Individual provider Active NPI

Charles Niziol, MD

  • Emergency Medicine Physician
  • Texarkana, TX
National Provider Identifier
1073552741
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
E18041 Issued in TX
Practice address
1000 Pine St
Texarkana, TX 75501-5100
Phone
(903) 798-8887
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X E18041 TX Primary

Addresses

Primary practice location

1000 Pine St
Texarkana, TX 75501-5100

Mailing address

2815 Kings Forest Dr
Kingwood, TX 77339-2450
Phone (281) 359-3314

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
I20040604000373 TX Practitioner - Emergency Medicine 7719969583 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E18041TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ess of Port Lavaca LLC Emergency Medicine CurrentSince Dec 1, 2019 Accepting new patients
Ess of South Texas LLC Emergency Medicine CurrentSince Dec 1, 2019 Accepting new patients
Four States Emergency Physicians Emergency Medicine Past Accepting new patients
Texas Em-1 Medical Services, PA Past Accepting new patients
Woodlands Emergency Physicians, LLP Emergency Medicine Past Accepting new patients
Emergency Health Services Associates, P.a. Emergency Medicine Past Accepting new patients
Hale Emergency Medicine Associates, PA Emergency Medicine Past Accepting new patients
Cleveland Emergency Group PA Emergency Medicine Past Accepting new patients
Texas Emergency Room Services PA Emergency Medicine Past Accepting new patients
Camino Real Emergency Physicians PLLC Emergency Medicine Past Accepting new patients
Trans Pecos Emergency Physicians Emergency Medicine Past Accepting new patients
Texas Em-1 Medical Services PA Emergency Medicine Past Accepting new patients
Texas Em-1 Medical Services, PA Past Accepting new patients
Motley Emergency Physicians Emergency Medicine Past Accepting new patients
Emergency Physicians of North Texas PLLC Emergency Medicine Past Accepting new patients
Texas Emergency Room Services PA Emergency Medicine Past Accepting new patients
Memorial City Neuro Diagnostic Past Accepting new patients
Matagorda Emergency Medicine Associates PA Emergency Medicine Past Accepting new patients
Texas Emergency Room Services , PA Emergency Medicine Past Accepting new patients
Texas Em-I Medical Services, PA Emergency Medicine Past Accepting new patients

Locations

100 Medical Dr
Borger, TX 79007
Phone (806) 273-1100

1353 N Travis St
Liberty, TX 77575
Phone (936) 336-7316

608 Strickland Dr
Orange, TX 77630
Phone (409) 883-1248

815 N Virginia St
Port Lavaca, TX 77979
Phone (361) 552-0325

10141 US 59 Hwy
Wharton, TX 77488
Phone (281) 491-6808

Interoperability endpoints

  • Direct secure messaging: charles.niziol@direct.myteamcare.com

Organizations & group practices 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1073552741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 KINGS FOREST DR",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773392450",
            "telephone_number": "281-359-3314",
            "fax_number": "214-712-2487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 PINE ST",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755015100",
            "telephone_number": "903-798-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIZIOL",
        "first_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "E18041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.