EAST TEXAS MEDICAL CENTER HENDERSON


Address: 300 Wilson St, Henderson, TX 75652-5956
Phone: 9036577541

EAST TEXAS MEDICAL CENTER HENDERSON (NPI# 1083848352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1083848352
Entity Type Organization
Organization Name EAST TEXAS MEDICAL CENTER HENDERSON
Other Organization Name ETMC HENDERSON CRNA
Practice Address 300 Wilson St
Henderson
TX 75652-5956
Practice Telephone 9036577541
Practice Fax Number 9036574009
Mailing Telephone 9036577541
Mailing Fax Number 9036574009
Enumeration Date 2009-05-14
Last Update Date 2011-07-19
Authorized Official Name MR. MARK S LEITNER (ADMINISTRATOR)
Authorized Official Telephone 9036553616
Is Organization Subpart Y
Parent Organization Name EAST TEXAS MEDICAL CENTER HENDERSON

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 367500000X Nurse Anesthetist, Certified Registered Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
TX 220328301 05

Other Provider/Organization Names

Other Name Type Code
ETMC Henderson CRNA Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1215164231 East Texas Medical Center Henderson General Acute Care Hospital 300 Wilson, Henderson, TX 75652-5956 2009-06-17
1942437967 East Texas Medical Center Henderson General Acute Care Hospital 300 Wilson St, Henderson, TX 75652-5956 2009-06-17
1376777649 East Texas Medical Center Henderson Clinic/Center 300 Wilson St, Henderson, TX 75652-5956 2009-05-14
1720212095 East Texas Medical Center Henderson Medicare Defined Swing Bed Unit 300 Wilson St, Henderson, TX 75652-5956 2009-05-14
1245464536 East Texas Medical Center Henderson Clinic/Center 300 Wilson St, Henderson, TX 75652-5956 2009-05-14
1770717167 East Texas Medical Center Henderson General Acute Care Hospital 300 Wilson St, Henderson, TX 75652-5956 2009-05-13

Office Location

Street Address 300 WILSON ST
City HENDERSON
State TX
Zip Code 75652-5956

Providers in the same location

NPI Name Taxonomy Address Enumeration
1255954509 Shawna Elizabeth Sharp Nurse Practitioner 300 Wilson St, Henderson, TX 75652-5956 2020-05-21
1053953794 Mica Ladon Norman Nurse Practitioner 300 Wilson St, Henderson, TX 75652-5956 2019-10-15
1639670466 Henderson Hospital, LLC Nurse Anesthetist, Certified Registered 300 Wilson St, Henderson, TX 75652-5956 2018-02-27
1043710437 Henderson Hospital, LLC Internal Medicine 300 Wilson St, Henderson, TX 75652-5956 2018-02-13
1952800310 Henderson Hospital, LLC Clinic/Center 300 Wilson St, Henderson, TX 75652-5956 2018-02-12
1326546797 Henderson Hospital, LLC General Acute Care Hospital 300 Wilson St, Henderson, TX 75652-5956 2018-01-31
1154730273 Tanager Emergency Physicians Pllc Emergency Medicine 300 Wilson St, Henderson, TX 75652-5956 2014-08-04
1376828400 Kwabena Agyapong Osman General Acute Care Hospital 300 Wilson St, Henderson, TX 75652-5956 2011-10-20
1679899751 Rusk Physician Services Pa Hospitalist 300 Wilson St, Henderson, TX 75652-5956 2010-04-14
1942437967 East Texas Medical Center Henderson General Acute Care Hospital 300 Wilson St, Henderson, TX 75652-5956 2009-06-17
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1184264384 John Etakibuebu Pharmacist 2415 Hwy 79 S, Henderson, TX 75652 2020-01-15
1841758596 Janet Juanita Ray Registered Nurse 1987 Fm 2276 N, Henderson, TX 75652 2019-03-12
1912490483 Matthew Davis Acres Dentist 1910 Tx-43, Henderson, TX 75652 2018-06-11
1467863407 Counseling Services Counselor 1103 Wilson Street, Henderson, TX 75652 2014-05-13
1285900852 Linda June Pool Music Therapist 6861 Fm 1251 E., Henderson, TX 75652 2012-03-28
1780992586 Furqueron & Jackson Dentistry Partnership Dentist 1910 State Hwy 43 East, Henderson, TX 75652 2010-09-15
1235396359 Crystal Touchstone Physical Therapy Assistant 1010 W Main, Henderson, TX 75652 2008-05-16
1609082379 D&s Residential Services Intermediate Care Facility, Mentally Retarded 103 Truman, Henderson, TX 75652 2007-05-16
1790997302 Billy George Brown Dentist 300-b North High Street, Henderson, TX 75652 2007-05-04
1043379761 Donna G Mason-mcfalll Counselor 1103 Wilson St, Henderson, TX 75652 2006-12-08
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Taxonomy Information

Taxonomy Code 367500000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Anesthetist, Certified Registered

Taxonomy Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1790308500 Advanced Practice Pain Management and Anesthesia Consulting Pllc Nurse Anesthetist, Certified Registered 317 Wilson St, Henderson, TX 75652-5957 2020-05-27
1386201374 Jennifer Hope Roark Nurse Anesthetist, Certified Registered 566 Ruin Creek Rd., Po Drawer 59, Henderson, NC 27536-2927 2019-05-24
1629108105 Mary Elizabeth Hoversten Nurse Anesthetist, Certified Registered 1020 S Eastern Ave, 230, Henderson, NV 89052 2007-03-06
1386270460 Jacob Keith Poe Nurse Anesthetist, Certified Registered 566 Ruin Creek Rd, Henderson, NC 27536-2927 2020-03-20
1639670466 Henderson Hospital, LLC Nurse Anesthetist, Certified Registered 300 Wilson St, Henderson, TX 75652-5956 2018-02-27
1336560028 Jedidiah Polete Nurse Anesthetist, Certified Registered 129 W Lake Mead Pkwy, Suite B18, Henderson, NV 89015-6954 2013-12-23
1396089611 Tami B May Nurse Anesthetist, Certified Registered 566 Ruin Creek Rd, Henderson, NC 27536-2927 2012-11-27
1235484981 Matthew Lee Rigby Nurse Anesthetist, Certified Registered 129 W Lake Mead Pkwy, Suite B18, Henderson, NV 89015-6954 2012-07-18
1225309628 Michael R Hagerman Nurse Anesthetist, Certified Registered 1305 N Elm St, Henderson, KY 42420-2783 2012-01-18
1013205830 Jaime Parke Nurse Anesthetist, Certified Registered 129 W Lake Mead Pkwy, Suite B18, Henderson, NV 89015-6954 2011-07-13
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City HENDERSON
Zip Code 75652

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Dataset Information

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.

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