IMPACT PHYSICIAN GROUP, TEXAS LLC – Internal Medicine Physician, NPI 1740803113
Internal Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for IMPACT PHYSICIAN GROUP, TEXAS LLC
21 EASTBROOK BND STE 218
PEACHTREE CITY, GA 302691546
Phone: (678) 967-5599
Type: Mailing
302 GOBBLERS KNOB RD
LUFKIN, TX 759045419
Phone: (936) 632-2295
Type: Location
425 E Alton Gloor Blvd
Brownsville, TX 785263361
Phone: (956) 554-6000
Type: Location
615 Clinic Dr
Longview, TX 756055172
Phone: (903) 212-3105
Type: Location
3300 Farm to Market 1788
Midland, TX 79706
Phone: (432) 561-5915
Type: Location
8903 Floyd Curl Dr
San Antonio, TX 782403482
Phone: (469) 640-6500
Type: Location
4302 Princeton St
Lubbock, TX 794151304
Phone: (806) 749-2222
Type: Location
906 James St
Weslaco, TX 785969840
Phone: (956) 969-2222
Type: Location
1023 N Belt Line Rd
Mesquite, TX 751491788
Phone: (972) 216-2400
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-06-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-12-31 (158 days ago).
Enrollment records
1
Earliest due date
2025-12-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20200629000314 | O | Clinic/Group Practice | TX | 2025-12-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30269)
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