Individual provider Active NPI

Eleazar Vera Jr., MD

  • Family Medicine Physician
  • Gilmer, TX
National Provider Identifier
1407822299
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H8484 Issued in TX
Practice address
602 Titus St Ste 130
Gilmer, TX 75644-1780
Phone
(903) 758-2610
Fax
(903) 758-7081
NPI assigned
Feb 23, 2006
Last updated
Aug 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H8484 TX Primary

Addresses

Primary practice location

602 Titus St Ste 130
Gilmer, TX 75644-1780

Mailing address

1107 E Marshall Ave
Longview, TX 75601-5602
Phone (903) 758-2610

Other practice location 1

1901 Mulberry Ave Ste A
MT Pleasant, TX 75455-2369
Phone (903) 758-2610

Other practice location 2

1711 S Henderson Blvd Ste 400
Kilgore, TX 75662-3592
Phone (903) 758-2610

Other practice location 3

2131 S Mobberly Ave
Longview, TX 75602-3563
Phone (903) 758-2610

Other practice location 4

1107 E Marshall Ave
Longview, TX 75601-5602
Phone (903) 758-2610

Other practice location 5

201 E Loop 281
Longview, TX 75605-7911
Phone (903) 758-2610

Other practice location 6

1001 W Fairmont St
Longview, TX 75604-3511
Phone (903) 758-2610

Other practice location 7

425 N Fredonia St
Longview, TX 75601-6464
Phone (903) 758-2610

Other identifiers 4

IdentifierTypeStateIssuer
135145411MedicaidTX
8S5938OtherTXBLUE CROSS
123297OtherTXSUPERIOR
135145401MedicaidTX

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040430000732 TX Practitioner - Family Practice 2062409923 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at San Antonio, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Longview Wellness Center IncGroup PAC ID 1254367766, 22 clinicians

Practice addresses (Care Compare)

602 Titus St
Suite 130
Gilmer, TX 75644-1780
Phone (903) 758-2610

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
H8484TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2018 Accepting new patients
Longview Wellness Center Inc Family Medicine CurrentSince Sep 3, 2024 Accepting new patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2018 Accepting new patients
Dailey Medical Clinic Family Medicine CurrentSince Apr 1, 2023 Accepting new patients
Longview Wellness Center, Inc. CurrentSince Nov 18, 2025 Accepting new patients
Longview Wellness Center, Inc Family Medicine Current Accepting new patients
Longview Wellness Center, Inc. CurrentSince Sep 3, 2024 Accepting new patients
Longview Wellness Center Inc Family Medicine PastSince Jan 2, 2022 Accepting new patients
Dailey Medical Clinic Family Medicine Past Accepting new patients
Longview Wellness Center, Inc. Family Medicine PastSince Apr 1, 2020 Accepting new patients
Longview Wellness Center Inc Family Medicine PastSince Nov 26, 2023 Accepting new patients

Locations

1108 S Buffalo St
Canton, TX 75103
Phone (903) 567-1910

702 Davis St
Carthage, TX 75633
Phone (903) 693-3841

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

602 Titus St
Ste 130
Gilmer, TX 75644

1711 S Henderson Blvd
Ste 400
Kilgore, TX 75662
Phone (903) 984-1394

14069 FM 849
Lindale, TX 75771
Phone (903) 590-5263

1001 W Fairmont St
Longview, TX 75604

1107 E Marshall Ave
Longview, TX 75601
Phone (903) 212-4763

1701 Pine Tree Rd
Longview, TX 75604
Phone (713) 292-3177

201 E Loop 281
Longview, TX 75605

2131 S Mobberly Ave
Longview, TX 75602
Phone (903) 315-5750

425 N Fredonia St
Longview, TX 75601
Phone (903) 234-1452

1901 Mulberry Ave
Ste A
Mt Pleasant, TX 75455

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

Organizations & group practices 11

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.

Hospital & facility affiliations 2

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1407822299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 E MARSHALL AVE",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015602",
            "telephone_number": "903-758-2610",
            "fax_number": "903-758-7081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 TITUS ST STE 130",
            "city": "GILMER",
            "state": "TX",
            "postal_code": "756441780",
            "telephone_number": "903-758-2610",
            "fax_number": "903-758-7081"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 Mulberry Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "MT Pleasant",
            "state": "TX",
            "postal_code": "754552369",
            "country_code": "US",
            "telephone_number": "903-758-2610",
            "fax_number": "903-758-7081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1711 S Henderson Blvd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Kilgore",
            "state": "TX",
            "postal_code": "756623592",
            "country_code": "US",
            "telephone_number": "903-758-2610",
            "fax_number": "903-758-7081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2131 S Mobberly Ave",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756023563",
            "country_code": "US",
            "telephone_number": "903-758-2610",
            "fax_number": "903-758-7081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1107 E Marshall Ave",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756015602",
            "country_code": "US",
            "telephone_number": "903-758-2610",
            "fax_number": "903-758-7081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 E Loop 281",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756057911",
            "country_code": "US",
            "telephone_number": "903-758-2610",
            "fax_number": "903-758-7081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 W Fairmont St",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756043511",
            "country_code": "US",
            "telephone_number": "903-758-2610",
            "fax_number": "903-758-7081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "425 N Fredonia St",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756016464",
            "country_code": "US",
            "telephone_number": "903-758-2610",
            "fax_number": "903-758-7081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERA",
        "first_name": "ELEAZAR",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H8484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135145411",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8S5938",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPERIOR",
            "identifier": "123297",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135145401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilmer, TX

Sources for this page

Verify at the official NPI Registry.