C Ryan Easterling MD PA
Organization Active NPI Family Medicine Physician · Graham, TX
NPI 1477045292 · NPPES record last updated Jul 28, 2019
Key facts
- NPI
- 1477045292
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- C RYAN EASTERLING MD PA
- Practice address
- 1339 East St
Graham, TX 76450-4228 - Phone
- (940) 521-5500
- NPI assigned
- Jun 6, 2018
- Organization subpart
- No
Authorized official
- Name
- Christopher Easterling, MD
- Title
- Sole Owner
- Phone
- (940) 521-5500
Practitioners 9
-
Julie Ann Sherbert, MPAS, PA-C
-
Mary L Hiatt, APRN-CNP
-
John F Lucas III, MD
-
William P Martin, MD
-
Jared Hayden Mataska, M.D.
-
Leah B Smith, ACNP
-
Teresa McGuinness, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180731001844 | TX | Part B Supplier - Clinic/Group Practice | 7810245321 |
Receives reassigned benefits from 2 practitioners Practice locations: Graham, TX |
National Provider Directory
Locations
1339 East St
Graham, TX 76450
Phone (940) 264-2625
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
1339 East St
Graham, TX 76450-4228
Mailing address
1339 East St
Graham, TX 76450-4228
Phone (940) 521-5500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R2322 | Other | TX | MEDICAL LICENSE |
Other providers in Graham, TX
- James Todd Brewer
- Brian K Hill DDS PLLC
- Beryl Ann Brigham
- Josey Brown
- Kari Lynn Bullard
- Caddell Family Dentistry, PLLC
- Cardiosom, LLC
- Michael Castillo
- Dora Elisa Cawley
- Central Physical Therapy and Rehabilitation Inc
All providers in Graham, TX · Family Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.