EAST TEXAS MEDICAL CENTER CLARKSVILLE NPI 1063447159

NPI Information

NPI: 1063447159
Provider Name: EAST TEXAS MEDICAL CENTER CLARKSVILLE

Doing Business As: ETMC FIRST PHYSICIANS CLINIC CLARKSVILLE

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
3000 W MAIN ST
CLARKSVILLE, TX
ZIP 75426
Phone: (903) 632-5632
Get Directions

EAST TEXAS MEDICAL CENTER CLARKSVILLE is a rural health clinic center in Clarksville, TX. EAST TEXAS MEDICAL CENTER CLARKSVILLE NPI is 1063447159. The provider is registered as an organization entity type.
The provider Is Doing Business As Etmc First Physicians Clinic Clarksville.

The provider's business location address is:

3000 W MAIN ST
CLARKSVILLE, TX
ZIP 75426-371
Phone: (903) 632-5632
Fax: (903) 427-2719

The provider's authorized official is Tambri L Rolston .
The authorized official title is Regional Director Of Business Ser and has the following contact phone number (903) 946-5519.

The enumeration date for this NPI number is 7/11/2006 and was last updated on 2/26/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health	000292	TEXAS	Yes
2	282NR1301X	General Acute Care Hospital	Rural	000292	TEXAS	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	017887301	MEDICAID	TEXAS
2	45-8572	MEDICARE ID-TYPE UNSPECIFIED	TEXAS	MEDICARE PROVIDER NUMBER
3	063513801	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »