PULMONARY DISEASES MEDICINE CLINIC (NPI# 1114044328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114044328 |
| Entity Type | Organization |
| Organization Name | PULMONARY DISEASES MEDICINE CLINIC |
| Practice Address |
921 Texas Blvd Ste D Texarkana TX 75501-5163 |
| Practice Telephone | 9037923660 |
| Practice Fax Number | 9037933187 |
| Mailing Telephone | 9037923660 |
| Mailing Fax Number | 9037933187 |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2008-04-28 |
| Authorized Official Name | BECKY WATKINS (OFFICE MANAGER) |
| Authorized Official Telephone | 9037923660 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | TX BCBS | 0055R | 01 |
| AR | AR BCBS | 8P083 | 01 |
| TX | 1415531 01 | 05 | |
| AR | QUAL CHOICE | 90815000040 | 01 |
| TX | RR MEDICARE | DA7905 | 01 |
| OK | OK CAID | 200092730A | 01 |
| Street Address |
921 TEXAS BLVD STE D |
| City | TEXARKANA |
| State | TX |
| Zip Code | 75501-5163 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699066969 | Mandy Michelle Carter | Nurse Practitioner | 921 Texas Blvd Ste D, Texarkana, TX 75501-5163 | 2011-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598227951 | Shayla Lasonde Williams | Licensed Vocational Nurse | 409 Tracey Ave, Wake Village, TX 75501 | 2019-04-04 |
| 1861900904 | Tiffany Anne Baugus | Nurse Practitioner | 2600 St. Michael Drive, Texarkana, TX 75501 | 2018-01-10 |
| 1104363258 | Brent Willis | Nurse Anesthetist, Certified Registered | 203 La Grange Dr., Texarkana, TX 75501 | 2017-01-27 |
| 1154627644 | Patricia Maree Baker | Counselor | 1001 Texas Blvd., Suite 106, Texarkana, TX 75501 | 2011-02-01 |
| 1730323452 | William Leonard | Occupational Therapy Assistant | 2108 5th Street, Bridgeport, TX 75501 | 2009-04-24 |
| 1700071552 | Roger House Md, Psychiatric Services | Case Management | 2401 Summerhill Rd., Suite A, Texarkana, TX 75501 | 2007-09-13 |
| 1134248271 | Brent Bultemeier Pa | Chiropractor | 3207 New Boston Road, Texarkana, TX 75501 | 2007-03-28 |
| 1346395977 | Sharon E. Moore | Registered Nurse | Youree Drive, Shreveport, LA 75501 | 2007-01-24 |
| 1962553024 | Leary Independent School District | Local Education Agency (LEA) | 9500 W. New Boston Rd, Texarkana, TX 75501 | 2007-01-16 |
| 1780787390 | Christina Michelle Griffin | Physical Therapist | 1315 Walnut, Temple Memorial Rehabiliation Ctr, Texarkana, TX 75501 | 2006-09-07 |
| Find all providers in zip 75501 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598783870 | Carlos Luis Perez | Internal Medicine | 921 Texas Blvd, Ste D, Texarkana, TX 75501-5163 | 2006-07-17 |
| 1588167779 | Pulmonary & Internal Medicine of Texarkana | Internal Medicine | 5730 Summerhill Rd, Texarkana, TX 75503-1635 | 2018-03-14 |
| 1043322696 | Michelle R Dehan | Internal Medicine | 1550 Moores Ln, Texarkana, TX 75503-4657 | 2006-08-31 |
| 1083696801 | Collom and Carney Clinic Association | Internal Medicine | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2005-11-17 |
| 1174525174 | Malcolm A Smith | Internal Medicine | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2005-08-10 |
| 1649270539 | Bret F Craytor | Internal Medicine | 2600 Saint Michael Dr, Texarkana, TX 75503-5220 | 2005-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104431907 | Texas Lung Care Associates Pllc | Internal Medicine | 115 Wendover Ct, Southlake, TX 76092-8589 | 2020-09-09 |
| 1437782430 | Evette Karlene Robinson | Internal Medicine | 1904 Pine St Ste 4c, Abilene, TX 79601-2450 | 2020-02-18 |
| 1154964526 | Sridhar Badireddi Md Pa | Internal Medicine | 3500 Gaston Ave # Floors34, Dallas, TX 75246-2017 | 2019-10-17 |
| 1740830702 | Jamal Adel Turki | Internal Medicine | 20510 Walnut Canyon Dr, Katy, TX 77450-5427 | 2019-09-12 |
| 1245885342 | Manica Isiguzo, Md Pa | Internal Medicine | 34910 Interstate 10 W Ste 601, Boerne, TX 78006-9230 | 2019-08-06 |
| 1497243943 | Howard M Mintz Md Pllc | Internal Medicine | 10501 N Central Expy Ste 101, Dallas, TX 75231-2203 | 2018-04-30 |
| 1417457938 | Lung Specialist Associates of Texas Pllc | Internal Medicine | 300 N Highland Ave Ste 455, Sherman, TX 75092-7391 | 2018-02-21 |
| 1265943104 | Greater Houston Lung and Sleep Center Pllc | Internal Medicine | 6550 Fannin St Ste 2321, Houston, TX 77030-2723 | 2017-10-18 |
| 1164961405 | Texas Pulmonology Inc | Internal Medicine | 19315 Country Village Dr, Spring, TX 77388-3080 | 2017-02-20 |
| 1013382753 | Internal & Pulmonary Granbury | Internal Medicine | 2214 E Us Highway 377, Ste B, Granbury, TX 76049-6010 | 2015-12-07 |
| Find all providers with the same taxonomy | ||||
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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.