OrganizationActive
Four States Retina PLLC
NPI 1083580815 · Retina Specialist (Ophthalmology) Physician · Texarkana, TX
Provider details
- NPI number
- 1083580815
- Entity type
- Organization
- Primary specialty
- Retina Specialist (Ophthalmology) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Roshan George, Owner(903) 204-7642
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
5501 Medical Parkway Dr
Texarkana, TX 75503-4624
Phone: (804) 647-2381
Fax: (903) 204-7745
Approximate (ZIP-level) locationGet directions
Mailing address
5501 Medical Parkway Dr
Texarkana, TX 75503-4624
Registry dates
- Enumerated
- 2025-10-17
- Last updated
- 2026-02-19
- Certified
- 2026-02-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.