Genesisprimecare

LBN: East Texas Border Health Clinic
Genesisprimecare is an health care organization with primary practice located at 1400 College Dr , Texarkana TX 75503-3536. The organization recently has only one registered license in Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), which is considered as the primary health care specialty. East Texas Border Health Clinic can be contacted via phone (903) 791-1110, or through Roadcap, Carla via phone (903) 927-3782.

Contact Information

Primary practice address
1400 College Dr Texarkana TX 75503-3536
Phone: (903) 791-1110
Fax: (903) 791-9353
Website:
Map and Directions
Authorized official contact:
Name: Roadcap, Carla
Phone: (903) 927-3782

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X

Profile Details

NPI number 1083006084
LBN Legal business name East Texas Border Health Clinic
DBA Doing business as Genesisprimecare
Authorized official Roadcap, Carla
Entity Organization
Organization subpart 1 No
Enumeration date Feb 27th, 2015
Last updated Aug 28th, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083006084 NPPES
Texas MEDICAID 347907301
Texas MEDICAID 211550002

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