Organization
EAST TEXAS BORDER HEALTH CLINIC
Active
Parent organization
EAST TEXAS BORDER HEALTH CLINIC
Other names
Genesis PrimeCare
Organization subpart
Yes
Provider details
NPI number
Legal business name
EAST TEXAS BORDER HEALTH CLINIC
Authorized official
CARLA ROADCAP (CEO)
(903) 927-3782
Entity
Organization
Contact information
Practice address
4077 JEFFERSON AVE, TEXARKANA, AR 71854-1509
(903) 614-5270
Mailing address
PO BOX 1326, MARSHALL, TX 75671-1326
(903) 927-3782
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
104100000X
Social Worker
—
—
207Q00000X
Family Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
09/27/2018
Last updated
08/28/2023
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