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Organization
LION STAR NACOGDOCHES HOSPITAL, LLC
Active
Organization
LION STAR NACOGDOCHES HOSPITAL, LLC
Active
Parent organization
LION STAR NACOGDOCHES HOSPITAL, LLC
Other names
Nacogdoches Memorial Professional Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
LION STAR NACOGDOCHES HOSPITAL, LLC
Authorized official
MATTHEW MALLOY RN (DIRECTOR OF OPERATIONS)
(936) 568-8427
Entity
Organization
Contact information
Practice address
1204 N MOUND ST, NACOGDOCHES, TX 75961-4027
(936) 568-8427
Mailing address
1204 N MOUND ST, NACOGDOCHES, TX 75961-4027
(936) 568-8427
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
2084N0400X
Neurology Physician
—
—
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
208800000X
Urology Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
367A00000X
Advanced Practice Midwife
—
—
Other
Enumeration date
09/10/2021
Last updated
08/16/2023
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