East Texas Medical Center Carthage

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

EAST TEXAS MEDICAL CENTER CARTHAGE

Practice address

409 Cottage Rd
Carthage, TX 75633-1466

Phone

(903) 693-3841

Fax

(903) 694-4633

NPI assigned

Nov 14, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Gary M Hudson

Title

Administrator

Phone

(903) 693-3841

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• ETMC Carthage Doing business as

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932271947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 549",
            "city": "CARTHAGE",
            "state": "TX",
            "postal_code": "756330549",
            "telephone_number": "903-693-3841",
            "fax_number": "903-694-4633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 COTTAGE RD",
            "city": "CARTHAGE",
            "state": "TX",
            "postal_code": "756331466",
            "telephone_number": "903-693-3841",
            "fax_number": "903-694-4633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS MEDICAL CENTER CARTHAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "903-693-3841",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP",
            "identifier": "00374K",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18095401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ETMC Carthage",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• East Texas Medical Center Carthage
• East Texas Medical Center Carthage
• East Texas Medical Center Carthage
• East Texas Medical Center Carthage
• East Texas Medical Center Carthage
• Eleanor Eckels, LPC
• Olen Wayne English
• Cathleen Marie Fabbiani, NP
• Family Strategies Counseling Center
• Miranda Leanne Farmer, FNP-C

• All providers in Carthage, TX
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.