East Texas Medical Center Carthage

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

EAST TEXAS MEDICAL CENTER CARTHAGE

Doing business as

East Texas Medical Center Health Clinic Carthage

Practice address

409 Cottage Rd
Carthage, TX 75633-1466

Phone

(903) 693-3841

Fax

(903) 694-4633

NPI assigned

Nov 24, 2006

Last updated

Aug 14, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Gary M Hudson

Title

Administrator

Phone

(903) 693-3841

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• East Texas Medical Center Health Clinic Carthage Doing business as

Practitioners 1

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.

• Theresa Chadwick, PA-C

  • Medical Physician Assistant
  • Carthage, TX
  • NPI 1427127638
  NPD (past)

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439510400000",
    "number": "1215003116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 COTTAGE RD",
            "city": "CARTHAGE",
            "state": "TX",
            "postal_code": "756331466",
            "telephone_number": "903-693-3841",
            "fax_number": "903-694-4633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 COTTAGE RD",
            "city": "CARTHAGE",
            "state": "TX",
            "postal_code": "756331466",
            "telephone_number": "903-693-3841",
            "fax_number": "903-694-4633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS MEDICAL CENTER CARTHAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2015-08-14",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "903-693-3841",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF TEXAS",
            "identifier": "00374K",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063445302",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063445303",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Texas Medical Center Health Clinic Carthage",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ben B Donald II, OD
• Susan Giroux Donald, OD
• Emily Dunn, FNP-C
• Adam Duran, MD
• East Texas Medical Center Carthage (ETMC Carthage)
• East Texas Medical Center Carthage (ETMC Carthage)
• East Texas Medical Center Carthage (ETMC First Physicians Clinic Center III)
• East Texas Medical Center Carthage (ETMC First Physician Clinic Carthage)
• East Texas Medical Center Carthage (ETMC Carthage)
• East Texas Medical Center Carthage (ETMC Carthage)

• Rural Health Clinic/Center in Carthage, TX
• Providers in Carthage, TX by specialty
• Rural Health Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2015; 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.