EAST TEXAS BORDER HEALTH CLINIC (NPI# 1093186249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093186249 |
| Entity Type | Organization |
| Organization Name | EAST TEXAS BORDER HEALTH CLINIC |
| Other Organization Name | GENESIS PRIMECARE |
| Practice Address |
1205 E 35th St Texarkana AR 71854-2746 |
| Mailing Address |
Po Box 1326 Marshall TX 75671-1326 |
| Practice Telephone | 8702160080 |
| Practice Fax Number | 8702160093 |
| Mailing Telephone | 9039273782 |
| Mailing Fax Number | 9039271764 |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2020-09-03 |
| Authorized Official Name | CARLA ROADCAP (CEO) |
| Authorized Official Telephone | 9039273782 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 213389749 | 05 | |
| TX | 356940201 | 05 |
| Other Name | Type Code |
|---|---|
| Genesis PrimeCare | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598366718 | East Texas Border Health Clinic | Clinic/Center | 1411 College Dr, Texarkana, TX 75503-3533 | 2020-11-04 |
| 1780295741 | East Texas Border Health Clinic | Clinic/Center | 705 S Grove St, Marshall, TX 75670-5220 | 2020-08-13 |
| 1811485055 | East Texas Border Health Clinic | Clinic/Center | 815 S Washington Ave Ste 203, Marshall, TX 75670-5341 | 2018-04-24 |
| 1588092472 | East Texas Border Health Clinic | Clinic/Center | 401 N Grove Street, Marshall, TX 75670-3255 | 2013-10-31 |
| 1700134996 | East Texas Border Health Clinic | General Practice | 1500 W. Grand Ave., Marshall, TX 75671 | 2012-08-21 |
| 1659567337 | East Texas Border Health Clinic | Clinic/Center | 106 N Alley Street, Jefferson, TX 75657-1408 | 2007-09-17 |
| 1194332155 | East Texas Border Health Clinic | Social Worker | 1011 S William St, Atlanta, TX 75551-3245 | 2020-09-24 |
| 1023630969 | East Texas Border Health Clinic | Clinic/Center | 622 S Grove St, Marshall, TX 75670-5251 | 2020-05-14 |
| 1528616992 | East Texas Border Health Clinic | Pharmacy | 1400 College Dr, Texarkana, TX 75503-3536 | 2019-08-29 |
| 1548745383 | East Texas Border Health Clinic | Counselor | 4077 Jefferson Ave, Texarkana, AR 71854-1509 | 2018-09-27 |
| Street Address |
1205 E 35TH ST |
| City | TEXARKANA |
| State | AR |
| Zip Code | 71854-2746 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639163363 | Spanish Trace Clinic | Family Medicine | 1205 E 35th St, Texarkana, AR 71854-2746 | 2005-09-08 |
| 1730643115 | Maranda Wells | Nurse Practitioner | 1205 E 35th St, Texarkana, AR 71854-2746 | 2019-01-30 |
| 1053840082 | Crystal Marie Stanberry | Nurse Practitioner | 1205 E 35th St, Texarkana, AR 71854-2746 | 2017-06-04 |
| 1023461399 | Tommy Caldwell | Nurse Practitioner | 1205 E 35th St, Texarkana, AR 71854-2746 | 2016-07-21 |
| 1578947925 | Mary Williams | Nurse Practitioner | 1205 E 35th St, Texarkana, AR 71854-2746 | 2015-07-15 |
| 1750765673 | Jennifer Miller | Nurse Practitioner | 1205 E 35th St, Texarkana, AR 71854-2746 | 2015-07-10 |
| 1780075473 | Sam Allen Nix | Nurse Practitioner | 1205 E 35th St, Texarkana, AR 71854-2746 | 2015-02-17 |
| 1700274909 | Pamela May | Nurse Practitioner | 1205 E 35th St, Texarkana, AR 71854 | 2014-12-23 |
| 1104169895 | Kelly Leshell Hardin | Registered Nurse | 1205 E 35th St, Texarkana, AR 71854-2746 | 2013-04-01 |
| 1992081491 | Jody A Barham | Nurse Practitioner | 1205 E 35th St, Texarkana, AR 71854-2746 | 2011-10-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962988253 | Holly Renee Snipe | Registered Nurse | 4700 Sunbury Dr, Texarkana, AR 71854 | 2018-07-19 |
