| Longview Wellness Center, Inc | |
|
1107 E Marshall Ave Longview TX 75601-5602 | |
| (903) 758-2610 | |
| (903) 758-3124 |
| Full Name | Longview Wellness Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1107 E Marshall Ave, Longview, Texas |
| Authorized Official Name and Position | Timothy Chad Jones (CEO) |
| Authorized Official Contact | 9037582610 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Longview Wellness Center, Inc 1107 E Marshall Ave Longview TX 75601-5602 Ph: (903) 758-2610 | Longview Wellness Center, Inc 1107 E Marshall Ave Longview TX 75601-5602 Ph: (903) 758-2610 |
| NPI Number | 1942269493 |
|---|---|
| Provider Enumeration Date | 03/22/2006 |
| Last Update Date | 11/14/2025 |
| Medicare PECOS PAC ID | 1254367766 |
|---|---|
| Medicare Enrollment ID | O20050714001046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942269493 | NPI | - | NPPES |
| 081382603 | Medicaid | TX | |
| 111796203 | Medicaid | TX | |
| 111796204 | Medicaid | TX | |
| 180330601 | Medicaid | TX | |
| 111796201 | Medicaid | TX | |
| 183824501 | Medicaid | TX | |
| 081382602 | Medicaid | TX |
| Provider Name | Eleazar Vera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407822299 PECOS PAC ID: 2062409923 Enrollment ID: I20040430000732 |
| Provider Name | Jerome Clayton Young |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518958230 PECOS PAC ID: 1850382821 Enrollment ID: I20040519000757 |
| Provider Name | Annette O Okpeki |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699774489 PECOS PAC ID: 0648261099 Enrollment ID: I20040524000406 |
| Provider Name | Janet Kelley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225005531 PECOS PAC ID: 8527041193 Enrollment ID: I20040612000698 |
| Provider Name | Donna C Britton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568454569 PECOS PAC ID: 4486638087 Enrollment ID: I20040614000171 |
| Provider Name | Sabrina Benefield Castle |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023085925 PECOS PAC ID: 4880664614 Enrollment ID: I20040729000284 |
| Provider Name | Melissa S Slovak Tucker |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1477540003 PECOS PAC ID: 7214909696 Enrollment ID: I20040806000852 |
| Provider Name | James E Mauldin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1306813662 PECOS PAC ID: 3870547813 Enrollment ID: I20050311000522 |
| Provider Name | Lynn M Brazell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356318273 PECOS PAC ID: 7113972902 Enrollment ID: I20050315000246 |
| Provider Name | Francis J Tibiletti |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245207638 PECOS PAC ID: 5890740237 Enrollment ID: I20050317000875 |
| Provider Name | Wendy Markowitz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1659477222 PECOS PAC ID: 3870538754 Enrollment ID: I20050621001255 |
| Provider Name | Mark L Lobaugh |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1710984091 PECOS PAC ID: 7719874742 Enrollment ID: I20050711000520 |
| Provider Name | Yasser F Zeid |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1548369424 PECOS PAC ID: 1850325663 Enrollment ID: I20050921000713 |
| Provider Name | Arlene Faye Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659395911 PECOS PAC ID: 3476578527 Enrollment ID: I20051017000342 |
| Provider Name | Roy A Mcclintock |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437217494 PECOS PAC ID: 2769446293 Enrollment ID: I20051123000403 |
| Provider Name | Gloria S Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831237775 PECOS PAC ID: 9638191166 Enrollment ID: I20051228000328 |
| Provider Name | Angela D Houghton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1407840606 PECOS PAC ID: 7911914551 Enrollment ID: I20060307000636 |
| Provider Name | Charles Keith Grisham |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356531180 PECOS PAC ID: 1355351040 Enrollment ID: I20060425000744 |
| Provider Name | Anita J Chin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730110446 PECOS PAC ID: 3375547805 Enrollment ID: I20060914000108 |
| Provider Name | Doreen A Moser |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1194721944 PECOS PAC ID: 3274531918 Enrollment ID: I20061113000534 |
| Provider Name | Michael E Esedebe |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952410037 PECOS PAC ID: 1850391871 Enrollment ID: I20061221000515 |
