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
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up