MR. ROBERT DERRICK DOUGLAS (NPI# 1104442508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104442508 |
| Entity Type | Individual |
| Full Name | MR. ROBERT DERRICK DOUGLAS |
| Credential | ST |
| Practice Address |
1302 Tom Temple Dr Lufkin TX 75904-5581 |
| Mailing Address |
8477 S Suncoast Blvd Homosassa FL 34446-5028 |
| Practice Telephone | 3663410549 |
| Practice Fax Number | 3523827781 |
| Mailing Telephone | 3523827214 |
| Mailing Fax Number | 3523827781 |
| Enumeration Date | 2020-06-22 |
| Last Update Date | 2020-06-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2355S0801X |
Specialist/Technologist Specialization: Speech-Language Assistant |
112439 | TX | Speech, Language and Hearing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194108225 | Robert Douglas Jr. | Contractor | 65 Grand Valley Ct, Howard, OH 43028-9200 | 2015-07-07 |
| 1730436593 | Robert T Douglas | Pharmacist | 335 Se Valley View Way, Chehalis, WA 98532-4304 | 2012-08-11 |
| 1710243167 | Robert Gordon Douglas Jr. | Internal Medicine | 265 Old Black Point Rd, Niantic, CT 06357-3732 | 2012-04-10 |
| 1053574137 | Robert James Douglas | Specialist | 13865 Locust Ln, Nampa, ID 83686-9367 | 2008-07-08 |
| 1003938663 | Robert Duane Douglas | Dentist | 160 S Bellwood Dr Ste B, East Alton, IL 62024-2086 | 2007-04-04 |
| 1861516239 | Robert Dean Douglas | Optometrist | 12412 Stafford St, Ravenna, MI 48451-0307 | 2007-03-19 |
| 1538182399 | Robert M Douglas | Radiology | 400 South 43rd Street, C/o Valley Radiation Oncology, Renton, WA 98055 | 2006-07-25 |
| 1790757417 | Robert N Douglas | Dentist | 424 Route 304, Bardonia, NY 10954-1613 | 2006-02-06 |
| 1275856510 | Robert Leslie Douglas | Counselor | 10 Fiske Pl, Suite 228, Mount Vernon, NY 10550-3205 | 2010-03-01 |
| 1366532236 | Robert M Douglas | Family Medicine | 5555 E Arapahoe Rd, Centennial, CO 80122-2312 | 2006-10-13 |
| Street Address |
1302 TOM TEMPLE DR |
| City | LUFKIN |
| State | TX |
| Zip Code | 75904-5581 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598714941 | Mrc Pinecrest | Home Health | 1302 Tom Temple Dr, Lufkin, TX 75904-5550 | 2006-05-10 |
| 1114292620 | Chardin Dachelet | Speech-Language Pathologist | 1302 Tom Temple Dr, Lufkin, TX 75904-5581 | 2012-03-16 |
| 1215206230 | William Bearden | Physical Therapy Assistant | 1302 Tom Temple Dr, Lufkin, TX 75904-5581 | 2011-12-20 |
| 1457629784 | Richard Goates | Physical Therapist | 1302 Tom Temple Dr, Lufkin, TX 75904-5581 | 2011-12-01 |
| 1841587573 | Scott Turner | Physical Therapy Assistant | 1302 Tom Temple Dr, Lufkin, TX 75904-5581 | 2011-07-01 |
| 1104113968 | Virginia B Spore | Physical Therapist | 1302 Tom Temple Dr, Lufkin, TX 75904-5581 | 2011-06-30 |
| 1568752764 | Tiffani Creel | Occupational Therapy Assistant | 1302 Tom Temple Dr, Lufkin, TX 75904-5581 | 2011-04-10 |
| 1871892356 | Arvin Tiu | Physical Therapist | 1302 Tom Temple Dr, Lufkin, TX 75904-5581 | 2011-03-23 |
| 1124324702 | Gary Mcgiven | Physical Therapist | 1302 Tom Temple Dr, Lufkin, TX 75904-5581 | 2011-01-31 |
| 1679878896 | Glenda Kelley | Speech-Language Pathologist | 1302 Tom Temple Dr, Lufkin, TX 75904-5581 | 2011-01-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437759750 | David Kent Emmerling | Pharmacist | Walmart Pharmacy 10-0140, 2500 Daniel Mccall Drive, Lufkin, TX 75904 | 2020-10-27 |
| 1831732718 | Isaac Kwame Agyare | Pharmacist | 1522 West Frank Ave. Room 127, Lufkin, TX 75904 | 2019-10-23 |
