NPIMap

Organization Active NPI

Permian Premier Health Services Inc

Doing business as Steward Medical Group of Texas

  • Specialist
  • Texarkana, TX
National Provider Identifier
1487211843
Registry record updated May 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PERMIAN PREMIER HEALTH SERVICES INC
Doing business as
Steward Medical Group of Texas
Practice address
1002 Texas Blvd Ste 322
Texarkana, TX 75501-5118
Phone
(903) 791-1878
Fax
(903) 791-1882
NPI assigned
May 21, 2019
Last updated
May 21, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2019

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

Authorized official

Name
Jonathan A Demke
Title
Ceo
Phone
(615) 467-1072

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary
Obstetrics & Gynecology Physician 207V00000X NU
Interventional Pain Medicine Physician 208VP0014X NU

Addresses

Primary practice location

1002 Texas Blvd Ste 322
Texarkana, TX 75501-5118

Mailing address

PO Box 24573
Belfast, ME 04915-4496
Phone (855) 660-0300

Other names 1

  • STEWARD MEDICAL GROUP OF TEXAS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Permian Premier Health Services Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558396800000",
    "number": "1487211843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24573",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154496",
            "telephone_number": "855-660-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 TEXAS BLVD STE 322",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755015118",
            "telephone_number": "903-791-1878",
            "fax_number": "903-791-1882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERMIAN PREMIER HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-21",
        "last_updated": "2019-05-21",
        "status": "A",
        "authorized_official_last_name": "DEMKE",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "615-467-1072"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STEWARD MEDICAL GROUP OF TEXAS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Texarkana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2019; 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.