Active NPI
East Texas Id Associates PLLC
- Infectious Disease Physician
- Lufkin, TX
National Provider Identifier
1881444040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- Legal business name
- EAST TEXAS ID ASSOCIATES PLLC
- Practice address
- 505 S John Redditt Dr
Lufkin, TX 75904-3120 - Phone
- (936) 634-8311
- NPI assigned
- Mar 22, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mandeep Bains
- Title
- Manager
- Phone
- (936) 255-7330
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | Primary |
Addresses
Primary practice location
505 S John Redditt Dr
Lufkin, TX 75904-3120
Mailing address
PO Box 150456
Lufkin, TX 75915-0456
Phone (936) 255-7330
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Infectious Disease Physician
- Lufkin, TX
- NPI 1700020278
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711065600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1751241600000",
"number": "1881444040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 150456",
"city": "LUFKIN",
"state": "TX",
"postal_code": "759150456",
"telephone_number": "936-255-7330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 S JOHN REDDITT DR",
"city": "LUFKIN",
"state": "TX",
"postal_code": "759043120",
"telephone_number": "936-634-8311"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EAST TEXAS ID ASSOCIATES PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-03-22",
"last_updated": "2025-06-30",
"certification_date": "2025-06-30",
"status": "A",
"authorized_official_last_name": "BAINS",
"authorized_official_first_name": "MANDEEP",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "936-255-7330"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Infectious Disease",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lufkin, TX
- East Texas Foot Associates
- East Texas Heart & Vascular Imaging LTD
- East Texas Heart & Vascular Imaging of Lufkin, PA
- East Texas Hematology & Oncology
- East Texas Hematology & Oncology
- East Texas Internal Medicine PA
- East Texas Neuro Rehab
- East Texas Open MRI & Diagnostics L.P.
- East Texas Premier Pediatrics PLLC
- East Texas Therapy Centers, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.