P Praxis·MD
● Active Type 2 · Organization

East Lake Medical, Pllc

Nurse Practitioner·Tyler, TX· NPI 1497494777 · Enumerated 2022 · 3 years on NPI
East Lake Medical, Pllc is 1 of 5264 nurse practitioner organizations in Texas.
NPI age
3 years
Enumerated 2022-06-03
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
📞 9036508619fax 9036508576
Mailing address
11980 State Highway 64 E Ste G
Tyler, TX 757072541
📞 9036508619fax 9036508576

Authorized official

Jena Decanter, NP
Nurse Practitioner
📞 9036508619

Individual providers at this organization

1 individual provider on file at this primary practice address.

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...
    taxonomy 363L00000X

Practice context

Multi-provider organization. 1 individual provider on file at this primary address.

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How to verify this organization

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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