Individual provider Active NPI

Christina Wade

  • Family Nurse Practitioner
  • New Boston, TX
National Provider Identifier
1508336470
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP139080 Issued in TX
Practice address
114 W US Highway 82
New Boston, TX 75570-2804
Phone
(479) 530-3245
Fax
(903) 628-0712
NPI assigned
Dec 4, 2018
Last updated
Aug 13, 2026By the provider in NPPES
Sex
Female
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP139080 TX Primary
Nurse Practitioner 363L00000X AP139080 TX

Addresses

Primary practice location

114 W US Highway 82
New Boston, TX 75570-2804

Mailing address

864 County Road 4105
New Boston, TX 75570-5126
Phone (903) 280-4400

Other practice location 1

1002 Texas Blvd Ste 401
Texarkana, TX 75501-5113
Phone (903) 792-4003

Other identifiers 3

IdentifierTypeStateIssuer
400234701MedicaidTX
AP139080OtherTXAPRN LICENSE
27870OtherTXPRESCRIPTIVE AUTHORIZATION

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190726000029 TX Practitioner - Nurse Practitioner 1254667397 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP139080TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Jun 17, 2024 Accepting new patients
Apex Wound Management LLC CurrentSince Apr 1, 2025 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jun 17, 2024 Accepting new patients
B Pediatrics PLLC Family PastSince Feb 3, 2020 Accepting new patients
Burns Professional Office Past Accepting new patients

Locations

2006 Moores Ln
Texarkana, TX 75503
Phone (903) 792-6944

3003 Richmond Rd
Texarkana, TX 75503
Phone (918) 740-9476

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1543881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1508336470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "864 COUNTY ROAD 4105",
            "city": "NEW BOSTON",
            "state": "TX",
            "postal_code": "755705126",
            "telephone_number": "903-280-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 W US HIGHWAY 82",
            "city": "NEW BOSTON",
            "state": "TX",
            "postal_code": "755702804",
            "telephone_number": "479-530-3245",
            "fax_number": "903-628-0712"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1002 Texas Blvd Ste 401",
            "address_purpose": "LOCATION",
            "city": "Texarkana",
            "state": "TX",
            "postal_code": "755015113",
            "country_code": "US",
            "telephone_number": "903-792-4003",
            "fax_number": "903-794-6743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADE",
        "first_name": "CHRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-04",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP139080",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP139080",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400234701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE",
            "identifier": "AP139080",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESCRIPTIVE AUTHORIZATION",
            "identifier": "27870",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Boston, TX

Sources for this page

Verify at the official NPI Registry.