| Northeast Texas Intensivists, Pllc | |
|
700 E Marshall Ave Longview TX 75601-5580 | |
| (903) 315-2000 | |
| Not Available |
| Full Name | Northeast Texas Intensivists, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 700 E Marshall Ave, Longview, Texas |
| Authorized Official Name and Position | Michael Pawlowski (OWNER/PRESIDENT) |
| Authorized Official Contact | 3376091221 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Texas Intensivists, Pllc 200 Corporate Blvd Lafayette LA 70508-3870 Ph: (800) 893-9698 | Northeast Texas Intensivists, Pllc 700 E Marshall Ave Longview TX 75601-5580 Ph: (903) 315-2000 |
| NPI Number | 1497536676 |
|---|---|
| Provider Enumeration Date | 10/12/2023 |
| Last Update Date | 06/12/2024 |
| Medicare PECOS PAC ID | 5092167528 |
|---|---|
| Medicare Enrollment ID | O20240119001805 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497536676 | NPI | - | NPPES |
| Provider Name | Song Md Hong |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1043311806 PECOS PAC ID: 9537129390 Enrollment ID: I20041015000296 |
| Provider Name | Baher M Elhalwagi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1235116393 PECOS PAC ID: 8325145709 Enrollment ID: I20070518000437 |
| Provider Name | Nikolay Azarov |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1093937948 PECOS PAC ID: 0446330989 Enrollment ID: I20080109000456 |
| Provider Name | Ryan R Gunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699940775 PECOS PAC ID: 2860564945 Enrollment ID: I20080707000444 |
| Provider Name | Eli Azzi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1770548786 PECOS PAC ID: 9032107602 Enrollment ID: I20081121000023 |
| Provider Name | Venkatesh Babu Donty |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1518168160 PECOS PAC ID: 6406906791 Enrollment ID: I20090608000483 |
| Provider Name | William Scott Cantwell |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1851592075 PECOS PAC ID: 4284799479 Enrollment ID: I20091209000404 |
| Provider Name | Mohammad K Khedr |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1427051705 PECOS PAC ID: 5496731341 Enrollment ID: I20100113000206 |
| Provider Name | Jacy L Retz |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1285667089 PECOS PAC ID: 5890883615 Enrollment ID: I20100831000888 |
| Provider Name | Muhammad A Siddiqui |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1689824443 PECOS PAC ID: 7214053297 Enrollment ID: I20100928000171 |
| Provider Name | Adam Jing-cheng Yu |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1437136520 PECOS PAC ID: 5799967121 Enrollment ID: I20110307000818 |
| Provider Name | R Kent Vandergriff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215230586 PECOS PAC ID: 1254515935 Enrollment ID: I20110404000539 |
| Provider Name | Carlton John Rojas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760770028 PECOS PAC ID: 7315119377 Enrollment ID: I20111017000641 |
| Provider Name | Jeremy Shane Locke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518214493 PECOS PAC ID: 4587813118 Enrollment ID: I20120925000816 |
| Provider Name | Delinda Wills |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063531804 PECOS PAC ID: 4880848118 Enrollment ID: I20130410000507 |
| Provider Name | Sam Eljammal |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1669604310 PECOS PAC ID: 3577694751 Enrollment ID: I20130830000473 |
| Provider Name | Suman K Sinha |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1114947900 PECOS PAC ID: 8628061397 Enrollment ID: I20140220001345 |
| Provider Name | Gautam Baskaran |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1679732549 PECOS PAC ID: 5799914313 Enrollment ID: I20140716001364 |
| Provider Name | Saima B Memon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952484339 PECOS PAC ID: 5294833141 Enrollment ID: I20150716002514 |
| Provider Name | Tyson E Becker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1205068111 PECOS PAC ID: 1951620541 Enrollment ID: I20160217000439 |
| Provider Name | Lisa Gamble |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1710998232 PECOS PAC ID: 5991779175 Enrollment ID: I20161031000417 |
| Provider Name | Matthew S Greene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942743547 PECOS PAC ID: 6305128240 Enrollment ID: I20170130000260 |
| Provider Name | Terri Lee Hoffman |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1871512137 PECOS PAC ID: 3577450733 Enrollment ID: I20170412001810 |
| Provider Name | Julius Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144769365 PECOS PAC ID: 7810265196 Enrollment ID: I20170608002298 |
| Provider Name | Steven H Hsu |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1164708772 PECOS PAC ID: 9234451188 Enrollment ID: I20170628003224 |
| Provider Name | Yordanos Habtegebriel |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1053699694 PECOS PAC ID: 5294055760 Enrollment ID: I20170801001565 |
