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

Marvin Dean Pennington, PA

Individual provider Surgical Physician Assistant · NPI 1972534683

Marvin Dean Pennington, PA is a Physician Assistant in Tyler, Texas. Qualified in 1998, 28 years ago. Practices with Ortholonestar PLLC, a 415-clinician group and accepts Medicare assignment.

Years since qualifying
28
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

3414 Golden Rd
Tyler, TX 75701-8336
Phone: (903) 939-7500
Fax: (800) 248-0426
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X

Record details

NPI number1972534683
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 5, 2006
Last updated in NPPESMay 19, 2024
Certification dateMay 19, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1998 (28 years in practice)
Group practice Ortholonestar Pllc — 415 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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