Individual provider Active NPI

David Huston, P.A.

  • Physician Assistant
  • Tyler, TX
National Provider Identifier
1215967823
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA04182 Issued in TX
Practice address
1814 Roseland Blvd
Suite 200
Tyler, TX 75701-4262
Phone
(903) 531-2500
Fax
(903) 592-4468
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA04182 TX Primary

Addresses

Primary practice location

1814 Roseland Blvd
Suite 200
Tyler, TX 75701-4262

Mailing address

1814 Roseland Blvd
Suite 200
Tyler, TX 75701-4262
Phone (903) 531-2500

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051129000826 TX Practitioner - Physician Assistant 8123048626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

18118 FM 344
Flint, TX 75762-6010
Phone (903) 825-3292

700 Olympic Plaza Cir
Suite 850
Tyler, TX 75701-1955
Phone (903) 596-3504

Hospital & facility affiliations

  • Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083
  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
  • University of Texas Health Science Center at Tyler Hospital, Tyler, TX, CCN 450690
  • Ut Health East Texas Athens Hospital Hospital, Athens, TX, CCN 450389

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA04182TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Starks Medical Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dhuston355334@ahs.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215967823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 ROSELAND BLVD",
            "address_2": "SUITE 200",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757014262",
            "telephone_number": "903-531-2500",
            "fax_number": "903-592-4468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 ROSELAND BLVD",
            "address_2": "SUITE 200",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757014262",
            "telephone_number": "903-531-2500",
            "fax_number": "903-592-4468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSTON",
        "first_name": "DAVID",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.