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NACOGDOCHES INTERNAL MEDICINE PLLC NPI 1609319458


NPI Information

NPI: 1609319458
Provider Name: NACOGDOCHES INTERNAL MEDICINE PLLC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
412 NORTH ST STE E
NACOGDOCHES, TX
ZIP 75961
Phone: (936) 560-1812
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NACOGDOCHES INTERNAL MEDICINE PLLC is an internal medicine in Nacogdoches, TX. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. NACOGDOCHES INTERNAL MEDICINE PLLC NPI is 1609319458. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

412 NORTH ST STE E
NACOGDOCHES, TX
ZIP 75961
Phone: (936) 560-1812
Fax: (936) 560-3070

The provider's authorized official is Walter Brad Wilson .
The authorized official title is President and has the following contact phone number (936) 560-1812.

The enumeration date for this NPI number is 11/28/2016 and was last updated on 5/21/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal MedicineH3293TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1377530601MEDICAIDTEXAS
2113906502MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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