NACOGDOCHES INTERNAL MEDICINE PLLC (NPI# 1609319458) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609319458 |
| Entity Type | Organization |
| Organization Name | NACOGDOCHES INTERNAL MEDICINE PLLC |
| Practice Address |
412 North St Ste E Nacogdoches TX 75961 |
| Mailing Address |
412 North St Ste E Nacogdoches TX 75961-5070 |
| Practice Telephone | 9365601812 |
| Practice Fax Number | 9365603070 |
| Mailing Telephone | 9365601812 |
| Mailing Fax Number | 9365603070 |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2018-05-21 |
| Authorized Official Name | DR. WALTER BRAD WILSON (PRESIDENT) |
| Authorized Official Telephone | 9365601812 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | H3293 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 113906502 | 05 | |
| TX | 377530601 | 05 |
| Street Address |
412 NORTH ST STE E |
| City | NACOGDOCHES |
| State | TX |
| Zip Code | 75961 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679530356 | Walter Brad Wilson | Internal Medicine | 412 North St Ste E, Nacogdoches, TX 75961 | 2006-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578195582 | Trevon Jerrell Jones | Specialist/Technologist | 13010 Sfa Station, Nacogdoches, TX 75961 | 2020-02-07 |
| 1275014094 | Connie Nicole Hamner | Licensed Vocational Nurse | 214 Cr 387, Nacogdoches, TX 75961 | 2018-08-29 |
| 1689175804 | Barbara Stracener | Registered Nurse | 234 Grove Lane, Nacogdoches, TX 75961 | 2018-02-22 |
| 1710425541 | St.alyssamedical Center | Clinic/Center | 1303 N. Mound Street, Nacogdoches, TX 75961 | 2017-01-31 |
| 1972982866 | Deanna Ellen Bishop | Nurse Practitioner | 1309 S. University Dr, East Texas Community Health Services, Inc., Nacogdoches, TX 75961 | 2015-05-25 |
| 1659798155 | Dr. Ronnie Hancock Family Dentistry, Pllc | Dental Hygienist | 1302 Raguet Street, Nacogdoches, TX 75961 | 2014-03-21 |
| 1205095585 | Chris R Chambers | Surgery | 1018 N Mound St Ste 106, Nacogdoches, TX 75961 | 2008-06-03 |
| 1972790285 | Assisted Living Concepts Inc | Assisted Living Facility | 901 Oakview Drive, Nacogdoches, TX 75961 | 2007-10-01 |
| 1356492151 | James Knox Dowling | Pediatrics | 2106 N. Raguet, Nacogdoches, TX 75961 | 2007-01-16 |
| 1487704441 | Flamen Ball | Pediatrics | 2106 North Raguet St., Nacogdoches, TX 75961 | 2007-01-11 |
| Find all providers in zip 75961 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 |
|---|---|---|---|---|
| 1265060263 | David L. Duke IIi, Md Pllc | Internal Medicine | 1216 Raguet St, Nacogdoches, TX 75961-4228 | 2020-03-27 |
| 1235661018 | David Vinther | Internal Medicine | 409 Russell Blvd Ste D, Nacogdoches, TX 75965-1248 | 2017-03-30 |
| 1952673287 | Olufemi Oladele-ajose Md PC | Internal Medicine | 4848 Ne Stallings Dr Ste 103, Nacogdoches, TX 75965-1208 | 2012-02-01 |
| 1376857268 | Xiomara Velazco, M.d. P.a. | Internal Medicine | 4800 Ne Stallings Dr., Suite 1500, Nacogdoches, TX 75965-1207 | 2010-08-03 |
| 1902957244 | Mathews Lal George | Internal Medicine | 4848 Ne Stallings Dr Ste 207, Nacogdoches, TX 75965-1266 | 2007-01-15 |
| 1861541211 | Scott S Oh | Internal Medicine | 1329 N University Dr Ste E5, Nacogdoches, TX 75961-4226 | 2007-01-08 |
| 1255492211 | David L Duke IIi | Internal Medicine | 1216 Raguet, Nacogdoches, TX 75961-4228 | 2006-12-13 |
| 1770660771 | Patrick G Taylor | Internal Medicine | 1001 North Mound, Nacogdoches, TX 75961 | 2006-11-01 |
| 1538185517 | Richard Lynn Baker | Internal Medicine | 1301 Raguet St, Nacogdoches, TX 75961-4249 | 2006-07-14 |
| 1851326607 | Joseph Earl Davis | Internal Medicine | 1320 N University Dr, Nacogdoches, TX 75961-4269 | 2006-07-11 |
| Find all providers in NACOGDOCHES | ||||
| City | NACOGDOCHES |
| Zip Code | 75961 |
Please comment or provide details below to improve the information on NACOGDOCHES INTERNAL MEDICINE PLLC.
| 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.