Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

East Lake Medical, PLLC

Organization Nurse Practitioner · NPI 1497494777

East Lake Medical, PLLC is a Nurse Practitioner in Tyler, Texas. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11980 State Highway 64 E Ste G
Tyler, TX 75707-2541
Phone: (903) 650-8619
Fax: (903) 650-8576
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X

Record details

NPI number1497494777
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jena Decanter — Nurse Practitioner · (903) 650-8619
NPI enumeratedJune 3, 2022
Last updated in NPPESJune 3, 2022
Certification dateJune 3, 2022
Mailing address11980 State Highway 64 E Ste G, Tyler, TX 75707-2541

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