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ETMC PHYSICIAN GROUP INC. NPI 1720578941


NPI Information

NPI: 1720578941
Provider Name: ETMC PHYSICIAN GROUP INC.

Doing Business As: UT HEALTH EAST TEXAS PHYSICIANS

Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization

CLIA Number: 45D0924480

Address:
1000 E 5TH ST STE 400
TYLER, TX
ZIP 75701
Phone: (903) 593-1749
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ETMC PHYSICIAN GROUP INC. is a durable medical equipment medical supplies in Tyler, TX. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. ETMC PHYSICIAN GROUP INC. NPI is 1720578941. The provider is registered as an organization entity type.
The provider Is Doing Business As Ut Health East Texas Physicians.

The provider's business location address is:

1000 E 5TH ST STE 400
TYLER, TX
ZIP 75701-362
Phone: (903) 593-1749

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

The CLIA number assigned to this NPI record is 45D0924480 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 5/14/2018 and was last updated on 5/14/2018.


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 SuppliesYes

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

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