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Organization

EAST TEXAS MEDICAL CENTER QUITMAN

Active
Other names
ETMC First Physicians Clinic Mineola 2
Organization subpart
No

Provider details

NPI number
Authorized official
THOMAS O'GORMAN (REGIONAL CFO)
(903) 946-5520
Entity
Organization

Contact information

Practice address
1220 N PACIFIC AVE, STE 2, MINEOLA, TX 75773-1054
(903) 569-0610
(903) 569-0676
Mailing address
P.O. 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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
017624004
TX
05
017624006
TX
Enumeration date
07/30/2006
Last updated
08/05/2010
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