Diagnostic Clinic of Longview – Internal Medicine Physician, NPI 1932640349
Internal Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Loading map...
Provider Addresses for Diagnostic Clinic of Longview
707, Hollybrook Drive, Longview, Gregg County, Texas, 75605, United States
LONGVIEW, TX 756052410
Phone: (903) 757-6042
Fax: (903) 232-8226
Type: Location
707 Hollybrook Dr Ste 500
Longview, TX 756052409
Phone: (903) 232-8276
Fax: (903) 234-9126
Type: Location
P.O. BOX 610393
DALLAS, TX 752610393
Phone: (903) 757-6042
Fax: (903) 232-8226
Type: Mailing
PO BOX 29343
BELFAST, ME 049152045
Phone: (903) 757-6042
Fax: (903) 232-8226
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
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: 2018-05-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Revalidation due soon
Earliest CMS due date is 2026-08-31 (85 days away).
Enrollment records
2
Earliest due date
2026-08-31
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 |
|---|---|---|---|---|
| O20170831003007 | O | Clinic/Group Practice | TX | TBD |
| O20180518000645 | O | Physician - General Practice | TX | 2026-08-31 |
What to do next
- Confirm the due date on the CMS Revalidation Lookup Tool.
- Complete revalidation in PECOS before the published due date.
- If you have multiple enrollment records, revalidate each one on its own schedule.
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 75605)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.