Luis A Destarac Maselli (NPI# 1477513927, PAC ID# 3375504251) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PULMONARY DISEASE.
| Nation Provider ID (NPI) | 1477513927 |
| PAC ID by PECOS | 3375504251 |
| Professional Enrollment ID | I20041023000284 |
| Full Name | Luis A Destarac Maselli |
| Organization Legal Name | ETMC PHYSICIAN GROUP, INC. |
| Address |
2701 Us Hwy 271 N Ut Health East Texas Physicians Pittsburg TX 75686-4289 |
| Phone Number | 9039465442 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1991 |
| Primary Specialty | PULMONARY DISEASE |
| Group Practice PAC ID | 4486915600 |
| Number of Group Practice Members | 206 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 450083 | EAST TEXAS MEDICAL CENTER |
| 450102 | MOTHER FRANCES HOSPITAL |
| 451380 | EAST TEXAS MEDICAL CENTER QUITMAN |
| 450389 | EAST TEXAS MEDICAL CENTER ATHENS |
| 450236 | CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS |
| Address | Phone | Organization |
|---|---|---|
| 18118 Fm 344, Ut Health East Texas Physicians, Flint, TX 75762-6010 | 9038253292 | ETMC PHYSICIAN GROUP, INC. |
| 2701 Us Hwy 271 N, Ut Health East Texas Physicians, Pittsburg, TX 75686-4289 | 9039465442 | ETMC PHYSICIAN GROUP, INC. |
| 117 N Winnsboro St, Ut Health East Texas Physicians, Quitman, TX 75783-2144 | 9037636220 | ETMC PHYSICIAN GROUP, INC. |
| 709 E Goode St, Quitman, TX 75783-1623 | ETMC PHYSICIAN GROUP, INC. | |
| 1000 S Beckham Ave, Tyler, TX 75701-1908 | 9035905611 | ETMC PHYSICIAN GROUP, INC. |
| 912 S Fleishel Ave, Ut Health East Texas Physicians, Tyler, TX 75701-2018 | 9035926901 | ETMC PHYSICIAN GROUP, INC. |
| 912 S Fleishel Ave, Tyler, TX 75701-2018 | 9035926901 | PULMONARY SPECIALISTS OF TYLER |
| Organization Legal Name | ETMC PHYSICIAN GROUP, INC. |
| Physicians | 178 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Varalaxmi Nannaka | Pulmonary Disease | Etmc Physician Group, Inc. | 305 Cottage Rd, Carthage, TX 75633-1511 |
| Betsy Jill Chappell | Nurse Practitioner | Etmc Physician Group, Inc. | 406 E Hwy 243, Canton, TX 75103-2409 |
| Andrea Corine Cooley | Cardiac Surgery | Etmc Physician Group, Inc. | 1000 E 5th St, Suite 400, Tyler, TX 75701-3362 |
| Jason S Murry | General Surgery | Etmc Physician Group, Inc. | 1020 E Idel St, Ut Health East Texas Physicians, Tyler, TX 75701-2024 |
| Ronald J Pinkenburg | Ophthalmology | Etmc Physician Group, Inc. | 16911 Village Lake Dr, Lindale, TX 75771-5065 |
| Francine Fraser Mccain | Obstetrics/gynecology | Etmc Physician Group, Inc. | 1336 S Palestine St, Athens, TX 75751-3621 |
| Lori Fuquay | Nurse Practitioner | Etmc Physician Group, Inc. | 601 Hwy 110 N, Suite O, Whitehouse, TX 75791-3037 |
| Michael Jason Chastant | Nurse Practitioner | Etmc Physician Group, Inc. | 2608 Mcdonald Rd, Tyler, TX 75701-5934 |
| Joseph Leonard Decarlo | Urology | Etmc Physician Group, Inc. | 911 S Beckham Ave, Tyler, TX 75701-1907 |
| Eric D Reed | Otolaryngology | Etmc Physician Group, Inc. | 301 W 19th St, Mt Pleasant, TX 75455-2322 |
| Street Address |
