# EAST TEXAS MEDICAL CENTER HEALTHCARE ASSOCIATES

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

## Provider details

- **NPI number:** 1629252937
- **Authorized official:** MS. KIM PEARSON-WAHL (VICE PRESIDENT)
- **Authorized official phone:** (903) 535-6890

## Contact information

- **Practice address:** 904 S BECKHAM AVE, TYLER, TX 75701-1906
- **Practice address phone:** (903) 596-3555
- **Practice address fax:** (903) 596-3560
- **Mailing address:** PO BOX 9477, TYLER, TX 75711-9477
- **Mailing address phone:** (903) 594-2450
- **Mailing address fax:** (903) 939-0610

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | — |
| 111N00000X | Chiropractor | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | — |
| 207X00000X | Orthopaedic Surgery Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 208800000X | Urology Physician | — | NULL | — |
| 208800000X | Urology Physician | — | — | — |
| 208VP0000X | Pain Medicine Physician | — | NULL | — |
| 208VP0000X | Pain Medicine Physician | — | — | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | NULL | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | — | — |
| 213E00000X | Podiatrist | — | NULL | — |
| 213E00000X | Podiatrist | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 12/21/2007
- **Last updated:** 12/21/2007