Organization Active NPI

Texarkana Senior Care Clinic PLLC

  • Geriatric Medicine (Family Medicine) Physician
  • Texarkana, TX
National Provider Identifier
1609443829
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
TEXARKANA SENIOR CARE CLINIC PLLC
Practice address
4321 McKnight Rd
Texarkana, TX 75503-0929
Phone
(903) 716-8808
Fax
(903) 716-8799
NPI assigned
Jun 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Authorized official

Name
Andrea K Heflin, CERTIFIED NURSE PRAC
Title
Member
Phone
(903) 716-8808

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X Primary

Addresses

Primary practice location

4321 McKnight Rd
Texarkana, TX 75503-0929

Mailing address

4321 McKnight Rd
Texarkana, TX 75503-0929
Phone (903) 716-8808

Other practice location 1

5902 Summerfield Dr Ste A
Texarkana, TX 75503-4307
Phone (903) 716-8808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210818004035 TX Part B Supplier - Clinic/Group Practice 4688079320 Practice locations: Texarkana, TX

National Provider Directory

National Provider Directory

Locations

5902 Summerfield Dr
Ste A
Texarkana, TX 75503
Phone (903) 716-8808

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24317/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756252800000",
    "number": "1609443829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4321 MCKNIGHT RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755030929",
            "telephone_number": "903-716-8808",
            "fax_number": "903-716-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 MCKNIGHT RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755030929",
            "telephone_number": "903-716-8808",
            "fax_number": "903-716-8799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5902 Summerfield Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Texarkana",
            "state": "TX",
            "postal_code": "755034307",
            "country_code": "US",
            "telephone_number": "903-716-8808",
            "fax_number": "903-716-8799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TEXARKANA SENIOR CARE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-07",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A",
        "authorized_official_last_name": "HEFLIN",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "903-716-8808",
        "authorized_official_credential": "CERTIFIED NURSE PRAC"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.