Organization
EAST TEXAS MEDICAL CENTER CARTHAGE
Active
Organization
EAST TEXAS MEDICAL CENTER CARTHAGE
Active
Other names
ETMC First Physician Clinic Carthage
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY M HUDSON (ADMINISTRATOR)
(903) 693-3841
Entity
Organization
Contact information
Practice address
702 DAVIS ST, CARTHAGE, TX 75633-1460
(903) 693-3841
(903) 694-4633
Mailing address
PO BOX 549, CARTHAGE, TX 75633-0549
(903) 693-3841
(903) 694-4633
Taxonomy
Speciality
Code
Description
License number
State
261QA0005X
Ambulatory Family Planning Facility
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00374K
BLUE CROSS OF TEXAS
TX
Enumeration date
11/14/2006
Last updated
10/26/2007
Update your record
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