| 1023500634 | Carlotta A Powell | Counselor | 7000 N Stateline Ave, Texarkana, AR 71854 | 2018-05-31 |
| 1326538810 | Chad Roldan | Occupational Therapy Assistant | 6402 Countryside Dr, Texarkana, AR 71854 | 2018-05-10 |
| 1649797481 | Alliance Counseling Agency LLC | Community/Behavioral Health | 819 Beech St, Texarkana, AR 71854 | 2017-08-23 |
| 1366971467 | Kimberly Dian Cox | Case Manager/Care Coordinator | 7000 North Stateline Ave, Texarkana, AR 71854 | 2017-06-12 |
| 1295260040 | Seniors for Senior Care | Adult Companion | 4613 Parkway Dr., Texarkana, AR 71854 | 2017-04-28 |
| 1033650635 | Texarkana Eye Associates | Optometrist | 114 East 49th St, Texarkana, AR 71854 | 2017-03-15 |
| 1881064731 | Texarkana Group, P.l.l.c | Chiropractor | 2100 N. State Line Ave., Texarkana, AR 71854 | 2015-10-05 |
| 1528301819 | Megan Guercio | Specialist/Technologist | 1002 East 35th Street, Texarkana, AR 71854 | 2013-04-04 |
| 1831439116 | James Wesley Mcraven | Nurse Practitioner | 210 N. Stateline, Suite 301, Texarkana, AR 71854 | 2013-02-22 |
| Find all providers in zip 71854 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598366718 | East Texas Border Health Clinic | Clinic/Center | 1411 College Dr, Texarkana, TX 75503-3533 | 2020-11-04 |
| 1831661412 | Special Health Resources for Texas Incorporated | Clinic/Center | 1911 Galleria Oaks Dr, Texarkana, TX 75503-4617 | 2018-12-20 |
| 1942665112 | Special Health Resources for Texas, Inc. | Clinic/Center | 300 E 6th St, Texarkana, AR 71854-5207 | 2015-12-15 |
| 1083006084 | East Texas Border Health Clinic | Clinic/Center | 2604 Saint Michael Dr Ste 410, Texarkana, TX 75503-2378 | 2015-02-27 |
| 1326460858 | Special Health Resources for Texas Incorporated | Clinic/Center | 1102 Main St, Texarkana, TX 75501-4313 | 2014-01-17 |
| 1053663690 | East Texas Border Health Clinic | Clinic/Center | 1400 College Dr, Texarkana, TX 75503-3536 | 2012-10-05 |
| 1417123258 | Department of Veterans Affairs | Clinic/Center | 910 Realtor Avenue, Texarkana, AR 71854-5066 | 2008-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962014316 | Healthy Connections, Inc. | Clinic/Center | 1306 W Collin Raye Dr Ste B, De Queen, AR 71832-2502 | 2020-08-18 |
| 1982221065 | Arcare | Clinic/Center | 7300 Dollarway Rd Ste 116, White Hall, AR 71602-3023 | 2020-07-06 |
| 1669099073 | St Francis House Nwa, Inc | Clinic/Center | 1923 W Pickens Road, Pea Ridge, AR 72751 | 2020-07-01 |
| 1427674696 | Arcare | Clinic/Center | 11520 Sr 27, Hector, AR 72843-8710 | 2020-06-23 |
| 1487280384 | Arcare | Clinic/Center | 2805 Mid Cities Dr Ste 1, Bentonville, AR 72712-4291 | 2020-03-23 |
| 1073144028 | Arcare | Clinic/Center | 145 N Curtis Ave, Pea Ridge, AR 72751-3407 | 2020-01-29 |
| 1396383758 | Mainline Health Systems Inc | Clinic/Center | 1012 E Church St Ste B, Warren, AR 71671-3530 | 2019-12-17 |
| 1275177883 | Boston Mountain Rural Health Center, Inc | Clinic/Center | 1201 North Panther Ave # 3, Yellville, AR 72687 | 2019-11-06 |
| 1649814138 | St Francis House Nwa, Inc | Clinic/Center | 2328 Cardinal Drive, Springdale, AR 72764-4469 | 2019-10-29 |
| 1104469832 | Arcare | Clinic/Center | 501 Millwood Cir Ste E, Maumelle, AR 72113-6304 | 2019-10-25 |
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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.