Organization
EAST TEXAS MEDICAL CENTER
Active
Organization
EAST TEXAS MEDICAL CENTER
Active
Other names
ETMC Crockett Family Medical Center RHC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY CUTLER (ADMINISTRATOR)
(936) 546-3862
Entity
Organization
Contact information
Practice address
1100 E LOOP 304, SUITE 200, CROCKETT, TX 75835-1810
(936) 544-5132
(936) 544-3792
Mailing address
PO BOX 1304, PITTSBURG, TX 75686-2203
(936) 544-5132
(936) 544-3792
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
095181602
—
TX
Enumeration date
11/10/2005
Last updated
02/24/2015
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