Organization
EAST TEXAS MEDICAL CENTER JACKSONVILLE
Active
Other names
ETMC First Physicians Clinic Jacksonville
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK R ENDRES (ADMINISTRATOR)
(903) 541-5100
Entity
Organization
Contact information
Practice address
203 NACOGDOCHES ST, SUITE 280, JACKSONVILLE, TX 75766-2444
(903) 541-5396
(903) 541-5393
Mailing address
501 S RAGSDALE ST, ADMINISTRATION, JACKSONVILLE, TX 75766-2434
(903) 541-5100
(903) 541-5068
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130612807
—
TX
01
—
130612808
THSTEPS
TX
Enumeration date
12/01/2011
Last updated
11/08/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us