Organization
EAST TEXAS MEDICAL CENTER QUITMAN
Active
Organization
EAST TEXAS MEDICAL CENTER QUITMAN
Active
Other names
ETMC First Physicians Clinic Mineola
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WARREN ROBICHEAUX (REGIONAL ADMINISTRATION)
(903) 946-5500
Entity
Organization
Contact information
Practice address
1220 N PACIFIC ST, MINEOLA, TX 75773-1054
(903) 569-6124
(903) 569-2467
Mailing address
PO BOX 1304, PITTSBURG, TX 75686-2203
(903) 946-5519
(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
—
017624001
—
TX
05
—
063351301
—
TX
Enumeration date
07/30/2006
Last updated
08/17/2016
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