EAST TEXAS BORDER HEALTH CLINIC NPI 1598366718

NPI Information

NPI: 1598366718
Provider Name: EAST TEXAS BORDER HEALTH CLINIC
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 45D2144414

Address:
1411 COLLEGE DR
TEXARKANA, TX
ZIP 75503
Phone: (903) 791-1110
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EAST TEXAS BORDER HEALTH CLINIC is a federally qualified health center (fqhc) clinic center in Texarkana, TX. EAST TEXAS BORDER HEALTH CLINIC NPI is 1598366718. The provider is registered as an organization entity type.

The provider's business location address is:

1411 COLLEGE DR
TEXARKANA, TX
ZIP 75503-533
Phone: (903) 791-1110
Fax: (903) 794-2979

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 CLIA number assigned to this NPI record is 45D2144414 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/4/2020 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	License Number	License State	Primary
1	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: 5/5/2024

NPI Synchronization or Removal

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