PERMIAN PREMIER HEALTH SERVICES INC (NPI# 1487211843) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487211843 |
| Entity Type | Organization |
| Organization Name | PERMIAN PREMIER HEALTH SERVICES INC |
| Practice Address |
1002 Texas Blvd Ste 322 Texarkana TX 75501-5118 |
| Mailing Address |
Po Box 24573 Belfast ME 04915-4496 |
| Practice Telephone | 9037911878 |
| Practice Fax Number | 9037911882 |
| Mailing Telephone | 8556600300 |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2019-05-21 |
| Authorized Official Name | JONATHAN A DEMKE (CEO) |
| Authorized Official Telephone | 6154671072 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 174400000X | Specialist | Other Service Providers |
| Other Name | Type Code |
|---|---|
| STEWARD MEDICAL GROUP OF TEXAS | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558839076 | Permian Premier Health Services Inc | Family Medicine | 2929 Calder St Ste 100, Beaumont, TX 77702-1841 | 2018-11-02 |
| 1871149807 | Permian Premier Health Services Inc | Clinic/Center | 2301 S Gregg St, Big Spring, TX 79720-5531 | 2019-08-15 |
| 1972168425 | Permian Premier Health Services Inc | Specialist | 1401 St Joseph Pkwy, Houston, TX 77002-8301 | 2019-05-09 |
| 1285299131 | Permian Premier Health Services Inc | Contractor | 520 E 6th St, Odessa, TX 79761-4527 | 2019-05-07 |
| 1578024303 | Permian Premier Health Services Inc | Clinic/Center | 2301 S Gregg St, Big Spring, TX 79720-5531 | 2019-03-26 |
| 1982169603 | Permian Premier Health Services Inc | Clinical Medical Laboratory | 2929 Calder St Ste 100, Beaumont, TX 77702-1841 | 2019-02-06 |
| 1932664091 | Permian Premier Health Services Inc | Anesthesiology | 2301 S Gregg St, Big Spring, TX 79720-5531 | 2019-02-04 |
| 1285664763 | Permian Premier Health Services Inc | Contractor | 520 E 6th St, Odessa, TX 79761-4527 | 2006-07-03 |
| Street Address |
1002 TEXAS BLVD STE 322 |
| City | TEXARKANA |
| State | TX |
| Zip Code | 75501-5118 |
| 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 | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619142072 | George F. Moricz, M.d., P.a. | Specialist | 1002 Texas Blvd Ste 301, Texarkana, TX 75501-5118 | 2008-04-28 |
| 1154474674 | The Specialists for Women of Texarkana Pllc | Specialist | 1002 Texas Blvd Ste 200, Texarkana, TX 75501-5133 | 2007-01-19 |
| 1568419984 | Texarkana Eye Group Plc | Specialist | 3211 Sugar Hill Rd, Texarkana, AR 71854-9219 | 2006-05-30 |
| 1871546051 | Roger Dale House | Specialist | 2401 Summerhill Rd, Suite A, Texarkana, TX 75501-3570 | 2006-05-18 |
| 1104884386 | Mark A Wren | Specialist | 4613 Parkway Dr Ste 1, Texarkana, AR 71854-1142 | 2006-05-03 |
| 1962490458 | Charles Edward Hollingsworth II | Specialist | 5420 Medical Parkway Dr, Texarkana, TX 75503-4622 | 2005-10-10 |
| 1407841695 | Russ Todd Nelson | Specialist | 4303 Texas Blvd, Ste 8, Texarkana, TX 75503-3097 | 2005-09-14 |
| 1063419307 | Hayden H Franks | Specialist | 2011 Moores Ln, Texarkana, TX 75503-1841 | 2005-07-01 |
| 1063419646 | Stanley Cleveland Knowles | Specialist | 1920 Moores Ln, Suite A, Texarkana, TX 75503-4664 | 2005-06-28 |
| 1649275496 | David Lee Carlisle | Specialist | 1000 Pine St, Texarkana, TX 75501-5100 | 2005-06-17 |
| Find all providers in TEXARKANA | ||||
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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.