San Augustine Family Practice PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

K1721 Issued in TX

Legal business name

SAN AUGUSTINE FAMILY PRACTICE PA

Practice address

200 E Livingston St
San Augustine, TX 75972-2028

Phone

(936) 275-9910

Fax

(936) 275-9710

NPI assigned

Dec 8, 2006

Last updated

Nov 8, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephanie Deann Anderson

Title

Billing & Collections

Phone

(936) 275-9910

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chad Michael Moody, PA-C

  • Medical Physician Assistant
  • Hemphill, TX
  • NPI 1487617890
  NPD (past)
• Kevin Lee Murphy, PA-C

  • Physician Assistant
  • Nacogdoches, TX
  • NPI 1548483472
  NPD (past)
• Jeffrey Alan Watson, MD

  • Emergency Medicine Physician
  • San Augustine, TX
  • NPI 1346252673
  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194480000000",
    "number": "1043379597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E LIVINGSTON ST",
            "city": "SAN AUGUSTINE",
            "state": "TX",
            "postal_code": "759722028",
            "telephone_number": "936-275-9910",
            "fax_number": "936-275-9710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E LIVINGSTON ST",
            "city": "SAN AUGUSTINE",
            "state": "TX",
            "postal_code": "759722028",
            "telephone_number": "936-275-9910",
            "fax_number": "936-275-9710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN AUGUSTINE FAMILY PRACTICE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-11-08",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "DEANN",
        "authorized_official_title_or_position": "BILLING & COLLECTIONS",
        "authorized_official_telephone_number": "936-275-9910"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K1721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8K5535",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0084KU",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Curtis Leon Pillow Jr., PTA
• Raishaun Evett Randle, LVN
• Shea V Reese, LPTA
• Republic of Texas Inpatient Services PLLC
• San Augustine City County Hospital District (San Augustine County EMS)
• San Augustine Isd
• San Augustine Management LLC (Hillcrest Assisted Living)
• San Augustine Pharmacy1St LLC (San Augustine Drug Company)
• Malaika Ilene Sigler, LVN
• SNG - San Augustine Dialysis Center LP

• Family Medicine Physician in San Augustine, TX
• Providers in San Augustine, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.