East Texas Medical Center Gilmer
Organization Active NPI Rural Health Clinic/Center · Daingerfield, TX
NPI 1619124658 · NPPES record last updated Oct 27, 2008
Key facts
- NPI
- 1619124658
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- EAST TEXAS MEDICAL CENTER GILMER
- Practice address
- 1402 Linda Dr
Daingerfield, TX 75638-2132 - Phone
- (903) 841-7100
- Fax
- (903) 841-7286
- NPI assigned
- Aug 21, 2008
- Organization subpart
- Yes
- Parent organization (as reported)
- EAST TEXAS MEDICAL CENTER
Authorized official
- Name
- Mr. Thomas M O'Gorman
- Title
- Regional Chief Financial Officer
- Phone
- (903) 856-4520
Practitioners 12
-
David Royce Arrington, CRNA
-
Daniel C Bennett, MD
-
Niaz Farhat, MD
-
Rajan S Kohli, M.D
-
Hernan E Miranda, MD
-
Marian Kathleen Querry, D.O.
-
Ilanko Upendran, MD
-
Ramon G. Villafria, M.D.
-
Todd A. Campbell, M.D.
-
Mark S. Malone, MD
-
Raelanda Smith, MD
National Provider Directory
- Part of
- East Texas Medical Center-Gilmer
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
1402 Linda Dr
Daingerfield, TX 75638-2132
Mailing address
PO Box 1237
Gilmer, TX 75644-1237
Phone (903) 841-7100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 453406 | Other | TX | MEDICARE RURAL HEALTH CLINIC |
| 168447408 | Medicaid | TX | |
| 168447406 | Medicaid | TX |
Other names
- ETMC Physicans Clinic
Other providers in Daingerfield, TX
- Lynn Bourdon
- Brookshire Grocery Company
- Daingerfield-Lone Star Isd
- Dickinson & Wells PLLC
- Ronald Dickinson
- Elitecare DME LLC
- Fannin County Hospital Authority
- Morgan Frost
- Alvin Eugene Hinson
- J Jireh LLC
All providers in Daingerfield, TX · Rural Health 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 Oct 27, 2008. 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.