MEDEVAL, LLC (NPI# 1740548346) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740548346 |
| Entity Type | Organization |
| Organization Name | MEDEVAL, LLC |
| Practice Address |
5109 High Dr Texarkana TX 75503-0117 |
| Practice Telephone | 9032937093 |
| Mailing Telephone | 9032937093 |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2018-01-04 |
| Authorized Official Name | DEWITT CHARLES FORTENBERRY (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 9036145357 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | L8691 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
5109 HIGH DR |
| City | TEXARKANA |
| State | TX |
| Zip Code | 75503-0117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770049397 | Jeffery Nash | Nurse Practitioner | #4 Valley View Circle, Texarkana, TX 75503 | 2019-02-19 |
| 1821583501 | Brandy D Acker | Psychologist | 3615 Richmond Rd, Texarkana, TX 75503 | 2018-06-26 |
| 1366935066 | Samantha Lee Harris | Nurse Practitioner | 4116 Mcknight Rd, Texarkana, TX 75503 | 2018-06-07 |
| 1811416910 | Heather Alison Gerber | Nurse Practitioner | 5903 Brenda Street, Texarkana, TX 75503 | 2017-09-11 |
| 1952838682 | John Kyle Abney | Counselor | 4134 Mcknight Rd, Texarkana, TX 75503 | 2017-05-12 |
| 1699151514 | Piney Woods Er IIi LLC | Clinic/Center | 4102 Gibson Lane, Texarkana, TX 75503 | 2015-08-03 |
| 1609282433 | Colby Rebecca Pair | Physician Assistant | 2604 St. Michael Dr., Suite 310, Texarkana, TX 75503 | 2014-07-01 |
| 1265842496 | Healthcare Express, LLP | Clinic/Center | 3513 Richmond Rd, Texarkana, TX 75503 | 2014-04-28 |
| 1134540628 | Eagle Dental Center of Texarkana Pllc | Dentist | 4009 Moores Ln, Texarkana, TX 75503 | 2013-12-30 |
| 1326481664 | Juancarlo S. Pascual | Family Medicine | 604 St. Michael Dr, Suite 340, Texarkana, TX 75503 | 2013-04-16 |
| Find all providers in zip 75503 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134313802 | Valerie Ann Smith | General Practice | 1400 College Dr Ste 204, Texarkana, TX 75503-3575 | 2007-09-05 |
| 1629464680 | Raman Dhillon | General Practice | 2600 Saint Michael Dr, Texarkana, TX 75503-5220 | 2015-04-07 |
| 1174947618 | Christus Health Ark-la-tex | General Practice | 2600 Saint Michael Dr, Texarkana, TX 75503-5220 | 2014-02-04 |
| 1710301254 | Christus Health Ark-la-tex | General Practice | 2400 Saint Michael Dr, Texarkana, TX 75503-2374 | 2014-02-04 |
| 1740603521 | Christus Health Ark-la-tex | General Practice | 2604 Saint Michael Dr, 1st Floor, Texarkana, TX 75503-2379 | 2014-01-29 |
| 1972820827 | Express Care | General Practice | 5483 Summerhill Rd, Texarkana, TX 75503-4608 | 2010-04-30 |
| 1558511261 | Lori Lynn Douglas | General Practice | 3510 Richmond Rd, Suite C, Texarkana, TX 75503-0714 | 2008-09-30 |
| 1184802381 | Ronald David Rush | General Practice | 5503 N Stateline Ave, Texarkana, TX 75503-5303 | 2008-02-11 |
| 1568657393 | Mark E Sutherland M.d.,p.a | General Practice | 2717 Summerhill Rd, Texarkana, TX 75503-3957 | 2007-09-14 |
| 1184623266 | Christus Health Ark-la-tex | General Practice | 1400 College Dr, Suite 202, Texarkana, TX 75503-3579 | 2005-07-20 |
| 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.