Diagnostic Clinic of Longview PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

DIAGNOSTIC CLINIC OF LONGVIEW PA

Practice address

707 Hollybrook Dr
Longview, TX 75605-2410

Phone

(903) 757-6042

Fax

(903) 232-8226

NPI assigned

Sep 6, 2005

Last updated

Oct 8, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Dora C Reeves

Title

Credentialing Coordinator

Phone

(903) 291-6062

Specialties & licenses 15

Addresses

Other identifiers 4

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

• Longview Medical Center LP

  dba Longview Regional Medical Center

  • General Acute Care Hospital
  • Longview, TX
  • NPI 1528026267

  Member Of

  NPD member
• Longview Medical Center LP

  dba Longview Regional Medical Center

  • Rehabilitation Hospital Unit
  • Longview, TX
  • NPI 1699733097

  Member Of

  NPD member

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23550/brand/1/csg/1/fhir/r4

Practitioners 140

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.

• Cinthia Acevedo, AGACNP

  • Acute Care Nurse Practitioner
  • Longview, TX
  • NPI 1184439408
  NPD (past)
• Jose Guillermo Acevedo, M.D.

  • Internal Medicine Physician
  • Longview, TX
  • NPI 1295869006
  NPD (past)
• Anthony J Agostini, DO

  • Cardiovascular Disease Physician
  • Amarillo, TX
  • NPI 1245234293
  NPD (past)
• Timothy Frank Archer, MD

  • Emergency Medicine Physician
  • Longview, TX
  • NPI 1205814993
  NPD (past)
• Deidra Lynn Baker, NP

  • Obstetrics & Gynecology Nurse Practitioner
  • Longview, TX
  • NPI 1962508929
  NPD (past)
• William N Barker Jr., ACNP

  • Acute Care Nurse Practitioner
  • Longview, TX
  • NPI 1457501025
  NPD (past)
• Genie Bartlett, RN, FNP

  • Family Nurse Practitioner
  • Longview, TX
  • NPI 1346232444
  NPD (past)
• Lora Barton

  • Acute Care Nurse Practitioner
  • Longview, TX
  • NPI 1356156657
  NPD (past)
• Faranak Behnia, M.D.

  • Maternal & Fetal Medicine Physician
  • Houston, TX
  • NPI 1356375380

  Obstetrics & Gynecology

  NPD (past)
• Joseph F Bianca, MD

  • Gynecology Physician
  • Longview, TX
  • NPI 1366419863
  NPD (past)
• Linda C Boggs, NP

  • Women's Health Nurse Practitioner
  • Longview, TX
  • NPI 1164499661
  NPD (past)
• Chandler Dyan Brooks, FNP

  • Family Nurse Practitioner
  • Longview, TX
  • NPI 1982379640
  NPD (past)

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791417600000",
    "number": "1386638468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 HOLLYBROOK DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052410",
            "telephone_number": "903-757-6042",
            "fax_number": "903-232-8226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 HOLLYBROOK DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052410",
            "telephone_number": "903-757-6042",
            "fax_number": "903-232-8226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC CLINIC OF LONGVIEW PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-06",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A",
        "authorized_official_last_name": "REEVES",
        "authorized_official_first_name": "DORA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "903-291-6062",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130964307",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130964302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME RR MEDICARE",
            "identifier": "45D0482673",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130964306",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sita Mahalakshmi Devulapalli, M.D.
• Erick Evandro Di Matteo
• Diagnostic Health Solutions, LLC
• Taylor Griffin Dickerson, MD
• Andrew Dickhute
• Lois Ann Dietrich, PT
• Callie Dimond, LPC ASSOCIATE

• Internal Medicine Physician in Longview, TX
• Providers in Longview, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2026; 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.