East Texas Babtist University

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

Legal business name

EAST TEXAS BABTIST UNIVERSITY

Doing business as

ETBU Sports Medicine

Practice address

1 Tiger Dr
Marshall, TX 75670-1412

Phone

(903) 923-2237

NPI assigned

Sep 11, 2014

Last updated

Sep 11, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marcus Holiday

Title

Head Trainer for Sports Medicine

Phone

(903) 923-2237

Specialties & licenses 1

Addresses

Other names 1

• ETBU Sports Medicine Doing business as

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410393600000",
    "number": "1730580499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 SPRING VALLEY RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443995",
            "telephone_number": "800-555-9073",
            "fax_number": "972-367-3452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TIGER DR",
            "city": "MARSHALL",
            "state": "TX",
            "postal_code": "756701412",
            "telephone_number": "903-923-2237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS BABTIST UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-11",
        "last_updated": "2014-09-11",
        "status": "A",
        "authorized_official_last_name": "HOLIDAY",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_title_or_position": "HEAD TRAINER FOR SPORTS MEDICINE",
        "authorized_official_telephone_number": "903-923-2237"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ETBU Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dudley Consulting & Coaching Services, LLC. (Mitchell Wellness & Recovery Services)
• Dudley Consulting & Coaching Services, LLC.
• Crystal Dionne Dudley, LPC, LCDC
• Janice Larue Dudley, LVN
• Douglas E Duncan, MD
• East Texas Border Health Clinic
• East Texas Border Health Clinic (Genesis PrimeCare)
• East Texas Border Health Clinic (Genesis PrimeCare Pharmacy Marshall)
• East Texas Border Health Clinic (Genesis PrimeCare)
• East Texas Border Health Clinic (Genesis Prime Care)

• Sports Medicine (Orthopaedic Surgery) Physician in Marshall, TX
• Providers in Marshall, TX by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; 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.