NPIMap

Organization Active NPI

East Texas Medical Center Healthcare Associates

Doing business as East Texas Emergency Physicians

  • Emergency Medicine Physician
  • Tyler, TX
National Provider Identifier
1699719872
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
EAST TEXAS MEDICAL CENTER HEALTHCARE ASSOCIATES
Doing business as
East Texas Emergency Physicians
Practice address
1000 S Beckham
Tyler, TX 75701
Phone
(903) 597-0351
Fax
(903) 596-3560
NPI assigned
Jun 16, 2006
Last updated
Apr 11, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Authorized official

Name
Rebecca Mangum
Title
VP
Phone
(903) 596-3594

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

1000 S Beckham
Tyler, TX 75701

Mailing address

PO Box 6455
Tyler, TX 75711-6455

Other identifiers 1

IdentifierTypeStateIssuer
151671801MedicaidTX

Other names 1

  • East Texas Emergency Physicians Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491868800000",
    "number": "1699719872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6455",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757116455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S BECKHAM",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75701",
            "telephone_number": "903-597-0351",
            "fax_number": "903-596-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS MEDICAL CENTER HEALTHCARE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2017-04-11",
        "status": "A",
        "authorized_official_last_name": "MANGUM",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "903-596-3594"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151671801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Texas Emergency Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; 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.