MEMORIAL MEDICAL CENTER OF EAST TEXAS (NPI# 1538114442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538114442 |
| Entity Type | Organization |
| Organization Name | MEMORIAL MEDICAL CENTER OF EAST TEXAS |
| Other Organization Name | EKG GROUP |
| Practice Address |
1201 W Frank Ave Lufkin TX 75904-3357 |
| Practice Telephone | 9366313474 |
| Practice Fax Number | 9366313475 |
| Mailing Telephone | 9366313474 |
| Mailing Fax Number | 9366313475 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. FONDA R SULLIVAN (INSURANCE SUPERVISOR) |
| Authorized Official Telephone | 9366313474 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | G4097 | TX | Other Service Providers |
| N | 174400000X | Specialist | H9325 | TX | Other Service Providers |
| N | 174400000X | Specialist | L9581 | TX | Other Service Providers |
| N | 174400000X | Specialist | H4425 | TX | Other Service Providers |
| N | 174400000X | Specialist | J0855 | TX | Other Service Providers |
| N | 174400000X | Specialist | E8818 | TX | Other Service Providers |
| N | 174400000X | Specialist | F8981 | TX | Other Service Providers |
| N | 174400000X | Specialist | E1447 | TX | Other Service Providers |
| N | 174400000X | Specialist | H0057 | TX | Other Service Providers |
| Y | 174400000X | Specialist | F8398 | TX | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE CROSS | 00N10T | 01 |
| Other Name | Type Code |
|---|---|
| EKG Group | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992745368 | Memorial Medical Center of East Texas | Anesthesiology | 1201 W Frank Ave, Lufkin, TX 75904-3357 | 2006-06-07 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MEMORIAL MEDICAL CENTER OF EAST TEXAS | 1201 W Frank Ave, Lufkin, TX 75904-3357 |
| Street Address |
1201 W FRANK AVE |
| City | LUFKIN |
| State | TX |
| Zip Code | 75904-3357 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629059548 | Joe Parker Tait | Registered Nurse | 1201 W Frank Ave, Lufkin, TX 75904-3357 | 2005-11-08 |
| 1851955033 | Shaquitta Lashae Hood | Licensed Vocational Nurse | 1201 W Frank Ave, Lufkin, TX 75904-3357 | 2019-04-23 |
| 1730653841 | Alejos Salais Jr. | Nurse Anesthetist, Certified Registered | 1201 W Frank Ave, Lufkin, TX 75904-3357 | 2019-01-11 |
| 1881173060 | Hospitalist Medicine Physicians of Texas - Lufkin, Pllc | Internal Medicine | 1201 W Frank Ave, Lufkin, TX 75904-3357 | 2018-08-09 |
| 1528578051 | Destiny Michelle New | Nurse Practitioner | 1201 W Frank Ave, Lufkin, TX 75904-3357 | 2017-10-11 |
| 1144748286 | Pineywoods Pain Associates, Pllc | Nurse Anesthetist, Certified Registered | 1201 W Frank Ave, Anesthesia Department, Lufkin, TX 75904-3357 | 2017-09-08 |
| 1336675032 | Patrick Imonitie Igharosa | Internal Medicine | 1201 W Frank Ave, Lufkin, TX 75904-3357 | 2017-05-02 |
| 1972053684 | Patricia Gay Lawson | Nurse Practitioner | 1201 W Frank Ave, Lufkin, TX 75904 | 2016-10-05 |
| 1811445091 | Morgan Grebe | Physician Assistant | 1201 W Frank Ave, Lufkin, TX 75904-3357 | 2016-09-15 |
| 1083162473 | Memorial Health System of East Texas | Clinic/Center | 1201 W Frank Ave, Lufkin, TX 75904 | 2016-09-14 |
| 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 | 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 |
|---|---|---|---|---|
| 1346418738 | Garcia Heart Center Pllc | Specialist | 1111 W Frank Ave Ste 202, Lufkin, TX 75904-3308 | 2008-02-19 |
| 1083806020 | Stig Peitersen Md Pa | Specialist | 1111 W Frank Ave Ste 302, Lufkin, TX 75904-3323 | 2007-08-14 |
| 1497968556 | Francisco N Cardenas | Specialist | 1111 West Frank Ave, Ste 303, Lufkin, TX 75904-3303 | 2007-05-07 |
| 1063549715 | Stig Enggaard Peitersen | Specialist | 1111 West Frank Street, Lufkin, TX 75904 | 2007-02-28 |
| 1720121460 | Matthew J Rowley, M.d. P.a. | Specialist | 107 Christie Dr, Lufkin, TX 75904-5575 | 2007-02-14 |
| 1619031945 | Edward Domingue | Specialist | 409 Gaslight Boulevard, Lufkin, TX 75904-3170 | 2006-12-21 |
| 1427087071 | Prashant Kumar | Specialist | 409 Gaslight Blvd, Lufkin, TX 75904-3132 | 2006-07-03 |
| 1871538702 | Matthew Joseph Rowley | Specialist | 107 Christie Street, Lufkin, TX 75904-5575 | 2006-06-17 |
| 1124097399 | George William Newton | Specialist | 704 Gaslight Blvd, Lufkin, TX 75904-3153 | 2006-03-17 |
| 1861469512 | Michael Alan Waters | Specialist | 309 S. Medford Dr., Lufkin, TX 75901-5245 | 2006-03-01 |
| Find all providers in LUFKIN | ||||
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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.