NPIMap

Organization Active NPI

East Texas Health and Wellness

  • General Practice Physician
  • Marshall, TX
National Provider Identifier
1073163549
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
EAST TEXAS HEALTH AND WELLNESS
Practice address
1600 S Washington Ave
Marshall, TX 75670-6852
Phone
(903) 320-3200
Fax
(903) 471-8655
NPI assigned
Sep 17, 2019
Last updated
Sep 17, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
EAST TEXAS PRECISION MEDICINE, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Authorized official

Name
Kimberly D Barbolla, DONPI 1437132081
Title
Managing Member
Phone
(903) 320-3200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

1600 S Washington Ave
Marshall, TX 75670-6852

Mailing address

PO Box 45
Marshall, TX 75671-0045
Phone (903) 320-3200

National Provider Directory

National Provider Directory
Part of
East Texas Precision Medicine PLLC

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HBHHBD

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568678400000",
    "number": "1073163549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45",
            "city": "MARSHALL",
            "state": "TX",
            "postal_code": "756710045",
            "telephone_number": "903-320-3200",
            "fax_number": "903-471-8655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S WASHINGTON AVE",
            "city": "MARSHALL",
            "state": "TX",
            "postal_code": "756706852",
            "telephone_number": "903-320-3200",
            "fax_number": "903-471-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS HEALTH AND WELLNESS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAST TEXAS PRECISION MEDICINE, PLLC",
        "enumeration_date": "2019-09-17",
        "last_updated": "2019-09-17",
        "status": "A",
        "authorized_official_last_name": "BARBOLLA",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "903-320-3200",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshall, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; 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.