Organization
EAST TEXAS BORDER HEALTH CLINIC
Active
Parent organization
EAST TEXAS BORDER HEALTH CLINIC
Other names
Genesis PrimeCare
Organization subpart
Yes
Provider details
NPI number
Legal business name
EAST TEXAS BORDER HEALTH CLINIC
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
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
01/05/2017
Last updated
08/28/2023
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