GARY P ENGSTROM (NPI# 1336149731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336149731 |
| Entity Type | Individual |
| Full Name | GARY P ENGSTROM |
| Credential | MD |
| Practice Address |
5002 Cowhorn Creek Rd Texarkana TX 75503-9766 |
| Practice Telephone | 9036143000 |
| Practice Fax Number | 9036143525 |
| Mailing Telephone | 9036143000 |
| Mailing Fax Number | 9036143525 |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2011-04-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
J1988 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 043953101 | 05 | |
| AR | 131935001 | 05 |
| Street Address |
5002 COWHORN CREEK RD |
| City | TEXARKANA |
| State | TX |
| Zip Code | 75503-9766 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447255229 | Jeffrey David Decaprio | Surgery | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2005-06-17 |
| 1225681604 | Lauren N. Hadaway | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2019-07-24 |
| 1144872839 | Brandi M. Martin | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2019-07-12 |
| 1093292104 | Heidi R Smith | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2018-07-20 |
| 1194215814 | Angela L Bowen | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2018-05-17 |
| 1689174955 | Cody C Ray | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2018-02-13 |
| 1699282087 | Melissa Ann Lamon | Registered Nurse | 5002 Cowhorn Creek Rd, Texarkana, TX 75503 | 2018-01-07 |
| 1013443589 | Laura L Jackson | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2017-05-03 |
| 1316478852 | Schamma Salomon | Internal Medicine | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2017-03-26 |
| 1346781325 | Melissa Elizabeth Redfearn | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2017-03-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770049397 | Jeffery Nash | Nurse Practitioner | #4 Valley View Circle, Texarkana, TX 75503 | 2019-02-19 |
| 1821583501 | Brandy D Acker | Psychologist | 3615 Richmond Rd, Texarkana, TX 75503 | 2018-06-26 |
| 1366935066 | Samantha Lee Harris | Nurse Practitioner | 4116 Mcknight Rd, Texarkana, TX 75503 | 2018-06-07 |
| 1811416910 | Heather Alison Gerber | Nurse Practitioner | 5903 Brenda Street, Texarkana, TX 75503 | 2017-09-11 |
| 1952838682 | John Kyle Abney | Counselor | 4134 Mcknight Rd, Texarkana, TX 75503 | 2017-05-12 |
| 1699151514 | Piney Woods Er IIi LLC | Clinic/Center | 4102 Gibson Lane, Texarkana, TX 75503 | 2015-08-03 |
| 1609282433 | Colby Rebecca Pair | Physician Assistant | 2604 St. Michael Dr., Suite 310, Texarkana, TX 75503 | 2014-07-01 |
| 1265842496 | Healthcare Express, LLP | Clinic/Center | 3513 Richmond Rd, Texarkana, TX 75503 | 2014-04-28 |
| 1134540628 | Eagle Dental Center of Texarkana Pllc | Dentist | 4009 Moores Ln, Texarkana, TX 75503 | 2013-12-30 |
| 1326481664 | Juancarlo S. Pascual | Family Medicine | 604 St. Michael Dr, Suite 340, Texarkana, TX 75503 | 2013-04-16 |
| Find all providers in zip 75503 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205399961 | Christus Health Ark-la-tex | Internal Medicine | 5002 Cowhorn Creek Rd Ste 3205, Texarkana, TX 75503-9766 | 2019-04-10 |
| 1801869235 | Edward Armand Eichler Jr. | Internal Medicine | 2604 St. Michael Dr, Suite 210, Texarkana, TX 75503 | 2006-02-08 |
| 1063410637 | Jayendra D. Patel | Internal Medicine | 2600 Saint Michael Dr, Texarkana, TX 75503-5220 | 2005-07-08 |
| 1790162238 | Christus Health Ark-la-tex | Internal Medicine | 2604 Saint Michael Dr, Ste 238, Texarkana, TX 75503-2379 | 2015-05-05 |
| 1588715916 | Sunil A Patel | Internal Medicine | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2007-01-13 |
| 1114909934 | Collom & Carney Clinic | Internal Medicine | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2005-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861958704 | Thi of Texas At Samaritan Hospice LLC | Internal Medicine | 12001 N Central Expy Ste 550, Dallas, TX 75243-3943 | 2019-02-15 |
| 1417485822 | Ahmad Ghorab | Internal Medicine | 1515 Holcombe Blvd #1445, Houston, TX 77030 | 2017-05-30 |
| 1063952943 | Irfan Jawed Md Pllc | Internal Medicine | 4102 Woodlawn Avenue, Ste 160, Pasadena, TX 77504 | 2017-02-27 |
| 1366981615 | Houston Cancer Treatment Centers Pa. | Internal Medicine | 4102 Woodlawn Ave Ste 160, Pasadena, TX 77504-1922 | 2017-02-20 |
| 1508222720 | Maurizio Bendandi | Internal Medicine | 6722 Mimosa Ln, Dallas, TX 75230-5214 | 2016-01-04 |
| 1245642073 | Juan Francisco Garza | Internal Medicine | 3333 Bayshore Blvd Ste 320, Pasadena, TX 77504-1950 | 2014-05-28 |
| 1124463211 | Oluchi Oke | Internal Medicine | 1515 Holcombe Blvd Unit 463, Division of Cancer Medicine, Houston, TX 77030-4000 | 2013-05-03 |
| 1710229323 | Adaeze Nwosu- Iheme | Internal Medicine | 2700 Citizens Plz Ste 200, Victoria, TX 77901-5756 | 2013-03-21 |
| 1144570599 | Gummadi & Desai LLC | Internal Medicine | 2717 Michael Angelo Ste 302, Edinburg, TX 78539-1409 | 2012-09-13 |
| 1386904357 | Amir A Rasheed M.d Pa | Internal Medicine | 1140 Westmont Dr Ste 340, Houston, TX 77015-4363 | 2012-05-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.