East Texas Medical Clinic,P.a
Organization Active NPI Primary Care Clinic/Center · Center, TX
NPI 1255729323 · NPPES record last updated Dec 24, 2014
Key facts
- NPI
- 1255729323
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- License
- K7000 (TX)
- Legal business name
- EAST TEXAS MEDICAL CLINIC,P.A
- Practice address
- 1743 Southview Cir
Center, TX 75935-9324 - Phone
- (936) 591-8888
- Fax
- (936) 591-8884
- NPI assigned
- Dec 24, 2014
- Organization subpart
- No
Authorized official
- Name
- Ajitha Chandramohan, M.D
- Title
- Medical Director
- Phone
- (936) 591-8888
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | K7000 | TX | Yes |
Addresses
Primary practice location
1743 Southview Cir
Center, TX 75935-9324
Mailing address
1743 Southview Cir
Center, TX 75935-9324
Phone (936) 591-8888
Other providers in Center, TX
- East Texas Management, LLC
- East Texas Medical Center Carthage
- East Texas Medical Center Carthage
- East Texas Medical Center Carthage
- East Texas Medical Center Carthage
- Madelyn Eaves
- Excelsior Isd
- Fannin County Hospital Authority
- Federico Ilang-Ilang
- Sarah Katherine Fenley
All providers in Center, TX · Primary Care Clinic/Center in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 24, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.