East Texas Medical Center Clarksville

Primary specialty

Rural Acute Care HospitalTaxonomy code 282NR1301X

License

000282 Issued in TX

Legal business name

EAST TEXAS MEDICAL CENTER CLARKSVILLE

Practice address

3000 W Main St
Clarksville, TX 75426-3371

Phone

(903) 427-6400

Fax

(903) 427-2719

NPI assigned

Jul 8, 2006

Organization subpart

No

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

Authorized official

Name

Mr. William Perry Henderson

Title

Senior Administrator

Phone

(903) 946-5500

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364428800000",
    "number": "1679506174",
    "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": "903-427-6400",
            "fax_number": "903-427-2719"
        },
        {
            "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",
            "fax_number": "903-427-2719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS MEDICAL CENTER CLARKSVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2013-03-28",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "PERRY",
        "authorized_official_title_or_position": "SENIOR ADMINISTRATOR",
        "authorized_official_telephone_number": "903-946-5500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "TX",
            "license": "000282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103862905",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• CVS Pharmacy Inc (CVS Pharmacy # 11152)
• Daily Medical Supply, Inc. (Home Oxygen & Medical Equipment)
• Detroit I.S.D.
• East Texas Medical Center Clarksville (ETMC First Physicians Clinic Clarksville)
• East Texas Medical Center Clarksville (ETMC First Physicians Clinic Clarksville)
• East Texas Medical Center-Clarksville
• Devabrata Ganguly, M.D.
• Brittany Kaye Graham, FNP-C
• H H Y, LLC (Red River Urgent Care)
• H H Y, LLC (Red River Urgent Care)

• Rural Acute Care Hospital in Clarksville, TX
• Providers in Clarksville, TX by specialty
• Rural Acute Care Hospital in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; 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.