NPIMap

Organization Active NPI

East Texas Medical Center Rehabilitation Hospital

  • Rehabilitation Hospital
  • Tyler, TX
National Provider Identifier
1700901873
Registry record updated Sep 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
License
000799 Issued in TX
Legal business name
EAST TEXAS MEDICAL CENTER REHABILITATION HOSPITAL
Practice address
701 Olympic Plaza Cir
Tyler, TX 75701-1950
Phone
(903) 596-3258
Fax
(903) 596-3006
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2010

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

Authorized official

Name
Mr. Eddie L Howard
Title
VP-Coo
Phone
(903) 596-3258

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X 000799 TX Primary

Addresses

Primary practice location

701 Olympic Plaza Cir
Tyler, TX 75701-1950

Mailing address

701 Olympic Plaza Cir
Tyler, TX 75701-1950
Phone (903) 596-3258

Other identifiers 1

IdentifierTypeStateIssuer
021177301MedicaidTX

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285200000000",
    "number": "1700901873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 OLYMPIC PLAZA CIR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011950",
            "telephone_number": "903-596-3258",
            "fax_number": "903-596-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 OLYMPIC PLAZA CIR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011950",
            "telephone_number": "903-596-3258",
            "fax_number": "903-596-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS MEDICAL CENTER REHABILITATION HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2010-09-23",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VP-COO",
        "authorized_official_telephone_number": "903-596-3258",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "TX",
            "license": "000799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021177301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Sep 23, 2010; 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.