Organization
ETMC PHYSICIAN GROUP INC.
Active
Parent organization
AHS EAST TEXAS HEALTH SYSTEM, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AHS EAST TEXAS HEALTH SYSTEM, LLC
Authorized official
STEPHEN C PETROVICH (EVP AND SECRETARY)
(615) 296-3000
Entity
Organization
Contact information
Practice address
1000 S BECKHAM AVE, TYLER, TX 75701-1908
(903) 590-5611
(903) 535-6884
Mailing address
PO BOX 9477, TYLER, TX 75711-9477
(903) 594-2450
(903) 509-0493
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
12/28/2017
Last updated
10/09/2020
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