EAST TEXAS MEDICAL CENTER CROCKETT (NPI# 1073500799) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073500799 |
| Entity Type | Organization |
| Organization Name | EAST TEXAS MEDICAL CENTER CROCKETT |
| Other Organization Name | ETMC CROCKETT |
| Practice Address |
1100 E Loop 304 Crockett TX 75835-1810 |
| Mailing Address |
Po Box 1129 Crockett TX 75835-1129 |
| Practice Telephone | 9365463803 |
| Practice Fax Number | 9365463816 |
| Mailing Telephone | 9365463862 |
| Mailing Fax Number | 9365463816 |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. STACY BAILEY DISE (BUSINESS OFFICE MANAGER) |
| Authorized Official Telephone | 9365463810 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 000185 | TX | Hospitals |
| Other Name | Type Code |
|---|---|
| ETMC Crockett | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083835219 | East Texas Medical Center Crockett | General Acute Care Hospital | 1100 E Loop 304, Crockett, TX 75835-1810 | 2007-05-02 |
| 1326101692 | East Texas Medical Center Crockett | General Acute Care Hospital | 1100 E Loop 304, Crockett, TX 75835-1810 | 2006-12-18 |
| 1831251479 | East Texas Medical Center Crockett | General Acute Care Hospital | 1100 E Loop 304, Crockett, TX 75835-1810 | 2006-12-13 |
| 1912081290 | East Texas Medical Center Crockett | Long Term Care Hospital | 1100 E Loop 304, Crockett, TX 75835-1810 | 2006-10-24 |
| 1619941291 | East Texas Medical Center Crockett | Clinic/Center | 1100 E Loop 304, Crockett, TX 75835-1810 | 2006-02-13 |
| Street Address |
1100 E LOOP 304 |
| City | CROCKETT |
| State | TX |
| Zip Code | 75835-1810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194334532 | Patrick Allen Harvey | Pharmacist | 1100 E Loop 304, Crockett, TX 75835-1810 | 2020-07-30 |
| 1114435260 | Crockett Medical Center, LLC | General Acute Care Hospital | 1100 E Loop 304, Crockett, TX 75835-1810 | 2018-01-10 |
| 1700269941 | Timberlands Healthcare, LLC | Medicare Defined Swing Bed Unit | 1100 E Loop 304, Crockett, TX 75835-1810 | 2015-07-07 |
| 1306223458 | Timberlands Healthcare, LLC | General Acute Care Hospital | 1100 E Loop 304, Crockett, TX 75835-1810 | 2015-04-28 |
| 1013301647 | Lifeguard Ambulanceservice of Texas, LLC | Ambulance | 1100 E Loop 304, Crockett, TX 75835-1810 | 2015-03-20 |
| 1588957856 | Walter Cody Cox | Emergency Medicine | 1100 E Loop 304, Crockett, TX 75835-1810 | 2011-05-19 |
| 1083835219 | East Texas Medical Center Crockett | General Acute Care Hospital | 1100 E Loop 304, Crockett, TX 75835-1810 | 2007-05-02 |
| 1326101692 | East Texas Medical Center Crockett | General Acute Care Hospital | 1100 E Loop 304, Crockett, TX 75835-1810 | 2006-12-18 |
| 1831251479 | East Texas Medical Center Crockett | General Acute Care Hospital | 1100 E Loop 304, Crockett, TX 75835-1810 | 2006-12-13 |
| 1912081290 | East Texas Medical Center Crockett | Long Term Care Hospital | 1100 E Loop 304, Crockett, TX 75835-1810 | 2006-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568012862 | Ruby R. Adler | Technician | 2301 N 4th Street, Crockett, TX 75835 | 2019-09-18 |
| 1366712978 | Traditions Hospice of Madisonville, LLC | Hospice Care, Community Based | 600e Loop 304, Crockett, TX 75835 | 2012-01-12 |
| 1538458633 | Northeast Texas Home Health Agency Ltd | Home Health | 2001 E Houston Ave, Crockett, TX 75835 | 2011-03-30 |
| 1508096553 | D&c Medical Associates | Family Medicine | 1100 Loop 3048 East, Suite 200, Crockett, TX 75835 | 2009-07-23 |
| 1356466346 | John Vernon Garner | Dentist | 102 North Grace, Crockett, TX 75835 | 2007-03-20 |
| 1023148467 | Houston County Home Health Care, Inc. | Durable Medical Equipment & Medical Supplies | 1703 E Hwy 21 E, Crockett, TX 75835 | 2007-03-06 |
| 1407944382 | Davy Crockett Drug, Inc. | Pharmacy | 107 S 4th St, Crockett, TX 75835 | 2006-10-10 |
| 1437177052 | John Allan Burnett | Emergency Medicine | 1100 Loop 340 E, Crockett, TX 75835 | 2006-07-18 |
| 1720022593 | Stanley Roger Speegle | Family Medicine | 1100 Loop 304 East, Crockett, TX 75835 | 2006-06-15 |
| 1649219809 | Jeanne M. Hopple | Nurse Practitioner | The Heart Institute of East Texas, Crocket, 951 E. Loop 304, Crockett, TX 75835 | 2006-06-05 |
| Find all providers in zip 75835 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114435260 | Crockett Medical Center, LLC | General Acute Care Hospital | 1100 E Loop 304, Crockett, TX 75835-1810 | 2018-01-10 |
| 1306223458 | Timberlands Healthcare, LLC | General Acute Care Hospital | 1100 E Loop 304, Crockett, TX 75835-1810 | 2015-04-28 |
| 1083835219 | East Texas Medical Center Crockett | General Acute Care Hospital | 1100 E Loop 304, Crockett, TX 75835-1810 | 2007-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184233785 | Hendrick Medical Center Brownwood | General Acute Care Hospital | 1501 Burnett Rd, Brownwood, TX 76801-8520 | 2020-07-29 |
| 1487271375 | Methodist Hospitals of Dallas | General Acute Care Hospital | 1201 E Us Hwy 287, Midlothian, TX 76065 | 2020-06-26 |
| 1275177032 | Heights Hospital LLC | General Acute Care Hospital | 1917 Ashland St Ste 600, Houston, TX 77008-3907 | 2019-11-04 |
| 1457994188 | Vhs Harlingen Hospital Company, LLC | General Acute Care Hospital | 1021 W Interstate 2, Weslaco, TX 78596 | 2019-10-25 |
| 1750932117 | Lumberton Hospital LLC | General Acute Care Hospital | 220 Blanco St, Lumberton, TX 77657-8620 | 2019-09-26 |
| 1619524568 | Intermed Rcm, LLC | General Acute Care Hospital | 539 W Commerce St # 310, Dallas, TX 75208-1953 | 2019-08-23 |
| 1841844735 | Emerus Bhs Sa Thousand Oaks, LLC | General Acute Care Hospital | 806 Cupples Rd, San Antonio, TX 78237-4410 | 2019-07-29 |
| 1316505043 | Ethicus Hospital Dfw LLC | General Acute Care Hospital | 1401 E. Trinity Mills Road, Carroliton, TX 75006 | 2019-05-29 |
| 1669954194 | Southcross Hospital LLC | General Acute Care Hospital | 4243 E Southcross Blvd Ste 100, San Antonio, TX 78222-3727 | 2018-08-31 |
| 1356822167 | Stat Emergency Center of Del Rio LLC | General Acute Care Hospital | 2600 Veterans Blvd, Del Rio, TX 78840-3108 | 2018-08-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.