Organization
EAST TEXAS MEDICAL CENTER HEALTHCARE ASSOCIATES
Active
Other names
First Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA MANGUM (VP)
(903) 596-3594
Entity
Organization
Contact information
Practice address
901 TURTLE CREEK DR, TYLER, TX 75701
(903) 596-3555
(903) 596-3560
Mailing address
PO BOX 9477, TYLER, TX 75711-9477
(903) 594-2450
(903) 939-0610
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
4278
TX
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2084P0800X
Psychiatry Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00T07K
BLUE CROSS
TX
05
—
085332701
—
TX
05
—
130864502
—
TX
05
—
130864507
—
TX
01
—
4944030003
PALMETTO DME
TX
01
—
CC6186
RAILROAD MEDICARE
TX
01
—
CC7791
RAILROAD MEDICARE
TX
01
—
CD9882
RAILROAD MEDICARE
TX
Enumeration date
06/16/2006
Last updated
04/11/2017
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