# EAST TEXAS MEDICAL CENTER CROCKETT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ETMC Crockett
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073500799
- **Authorized official:** MRS. STACY BAILEY DISE (BUSINESS OFFICE MANAGER)
- **Authorized official phone:** (936) 546-3810

## Contact information

- **Practice address:** 1100 E LOOP 304, CROCKETT, TX 75835-1810
- **Practice address phone:** (936) 546-3803
- **Practice address fax:** (936) 546-3816
- **Mailing address:** PO BOX 1129, CROCKETT, TX 75835-1129
- **Mailing address phone:** (936) 546-3862
- **Mailing address fax:** (936) 546-3816

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 000185 | TX | Yes |

## Other

- **Enumeration date:** 09/29/2005
- **Last updated:** 08/22/2020