EAST TEXAS BORDER HEALTH CLINIC (NPI# 1194332155) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194332155 |
| Entity Type | Organization |
| Organization Name | EAST TEXAS BORDER HEALTH CLINIC |
| Practice Address |
1011 S William St Atlanta TX 75551-3245 |
| Mailing Address |
Po Box 1326 Marshall TX 75671-1326 |
| Practice Telephone | 9037962868 |
| Practice Fax Number | 9037960802 |
| Mailing Telephone | 9039273782 |
| Mailing Fax Number | 9039271764 |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2020-09-24 |
| Authorized Official Name | CARLA ROADCAP (CEO) |
| Authorized Official Telephone | 9039273782 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| GENESIS PRIME CARE | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2604 Saint Michael Dr Ste 410, Texarkana, TX 755032378 | 9036145570 | 9036145599 |
| 618 S Grove St Ste 100&300, Marshall, TX 756705294 | 9039276620 | |
| 620 S Grove St Ste 105, Marshall, TX 756705295 | 9039359441 | 9039381246 |
| 1400 College Dr, Texarkana, TX 755033536 | 9037911110 | 9037919353 |
| 815 S Washington Ave Ste 203, Marshall, TX 756705341 | 9039276850 | 9039276857 |
| 805 Lindsey Dr, Marshall, TX 756705271 | 9039381146 | 9039272434 |
| 622 S Grove St, Marshall, TX 756705251 | 9037027900 | 9037027904 |
| 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 |
| 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 |
| 1053845636 | East Texas Border Health Clinic | Clinic/Center | 618 S Grove St Ste 100&300, Marshall, TX 75670-5294 | 2017-04-20 |
| Street Address |
1011 S WILLIAM ST |
| City | ATLANTA |
| State | TX |
| Zip Code | 75551-3245 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588668453 | Stephen K Erlewine | Nurse Practitioner | 1011 S William St, Atlanta, TX 75551 | 2005-06-09 |
| 1740807759 | Kelli Michelle Thompson | Nurse Practitioner | 1011 S William St, Atlanta, TX 75551-3245 | 2020-06-26 |
| 1700402708 | Rae Shannon Hammonds | Nurse Practitioner | 1011 S William St, Atlanta, TX 75551-3245 | 2020-06-25 |
| 1316459852 | Melanie A Stone | Nurse Practitioner | 1011 S William St, Atlanta, TX 75551 | 2017-10-24 |
| 1396256061 | Jared Chase Anderson | Social Worker | 1011 S William St, Atlanta, TX 75551-3245 | 2017-10-20 |
| 1376077164 | Christian Ferrer | Family Medicine | 1011 S William St, Atlanta, TX 75551-3245 | 2017-04-18 |
| 1114388113 | Tiffany Lynne Griffin | Nurse Practitioner | 1011 S William St, Atlanta, TX 75551 | 2016-03-18 |
| 1366828303 | East Texas Border Health Clinic | Clinic/Center | 1011 S William St, Atlanta, TX 75551-3245 | 2015-07-31 |
| 1841629581 | Jennifer Sellers | Counselor | 1011 S William St, Atlanta, TX 75551-3245 | 2013-11-04 |
| 1942555669 | Yvonne Fellers | Social Worker | 1011 S William St, Atlanta, TX 75551-3245 | 2012-07-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346879921 | Wendy Sue Willoughby | Pharmacy Technician | 201 Us Hwy 59, Atlanta, TX 75551 | 2020-04-06 |
| 1689154759 | Bobbye Francene Rankin | Physical Therapy Assistant | 109 Cr 3544, Atlanta, TX 75551 | 2018-08-18 |
| 1447668538 | Winnie-stowell Hospital District | Skilled Nursing Facility | 1104 S. William Street, Atlanta, TX 75551 | 2014-08-01 |
| 1912176983 | Glenna B Frost | Speech-Language Pathologist | 1001 West Main Street, Atlanta, TX 75551 | 2008-02-25 |
| 1043438823 | Shelia Kaye Langbartels | Optometrist | 201 Hwy. 59 South, Atlanta, TX 75551 | 2007-04-24 |
| 1598838583 | Tim C Hogan | Dentist | 402 S William St, Hogan Dental Clinic, Atlanta, TX 75551 | 2006-11-16 |
| 1003991290 | Jimmy Glenn Stillwell | Nurse Anesthetist, Certified Registered | 1007 S Williams, Atlanta Memorial Hospital, Atlanta, TX 75551 | 2006-10-26 |
| 1336248376 | Miles Drug Company | Pharmacist | 122 N East St, Atlanta, TX 75551 | 2006-09-22 |
| 1417050667 | Danny Warren Addington | Dentist | 307 East Hiram, Atlanta, TX 75551 | 2006-09-06 |
| 1912917899 | Atlanta Nursing Homes Inc. | Skilled Nursing Facility | 200 Live Oak, Atlanta, TX 75551 | 2006-08-09 |
| Find all providers in zip 75551 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800836 | Ascend Medical Georgia PC | Family Medicine | One Alliance Center, 3500 Lenox Road Suite 1500, Atlanta, GA 30326 | 2020-08-04 |
| 1912521782 | Eagles Landing Family Practice, LLC | Family Medicine | 3333 Riverwood Pkwy Se Ste 250, Atlanta, GA 30339-3304 | 2020-06-08 |
| 1487297164 | Deavmed L.l.c | Family Medicine | 3915 Cascade Rd Sw Ste T-90, Atlanta, GA 30331-8660 | 2019-10-24 |
| 1598319287 | Vibrant Family Medicine, P.C. | Family Medicine | 6667 Vernon Woods Dr Ste A19, Atlanta, GA 30328-3215 | 2019-07-30 |
| 1649739020 | Accumedic Diagnostic Management LLC | Family Medicine | 373 W Lake Ave Nw, Atlanta, GA 30318-8123 | 2019-03-15 |
| 1679037758 | Harrigan Medical Consulting Services, Inc | Family Medicine | 3280 Howell Mill Rd Nw Ste 207, Atlanta, GA 30327-4100 | 2019-01-23 |
| 1184197337 | Todd Ware Davis | Family Medicine | 942 Fern Ave Se, Atlanta, GA 30315-1813 | 2019-01-09 |
| 1881165207 | Le Reve Medical Clinic PC | Family Medicine | 1827 Powers Ferryy Rd Se Bldg 7, Suite 150, Atlanta, GA 30339 | 2018-12-11 |
| 1265902092 | Gregory Stephen Wallace | Family Medicine | 1042 Mason Woods Dr Ne, Atlanta, GA 30329-3802 | 2018-12-05 |
| 1124596069 | Longevity Medical Center, PC | Family Medicine | 4646 N Shallowford Rd Ste 300, Atlanta, GA 30338-6308 | 2018-11-08 |
| Find all providers in ATLANTA | ||||
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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.