MEDEVAL, LLC
NPI 1740548346
General Practice in Texarkana, TX

Q: What is Medeval, LLC's NPI number?

The NPI number for Medeval, LLC is 1740548346. It was assigned to this organization in the NPPES registry on May 2, 2012.

Q: What is Medeval, LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Q: When was this NPI record last updated?

The NPPES record for Medeval, LLC was last updated on September 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 02, 2012

4920 ELIZABETH ST, TEXARKANA, TX 75503(903) 792-3812 Get Directions Write a Review

NPPES record last updated: September 17, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Medeval, Llc NPPES

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

MEDEVAL, LLC (NPI 1740548346) is a healthcare organization registered as a general practice in Texarkana, Texas and active in the NPI registry since May 2012. The organization maintains a secondary practice location in Texarkana and lists Dewitt Charles Fortenberry, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1740548346

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameMEDEVAL, LLC

Location Address4920 ELIZABETH STTexarkana, TX 75503-2912

Mailing Address116 Westlake RdTexarkana, TX 75501-0006 · (903) 293-7093

Phone(903) 792-3812

Organization SubpartNo

Authorized OfficialDewitt Charles FortenberryMedical Director · (301) 641-5512

Enumeration DateMay 2, 2012

Last NPPES UpdateSeptember 17, 2023

NPPES CertifiedSeptember 17, 2023

✔ NPI 1740548346 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in TX · L8691

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

4920 ELIZABETH ST, Texarkana, TX 75503

Open in Google Maps ↗

Secondary Practice Location 1

Location 1116 Westlake RdTexarkana, TX 75501-0006 · Phone (903) 293-7093

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Other Providers at the Same Location NPPES 2

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

TEXARKANA NURSING & HEALTHCARE

Clinical Nurse Specialist (Long-Term Care)

4920 ELIZABETH ST
TEXARKANA, TX 75503

Bowie County (903) 792-3812

WINNIE-STOWELL HOSPITAL DISTRICT

Skilled Nursing Facility

4920 ELIZABETH ST
TEXARKANA, TX 75503

Bowie County (903) 792-3812

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Medeval, LLC's NPI number?

The NPI number for Medeval, LLC is 1740548346. It was assigned to this organization in the NPPES registry on May 2, 2012.

Where is Medeval, LLC located?

Medeval, LLC is located at 4920 Elizabeth St, Texarkana, TX 75503. The listed phone number is (903) 792-3812.

What is Medeval, LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

What insurance does Medeval, LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 2 other insurers list Medeval, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Medeval, LLC was last updated on September 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.