NPI age
19 years
Enumerated 2006-05-30
● Active Type 2 · Organization
Memorial Hospital Polk County
Memorial Hospital Polk County is 1 of 4038 specialist organizations in Texas.
Primary specialty
Specialist
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Sullivan
Insurance Supervisor
Last NPPES update
2025-09-11
Source: monthly bulk 2026-05
How this organization compares
Across 4038 active specialist providers in Texas.
NPI age
19 years
≈ at median (18 yr)
Practice locations
1
0 secondary on file
Subspecialties
1
In the 7% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-05Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
1717 Highway 59 Loop N
Livingston, TX 773515703
Mailing address
1717 Highway 59 Loop N
Livingston, TX 773515703
Authorized official
Fonda R Sullivan
Insurance Supervisor
📞 9366313474
Individual providers at this organization
6 individual providers on file at this primary practice address.
- Richard Avery, DO Internal Medicine NPI 1023073822
- William Avery, DO Radiology NPI 1316035777
- Alana Beck, NP Nurse Practitioner NPI 1548798556
- Dan Carr, CRNA Nurse Anesthetist, Certified Registered NPI 1417025602
- Earl Clark, PAC Physician Assistant NPI 1861565046
- Michael Lukenovich, FNP Nurse Practitioner NPI 1649755430
Specialties
-
Specialist PrimaryAn 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.
-
Nurse Anesthetist, Certified Registered(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 00479N | BLUE CROSS GRP |
| 05 (TX) | 080663002 |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Anesthesia Group
Practice context
Multi-provider organization. 6 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.