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

Lion Star Nacogdoches Hospital, LLC

Organization Family Medicine Physician · NPI 1316616550

Lion Star Nacogdoches Hospital, LLC is a Family Medicine Physician in Nacogdoches, Texas. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
15
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1204 N Mound St
Nacogdoches, TX 75961-4027
Phone: (936) 568-8427
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Cardiovascular Disease Physician Taxonomy 207RC0000X
Obstetrics & Gynecology Physician Taxonomy 207V00000X
Otolaryngology Physician Taxonomy 207Y00000X
Anatomic Pathology & Clinical Pathology Physician Taxonomy 207ZP0102X
Neurology Physician Taxonomy 2084N0400X
Surgery Physician Taxonomy 208600000X
Vascular Surgery Physician Taxonomy 2086S0129X
Urology Physician Taxonomy 208800000X
Physician Assistant Taxonomy 363A00000X
Nurse Practitioner Taxonomy 363L00000X
Family Nurse Practitioner Taxonomy 363LF0000X
Women's Health Nurse Practitioner Taxonomy 363LW0102X
Advanced Practice Midwife Taxonomy 367A00000X

Record details

NPI number1316616550
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationLion Star Nacogdoches Hospital, LLC
Authorized official Matthew Malloy — Director Of Operations · (936) 568-8427
Other names Nacogdoches Memorial Professional Group; Nacogdoches Memorial Professional Group
NPI enumeratedSeptember 10, 2021
Last updated in NPPESAugust 16, 2023
Certification dateAugust 16, 2023
Mailing address1204 N Mound St, Nacogdoches, TX 75961-4027

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