Medical Center

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

F7521 Issued in TX

Legal business name

MEDICAL CENTER

Practice address

203 A East Jefferson
Whitney, TX 76692

Phone

(254) 694-9400

Fax

(254) 694-9175

NPI assigned

Dec 13, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Teresa V Manax, M.D.NPI 1538362348

Title

Co-Owner

Phone

(254) 694-9400

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Teresa Manax, MD

  • Family Medicine Physician
  • Irving, TX
  • NPI 1538362348
  NPD (past) Authorized official
• Donna Jean Walker, NP

  • Family Nurse Practitioner
  • Bristol, TN
  • NPI 1841568318
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780746339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2570",
            "city": "WHITNEY",
            "state": "TX",
            "postal_code": "766925570",
            "telephone_number": "254-694-9400",
            "fax_number": "254-694-9175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 A EAST JEFFERSON",
            "city": "WHITNEY",
            "state": "TX",
            "postal_code": "76692",
            "telephone_number": "254-694-9400",
            "fax_number": "254-694-9175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MANAX",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "254-694-9400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "TX",
            "license": "F7521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "88600Y",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lake Whitney Physical Therapy PC
• Lake Whitney Physicians Clinic LLC
• Lakeside Physicians Management LLC
• Jamie Lee, APRN, FNP-C
• Jorge Armando Marcial, M.D.
• Rosa Isela Mendoza, RN
• Sejalben A Mistry
• Lauren E Montgomery
• Leslie Ann-Sikes Montgomery, FNP
• Motion Therapy Staffing Inc.

• Point of Service in Whitney, TX
• Providers in Whitney, TX by specialty
• Point of Service in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.