Etmc First Physicians Clinic Jacksonville

LBN: East Texas Medical Center Jacksonville
Etmc First Physicians Clinic Jacksonville is an health care organization with primary practice located at 203 Nacogdoches St Suite 280, Jacksonville TX 75766-2444. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rural Health, which is considered as the primary health care specialty. East Texas Medical Center Jacksonville can be contacted via phone (903) 541-5396, or through Endres, Jack R via phone (903) 541-5100.

Contact Information

Primary practice address
203 Nacogdoches St Suite 280 Jacksonville TX 75766-2444
Phone: (903) 541-5396
Fax: (903) 541-5393
Website:
Map and Directions
Authorized official contact:
Name: Endres, Jack R
Phone: (903) 541-5100

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rural Health 261QR1300X

Profile Details

NPI number 1821366170
LBN Legal business name East Texas Medical Center Jacksonville
DBA Doing business as Etmc First Physicians Clinic Jacksonville
Authorized official Endres, Jack R
Entity Organization
Organization subpart 1 No
Enumeration date Dec 1st, 2011
Last updated Nov 8th, 2012 - about 13 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 1821366170 NPPES
Texas MEDICAID 130612807
Texas Other 130612808

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