Organization
EAST TEXAS MEDICAL CENTER PITTSBURG
Active
Organization
EAST TEXAS MEDICAL CENTER PITTSBURG
Active
Other names
ETMC First Physicians Rural Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. W PERRY HENDERSON (ADMINISTRATOR)
(903) 856-4501
Entity
Organization
Contact information
Practice address
2701 U.S. HWY 271 N, PITTSBURG, TX 75686-4289
(903) 946-5442
(903) 946-5258
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
438
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
138374713
—
TX
05
—
138374714
—
TX
01
—
K95J
BCBS RURAL HEALTH
TX
Enumeration date
01/08/2007
Last updated
10/15/2009
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