| Provider Name | Ricky A Paul |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073699500 PECOS PAC ID: 3577546696 Enrollment ID: I20070222000254 |
| Provider Name | John H Shum |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861616047 PECOS PAC ID: 1153421128 Enrollment ID: I20070705000586 |
| Provider Name | Jaclyn P Gilliam |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1154483113 PECOS PAC ID: 7911960117 Enrollment ID: I20071005000428 |
| Provider Name | Robert B Thomas |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740310036 PECOS PAC ID: 2365529252 Enrollment ID: I20080402000418 |
| Provider Name | Carrie D Hinton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912914151 PECOS PAC ID: 6709956709 Enrollment ID: I20080603000345 |
| Provider Name | Kim M Schaus |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851445340 PECOS PAC ID: 6800957929 Enrollment ID: I20081209000055 |
| Provider Name | Annmarie M Ledley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1295731016 PECOS PAC ID: 0749261840 Enrollment ID: I20090604000407 |
| Provider Name | Ralph J Turner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1013950997 PECOS PAC ID: 2961436928 Enrollment ID: I20090727000065 |
| Provider Name | Paul L Lin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497722714 PECOS PAC ID: 7113066200 Enrollment ID: I20091202000737 |
| Provider Name | Margaret L Morton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1972570539 PECOS PAC ID: 5294874384 Enrollment ID: I20091202000746 |
| Provider Name | Robert M Wheeler |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851368831 PECOS PAC ID: 0840293403 Enrollment ID: I20091202000748 |
| Provider Name | Linda C Boggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164499661 PECOS PAC ID: 9830238732 Enrollment ID: I20091207000415 |
| Provider Name | Christopher A Yancey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346217783 PECOS PAC ID: 2163562752 Enrollment ID: I20091211000347 |
| Provider Name | Philip Scott Hunter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700893039 PECOS PAC ID: 8628110343 Enrollment ID: I20100120000155 |
| Provider Name | Bernardine Amadi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487885901 PECOS PAC ID: 1850421280 Enrollment ID: I20100611000297 |
| Provider Name | Ramon G Villafria |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619997319 PECOS PAC ID: 8426019084 Enrollment ID: I20100618000689 |
| Provider Name | Mark Allison Little |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1699772863 PECOS PAC ID: 7012014707 Enrollment ID: I20100805001032 |
| Provider Name | Christopher Norman Mason |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215924832 PECOS PAC ID: 7315919552 Enrollment ID: I20100817000076 |
| Provider Name | John M Mckenzie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366547846 PECOS PAC ID: 5395860704 Enrollment ID: I20100908001042 |
| Provider Name | Joseph L Petty |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1649461211 PECOS PAC ID: 1557486404 Enrollment ID: I20100915000587 |
| Provider Name | Rachel Ann Everson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992936603 PECOS PAC ID: 0648469148 Enrollment ID: I20110114000412 |
| Provider Name | Marcy J Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548229990 PECOS PAC ID: 6709062417 Enrollment ID: I20110513000529 |
| Provider Name | Sylyna G Kennedy |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1750421095 PECOS PAC ID: 6507034782 Enrollment ID: I20110713000503 |
| Provider Name | Patricia Brooke Simmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346556420 PECOS PAC ID: 0547430928 Enrollment ID: I20110822000262 |
| Provider Name | Aric C Gillen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720285158 PECOS PAC ID: 3870765738 Enrollment ID: I20111019000245 |
| Provider Name | Thiendella Diagne |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538330352 PECOS PAC ID: 5799851937 Enrollment ID: I20111116000900 |
| Provider Name | Dennis C Eisenberg |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851382154 PECOS PAC ID: 1052570587 Enrollment ID: I20120302000045 |
| Provider Name | Omar Robert Sarmini |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417945262 PECOS PAC ID: 6709814338 Enrollment ID: I20120314000330 |
