East Texas Premier Pediatrics PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

EAST TEXAS PREMIER PEDIATRICS PLLC

Practice address

1 Medical Center Blvd Ste B
Lufkin, TX 75904-3173

Phone

(936) 671-3428

NPI assigned

Mar 20, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charlia Devon Swink

Title

Credentialing

Phone

(214) 729-6038

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cristina M Graves, MD

  • Pediatrics Physician
  • Lufkin, TX
  • NPI 1811009939
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1023710332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 AUTUMN LAKE DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759047489",
            "telephone_number": "214-729-6038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD STE B",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043173",
            "telephone_number": "936-671-3428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS PREMIER PEDIATRICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-20",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "SWINK",
        "authorized_official_first_name": "CHARLIA",
        "authorized_official_middle_name": "DEVON",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "214-729-6038"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Texas Hematology & Oncology
• East Texas Id Associates PLLC
• East Texas Internal Medicine PA
• East Texas Neuro Rehab
• East Texas Open MRI & Diagnostics L.P.
• East Texas Therapy Centers, LLC
• East Texas Women'S Clinic
• Michael Eddins, FNP-C
• Julieta Banda Edmond, MA
• Laura Edmundson, PHARMD

• Pediatrics Physician in Lufkin, TX
• Providers in Lufkin, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.