ETMC PHYSICIAN GROUP INC. NPI 1598332868

NPI Information

NPI: 1598332868
Provider Name: ETMC PHYSICIAN GROUP INC.
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 45D1091354

Address:
14069 FM 849
LINDALE, TX
ZIP 75771
Phone: (903) 590-5263
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ETMC PHYSICIAN GROUP INC. is a rural health clinic center in Lindale, TX. ETMC PHYSICIAN GROUP INC. NPI is 1598332868. The provider is registered as an organization entity type.

The provider's business location address is:

14069 FM 849
LINDALE, TX
ZIP 75771-160
Phone: (903) 590-5263

The provider's authorized official is Stephen C. Petrovich .
The authorized official title is Evp General Counsel and has the following contact phone number (615) 296-3594.

The CLIA number assigned to this NPI record is 45D1091354 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/7/2021 and was last updated on 6/7/2021.

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			Yes

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

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