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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