East Texas Medical Center Pittsburg

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

F4587 Issued in TX

Legal business name

EAST TEXAS MEDICAL CENTER PITTSBURG

Doing business as

ETMC First Physicians Clinic Mount Vernon

Practice address

506 South State Hwy 37
Mt Vernon, TX 75457-0477

Phone

(903) 537-8222

NPI assigned

Aug 31, 2006

Last updated

Feb 23, 2015By 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

Mr. William P Henderson

Title

Senior Administrator

Phone

(903) 537-8000

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• ETMC First Physicians Clinic Mount Vernon Doing business as

Locations

Practitioners 2

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.

• David A Hester, M.D.

  • Orthopaedic Surgery Physician
  • Mount Pleasant, TX
  • NPI 1780656462
  NPD (past)
• Corey Shawn Schoenewe, DO

  • Family Medicine Physician
  • Tulsa, OK
  • NPI 1780646984
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424649600000",
    "number": "1790897189",
    "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": "903-537-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 SOUTH STATE HWY 37",
            "city": "MT VERNON",
            "state": "TX",
            "postal_code": "754570477",
            "telephone_number": "903-537-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS MEDICAL CENTER PITTSBURG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-02-23",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "SENIOR ADMINISTRATOR",
        "authorized_official_telephone_number": "903-537-8000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "TX",
            "license": "F4587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS ETMC RHC",
            "identifier": "00L04L",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136140406",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136140410",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136140408",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ETMC First Physicians Clinic Mount Vernon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laure Colvin, LPC
• Don R. Huffstetler,D.D.S., P.C.
• Eak Good Neighbor Properties (EAK Good Neighbor Home Care)
• East Texas Medical Center Mount Vernon
• East Texas Medical Center Mount Vernon
• Aleesa Jordan Ellison, COTA
• Franklin Dentistry Associates PA
• Franklin Emergency Medicine Associates PA
• Shirley Sanders Gibbs, LPC
• Givens & Coe Health & Wellness PLLC

• Rural Health Clinic/Center in Mount Vernon, TX
• Providers in Mount Vernon, TX by specialty
• Rural Health Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; 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.