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Itasca Healing Medical Practice

Family Medicine Physician in Nacogdoches, TX · enumerated 2024 · authorized official Suzanna Fuller, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1023867546

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Registry record

Entity type Organization (Type 2)
Legal business name Itasca Healing Medical Practice
Practice address 223 King St, Nacogdoches, TX, 75961
Phone (936) 622-0552
Fax (936) 622-0554
Enumeration date May 16, 2024
Last updated in NPPES Oct 2, 2024

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Suzanna Fuller
Title Owner
Phone (936) 250-2062

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Itasca Healing Medical Practice?
The NPI for Itasca Healing Medical Practice is 1023867546, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Itasca Healing Medical Practice?
NPPES lists Suzanna Fuller (Owner) as the authorized official for this organization.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2024-10-02.