| |
805 Lindsey Dr Marshall TX 75670-5271 | |
(903) 938-1146 | |
(903) 927-2434 |
Full Name | |
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Speciality | Clinic/Center |
Location | 805 Lindsey Dr, Marshall, Texas |
Authorized Official Name and Position | Carla Roadcap (CEO) |
Authorized Official Contact | 9039273782 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 1326 Marshall TX 75671-1326 Ph: (903) 927-3782 | 805 Lindsey Dr Marshall TX 75670-5271 Ph: (903) 938-1146 |
NPI Number | 1558329797 |
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Provider Enumeration Date | 05/03/2006 |
Last Update Date | 06/13/2024 |
Medicare PECOS PAC ID | 8820038565 |
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Medicare Enrollment ID | O20050511001030 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558329797 | NPI | - | NPPES |
192226201 | Medicaid | TX | |
174139901 | Medicaid | TX | |
0089LZ | Other | TX | BLUECROSS BLUESHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Provider Name | Johnny W Jones |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1417958042 PECOS PAC ID: 7810971298 Enrollment ID: I20040614001626 |
Provider Name | Jeri Kellett Charles |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851429229 PECOS PAC ID: 1658343900 Enrollment ID: I20040809000418 |
Provider Name | Antoinette Riley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1659302545 PECOS PAC ID: 8820098007 Enrollment ID: I20070111000651 |
Provider Name | Ricky A Paul |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1073699500 PECOS PAC ID: 3577546696 Enrollment ID: I20070222000254 |
Provider Name | Jeffory W Beaty |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194715888 PECOS PAC ID: 5799886339 Enrollment ID: I20070726000174 |
Provider Name | Lloyd M Fruge |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1275547242 PECOS PAC ID: 9830248640 Enrollment ID: I20090528000213 |
Provider Name | Debra Wright-bowers |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1144459231 PECOS PAC ID: 9931254083 Enrollment ID: I20090826000269 |
Provider Name | James A Scales |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1750381158 PECOS PAC ID: 8820138621 Enrollment ID: I20091229000225 |
Provider Name | Joe Daniel Nichols |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1619080561 PECOS PAC ID: 0840329801 Enrollment ID: I20100831000455 |
Provider Name | Sherrie L Fitts |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194824193 PECOS PAC ID: 9234253014 Enrollment ID: I20100831000577 |
Provider Name | Nita Ann Little |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669465795 PECOS PAC ID: 1951595008 Enrollment ID: I20101102001104 |
Provider Name | Stephen K Erlewine |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588668453 PECOS PAC ID: 9537060801 Enrollment ID: I20101215000637 |
Provider Name | Rikki Dawn Sandvik |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1972808277 PECOS PAC ID: 9133305931 Enrollment ID: I20110511000873 |
Provider Name | Kristen L Coats |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417243700 PECOS PAC ID: 4789854431 Enrollment ID: I20110907001104 |
Provider Name | Sunnie Hooten |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386895191 PECOS PAC ID: 8224280904 Enrollment ID: I20121203000312 |
Provider Name | Veronica R Mccoy |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215032636 PECOS PAC ID: 5799908000 Enrollment ID: I20140516001323 |
Provider Name | Gregory Scott Hortman |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1972583383 PECOS PAC ID: 5294744900 Enrollment ID: I20151201001473 |
Provider Name | Norman Houchen |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1487637054 PECOS PAC ID: 5890099071 Enrollment ID: I20160209000799 |
Provider Name | Gary Reed Brouillette |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780044834 PECOS PAC ID: 4688970650 Enrollment ID: I20160317000768 |
Provider Name | Almer Hadaway |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720416308 PECOS PAC ID: 5890912109 Enrollment ID: I20160827000137 |
Provider Name | Krista Niemeyer |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124396833 PECOS PAC ID: 6002197894 Enrollment ID: I20170110003080 |
Provider Name | Stephanie K Ford |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598286734 PECOS PAC ID: 9638444904 Enrollment ID: I20171012001824 |
Provider Name | Jennifer Lynn Shipp |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316450497 PECOS PAC ID: 3375801707 Enrollment ID: I20171213000159 |
Provider Name | Danette R Allen |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1285060012 PECOS PAC ID: 0749540011 Enrollment ID: I20180206000270 |
