Organization
EAST TEXAS BORDER HEALTH CLINIC
Active
Other names
GENESIS PRIME CARE
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA ROADCAP (CEO)
(903) 927-3782
Entity
Organization
Contact information
Practice address
1011 S WILLIAM ST, ATLANTA, TX 75551-3245
(903) 796-2868
(903) 796-0802
Mailing address
PO BOX 1326, MARSHALL, TX 75671-1326
(903) 927-3782
(903) 927-1764
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
261QA0005X
Ambulatory Family Planning Facility
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
09/24/2020
Last updated
08/05/2024
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