NPIMap

Organization Active NPI

East Texas Family Healthcare, PLLC

  • Internal Medicine Physician
  • Jasper, TX
National Provider Identifier
1770754335
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
L0429 Issued in TX
Legal business name
EAST TEXAS FAMILY HEALTHCARE, PLLC
Practice address
1273 S Peachtree St
Jasper, TX 75951-4915
Phone
(409) 384-9200
NPI assigned
Mar 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Authorized official

Name
Dr. Kalyan Kumar Rath, M.D.NPI 1639188147
Title
Owner
Phone
(409) 384-9200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X L0429 TX Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X K1016 TX

Addresses

Primary practice location

1273 S Peachtree St
Jasper, TX 75951-4915

Mailing address

1273 S Peachtree St
Jasper, TX 75951-4915
Phone (409) 384-9200

Other practice location 1

920 N Magnolia St
Woodville, TX 75979-4519
Phone (409) 283-5556

Other practice location 2

1304 W Court St
Newton, TX 75966-3009
Phone (409) 379-2177

Other practice location 3

1905 N Margaret Ave
Kirbyville, TX 75956-1652
Phone (409) 420-0816

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051207000350 TX Part B Supplier - Clinic/Group Practice 2961310610 Receives reassigned benefits from 7 practitioners
Practice locations: Jasper, TX

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
45D0978208Family Healthcare1273 South Peachtree Street, Jasper, TX 75951Certificate of waiverJul 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
East Texas Family Healthcare PLLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1905 N Margaret Ave
Kirbyville, TX 75956
Phone (409) 420-0816

21034 US Highway 96 S
Kirbyville, TX 75956
Phone (409) 420-0816

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1206057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783987200000",
    "number": "1770754335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1273 S PEACHTREE ST",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759514915",
            "telephone_number": "409-384-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1273 S PEACHTREE ST",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759514915",
            "telephone_number": "409-384-9200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 N Magnolia St",
            "address_purpose": "LOCATION",
            "city": "Woodville",
            "state": "TX",
            "postal_code": "759794519",
            "country_code": "US",
            "telephone_number": "409-283-5556",
            "fax_number": "409-283-5557",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1304 W Court St",
            "address_purpose": "LOCATION",
            "city": "Newton",
            "state": "TX",
            "postal_code": "759663009",
            "country_code": "US",
            "telephone_number": "409-379-2177",
            "fax_number": "409-379-2188",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1905 N Margaret Ave",
            "address_purpose": "LOCATION",
            "city": "Kirbyville",
            "state": "TX",
            "postal_code": "759561652",
            "country_code": "US",
            "telephone_number": "409-420-0816",
            "fax_number": "409-420-0821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EAST TEXAS FAMILY HEALTHCARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-21",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A",
        "authorized_official_last_name": "RATH",
        "authorized_official_first_name": "KALYAN",
        "authorized_official_middle_name": "KUMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-384-9200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L0429",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K1016",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; 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.