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SOUTHERN PHYSICIAN GROUP MANAGEMENT LLC
NPI 1770162695
Internal Medicine in Nacogdoches, TX

Active since April 07, 2021
1204 N MOUND ST, NACOGDOCHES, TX 75961(936) 564-4611 Get Directions Write a Review

NPPES record last updated: July 26, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 26, 2022, Apr 20, 2021, Apr 7, 2021 (3 updates tracked since 2021).

About Southern Physician Group Management Llc NPPES

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

SOUTHERN PHYSICIAN GROUP MANAGEMENT LLC (NPI 1770162695) is a healthcare organization registered as an internal medicine in Nacogdoches, Texas and active in the NPI registry since April 2021. The organization lists Grant Douglass, President, as its authorized official.

NPPES Registry Identity

NPI1770162695
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameSOUTHERN PHYSICIAN GROUP MANAGEMENT LLC
Location Address1204 N MOUND STNacogdoches, TX 75961-4027
Mailing AddressPo Box 200039Dallas, TX 75320-0039
Phone(936) 564-4611
Organization SubpartNo
Authorized OfficialGrant DouglassPresident · (361) 729-0646
Enumeration DateApril 7, 2021
Last NPPES UpdateJuly 26, 20223 updates tracked since enumeration
NPPES CertifiedJuly 26, 2022
✔ NPI 1770162695 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedEmergency MedicineTaxonomy 207P00000X
1204 N MOUND ST, Nacogdoches, TX 75961
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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 20

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

LAWRENCE QUINN ROBINSON MD
Family Medicine
1204 N MOUND ST
NACOGDOCHES, TX 75961
Nacogdoches County (936) 569-4646
LIESEL E.A. LEEDY MD PA
Anesthesiology
1204 N MOUND ST
NACOGDOCHES, TX 75961
Nacogdoches County (936) 564-4611
NACOGDOCHES COUNTY HOSPITAL DISTRICT
Obstetrics & Gynecology
1204 N MOUND ST
NACOGDOCHES, TX 75961
Nacogdoches County (936) 568-8523
LION STAR NACOGDOCHES HOSPITAL, LLC
General Acute Care Hospital
1204 N MOUND ST
NACOGDOCHES, TX 75961
Nacogdoches County (936) 564-4611
MRS. SABRINA GUILLORY CNM
Advanced Practice Midwife
1204 N MOUND ST
NACOGDOCHES, TX 75961
Nacogdoches County (936) 569-4101
MARY BETH CALME M.D.
Radiology (Diagnostic Radiology)
1204 N MOUND ST, NACOGDOCHES MEMORIAL HOSPITAL RADIOLOGY DEPT
NACOGDOCHES, TX 75961
Nacogdoches County (936) 558-3567
LONE STAR EMERGENCY SERVICES OF EAST TEXAS PLLC
Emergency Medicine
1204 N MOUND ST
NACOGDOCHES, TX 75961
Nacogdoches County (936) 564-4611
WALLACE D WOMACK CRNA
Nurse Anesthetist, Certified Registered
1204 N MOUND ST
NACOGDOCHES, TX 75961
Nacogdoches County (936) 568-8525

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 Southern Physician Group Management LLC's NPI number?

The NPI number for Southern Physician Group Management LLC is 1770162695. It was assigned to this organization in the NPPES registry on April 7, 2021.

Where is Southern Physician Group Management LLC located?

Southern Physician Group Management LLC is located at 1204 N Mound St, Nacogdoches, TX 75961. The listed phone number is (936) 564-4611.

What is Southern Physician Group Management LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

When was this NPI record last updated?

The NPPES record for Southern Physician Group Management LLC was last updated on July 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.