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Organization
EAST TEXAS BORDER HEALTH CLINIC
Active
Organization
EAST TEXAS BORDER HEALTH CLINIC
Active
Other names
GENESIS PRIME CARE
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA ROADCAP (CEO)
(903) 927-3782
Entity
Organization
Contact information
Practice address
1011 S WILLIAM ST, ATLANTA, TX 75551-3245
(903) 796-2868
(903) 796-0802
Mailing address
PO BOX 1326, MARSHALL, TX 75671-1326
(903) 927-3782
(903) 927-1764
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
NULL
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
261QA0005X
Ambulatory Family Planning Facility
—
NULL
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
09/24/2020
Last updated
08/05/2024
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