ETMC PHYSICIAN GROUP INC. NPI 1609382662

NPI Information

  • NPI: 1609382662
  • Provider Name: ETMC PHYSICIAN GROUP INC.
  • Classification: Internal Medicine - 207RC0000X
  • Specialization: Cardiovascular Disease
  • Entity Type: Organization
  • CLIA Number: 45D2049842
  • Address: 1000 S BECKHAM AVE
    TYLER, TX
    ZIP 75701
  • Phone: (903) 590-5611

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NPI Details

ETMC PHYSICIAN GROUP INC. is a cardiovascular disease internal medicine in Tyler, TX. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. ETMC PHYSICIAN GROUP INC. NPI is 1609382662. The provider is registered as an organization entity type.

The provider's business location address is:

1000 S BECKHAM AVE
TYLER, TX
ZIP 75701-908
Phone: (903) 590-5611
Fax: (903) 535-6884

The provider's authorized official is Stephen C Petrovich .
The authorized official title is Evp And Secretary and has the following contact phone number (615) 296-3000.

The CLIA number assigned to this NPI record is 45D2049842 - other - physical dir clinic cath with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 12/28/2017 and was last updated on 10/9/2020.

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
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2207RC0000XInternal MedicineCardiovascular DiseaseYes

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: 3/30/2025

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