Organization
EAST TEXAS MEDICAL CENTER CLARKSVILLE
Active
Organization
EAST TEXAS MEDICAL CENTER CLARKSVILLE
Active
Other names
ETMC First Physicians Clinic Clarksville
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMBRI L ROLSTON (REGIONAL DIRECTOR OF BUSINESS SER)
(903) 946-5519
Entity
Organization
Contact information
Practice address
3000 W MAIN ST, CLARKSVILLE, TX 75426-3371
(903) 632-5632
(903) 427-2719
Mailing address
PO BOX 1304, PITTSBURG, TX 75686-2203
(903) 427-6400
(903) 427-2719
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
000292
TX
282NR1301X
Rural Acute Care Hospital
000292
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017887301
—
TX
05
—
063513801
—
TX
Enumeration date
07/11/2006
Last updated
02/26/2013
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