Organization
EAST TEXAS MEDICAL CENTER HENDERSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK S LEITNER (ADMINISTRATOR)
(903) 655-3616
Entity
Organization
Contact information
Practice address
300 WILSON ST, HENDERSON, TX 75652-5956
(903) 657-7541
(903) 657-4009
Mailing address
300 WILSON ST, HENDERSON, TX 75652-5956
(903) 657-7541
(903) 657-4009
Taxonomy
Speciality
Code
Description
License number
State
282NR1301X
Rural Acute Care Hospital
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208843701
—
TX
01
—
HH0063
BLUE CROSS BLUE SHIELD
TX
Enumeration date
05/13/2009
Last updated
08/09/2011
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