Individual provider Active NPI

Leah Gatdula, MD

  • Internal Medicine Physician
  • Longview, TX
National Provider Identifier
1740857291
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
V2483 Issued in TX
Practice address
701 E Marshall Ave Ste 400
Longview, TX 75601-5595
Phone
(903) 315-5600
NPI assigned
Jun 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X BP10075218 TX
Internal Medicine Physician 207R00000X V2483 TX Primary

Addresses

Primary practice location

701 E Marshall Ave Ste 400
Longview, TX 75601-5595

Mailing address

11937 US Highway 271
Tyler, TX 75708-3154
Phone (903) 877-7777

Other practice location 1

703 E Marshall Ave Ste 1001
Longview, TX 75601-5500
Phone (903) 753-7291

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240807002179 TX Practitioner - Internal Medicine 4587101688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

703 E Marshall Ave
Longview, TX 75601-5500

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
V2483TXMDInternal Medicine Physician
BP10075218TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas Internal Medicine CurrentSince Sep 3, 2024 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Sep 3, 2024 Accepting new patients

Locations

701 E Marshall Ave
Ste 400
Longview, TX 75601
Phone (903) 315-1696

703 E Marshall Ave
Ste 1001
Longview, TX 75601
Phone (903) 753-7291

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

Interoperability endpoints

  • Direct secure messaging: lgatdula255395@christushealth.direct-ci.net

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1740857291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11937 US HIGHWAY 271",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757083154",
            "telephone_number": "903-877-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E MARSHALL AVE STE 400",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015595",
            "telephone_number": "903-315-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "703 E Marshall Ave Ste 1001",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756015500",
            "country_code": "US",
            "telephone_number": "903-753-7291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GATDULA",
        "first_name": "LEAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-04",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10075218",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "V2483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.