Organization
EAST TEXAS BORDER HEALTH CLINIC
Active
Other names
Genesis PrimeCare
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY ENGEL (ENROLLMENT SPECIALIST)
(903) 927-3782
Entity
Organization
Contact information
Practice address
815 S WASHINGTON AVE STE 203, MARSHALL, TX 75670-5341
(903) 927-6850
Mailing address
PO BOX 1326, MARSHALL, TX 75671-1326
(903) 927-3782
(903) 927-1764
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
TX
Enumeration date
04/24/2018
Last updated
08/28/2023
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