| Provider Name | Harry P Froeschke |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1710975560 PECOS PAC ID: 8628006251 Enrollment ID: I20120412000317 |
| Provider Name | Ghassan N Fanous |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1013021146 PECOS PAC ID: 3375513872 Enrollment ID: I20120416000347 |
| Provider Name | Felicia K Coleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609132521 PECOS PAC ID: 9133381924 Enrollment ID: I20120423000755 |
| Provider Name | Wendy Mckinnon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790051548 PECOS PAC ID: 7517113400 Enrollment ID: I20120808000743 |
| Provider Name | T. Lynne Haygood-kane |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750394904 PECOS PAC ID: 7810885514 Enrollment ID: I20120910000405 |
| Provider Name | Julia Ann Russell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982954566 PECOS PAC ID: 6406005131 Enrollment ID: I20121012000362 |
| Provider Name | Javier Garcia |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932309838 PECOS PAC ID: 8729168695 Enrollment ID: I20130207000398 |
| Provider Name | Alexandra Dionne Kittrell |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1801134085 PECOS PAC ID: 2769629252 Enrollment ID: I20130430000237 |
| Provider Name | Khoshunda M Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093051872 PECOS PAC ID: 0941443873 Enrollment ID: I20130826000270 |
| Provider Name | Ngan K To |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1902239965 PECOS PAC ID: 7214170539 Enrollment ID: I20130905000170 |
| Provider Name | Kristi L Saxon |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1922068972 PECOS PAC ID: 7911943691 Enrollment ID: I20131022001413 |
| Provider Name | Jeffrey William Sewell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740288430 PECOS PAC ID: 7719908441 Enrollment ID: I20140529000330 |
| Provider Name | Vanessa Renee Neiman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326356130 PECOS PAC ID: 5294955191 Enrollment ID: I20140926001950 |
| Provider Name | Jennifer N Smith |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1396151817 PECOS PAC ID: 7810116688 Enrollment ID: I20141124001700 |
| Provider Name | Charlene Carter |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992108120 PECOS PAC ID: 1254653231 Enrollment ID: I20141202000648 |
| Provider Name | Monica G Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639574098 PECOS PAC ID: 2860301512 Enrollment ID: I20141229000659 |
| Provider Name | Nora Eades |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053712547 PECOS PAC ID: 4284952821 Enrollment ID: I20150413000300 |
| Provider Name | Tracy Lanell Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215353651 PECOS PAC ID: 0648592741 Enrollment ID: I20150806012033 |
| Provider Name | Marcus D Turney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144610106 PECOS PAC ID: 5991007577 Enrollment ID: I20160114000142 |
| Provider Name | James Harley Dozier |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457533101 PECOS PAC ID: 3476611419 Enrollment ID: I20160224001036 |
| Provider Name | Dana Lynn Shields |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1083073803 PECOS PAC ID: 1951606862 Enrollment ID: I20160301001317 |
| Provider Name | Graham Oliver Weaver |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811156227 PECOS PAC ID: 4587795273 Enrollment ID: I20160322000734 |
| Provider Name | Zareh H Khachikian |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215084603 PECOS PAC ID: 3971698069 Enrollment ID: I20160504002547 |
| Provider Name | Edward Clark |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730294232 PECOS PAC ID: 1658661525 Enrollment ID: I20160606000494 |
| Provider Name | Charles S Newlin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639437247 PECOS PAC ID: 8820382963 Enrollment ID: I20160811001687 |
| Provider Name | Molly K Mcstravick |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780940452 PECOS PAC ID: 7618264482 Enrollment ID: I20160921002266 |
| Provider Name | Ebenezer A Nii-moi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396930376 PECOS PAC ID: 9931299062 Enrollment ID: I20161205000792 |
| Provider Name | Gabrielle Misenheimer |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1356715981 PECOS PAC ID: 4587944681 Enrollment ID: I20161207000841 |
