PEDIATRIC BEHAVIORAL SPECIALIST OF EAST TEXAS, LLP (NPI# 1588906341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588906341 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC BEHAVIORAL SPECIALIST OF EAST TEXAS, LLP |
| Practice Address |
205 Gene Samford Dr Lufkin TX 75904-3359 |
| Practice Telephone | 9366342214 |
| Practice Fax Number | 9366399660 |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2013-03-20 |
| Authorized Official Name | MR. JEFFREY GLASS (DR/OWNER) |
| Authorized Official Telephone | 9366342214 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
G1593 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
205 GENE SAMFORD DR |
| City | LUFKIN |
| State | TX |
| Zip Code | 75904-3359 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023120136 | Jeffrey L Glass | Pediatrics | 205 Gene Samford Dr, Lufkin, TX 75904 | 2006-08-31 |
| 1033638929 | The Children's Clinic Rusk Pllc | Pediatrics | 205 Gene Samford Dr, Lufkin, TX 75904-3359 | 2017-09-12 |
| 1881799138 | Melissa H Handley | Pediatrics | 205 Gene Samford Dr, Lufkin, TX 75904 | 2006-09-13 |
| 1699870949 | Ghazala B Khan | Pediatrics | 205 Gene Samford Dr, Lufkin, TX 75904 | 2006-09-13 |
| 1508961855 | Childrens Clinic of Lufkin Pa | Pediatrics | 205 Gene Samford Dr, Lufkin, TX 75904 | 2006-09-13 |
| 1811009939 | Cristina M Graves | Pediatrics | 205 Gene Samford Dr, Lufkin, TX 75904 | 2006-08-31 |
| 1114039138 | George S Fidone | Pediatrics | 205 Gene Samford Dr, Lufkin, TX 75904 | 2006-08-31 |
| 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 | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861090243 | Ridgewood Psychiatry Pllc | Psychiatry & Neurology | 832 Ridgewood St, Brownsville, TX 78520 | 2020-10-16 |
| 1013525591 | El Paso Healthyminds Psychiatry, Pllc | Psychiatry & Neurology | 509 Rosinante Rd, El Paso, TX 79922-2224 | 2020-07-21 |
| 1073131686 | Nishan D. Adihetty Md, Pllc | Psychiatry & Neurology | 2219 Sawdust Rd Ste 1004, Spring, TX 77380-2580 | 2020-07-09 |
| 1063039535 | Sun Psychiatry Pllc | Psychiatry & Neurology | 12217 Sitting Bull Dr, El Paso, TX 79936-7891 | 2020-07-01 |
| 1942839113 | Fort Physicians & Professionals Pllc | Psychiatry & Neurology | 7140 Oakmont Boulevard, Fort Worth, TX 76132 | 2020-04-08 |
| 1720613532 | Ferruzzi Psychiatric Services, Pllc | Psychiatry & Neurology | 13409 Nw Military Hwy Ste 310, Shavano Park, TX 78231-1865 | 2020-03-12 |
| 1184276818 | Cesar Alejandro Soutullo Esperon | Psychiatry & Neurology | Ut Health, Department of Psychiatry, 1941 East Road, Houston, TX 77054-6010 | 2019-07-12 |
| 1881255594 | Aditya Sharma, Pllc | Psychiatry & Neurology | 4510 Medical Center Dr Ste 208, Mckinney, TX 75069-1602 | 2019-06-24 |
| 1154851590 | Stat Md Pllc | Psychiatry & Neurology | 2710 Sunset Strip Ste C, Greenville, TX 75402-3848 | 2017-06-18 |
| 1336693043 | Cognitive Psychiatry Pa | Psychiatry & Neurology | 1029 Highway 6 N, Ste 650-181, Houston, TX 77079-1043 | 2016-08-10 |
| 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.