Organization
EAST TEXAS MEDICAL CENTER QUITMAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM P HENDERSON (ADMINISTRATOR)
(903) 763-6336
Entity
Organization
Contact information
Practice address
117 N WINNSBORO ST, QUITMAN, TX 75783-2144
(903) 763-6300
(903) 763-6140
Mailing address
117 N WINNSBORO ST, QUITMAN, TX 75783-2144
(903) 763-6300
(903) 763-6140
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
000411
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017624002
—
TX
05
—
017624003
—
TX
Enumeration date
05/23/2005
Last updated
08/06/2014
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