NPIMap

Organization Active NPI

East Texas Medical Center Henderson

  • Rural Acute Care Hospital
  • Henderson, TX
National Provider Identifier
1770717167
Registry record updated Aug 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
Legal business name
EAST TEXAS MEDICAL CENTER HENDERSON
Practice address
300 Wilson St
Henderson, TX 75652-5956
Phone
(903) 657-7541
Fax
(903) 657-4009
NPI assigned
May 13, 2009
Last updated
Aug 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2011

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

Authorized official

Name
Mr. Mark S Leitner
Title
Administrator
Phone
(903) 655-3616

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Acute Care Hospital 282NR1301X TX Primary

Addresses

Primary practice location

300 Wilson St
Henderson, TX 75652-5956

Mailing address

300 Wilson St
Henderson, TX 75652-5956
Phone (903) 657-7541

Other identifiers 2

IdentifierTypeStateIssuer
208843701MedicaidTX
HH0063OtherTXBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 6

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1242172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312848000000",
    "number": "1770717167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 WILSON ST",
            "city": "HENDERSON",
            "state": "TX",
            "postal_code": "756525956",
            "telephone_number": "903-657-7541",
            "fax_number": "903-657-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WILSON ST",
            "city": "HENDERSON",
            "state": "TX",
            "postal_code": "756525956",
            "telephone_number": "903-657-7541",
            "fax_number": "903-657-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS MEDICAL CENTER HENDERSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-13",
        "last_updated": "2011-08-09",
        "status": "A",
        "authorized_official_last_name": "LEITNER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "903-655-3616",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208843701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "HH0063",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; 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.