NPIMap

Organization Active NPI

East Texas Medical Center Trinity

  • General Acute Care Hospital
  • Trinity, TX
National Provider Identifier
1821063553
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
000287 Issued in TX
Legal business name
EAST TEXAS MEDICAL CENTER TRINITY
Practice address
317 Prospect Dr
Trinity, TX 75862-6202
Phone
(936) 594-3541
Fax
(936) 744-1185
NPI assigned
Feb 17, 2006
Last updated
Aug 4, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

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

Authorized official

Name
Mr. Samuel L Brown
Title
Regional Cfo
Phone
(903) 946-5520

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 000287 TX Primary

Addresses

Primary practice location

317 Prospect Dr
Trinity, TX 75862-6202

Mailing address

PO Box 1304
Pittsburg, TX 75686-2203
Phone (936) 744-1123

Other identifiers 1

IdentifierTypeStateIssuer
121817401MedicaidTX

National Provider Directory

National Provider Directory

Locations

317 Prospect Dr
Trinity, TX 75862
Phone (936) 594-3541

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407110400000",
    "number": "1821063553",
    "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": "936-744-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 PROSPECT DR",
            "city": "TRINITY",
            "state": "TX",
            "postal_code": "758626202",
            "telephone_number": "936-594-3541",
            "fax_number": "936-744-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS MEDICAL CENTER TRINITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-17",
        "last_updated": "2014-08-04",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "REGIONAL CFO",
        "authorized_official_telephone_number": "903-946-5520",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "TX",
            "license": "000287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121817401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinity, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.