Organization Active NPI

Medmark Treatment Centers of Texas, Inc.

Doing business as MedMark Treatment Centers Lufkin

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Lufkin, TX
National Provider Identifier
1538511878
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
MEDMARK TREATMENT CENTERS OF TEXAS, INC.
Doing business as
MedMark Treatment Centers Lufkin
Practice address
216 N John Redditt Dr
Lufkin, TX 75904-2620
Phone
(936) 637-2223
NPI assigned
Jul 11, 2016
Last updated
Jul 29, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDMARK TREATMENT CENTERS OF TEXAS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Authorized official

Name
Bruce Jarvie
Title
VP, Treasurer
Phone
(214) 379-3300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

216 N John Redditt Dr
Lufkin, TX 75904-2620

Mailing address

1720 Lakepointe Dr Ste 117
Lewisville, TX 75057-6425
Phone (214) 379-3300

Other identifiers 1

IdentifierTypeStateIssuer
100004OtherTXOPOIOD TREATMENT PROGRAM LICENSE

Other names 1

  • MedMark Treatment Centers Lufkin Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opioid treatment program
Medicare-enrolled since May 20, 2026

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2059343Medmark Treatment Centers of Texas, Inc216 N John Redditt Dr, Lufkin, TX 75904Certificate of waiverMay 20, 2027

National Provider Directory

National Provider Directory
Part of
Medmark Treatment Ctr of TX

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1538511878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 LAKEPOINTE DR STE 117",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750576425",
            "telephone_number": "214-379-3300",
            "fax_number": "214-853-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 N JOHN REDDITT DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759042620",
            "telephone_number": "936-637-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDMARK TREATMENT CENTERS OF TEXAS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDMARK TREATMENT CENTERS OF TEXAS, INC",
        "enumeration_date": "2016-07-11",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "JARVIE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "VP, TREASURER",
        "authorized_official_telephone_number": "214-379-3300"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPOIOD TREATMENT PROGRAM LICENSE",
            "identifier": "100004",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedMark Treatment Centers Lufkin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lufkin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.