NPIMap

Organization Active NPI

East Texas Medical Specialists PLLC

  • Emergency Medicine Physician
  • Longview, TX
National Provider Identifier
1235162777
Registry record updated Jun 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
EAST TEXAS MEDICAL SPECIALISTS PLLC
Practice address
700 E Marshall Ave
Longview, TX 75601-5580
Phone
(903) 315-2000
NPI assigned
Jul 8, 2006
Last updated
Jun 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2008

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

Authorized official

Name
Stanley D. Upchurch, M.D.NPI 1083603021
Title
Partner
Phone
(903) 315-2445

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary
Internal Medicine Physician 207R00000X

Addresses

Primary practice location

700 E Marshall Ave
Longview, TX 75601-5580

Mailing address

9229 Lyndon B Johnson Fwy
Suite 250
Dallas, TX 75243-3405
Phone (972) 739-3097

Other identifiers 2

IdentifierTypeStateIssuer
165657101MedicaidTX
0008LTOtherTXBCBS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1235162777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9229 LYNDON B JOHNSON FWY",
            "address_2": "SUITE 250",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433405",
            "telephone_number": "972-739-3097",
            "fax_number": "972-739-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E MARSHALL AVE",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015580",
            "telephone_number": "903-315-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS MEDICAL SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "UPCHURCH",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "903-315-2445",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165657101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0008LT",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; 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.