Eastland Health Clinic PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

653723 Issued in TX

Legal business name

EASTLAND HEALTH CLINIC PLLC

Practice address

1004 W Main St
Eastland, TX 76448-2432

Phone

(254) 631-0111

Fax

(254) 631-0186

NPI assigned

Feb 2, 2012

Last updated

May 3, 2012By 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

Julie Berenda Stewart, FNPNPI 1457540338

Title

Family Nurse Practitioner

Phone

(254) 631-0111

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 4

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.

• Julie Berenda Stewart, NP

  • Family Nurse Practitioner
  • Eastland, TX
  • NPI 1457540338
  Medicare reassignment Care Compare group NPD Authorized official
• Roberto John Denny, FNP, APRN

  • Family Nurse Practitioner
  • Eastland, TX
  • NPI 1912787698
  Medicare reassignment Care Compare group NPD
• Jennifer Evans Tidroski, D.O.

  • Pediatrics Physician
  • Prescott, AZ
  • NPI 1639457245
  NPD
• Christopher Tidroski, D.O.

  • Family Medicine Physician
  • Eastland, TX
  • NPI 1144459868
  NPD (past)

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

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336003200000",
    "number": "1942572227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150415",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787150415",
            "telephone_number": "254-631-0111",
            "fax_number": "254-631-0186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 W MAIN ST",
            "city": "EASTLAND",
            "state": "TX",
            "postal_code": "764482432",
            "telephone_number": "254-631-0111",
            "fax_number": "254-631-0186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTLAND HEALTH CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-02",
        "last_updated": "2012-05-03",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "BERENDA",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "254-631-0111",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "653723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eastland Assisted Living Corporation (The Woodlands Assisted Living)
• Eastland Chiropractic Wellness Center PA
• Eastland Dental PLLC
• Eastland Dialysis Center, LLC (Eastland Dialysis Center)
• Eastland Drug Company Incorporated (Eastland Drug Co Inc)
• Eastland Independent School District
• Eastland Memorial Hospital District (Eastland Memorial Hosptial)
• Eastland Memorial Hospital District (EMH Regional Healthcare Clinic)
• Eastland Memorial Hospital District (Avir at Woodlands)
• Eastland Memorial Hospital District (Eastland Dialysis Center)

• Primary Care Clinic/Center in Eastland, TX
• Providers in Eastland, TX by specialty
• Primary Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; 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.

Verify at the official NPI Registry.