2701 US HWY 271 N UT HEALTH EAST TEXAS PHYSICIANS |
| City | PITTSBURG |
| State | TX |
| Zip | 75686-4289 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Steven F Griffin | Family Medicine | Pittsburg Hospital LLC | 2701 Us Hwy 271 N, Pittsburg, TX 75686-4289 |
| Kimberly Brown | Nurse Practitioner | Etmc Physician Group, Inc. | 2701 Us Hwy 271 N, Ut Health East Texas Physicians, Pittsburg, TX 75686-4289 |
| Kish L Carlton | Family Medicine | Etmc Physician Group, Inc. | 2701 Us Hwy 271 N, Ut Health East Texas Physicians, Pittsburg, TX 75686-4289 |
| Tonya J Youngblood | Family Medicine | Etmc Physician Group, Inc. | 2701 Us Hwy 271 N, Ut Health East Texas Physicians, Pittsburg, TX 75686-4289 |
| Betty L Vale | Nurse Practitioner | Etmc Physician Group, Inc. | 2701 Us Hwy 271 N, Ut Health East Texas Physicians, Pittsburg, TX 75686-4289 |
| David Irwin Jones | Critical Care (intensivists) | Etmc Physician Group, Inc. | 2701 Us Hwy 271 N, Ut Health East Texas Physicians, Pittsburg, TX 75686-4289 |
| James R Vanderburg Iii | Obstetrics/gynecology | Etmc Physician Group, Inc. | 2701 Us Hwy 271 N, Ut Health East Texas Physicians, Pittsburg, TX 75686-4289 |
| Blair R Macbeath | General Practice | Pittsburg Hospital LLC | 2701 Us Hwy 271 N, Pittsburg, TX 75686-4289 |
| Keith E James | Certified Registered Nurse Anesthetist (crna) | Pittsburg Hospital LLC | 2701 Us Hwy 271 N, Pittsburg, TX 75686-4289 |
| Maria M Crompton | Family Medicine | Etmc Physician Group, Inc. | 2701 Us Hwy 271 N, Ut Health East Texas Physicians, Pittsburg, TX 75686-4289 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cherie Jean Mcgahee | Clinical Social Worker | 156 Quitman St, Pittsburg, TX 75686-1350 | |
| Beverly K Spearman | Optometry | Beverly K Robertson Od PC | 135 Quitman St, Pittsburg, TX 75686-1359 |
| Jessica L Richardson | Optometry | Beverly K Robertson Od PC | 135 Quitman St, Pittsburg, TX 75686-1359 |
| Garth Johnson | Chiropractic | 210 Lafayette St, Pittsburg, TX 75686-1630 | |
| Evan Willian | Chiropractic | 210 Lafayette Park, Pittsburg, TX 75686-1630 | |
| Dia Dodson-hardeman | Chiropractic | 311 Lafayette St, Pittsburg, TX 75686-1709 | |
| Qasim Nayeem | Internal Medicine | Tanager Emergency Physicians Pllc | 2701 Us Hwy 271 N, Ut Health Pittsburg, Pittsburg, TX 75686-4289 |
| Scott J Lamb | Physical Medicine and Rehabilitation | Etmc Physician Group, Inc. | 2701 Us Hwy 271 N, Ut Health East Texas Physicians, Pittsburg, TX 75686-4289 |
| Leslie E Tingle | Family Medicine | Pittsburg Hospital LLC | 2701 Us Hwy 271 N, Pittsburg, TX 75686-4289 |
| William C Conner | Family Medicine | Etmc Physician Group, Inc. | 2701 Us Hwy 271 N, Ut Health East Texas Physicians, Pittsburg, TX 75686-4289 |
| Find all physicians in zip 75686 | |||
| City | PITTSBURG |
| Zip Code | 75686 |
| Specialty | PULMONARY DISEASE |
| City + Specialty | PITTSBURG + PULMONARY DISEASE |
Please comment or provide details below to improve the information on Luis A Destarac Maselli.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.