Organization
EAST TEXAS MEDICAL CENTER GILMER
Active
Parent organization
EAST TEXAS MEDICAL CENTER
Other names
ETMC Physicans Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
EAST TEXAS MEDICAL CENTER
Authorized official
MR. THOMAS M O'GORMAN (REGIONAL CHIEF FINANCIAL OFFICER)
(903) 856-4520
Entity
Organization
Contact information
Practice address
1402 LINDA DR, DAINGERFIELD, TX 75638-2132
(903) 841-7100
(903) 841-7286
Mailing address
PO BOX 1237, GILMER, TX 75644-1237
(903) 841-7100
(903) 841-7286
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168447406
—
TX
05
—
168447408
—
TX
01
—
453406
MEDICARE RURAL HEALTH CLINIC
TX
Enumeration date
08/21/2008
Last updated
10/27/2008
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