Genesis Primecare

LBN: East Texas Border Health Clinic
Genesis Primecare is an health care organization with primary practice located at 2131 S Mobberly Ave , Longview TX 75602-3563. 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) 758-3551, or through Roadcap, Carla via phone (903) 927-3782.

Contact Information

Primary practice address
2131 S Mobberly Ave Longview TX 75602-3563
Phone: (903) 758-3551
Fax:
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 1669872560
LBN Legal business name East Texas Border Health Clinic
DBA Doing business as Genesis Primecare
Authorized official Roadcap, Carla
Entity Organization
Organization subpart 1 No
Enumeration date Aug 27th, 2014
Last updated Aug 28th, 2023 - about last year

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 1669872560 NPPES
Texas MEDICAID 340584701

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