NPIMap

Organization Active NPI

East Texas Pediatrics

  • Pediatrics Physician
  • Marshall, TX
National Provider Identifier
1942532106
Registry record updated Feb 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
EAST TEXAS PEDIATRICS
Practice address
618 S Grove St Ste 100
Marshall, TX 75670-5294
Phone
(903) 927-6611
Fax
(903) 927-6230
NPI assigned
Feb 12, 2010
Last updated
Feb 12, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
GOOD SHEPHERD MEDICAL CENTER MARSHALLAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 12, 2010

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

Authorized official

Name
Misty Sprouse
Title
Director
Phone
(903) 927-6264

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

618 S Grove St Ste 100
Marshall, TX 75670-5294

Mailing address

PO Box 1325
Marshall, TX 75671-1325
Phone (903) 927-6611

National Provider Directory

National Provider Directory
Tax ID family
Christus Good Shepherd6 organizations share this tax ID, including this one
Part of
Christus Good Shepherd

Other organizations with this tax ID 5

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1265932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265932800000",
    "number": "1942532106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1325",
            "city": "MARSHALL",
            "state": "TX",
            "postal_code": "756711325",
            "telephone_number": "903-927-6611",
            "fax_number": "903-927-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 S GROVE ST STE 100",
            "city": "MARSHALL",
            "state": "TX",
            "postal_code": "756705294",
            "telephone_number": "903-927-6611",
            "fax_number": "903-927-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS PEDIATRICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GOOD SHEPHERD MEDICAL CENTER MARSHALL",
        "enumeration_date": "2010-02-12",
        "last_updated": "2010-02-12",
        "status": "A",
        "authorized_official_last_name": "SPROUSE",
        "authorized_official_first_name": "MISTY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "903-927-6264"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshall, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2010; 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.