NPIMap

Organization Active NPI

East Texas Medical Center Clarksville

  • Rural Health Clinic/Center
  • Clarksville, TX
National Provider Identifier
1104179910
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
EAST TEXAS MEDICAL CENTER CLARKSVILLE
Practice address
3000 W Main St
Clarksville, TX 75426-3371
Phone
(903) 427-6400
NPI assigned
Oct 17, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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

Authorized official

Name
Mrs. Tambri Rolston
Title
Regional Dir of Business Services
Phone
(903) 946-5519

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

3000 W Main St
Clarksville, TX 75426-3371

Mailing address

PO Box 1304
Pittsburg, TX 75686-2203
Phone (903) 946-5519

Other names 1

  • ETMC First Physicians Clinic Clarksville Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1104179910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1304",
            "city": "PITTSBURG",
            "state": "TX",
            "postal_code": "756862203",
            "telephone_number": "903-946-5519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 W MAIN ST",
            "city": "CLARKSVILLE",
            "state": "TX",
            "postal_code": "754263371",
            "telephone_number": "903-427-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS MEDICAL CENTER CLARKSVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-17",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "ROLSTON",
        "authorized_official_first_name": "TAMBRI",
        "authorized_official_title_or_position": "REGIONAL DIR OF BUSINESS SERVICES",
        "authorized_official_telephone_number": "903-946-5519",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ETMC First Physicians Clinic Clarksville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarksville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; 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.