# EAST TEXAS MEDICAL CENTER CLARKSVILLE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679506174
- **Authorized official:** MR. WILLIAM PERRY HENDERSON (SENIOR ADMINISTRATOR)
- **Authorized official phone:** (903) 946-5500

## Contact information

- **Practice address:** 3000 W MAIN ST, CLARKSVILLE, TX 75426-3371
- **Practice address phone:** (903) 427-6400
- **Practice address fax:** (903) 427-2719
- **Mailing address:** PO BOX 1304, PITTSBURG, TX 75686-2203
- **Mailing address phone:** (903) 427-6400
- **Mailing address fax:** (903) 427-2719

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282NR1301X | Rural Acute Care Hospital | 000282 | TX | Yes |

## Other

- **Enumeration date:** 07/08/2006
- **Last updated:** 03/28/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 103862905 | — | TX |