Stonewall Pediatric Health Center, LLC · Pediatrics Physician

1303 S. Unversity Dr, Nacogdoches, TX 75961

Overview

Stonewall Pediatric Health Center, LLC is a Pediatrics Physician (organization) practicing in Nacogdoches, Texas. The National Provider Identifier (NPI) is #1831031509, which was assigned on April 9, 2026, and the registration record was last updated on April 9, 2026. The practitioner's main practice location is at 1303 S. Unversity Dr, Nacogdoches, TX 75961; the contact telephone number is 9362194611. The primary taxonomy of Stonewall Pediatric Health Center, LLC is Pediatrics Physician (208000000X). The authorized official for Stonewall Pediatric Health Center, LLC is Mr. Desmond Tolbert (Ceo).

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Provider Information

NPI 1831031509
Entity Type Organization
Organization Name STONEWALL PEDIATRIC HEALTH CENTER, LLC
Provider Name STONEWALL PEDIATRIC HEALTH CENTER, LLC
Practice Address 1303 S. Unversity Dr
Nacogdoches
TX 75961
Practice Telephone 9362194611
Mailing Address 1303 S. Unversity Dr
Nacogdoches
TX 75961
Mailing Telephone 9362194611
Certification Date 2026-04-02
Enumeration Date 2026-04-09
Last Update Date 2026-04-09
Is Organization Subpart N

Authorized Official Information

Official Name MR. DESMOND TOLBERT
Official Title CEO
Telephone 9362194611

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
Y208000000XPediatrics193200000X MULTI-SPECIALTY GROUP

Taxonomy Information

Primary Taxonomy

Code 208000000X
Taxonomy Pediatrics Physician
Classification Pediatrics
Grouping Allopathic & Osteopathic Physicians
Definition: A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio
Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics.

Providers with the same taxonomy

Provider NameAddressTaxonomyEnumeration Date
Twilight Pediatric Medicine 440 Asbury Rd, Freeville, NY 13068-9740Pediatrics Physician2026-03-31
Ireland Buckley Banner 2829 Babcock Rd, San Antonio, TX 78229-6028Pediatrics Physician2026-03-31
Everkind Pediatrics 31717 Tradewinds Dr, Avon Lake, OH 44012-2915Pediatrics Physician2026-04-03
Children's Dentistry of Lithonia LLC 7215 Stonecrest Pkwy, Lithonia, GA 30038-2563Pediatrics Physician2026-03-26
North Florida Pediatrics Pa 3872 San Jose Park Dr, Jacksonville, FL 32217-4613Pediatrics Physician2026-04-02
Karessa James 1009 Dunham St Se, Grand Rapids, MI 49506-2658Pediatrics Physician2026-04-10
Giorgi Maziashvili 450 Chew St Ste 203, Allentown, PA 18102-3434Pediatrics Physician2026-04-09
Emerald Home Health LLC 8301 White Pine Dr, Fort Worth, TX 76123-1702Pediatrics Physician2026-03-26
Children's Healthcare Center, LLC 510 Washington Ave, Sandersville, GA 31082-1971Pediatrics Physician2026-04-10
Internal Medicine and Pediatrics of San Diego 8745 Aero Dr Ste 106, San Diego, CA 92123-1763Pediatrics Physician2026-04-06
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Location Information

Street Address 1303 S. UNVERSITY DR
City NACOGDOCHES
State TX
Zip Code 75961
Country US

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Nacogdoches County Hospital District 1204 N Mound St, Nacogdoches, TX 75961-4027Rehabilitation Hospital2006-06-29
Procare Nacogdoches LLC 1420 North St, Nacogdoches, TX 75961-4037Emergency Care Clinic/Center2023-06-12
Shadman Shaikh 1030 N University Dr, Nacogdoches, TX 75961-4208Pharmacist2026-02-17
Advanced Chiropractic Center LLC 1602 E Starr Ave Ste 201, Nacogdoches, TX 75961-4312Chiropractor2025-12-30
Nacogdoches County Hospital District 1204 N Mound St, Nacogdoches, TX 75961-4027Psychiatric Hospital2015-03-05
Nacogdoches County Hospital District 1204 N Mound St, Nacogdoches, TX 75961-4027Rural Acute Care Hospital2006-06-17
Lam Nhat Do 1424 North St, Nacogdoches, TX 75961-4037Pharmacist2021-08-22
Alex Demotte 1030 N University Dr, Nacogdoches, TX 75961-4208Pharmacist2025-12-29
Nacagdocles Anesthesia Group LLP 1329 N University, Suite E 1, Nacogdocles, TX 75961Anesthesiology Physician2006-11-27
Etx Metabolic Syndrome Relief PLLC 1220 North St Ste 100, Nacogdoches, TX 75961-4010Infusion Therapy Clinic/Center2025-12-17
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Sky's Pediatric Day Center, LLC 3381 G St Ste B, Merced, CA 95340-1002Pediatric Skilled Nursing Facility2024-07-01
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Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.