East Texas Medical Center Henderson

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

EAST TEXAS MEDICAL CENTER HENDERSON

Practice address

300 Wilson St
Henderson, TX 75652-5956

Phone

(903) 657-7541

Fax

(903) 657-4009

NPI assigned

May 14, 2009

Organization subpart

Yes

Parent organization

EAST TEXAS MEDICAL CENTER HENDERSONAs reported in NPPES

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

Authorized official

Name

Mr. Mark S Leitner

Title

Administrator

Phone

(903) 655-3616

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ETMC Henderson CRNA Doing business as

Part of

East Texas Medical Center

Locations

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.

• East Texas Medical Center Henderson

  • Rural Acute Care Hospital
  • Henderson, TX
  • NPI 1770717167
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John R. Baugh Jr., MD

  • Emergency Medicine Physician
  • Texarkana, TX
  • NPI 1447297239
  NPD

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

{
    "created_epoch": "1242259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311033600000",
    "number": "1083848352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 WILSON ST",
            "city": "HENDERSON",
            "state": "TX",
            "postal_code": "756525956",
            "telephone_number": "903-657-7541",
            "fax_number": "903-657-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WILSON ST",
            "city": "HENDERSON",
            "state": "TX",
            "postal_code": "756525956",
            "telephone_number": "903-657-7541",
            "fax_number": "903-657-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS MEDICAL CENTER HENDERSON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAST TEXAS MEDICAL CENTER HENDERSON",
        "enumeration_date": "2009-05-14",
        "last_updated": "2011-07-19",
        "status": "A",
        "authorized_official_last_name": "LEITNER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "903-655-3616",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220328301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ETMC Henderson CRNA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amsale Derese, DDS
• Dogwood Orthopaedic Clinic, PA
• John Lynn Duran, DDS
• East Texas Learning Lab
• East Texas Medical Center Healthcare Associates
• East Texas Medical Center Henderson
• East Texas Medical Center Henderson
• East Texas Medical Center Henderson
• East Texas Medical Center Henderson
• East Texas Medical Center Henderson

• Certified Registered Nurse Anesthetist in Henderson, TX
• Providers in Henderson, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; 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.