Memorial Specialty Hospital

Primary specialty

Special HospitalTaxonomy code 284300000X

License

000691 Issued in TX

Legal business name

MEMORIAL SPECIALTY HOSPITAL

Practice address

1201 Frank Street
Ste D
Lufkin, TX 75904

Phone

(936) 634-8111

Fax

(936) 639-7976

NPI assigned

Dec 21, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Duane Miller

Title

Business Office Director

Phone

(936) 634-8111

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Memorial Specialty Hospital Former legal business name

Locations

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528761600000",
    "number": "1497731426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1447",
            "address_2": "MEMORIAL SPECIALTY HOSPITAL",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759021447",
            "telephone_number": "936-634-8111",
            "fax_number": "936-639-7976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 FRANK STREET",
            "address_2": "STE D",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "75904",
            "telephone_number": "936-634-8111",
            "fax_number": "936-639-7976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL SPECIALTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-21",
        "last_updated": "2018-06-12",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DUANE",
        "authorized_official_title_or_position": "BUSINESS OFFICE DIRECTOR",
        "authorized_official_telephone_number": "936-634-8111",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": "TX",
            "license": "000691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H045017878",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Specialty Hospital",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Memorial Specialty Hospital",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Memorial Health System of East Texas
• Memorial Health System of East Texas
• Memorial Health System of East Texas
• Memorial Medical Center of East Texas
• Memorial Medical Center of East Texas
• Lauren Menefee, PT, DPT
• Vivek Menon, M.D.
• Nicole Mercado, DC
• Merritt Pember MD PA
• Carlie Rae Merritt, FNP

• All providers in Lufkin, TX
• Special Hospital in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; 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.