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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