Active NPI
Surya Prakash Lanka, M.D.
- Internal Medicine Physician
- Kilgore, TX
National Provider Identifier
1144213869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- J4657
- Practice address
- 2019B S Henderson Blvd
#12
Kilgore, TX 75662-3546 - Phone
- (903) 984-7512
- Fax
- (903) 984-5336
- NPI assigned
- Aug 28, 2005
- Last updated
- Aug 13, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | J4657 | TX | Primary |
Addresses
Primary practice location
2019B S Henderson Blvd
#12
Kilgore, TX 75662-3546
Mailing address
2019B S Henderson Blvd
#12
Kilgore, TX 75662-3546
Phone (903) 984-7512
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0993115-02 | Medicaid | TX |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070503000622 | TX | Practitioner - Internal Medicine | 9234235995 | Practice locations: Kilgore, TX |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2019 B S Henderson Blvd
Suite 12
Kilgore, TX 75662-3546
Phone (903) 984-7512
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| J4657 | TX | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Texas Treatment Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Kilgore, TX
- NPI 1023002425
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Longview, TX
- NPI 1124092036
-
dba Arbor Grace Guest Care Center
- Skilled Nursing Facility
- Kilgore, TX
- NPI 1538679931
Nursing home
-
dba UTHealth East Texas Henderson Hospital
- General Acute Care Hospital
- Henderson, TX
- NPI 1326546797
-
- Home Health Agency
- Longview, TX
- NPI 1336515832
-
dba Longview Regional Medical Center
- General Acute Care Hospital
- Longview, TX
- NPI 1528026267
-
dba Christus Mother Frances Hospital Tyler
- General Acute Care Hospital
- Tyler, TX
- NPI 1679578439
-
dba AccentCare Home Health of Texas
- Home Health Agency
- Longview, TX
- NPI 1669695722
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755043200000",
"number": "1144213869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2019B S HENDERSON BLVD",
"address_2": "#12",
"city": "KILGORE",
"state": "TX",
"postal_code": "756623546",
"telephone_number": "903-984-7512",
"fax_number": "903-984-5336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2019B S HENDERSON BLVD",
"address_2": "#12",
"city": "KILGORE",
"state": "TX",
"postal_code": "756623546",
"telephone_number": "903-984-7512",
"fax_number": "903-984-5336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANKA",
"first_name": "SURYA",
"middle_name": "PRAKASH",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-28",
"last_updated": "2025-08-13",
"certification_date": "2025-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "J4657",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0993115-02",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kilgore, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.