Individual provider Active NPI

Jack Menges Jr., MD

  • Emergency Medicine Physician
  • Texarkana, TX
National Provider Identifier
1033146899
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
K6776 Issued in TX
Practice address
2600 Saint Michael Dr
Texarkana, TX 75503-2372
Phone
(903) 614-1000
NPI assigned
Jun 27, 2006
Last updated
Mar 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X K6776 TX Primary
Family Medicine Physician 207Q00000X K6776 TX

Addresses

Primary practice location

2600 Saint Michael Dr
Texarkana, TX 75503-2372

Mailing address

6908 Shadow BRK
Texarkana, TX 75503-5444
Phone (903) 223-6933

Other identifiers 1

IdentifierTypeStateIssuer
200021700AMedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040428001091 TX Practitioner - Family PracticePractitioner - Emergency Medicine 4385631670 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
University of Texas Southwestern Medical School at Dallas, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Texas Medical Services PLLCGroup PAC ID 5890156541, 5 clinicians

Practice addresses (Care Compare)

2001 N Jefferson Ave
Mt Pleasant, TX 75455-2338
Phone (903) 577-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35908TNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Union Emergency Physicians, PLLC Emergency Medicine CurrentSince Sep 17, 2024 Accepting new patients
Texarkana Emergency Physicians PLLC Emergency Medicine CurrentSince May 10, 2014 Accepting new patients
East Texas Medical Services PLLC Emergency Medicine CurrentSince Jan 1, 2025 Accepting new patients
Eastland Memorial Hospital District Past Accepting new patients
Texarkana Emergency Medicine Physicians,PA Emergency Medicine Past Accepting new patients
Emergency Associates of Texas, PA Emergency Medicine Past Accepting new patients
Eastland Memorial Hospital District Past Accepting new patients

Locations

2001 N Jefferson Ave
Mt Pleasant, TX 75455
Phone (903) 434-8044

1000 Pine St
Texarkana, TX 75501
Phone (903) 798-7365

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

4250 Gibson Ln
Texarkana, TX 75503
Phone (903) 614-8100

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1033146899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6908 SHADOW BRK",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755035444",
            "telephone_number": "903-223-6933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 SAINT MICHAEL DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032372",
            "telephone_number": "903-614-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENGES",
        "first_name": "JACK",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "K6776",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K6776",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200021700A",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.