NPIMap

Organization Active NPI

East Texas Medical Center Grapeland Rural Health Clinic

  • Rural Health Clinic/Center
  • Grapeland, TX
National Provider Identifier
1255304101
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
EAST TEXAS MEDICAL CENTER GRAPELAND RURAL HEALTH CLINIC
Practice address
605 N Market St
Grapeland, TX 75844-2129
Phone
(936) 687-5986
Fax
(936) 687-5987
NPI assigned
Feb 10, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Stacy Bailey Dise
Title
Business Office Director
Phone
(936) 546-3862

Specialties & licenses 1

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

Addresses

Primary practice location

605 N Market St
Grapeland, TX 75844-2129

Mailing address

PO Box 1129
Crockett, TX 75835-1129
Phone (936) 546-3849

National Provider Directory

National Provider Directory
Tax ID family
East Texas Medical Center Crockett5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1139529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255304101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1129",
            "city": "CROCKETT",
            "state": "TX",
            "postal_code": "758351129",
            "telephone_number": "936-546-3849",
            "fax_number": "936-546-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 N MARKET ST",
            "city": "GRAPELAND",
            "state": "TX",
            "postal_code": "758442129",
            "telephone_number": "936-687-5986",
            "fax_number": "936-687-5987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS MEDICAL CENTER GRAPELAND RURAL HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DISE",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "BAILEY",
        "authorized_official_title_or_position": "BUSINESS OFFICE DIRECTOR",
        "authorized_official_telephone_number": "936-546-3862",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapeland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.