NPIMap

Organization Active NPI

Special Health Resources for Texas Incorporated

Doing business as Med Plaza III

  • Federally Qualified Health Center (FQHC)
  • Longview, TX
National Provider Identifier
1891280277
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SPECIAL HEALTH RESOURCES FOR TEXAS INCORPORATED
Doing business as
Med Plaza III
Practice address
705 E Marshall Ave Ste 3000
Longview, TX 75601-5661
Phone
(903) 315-2700
Fax
(903) 236-2575
NPI assigned
Jun 27, 2018
Last updated
Jun 27, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

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

Authorized official

Name
Kim Dale Nesvig
Title
Chief Executive Officer
Phone
(903) 234-0776

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

705 E Marshall Ave Ste 3000
Longview, TX 75601-5661

Mailing address

PO Box 2709
Longview, TX 75606-2709
Phone (903) 234-0776

Other names 1

  • MED PLAZA III Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530057600000",
    "number": "1891280277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2709",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756062709",
            "telephone_number": "903-234-0776",
            "fax_number": "903-234-9769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 E MARSHALL AVE STE 3000",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015661",
            "telephone_number": "903-315-2700",
            "fax_number": "903-236-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIAL HEALTH RESOURCES FOR TEXAS INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-27",
        "last_updated": "2018-06-27",
        "status": "A",
        "authorized_official_last_name": "NESVIG",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "903-234-0776"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MED PLAZA III",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MED PLAZA III",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 27, 2018; 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.