Organization
EAST TEXAS BORDER HEALTH CLINIC
Active
Other names
Genesis PrimeCare
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA ROADCAP (CEO)
(903) 927-3782
Entity
Organization
Contact information
Practice address
1400 COLLEGE DR, TEXARKANA, TX 75503-3536
(903) 791-1110
(903) 791-9353
Mailing address
PO BOX 1326, MARSHALL, TX 75671-1326
(903) 927-3782
(903) 927-1764
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
192226202
—
TX
05
—
198049002
—
AR
Enumeration date
10/05/2012
Last updated
06/13/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up