| Provider Name | Pavan Irukulla |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1184860926 PECOS PAC ID: 7911062310 Enrollment ID: I20170809001944 |
| Provider Name | Matthew H Wilkerson |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1134566946 PECOS PAC ID: 3577707199 Enrollment ID: I20180208002016 |
| Provider Name | Oluwaseyi D Adejorin |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1770895252 PECOS PAC ID: 9638312820 Enrollment ID: I20180511001137 |
| Provider Name | Ehson Javaid |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1528351715 PECOS PAC ID: 3870813611 Enrollment ID: I20180712001803 |
| Provider Name | Mark W Smith |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1326111790 PECOS PAC ID: 1658465695 Enrollment ID: I20181029000934 |
| Provider Name | Allen Adams |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1700862794 PECOS PAC ID: 7517919053 Enrollment ID: I20181106000784 |
| Provider Name | Lalith P. Premachandra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083025530 PECOS PAC ID: 9931481926 Enrollment ID: I20181112000422 |
| Provider Name | Karina R Bartlett |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831518026 PECOS PAC ID: 1951683473 Enrollment ID: I20190607001369 |
| Provider Name | Jonathan Lewis Henderson |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1497910459 PECOS PAC ID: 5496995656 Enrollment ID: I20190624000879 |
| Provider Name | Leon L Tung |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1700171287 PECOS PAC ID: 7810111457 Enrollment ID: I20200204000821 |
| Provider Name | Eric Bradley Vogt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033739388 PECOS PAC ID: 1456772649 Enrollment ID: I20200526000461 |
| Provider Name | Vincente Nelson |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1306157110 PECOS PAC ID: 0345535977 Enrollment ID: I20210128002297 |
| Provider Name | Asghar Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922354174 PECOS PAC ID: 2062733009 Enrollment ID: I20210616000181 |
| Provider Name | Michael Patrick Hunter |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1386023471 PECOS PAC ID: 7810248853 Enrollment ID: I20210723000655 |
| Provider Name | Haley Nicole Fitzgerald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114598976 PECOS PAC ID: 7810393279 Enrollment ID: I20210909002713 |
| Provider Name | Brandi Ross-douglas |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1588779904 PECOS PAC ID: 0941205876 Enrollment ID: I20210930003000 |
| Provider Name | Murshed Nawaz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619533536 PECOS PAC ID: 9032441696 Enrollment ID: I20211005003372 |
| Provider Name | Pegan R Doss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487316626 PECOS PAC ID: 3375931876 Enrollment ID: I20211103001163 |
| Provider Name | Corey Jude Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730838905 PECOS PAC ID: 1850778911 Enrollment ID: I20220512000032 |
| Provider Name | Faisal Arif |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1891927810 PECOS PAC ID: 4284880881 Enrollment ID: I20220730000448 |
| Provider Name | Rashed A Alfarra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184078826 PECOS PAC ID: 8123312782 Enrollment ID: I20220815001622 |
| Provider Name | Ajit M Alexander |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1861888760 PECOS PAC ID: 8022313360 Enrollment ID: I20221003000028 |
| Provider Name | Kaylee Browning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073247516 PECOS PAC ID: 9537535687 Enrollment ID: I20221014002162 |
| Provider Name | Chandrasekhar Chada |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649605379 PECOS PAC ID: 8325331598 Enrollment ID: I20230105000226 |
| Provider Name | Tamer Hudali |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1770863615 PECOS PAC ID: 9739303157 Enrollment ID: I20230125000986 |
| Provider Name | Edwin Isaboke Karanja |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194292888 PECOS PAC ID: 2769855790 Enrollment ID: I20230222001805 |
| Provider Name | Ammar Malik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659720522 PECOS PAC ID: 9931496551 Enrollment ID: I20230807000112 |
| Provider Name | Michelle Shieh |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1669867156 PECOS PAC ID: 7517202419 Enrollment ID: I20230807002071 |
| Provider Name | Timothy R Shutter |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1285127704 PECOS PAC ID: 3870955107 Enrollment ID: I20230817001982 |
| Provider Name | Doris Li |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1053544569 PECOS PAC ID: 9739226697 Enrollment ID: I20231009001906 |
| Provider Name | Qalb Khan |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1104232925 PECOS PAC ID: 5092087403 Enrollment ID: I20240719001293 |
| Provider Name | Muhammad Omar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225438849 PECOS PAC ID: 4981926441 Enrollment ID: I20250516001849 |
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 |