NPI age
3 years
Enumerated 2022-06-03
● Active Type 2 · Organization
East Lake Medical, Pllc
East Lake Medical, Pllc is 1 of 5264 nurse practitioner organizations in Texas.
Primary specialty
Nurse Practitioner
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Decanter
Nurse Practitioner
Last NPPES update
2022-06-03
Source: monthly bulk 2026-05
How this organization compares
Across 5264 active nurse practitioner providers in Texas.
NPI age
3 years
↓ 5 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2022 → 2026
2022-06Enumerated in NPPES
2022
2026
Where they practice
Primary practice location
11980 State Highway 64 E Ste G
Tyler, TX 757072541
Mailing address
11980 State Highway 64 E Ste G
Tyler, TX 757072541
Authorized official
Jena Decanter, NP
Nurse Practitioner
📞 9036508619
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Jena Decanter, FNP Nurse Practitioner NPI 1215306584
Specialties
-
Nurse Practitioner Primary(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum...
Practice context
Multi-provider organization. 1 individual provider 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 →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.