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

Four States Retina PLLC

Organization Retina Specialist (Ophthalmology) Physician · NPI 1083580815

Four States Retina PLLC provides Retina Specialist (Ophthalmology) Physician services in Texarkana, Texas. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5501 Medical Parkway Dr
Texarkana, TX 75503-4624
Phone: (804) 647-2381
Fax: (903) 204-7745
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Retina Specialist (Ophthalmology) Physician (primary) Taxonomy 207WX0107X

Record details

NPI number1083580815
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Roshan George — Owner · (903) 204-7642
NPI enumeratedOctober 17, 2025
Last updated in NPPESFebruary 19, 2026
Certification dateFebruary 19, 2026
Mailing address5501 Medical Parkway Dr, Texarkana, TX 75503-4624

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