East Texas Family Support Clinic

LBN: East Texas Family Support Clinic
East Texas Family Support Clinic is an health care organization with primary practice located at 1305 Doctors Dr , Tyler TX 75701-2263. The organization recently has 3 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Multi-Specialty, Ambulatory Health Care Facilities / Medical Specialty, Ambulatory Health Care Facilities / Pain. Ambulatory Health Care Facilities / Pain is the primary health care specialty. East Texas Family Support Clinic can be contacted via phone (903) 525-9397, or through Blake, Jennifer A via phone (954) 557-2775.

Contact Information

Primary practice address
1305 Doctors Dr Tyler TX 75701-2263
Phone: (903) 525-9397
Fax: (903) 525-9398
Website:
Map and Directions
Authorized official contact:
Name: Blake, Jennifer A
Phone: (954) 557-2775

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X
Ambulatory Health Care Facilities / Medical Specialty 261QM2500X
Ambulatory Health Care Facilities / Pain 261QP3300X

Profile Details

NPI number 1699315499
LBN Legal business name East Texas Family Support Clinic
DBA Doing business as
Authorized official Blake, Jennifer A
Entity Organization
Organization subpart 1 No
Enumeration date Jan 9th, 2020
Last updated Jun 11th, 2020 - about 4 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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