EAST TEXAS BORDER HEALTH CLINIC NPI 1548745383

NPI Information

NPI: 1548745383
Provider Name: EAST TEXAS BORDER HEALTH CLINIC

Doing Business As: GENESIS PRIMECARE

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
4077 JEFFERSON AVE
TEXARKANA, AR
ZIP 71854
Phone: (903) 614-5270
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EAST TEXAS BORDER HEALTH CLINIC is a federally qualified health center (fqhc) clinic center in Texarkana, AR. EAST TEXAS BORDER HEALTH CLINIC NPI is 1548745383. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Genesis Primecare.

The provider's business location address is:

4077 JEFFERSON AVE
TEXARKANA, AR
ZIP 71854-509
Phone: (903) 614-5270

The provider's authorized official is Carla Roadcap .
The authorized official title is Ceo and has the following contact phone number (903) 927-3782.

The enumeration date for this NPI number is 9/27/2018 and was last updated on 8/28/2023.

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	Primary
1	101Y00000X	Counselor		No
2	104100000X	Social Worker		No
3	207Q00000X	Family Medicine		No
4	207V00000X	Obstetrics & Gynecology		No
5	208000000X	Pediatrics		No
6	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	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: 4/28/2024

NPI Synchronization or Removal

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