| Provider Name | Penny Shavers Blake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215489935 PECOS PAC ID: 1254613615 Enrollment ID: I20170119000245 |
| Provider Name | Jacqueline Moran Weber |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1689113060 PECOS PAC ID: 4880979590 Enrollment ID: I20170321000482 |
| Provider Name | Wendy M Fopay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851845366 PECOS PAC ID: 4587949607 Enrollment ID: I20170331001498 |
| Provider Name | Jimmy S Ellis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609891795 PECOS PAC ID: 5395805386 Enrollment ID: I20170425000330 |
| Provider Name | Jocelan Ramsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659468262 PECOS PAC ID: 0042586406 Enrollment ID: I20171030003330 |
| Provider Name | Sonja Edmonds |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487679023 PECOS PAC ID: 5698959997 Enrollment ID: I20171121000410 |
| Provider Name | Laura Childress |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104328947 PECOS PAC ID: 8325301211 Enrollment ID: I20180405001488 |
| Provider Name | Richard A Joos |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336148394 PECOS PAC ID: 8628383932 Enrollment ID: I20180613002296 |
| Provider Name | Carin Lynnae Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891288742 PECOS PAC ID: 7113274481 Enrollment ID: I20180717003984 |
| Provider Name | Obiloh E Egu |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1407831233 PECOS PAC ID: 5092810085 Enrollment ID: I20180917000341 |
| Provider Name | Raymond Barron |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1851821920 PECOS PAC ID: 5698012326 Enrollment ID: I20190219000226 |
| Provider Name | Angela Caren Fritz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780140194 PECOS PAC ID: 4587905609 Enrollment ID: I20190417002357 |
| Provider Name | Tiffany Yvette Gardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790257392 PECOS PAC ID: 8426391319 Enrollment ID: I20190516000851 |
| Provider Name | Elizabeth Ann Heeb Tidwell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1386023968 PECOS PAC ID: 3476834573 Enrollment ID: I20190615000140 |
| Provider Name | Jennifer Nicole Skiles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134784838 PECOS PAC ID: 9335472794 Enrollment ID: I20190618000784 |
| Provider Name | Vijaya Lakshmi Mandalapu |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730407818 PECOS PAC ID: 5294991022 Enrollment ID: I20190816001623 |
| Provider Name | Amit Bhavsar |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1427131986 PECOS PAC ID: 7315379443 Enrollment ID: I20191112000470 |
| Provider Name | Marissa A Kuykendall |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1992356588 PECOS PAC ID: 5294168860 Enrollment ID: I20191212001399 |
| Provider Name | Tracy Hunter Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740405711 PECOS PAC ID: 8628406170 Enrollment ID: I20200316000478 |
| Provider Name | Brian Ashford |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265622732 PECOS PAC ID: 2769664127 Enrollment ID: I20200428000422 |
| Provider Name | Kimberly Denise Prince |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780205427 PECOS PAC ID: 9739500950 Enrollment ID: I20200526001893 |
| Provider Name | Russell F Stanley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356797740 PECOS PAC ID: 1355633488 Enrollment ID: I20201013002007 |
| Provider Name | Kelly D Royce |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1619501608 PECOS PAC ID: 5294148540 Enrollment ID: I20210106002119 |
| Provider Name | Rana Skaf |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871562231 PECOS PAC ID: 0648224279 Enrollment ID: I20210302001341 |
| Provider Name | Carol Lazell |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1487808457 PECOS PAC ID: 8426459512 Enrollment ID: I20210628000364 |
| Provider Name | Roxanne A Lamarre |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881124642 PECOS PAC ID: 4183026206 Enrollment ID: I20210713000924 |
| Provider Name | Sandya Athigaman |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1295347326 PECOS PAC ID: 7911304829 Enrollment ID: I20210920002707 |
