Organization
EAST TEXAS MEDICAL CENTER QUITMAN
Active
Other names
ETMC First Physicians Clinic Quitman
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM P HENDERSON (VP AFFILIATE OPERATIONS)
(903) 946-5500
Entity
Organization
Contact information
Practice address
117 N WINNSBORO ST, QUITMAN, TX 75783-2144
(903) 763-6220
(903) 946-5531
Mailing address
PO BOX 1304, PITTSBURG, TX 75686-2203
(903) 763-6220
(903) 946-5531
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172427001
—
TX
05
—
172427002
—
TX
Enumeration date
07/30/2006
Last updated
08/06/2014
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