Organization Active NPI

E Remenchik MD PLLC

  • Internal Medicine Physician
  • Longview, TX
National Provider Identifier
1831406842
Registry record updated Jan 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G8366 Issued in TX
Legal business name
E REMENCHIK MD PLLC
Practice address
717 N 4TH St
Suite 3
Longview, TX 75601-5438
Phone
(903) 758-0020
Fax
(903) 758-0067
NPI assigned
Sep 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2012

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

Authorized official

Name
Dr. Ellen Jean Remenchik, M.D.
Title
Sole Member
Phone
(903) 553-0353

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X G8366 TX Primary

Addresses

Primary practice location

717 N 4TH St
Suite 3
Longview, TX 75601-5438

Mailing address

717 N 4TH St
Suite 3
Longview, TX 75601-5438
Phone (903) 758-0020

Other identifiers 1

IdentifierTypeStateIssuer
218907801MedicaidTX

National Provider Directory

National Provider Directory

Locations

717 N 4th St
Ste 3
Longview, TX 75601
Phone (903) 758-0020

Practitioners & affiliated clinicians

Practitioners 3

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": "1284336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326758400000",
    "number": "1831406842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 N 4TH ST",
            "address_2": "SUITE 3",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015438",
            "telephone_number": "903-758-0020",
            "fax_number": "903-758-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 N 4TH ST",
            "address_2": "SUITE 3",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015438",
            "telephone_number": "903-758-0020",
            "fax_number": "903-758-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E REMENCHIK MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-13",
        "last_updated": "2012-01-17",
        "status": "A",
        "authorized_official_last_name": "REMENCHIK",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "903-553-0353",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "G8366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218907801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2012; 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.