Kevin John Formes, D.O.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

M0077 Issued in TX

Practice address

2604 Saint Michael Dr Ste 346
Texarkana, TX 75503-2378

Phone

(903) 614-5750

NPI assigned

Apr 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in TX, AR2 enrollments

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 2

Specialty

Internal Medicine

Education

University of North Texas HSC, College of Osteopathic Med, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801
• Sevier County Medical Center Hospital, De Queen, AR, CCN 041333
• Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
• Howard Memorial Hospital Hospital, Nashville, AR, CCN 041311
• McCurtain Memorial Hospital Hospital, Idabel, OK, CCN 371342

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kformes428133@christushealth.direct-ci.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Christus Trinity Clinic Texas

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225
  Medicare reassignment Care Compare group NPD
• Permian Premier Health Services Inc

  • Contractor
  • Odessa, TX
  • NPI 1285664763

  AR

  Medicare reassignment
• Christus Trinity Clinic Texas

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christus Health Ark-la-Tex

  • General Practice Physician
  • Texarkana, TX
  • NPI 1184623266

  Hospital

  Care Compare affiliation
• Christus Health Ark-la-Tex

  • General Acute Care Hospital
  • Texarkana, TX
  • NPI 1295736734
  Care Compare affiliation
• Mother Frances Hospital Regional Health Care Center

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Care Compare affiliation
• Howard Memorial Hospital

  • Critical Access Hospital
  • Nashville, AR
  • NPI 1851484695
  Care Compare affiliation
• McCurtain Memorial Medical Management, Inc.

  • Critical Access Hospital
  • Idabel, OK
  • NPI 1063900975
  Care Compare affiliation
• Sevier County Medical Center

  • Critical Access Hospital
  • De Queen, AR
  • NPI 1386367506
  Care Compare affiliation

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1497878474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 TEXAS BLVD STE 401",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755015113",
            "telephone_number": "903-794-8820",
            "fax_number": "903-794-8878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 SAINT MICHAEL DR STE 346",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032378",
            "telephone_number": "903-614-5750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5002 Cowhorn Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Texarkana",
            "state": "TX",
            "postal_code": "755039766",
            "country_code": "US",
            "telephone_number": "903-614-3213",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1002 Texas Blvd",
            "address_2": "Suite 401",
            "address_purpose": "LOCATION",
            "city": "Texarkana",
            "state": "TX",
            "postal_code": "755015107",
            "country_code": "US",
            "telephone_number": "903-794-8820",
            "fax_number": "903-794-8878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2604 Saint Michael Dr Ste 238",
            "address_purpose": "LOCATION",
            "city": "Texarkana",
            "state": "TX",
            "postal_code": "755032378",
            "country_code": "US",
            "telephone_number": "903-794-8820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORMES",
        "first_name": "KEVIN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "M0077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211561001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00836010",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182168003",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200287540A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Charles Flint
• Steven W. Foltz, FNP-BC
• Sher Lynn Fomby, NP-C
• Christina E Fomuso, PHARMACIST
• Colin Alexander Forbes, PT
• Dewitt Charles Fortenberry, MD
• Foster Physical Therapy, Inc
• Gina Townsend Foster, PT
• Kaleigh Kristin Foster, FNP-C
• Warren Chris Foster, PT

• Interventional Cardiology Physician in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Interventional Cardiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.