NPIMap

Organization Active NPI

East Texas Medical Center Trinity

  • General Acute Care Hospital
  • Trinity, TX
National Provider Identifier
1043469638
Registry record updated Jul 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
450749 Issued in TX
Legal business name
EAST TEXAS MEDICAL CENTER TRINITY
Practice address
315 Prospect Dr
Trinity, TX 75862-6202
Phone
(936) 594-3595
Fax
(936) 544-3816
NPI assigned
Sep 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Terry Culter, CEO
Title
Administrator
Phone
(936) 546-3862

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 450749 TX Primary

Addresses

Primary practice location

315 Prospect Dr
Trinity, TX 75862-6202

Mailing address

315 Prospect Drive
P O Box 3169
Trinity, TX 75862-3169
Phone (936) 594-3595

Other identifiers 1

IdentifierTypeStateIssuer
079826601MedicaidTX

Other names 1

  • ETMC COMMUNITY HEALTH CLINIC Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
East Texas Medical Center Trinity6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248134400000",
    "number": "1043469638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 PROSPECT DRIVE",
            "address_2": "P O BOX 3169",
            "city": "TRINITY",
            "state": "TX",
            "postal_code": "758623169",
            "telephone_number": "936-594-3595",
            "fax_number": "936-544-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 PROSPECT DR",
            "city": "TRINITY",
            "state": "TX",
            "postal_code": "758626202",
            "telephone_number": "936-594-3595",
            "fax_number": "936-544-3816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS MEDICAL CENTER TRINITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-18",
        "last_updated": "2009-07-21",
        "status": "A",
        "authorized_official_last_name": "CULTER",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "936-546-3862",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "TX",
            "license": "450749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079826601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ETMC COMMUNITY HEALTH CLINIC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Trinity, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.