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DIAGNOSTIC CLINIC OF LONGVIEW PA NPI 1386638468


NPI Information

NPI: 1386638468
Provider Name: DIAGNOSTIC CLINIC OF LONGVIEW PA
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 45D0482673

Address:
707 HOLLYBROOK DR
LONGVIEW, TX
ZIP 75605
Phone: (903) 757-6042
Get Directions

DIAGNOSTIC CLINIC OF LONGVIEW PA is an internal medicine in Longview, TX. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. DIAGNOSTIC CLINIC OF LONGVIEW PA NPI is 1386638468. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

707 HOLLYBROOK DR
LONGVIEW, TX
ZIP 75605-410
Phone: (903) 757-6042
Fax: (903) 232-8226

The provider's authorized official is Dora C Reeves .
The authorized official title is Credentialing Coordinator and has the following contact phone number (903) 291-6062.

The CLIA number assigned to this NPI record is 45D0482673 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 9/6/2005 and was last updated on 2/5/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RS0012XInternal MedicineSleep MedicineTEXASNo
2207RG0100XInternal MedicineGastroenterologyTEXASNo
3332B00000XDurable Medical Equipment & Medical SuppliesNo
4207Q00000XFamily MedicineTEXASNo
5207RI0011XInternal MedicineInterventional CardiologyNo
6207RI0200XInternal MedicineInfectious DiseaseTEXASNo
7207V00000XObstetrics & GynecologyNo
8207X00000XOrthopaedic SurgeryNo
9207Y00000XOtolaryngologyNo
10208000000XPediatricsNo
112084N0400XPsychiatry & NeurologyNeurologyNo
12208600000XSurgeryNo
13207UN0901XNuclear MedicineNuclear CardiologyNo
14213ES0103XPodiatristFoot & Ankle SurgeryNo
15207R00000XInternal MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1130964306MEDICAIDTEXAS
2130964302MEDICAIDTEXAS
3130964307MEDICAIDTEXAS
445D0482673OTHERTEXASDME RR MEDICARE
50668930001MEDICARE NSCTEXAS
600T453MEDICARE PINTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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