East Texas Medical Center Clarksville
Clinic/Center, Rural Health in Clarksville, TX. Organization (NPI-2).
NPI number1104179910
StatusActive
Last updated in NPPESOct 17, 2012
Details
- NPI
- 1104179910
- Entity type
- Organization (NPI-2)
- Legal business name
- East Texas Medical Center Clarksville
- Organization subpart
- No
- Enumeration date
- Oct 17, 2012
- Last updated
- Oct 17, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR1300X | Clinic/Center, Rural Health | – | – | Yes |
Other names
- Etmc First Physicians Clinic Clarksville (Doing Business As)
Practice location
3000 W Main StClarksville, TX 75426-3371
Phone 903-427-6400
Mailing address
Po Box 1304Pittsburg, TX 75686-2203
Phone 903-946-5519
Authorized official
Tambri Rolston
Regional Dir Of Business Services
9039465519
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