Pulmonary Diseases Medicine Clinic

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

Legal business name

PULMONARY DISEASES MEDICINE CLINIC

Practice address

921 Texas Blvd Ste D
Texarkana, TX 75501-5163

Phone

(903) 792-3660

Fax

(903) 793-3187

NPI assigned

Mar 23, 2007

Organization subpart

No

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

Authorized official

Name

Becky Watkins

Title

Office Manager

Phone

(903) 792-3660

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

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

• Mandy Michelle Carter, ACNP

  • Acute Care Nurse Practitioner
  • Texarkana, TX
  • NPI 1699066969
  Medicare reassignment Care Compare group NPD
• Carlos Luis Perez, MD

  • Pulmonary Disease Physician
  • Texarkana, TX
  • NPI 1598783870
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209340800000",
    "number": "1114044328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 TEXAS BLVD STE D",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755015163",
            "telephone_number": "903-792-3660",
            "fax_number": "903-793-3187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 TEXAS BLVD STE D",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755015163",
            "telephone_number": "903-792-3660",
            "fax_number": "903-793-3187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULMONARY DISEASES MEDICINE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2008-04-28",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "BECKY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "903-792-3660"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUAL CHOICE",
            "identifier": "90815000040",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX BCBS",
            "identifier": "0055R",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BCBS",
            "identifier": "8P083",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1415531 01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OK CAID",
            "identifier": "200092730A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DA7905",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Professional Eye Care Associates PA
• Professional Hearing Services of Texas, LLC
• Professional Hearing Services PLLC
• Psychiatric Services Roger House, M.D.
• Pulmonary & Internal Medicine of Texarkana
• Bayard Paul Quinn, MD
• Savannah K Quinn, MS. LPC, RPT, ICST
• Rachael Keilin MD, PA
• Carol K Racheotes
• Radiology Consultants L L P

• Pulmonary Disease Physician in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Pulmonary Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.