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

Medeval, LLC

Organization General Practice Physician · NPI 1740548346

Medeval, LLC is a General Practice Physician in Texarkana, Texas. Works from 2 locations. Licensed in Texas.

Licensed in
TX
In the registry since
2012
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

4920 Elizabeth St
Texarkana, TX 75503-2912
Phone: (903) 792-3812
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 116 Westlake Rd, Texarkana, TX 75501-0006 — (903) 293-7093

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence L8691 (TX)

Record details

NPI number1740548346
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dewitt Fortenberry — Medical Director · (301) 641-5512
NPI enumeratedMay 2, 2012
Last updated in NPPESSeptember 17, 2023
Certification dateSeptember 17, 2023
Mailing address116 Westlake Rd, Texarkana, TX 75501-0006

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