| 1598314999 | Eva Faye Mcduffie | Technician | 1006 Sherwood Rd., Lufkin, TX 75904 | 2019-09-09 |
| 1477036119 | Tyra Williams | Occupational Therapy Assistant | 902 Hill Street, Lufkin, TX 75904 | 2018-09-10 |
| 1720560188 | Veronica Monique Kennedy | Pharmacist | 1522 West Frank, Lufkin, TX 75904 | 2018-09-02 |
| 1356821532 | Mark Anthony Plowman | Licensed Vocational Nurse | 379 Copperfield Loop, Lufkin, TX 75904 | 2018-08-17 |
| 1396222311 | Kevin Pulikottil Cherian | Occupational Therapist | 402 S John Redditt Dr., Lufkin, TX 75904 | 2018-07-23 |
| 1922593029 | Sarah Marie Stuart | Dentist | 103 N Brentwood Dr, Unit 400, Lufkin, TX 75904 | 2018-06-30 |
| 1083104004 | Pam Specialty Hospital of Lufkin, LLC | Long Term Care Hospital | 1201 W Frank Ave Ste D5, Lufkin, TX 75904 | 2018-05-15 |
| 1124523840 | Jane C Davidson | Nurse Practitioner | 1 Medical Center Blvd Ste C, Lufkin, TX 75904 | 2018-03-26 |
| Find all providers in zip 75904 | ||||
| Taxonomy Code | 2355S0801X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Speech-Language Assistant |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457987109 | Sandra Hinojosa | Specialist/Technologist | 103 Curry St, Lufkin, TX 75901-5127 | 2020-03-13 |
| 1841824497 | Danielle Lorin Lincoln | Specialist/Technologist | 415 S 1st St # 300a, Lufkin, TX 75901-3863 | 2020-02-22 |
| 1942786900 | Ranece Alafia Beckford | Specialist/Technologist | 106 E Lufkin Ave, Lufkin, TX 75901-2806 | 2018-07-12 |
| 1710488069 | Je'lisa Nicole Jordan | Specialist/Technologist | 924 Walker Loop, Lufkin, TX 75904-2833 | 2018-02-22 |
| 1427666932 | Jaclyn Pena | Specialist/Technologist | 415 S 1st St Ste 300, Lufkin, TX 75901-3800 | 2020-07-21 |
| 1578045944 | Chidinma Nebo | Specialist/Technologist | 106 E Lufkin Ave, Lufkin, TX 75901-2806 | 2018-09-03 |
| 1376021709 | Keenon Harris | Specialist/Technologist | 5038 Champions Dr, Lufkin, TX 75901-7346 | 2018-07-28 |
| 1740767508 | Ashley Ann Brown | Specialist/Technologist | 5038 Champions Dr, Lufkin, TX 75901-7346 | 2018-07-25 |
| 1134605645 | Julio Cesar Ramos | Specialist/Technologist | 106 E Lufkin Ave, Lufkin, TX 75901-2806 | 2018-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962001677 | Stephanie Lee Perez | Specialist/Technologist | 3200 Colonial Pkwy Apt 920, Belton, TX 76513-5841 | 2020-10-22 |
| 1750989257 | Paulina Ivonne Ramirez | Specialist/Technologist | 6903 Pamlico Dr, El Paso, TX 79912-3105 | 2020-10-15 |
| 1063010239 | Gabriella Anne Ruffo | Specialist/Technologist | 17823 Riata Canyon Ct, Cypress, TX 77433-2361 | 2020-10-11 |
| 1922605963 | Julianna Ruiz | Specialist/Technologist | 11709 Broadmoor Dr, Dallas, TX 75218-2053 | 2020-10-02 |
| 1134726151 | Autumn Kelsey Lee | Specialist/Technologist | 250 Bens Trl Apt 522, Fort Worth, TX 76120-7000 | 2020-10-02 |
| 1578160602 | Alexis Scoggin | Specialist/Technologist | 1908 Warwick Cir W, Longview, TX 75601-3139 | 2020-10-01 |
| 1184231524 | Andrea Wenceslada Guerrero | Specialist/Technologist | 222 N Expressway 77/83 Ste 104, Brownsville, TX 78521-2258 | 2020-09-29 |
| 1831706944 | Madeline Lee Lawson | Specialist/Technologist | 10018 Locke Ln, Houston, TX 77042-3102 | 2020-09-24 |
| 1215543665 | Leslie Ednis Pena | Specialist/Technologist | 1005 E 10th St Ste A, Weslaco, TX 78596-5133 | 2020-09-21 |
| 1982210472 | Juana Maria Perez | Specialist/Technologist | 5505 Burton Ln, Corpus Christi, TX 78411-4613 | 2020-09-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.