EAST TEXAS MEDICAL CENTER CARTHAGE NPI 1629314539

NPI Information

NPI: 1629314539
Provider Name: EAST TEXAS MEDICAL CENTER CARTHAGE

Doing Business As: ETMC FIRST PHYSICIANS CLINIC CENTER III

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

Specialization: Rural Health

Address:
305 COTTAGE RD
CARTHAGE, TX
ZIP 75633
Phone: (936) 590-4035
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EAST TEXAS MEDICAL CENTER CARTHAGE is a rural health clinic center in Carthage, TX. EAST TEXAS MEDICAL CENTER CARTHAGE NPI is 1629314539. The provider is registered as an organization entity type.
The provider Is Doing Business As Etmc First Physicians Clinic Center Iii.

The provider's business location address is:

305 COTTAGE RD
CARTHAGE, TX
ZIP 75633-511
Phone: (936) 590-4035
Fax: (936) 590-4146

The provider's authorized official is Gary M Hudson .
The authorized official title is Administrator and has the following contact phone number (903) 694-4652.

The enumeration date for this NPI number is 12/20/2012 and was last updated on 8/14/2014.

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

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
1	3187015-01	MEDICAID	TEXAS
2	673408	MEDICARE OSCAR/CERTIFICATION
3	3187015-02	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

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