Provider Name | Jared D Clark |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467011239 PECOS PAC ID: 6406182260 Enrollment ID: I20190731003397 |
Provider Name | Tirsa E Miller |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821554296 PECOS PAC ID: 1052653409 Enrollment ID: I20191011001677 |
Provider Name | Kelli Michelle Thompson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740807759 PECOS PAC ID: 9436574126 Enrollment ID: I20200728003096 |
Provider Name | Mikala Brooke Anderson |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1841729480 PECOS PAC ID: 0143646919 Enrollment ID: I20200811004055 |
Provider Name | Terri A Rowe |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1073892634 PECOS PAC ID: 9436376423 Enrollment ID: I20201007001784 |
Provider Name | Jody A Barham |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992081491 PECOS PAC ID: 6103092051 Enrollment ID: I20201008002207 |
Provider Name | Kelsie M Court |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1982128716 PECOS PAC ID: 4486926664 Enrollment ID: I20201228000022 |
Provider Name | Shannon Smith |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912507419 PECOS PAC ID: 7315350626 Enrollment ID: I20210106000311 |
Provider Name | Amanda M Smith |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720618390 PECOS PAC ID: 2062814031 Enrollment ID: I20210713003196 |
Provider Name | Andrea York |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1558368498 PECOS PAC ID: 4688867245 Enrollment ID: I20211018001553 |
Provider Name | Cheyanne B Autry |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639806607 PECOS PAC ID: 7214310739 Enrollment ID: I20220816003750 |
Provider Name | Jessica C Malca-pastakia |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518685957 PECOS PAC ID: 5496126088 Enrollment ID: I20230118001458 |
Provider Name | Tiffany A Mcfarland |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1730847237 PECOS PAC ID: 8628440302 Enrollment ID: I20230206001595 |
Provider Name | Melinda Fenton |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669165932 PECOS PAC ID: 4082073754 Enrollment ID: I20230629000912 |
Provider Name | Craig Martin Biggar |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1902350267 PECOS PAC ID: 6204285083 Enrollment ID: I20231206001715 |
Provider Name | Kayla Underwood |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821875568 PECOS PAC ID: 4284083817 Enrollment ID: I20231207004200 |
Provider Name | Stacy Michelle Humphrey |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1487810396 PECOS PAC ID: 3678996972 Enrollment ID: I20231218004212 |
Provider Name | Deborah James |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1629348982 PECOS PAC ID: 9931559895 Enrollment ID: I20231219002243 |
Provider Name | Ashli Kay Sutton |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1033359088 PECOS PAC ID: 4688024417 Enrollment ID: I20231220001442 |
Provider Name | Taylor Parker |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1669138772 PECOS PAC ID: 4688026446 Enrollment ID: I20240117001420 |
Provider Name | Rosharon Shunta Turner |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1588039671 PECOS PAC ID: 6507219789 Enrollment ID: I20240124003770 |
Provider Name | Amy E Miller |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1649328808 PECOS PAC ID: 0345685715 Enrollment ID: I20240226002898 |
Provider Name | Andrea Yarbrough |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1083315105 PECOS PAC ID: 6406399864 Enrollment ID: I20240613004134 |
Provider Name | Tina Etminan |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1275114811 PECOS PAC ID: 5496298630 Enrollment ID: I20240617002115 |
Provider Name | Jennifer A Robinson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154158699 PECOS PAC ID: 2769914134 Enrollment ID: I20241010002649 |
Provider Name | Tara Ashley Holland |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1639435233 PECOS PAC ID: 1850600248 Enrollment ID: I20241120004380 |
East Texas Border Health Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 622 S Grove St, Marshall, TX 75670 Phone: 903-702-7900 Fax: 903-702-7904 | |
East Texas Health And Wellness Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1600 S Washington Ave, Marshall, TX 75670 Phone: 903-320-3200 Fax: 903-471-8655 | |
Marshall Rural Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 805 Lindsey St, Marshall, TX 75670 Phone: 903-927-6140 Fax: 903-927-6117 | |
Harrison County Hospital Association Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 707 S Grove St, Marshall, TX 75670 Phone: 903-927-6662 Fax: 903-927-6625 |