MEMORIAL HOSPITAL POLK COUNTY
NPI 1215984687
Specialist in Livingston, TX

Q: What is Memorial Hospital Polk County's NPI number?

The NPI number for Memorial Hospital Polk County is 1215984687. It was assigned to this organization in the NPPES registry on May 30, 2006. The provider is doing business as Anesthesia Group.

Q: What is Memorial Hospital Polk County's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Active since May 30, 2006

1717 HIGHWAY 59 LOOP N, LIVINGSTON, TX 77351(936) 631-3474(936) 631-3475 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

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About Memorial Hospital Polk County NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MEMORIAL HOSPITAL POLK COUNTY (NPI 1215984687), doing business as Anesthesia Group, is a healthcare organization registered as a specialist in Livingston, Texas and active in the NPI registry since May 2006. The organization lists Fonda R Sullivan, Insurance Supervisor, as its authorized official.

NPPES Registry Identity

NPI1215984687

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NameMEMORIAL HOSPITAL POLK COUNTY

Location Address1717 HIGHWAY 59 LOOP NLivingston, TX 77351-5703

Mailing Address1717 Highway 59 Loop NLivingston, TX 77351-5703 · (936) 631-3474 · Fax (936) 631-3475

Phone(936) 631-3474

Fax(936) 631-3475

Organization SubpartNo

Authorized OfficialFonda R SullivanInsurance Supervisor · (936) 631-3474

Enumeration DateMay 30, 2006

Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration

✔ NPI 1215984687 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in TX · L6696

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Also ListedNurse Anesthetist, Certified RegisteredTaxonomy 367500000X · License 237108 (TX), 452164 (TX), 656746 (TX), 422854 (TX), 033599 (TX), 041553 (TX), 048803 (TX)

1717 HIGHWAY 59 LOOP N, Livingston, TX 77351

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Other Names 1

Doing Business AsAnesthesia Group

Other Identifiers 2

Other00479NTX · Blue Cross Grp

Medicaid080663002TX

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RICHARD M AVERY DO

Internal Medicine