espanol)Fritz MD, Braxton - Helotes ClinicGarcha MD, Jasmine - Val VerdeGrant MD, Andrine - San PedroHain Treviño MD, April - Alamo HeightsIndira MD, Priya - Westover HillsKonopacki MD, Michael - Hill CountryKosmatka MD, Timothy - WurzbachLim MD, John Brian - SchertzMartinez MD, Marie Mae - BlancoMcClelland MD, Tamre - Perrin BeitelMontemayor MD, Lenibet - Southwest Military (Hablo Espanol)Najera MD, Rodrigo- Highlands (Habla Espanol)Nguyen, DO, ThanhVi - Stone OaksOrtiz MD, Gabriel - Blanco (Hablo Espanol)Ortiz MD, Jose - San Pedro (Hablo Espanol)Pola DO, Bharath - Westover HillsPowell MD, Dan -Stone Oaks (Hablo Espanol)Quiñones MD, Manuel - Helotes (Hablo Espanol)Ramos MD, Steven - San PedroRodriguez MD, Orlando - Las Palmas (Hablo Espanol)Santoscoy DO, Raul - Ingram Park (Hablo Espanol)Saunders MD, Stacey - Leon Valley ClinicSepulveda MD, Mae - WurzbachSoza DO, Iveth - Val Verde (Hablo Espanol)Torres MD, Francisco - Southwest Military (Hablo Espanol)Torres MD, Luis - Southwest Military (Hablo Espanol)Varma MD, Archana - Hill CountryVillanueva Alvarez, Ricardo - New Braunfels ClinicWalter MD, James - WurzbachOrtiz MD, Gabriel - Blanco (Hablo Espanol)Wynn MD, Alexandra - Alamo Heights ClinicClark MD, Kristi - Wurzbach