| Provider Name | Ashley M Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174292056 PECOS PAC ID: 8820495302 Enrollment ID: I20210927000800 |
| Provider Name | Nermine R Rofael |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1114689890 PECOS PAC ID: 3971991381 Enrollment ID: I20211103001924 |
| Provider Name | Jacqueline Mojica |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134837792 PECOS PAC ID: 9638548704 Enrollment ID: I20221212002203 |
| Provider Name | Misti Dawn Bryant Bradshaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306595020 PECOS PAC ID: 4880066950 Enrollment ID: I20230220000037 |
| Provider Name | Sandra Aguilar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083486989 PECOS PAC ID: 2567810666 Enrollment ID: I20231130000902 |
| Provider Name | Jeremiah R Taylor |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1366897183 PECOS PAC ID: 3577911544 Enrollment ID: I20231130004092 |
| Provider Name | Tasha Marie Tovar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982368809 PECOS PAC ID: 7315399755 Enrollment ID: I20240122001177 |
| Provider Name | Meliana Amazan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477201127 PECOS PAC ID: 9436592276 Enrollment ID: I20240208000857 |
| Provider Name | Nina B Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417735325 PECOS PAC ID: 8820435431 Enrollment ID: I20240319000913 |
| Provider Name | Emili Lim |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164993382 PECOS PAC ID: 6709237985 Enrollment ID: I20240321002454 |
| Provider Name | Mary Lippencott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407393325 PECOS PAC ID: 7517318736 Enrollment ID: I20240321004122 |
| Provider Name | Jana Brown |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235200080 PECOS PAC ID: 3476903030 Enrollment ID: I20240326002259 |
| Provider Name | Jessica Bright |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548778426 PECOS PAC ID: 3577914787 Enrollment ID: I20240326003441 |
| Provider Name | Brenda K Greer-jennings |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508426727 PECOS PAC ID: 1254771843 Enrollment ID: I20240430001636 |
| Provider Name | Robert C Witt |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1326041815 PECOS PAC ID: 4688973373 Enrollment ID: I20240515000824 |
| Provider Name | Margarita O'neal |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780382846 PECOS PAC ID: 9931641420 Enrollment ID: I20240612001892 |
| Provider Name | Jamie Doan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992478820 PECOS PAC ID: 3577006964 Enrollment ID: I20240613001563 |
| Provider Name | Kristina P Nguyen |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1851080949 PECOS PAC ID: 4981147659 Enrollment ID: I20240621003824 |
| Provider Name | Dean Salomon Garza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568079473 PECOS PAC ID: 7911313770 Enrollment ID: I20240625002045 |
| Provider Name | Candy Cole |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215407416 PECOS PAC ID: 3476089145 Enrollment ID: I20241205002034 |
| Provider Name | Jennifer R Boynton |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1780712257 PECOS PAC ID: 4284883521 Enrollment ID: I20250108001008 |
| Provider Name | Monica D Fontenot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144042995 PECOS PAC ID: 6608304357 Enrollment ID: I20250317000185 |
Carebridge Medteam, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 515 N 3rd St, Longview, TX 75601 Phone: 903-475-3474 | |
Special Health Resources For Texas, Incorporated Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 409 N 6th St, Longview, TX 75601 Phone: 903-501-1747 Fax: 903-758-2283 | |
Family Focus Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 101b Woodbine Pl, Longview, TX 75601 Phone: 903-236-6222 Fax: 903-236-0808 | |
Whole Counseling, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 411 N Fredonia St Ste 114, Longview, TX 75601 Phone: 720-404-5682 | |
Gail D Stockman Md, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 815 N 4th St, Suite A, Longview, TX 75601 Phone: 406-253-3430 | |
Prime Care Managers, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4002 Technology Ctr, Longview, TX 75605 Phone: 903-247-0525 Fax: 903-230-2709 | |
Careatc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 448 E Loop 281, Longview, TX 75605 Phone: 430-267-2093 |