EAST TEXAS MEDICAL CENTER (NPI# 1235256884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235256884 |
| Entity Type | Organization |
| Organization Name | EAST TEXAS MEDICAL CENTER |
| Practice Address |
1000 S Beckham Ave Tyler TX 75701-1908 |
| Practice Telephone | 9035318170 |
| Practice Fax Number | 9035356102 |
| Mailing Telephone | 9035318170 |
| Mailing Fax Number | 9035356102 |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | MR. BYRON HALE (SENIOR VICE PRESIDENT FINANCE) |
| Authorized Official Telephone | 9035318010 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | TX | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE CROSS OF TEXAS ACUTE | HH0219 | 01 |
| TX | 020812601 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568964518 | East Texas Medical Center | Ambulance | 1501 Hogan Lane, Suite H, Bellmead, TX 76705-2480 | 2018-03-06 |
| 1699289785 | East Texas Medical Center | Clinic/Center | 117 N Winnsboro St, Quitman, TX 75783-2144 | 2017-11-28 |
| 1497804371 | East Texas Medical Center | Nurse Anesthetist, Certified Registered | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2007-01-09 |
| 1962483453 | East Texas Medical Center | Clinic/Center | 1100 E Loop 304, Suite 200, Crockett, TX 75835-1810 | 2005-11-10 |
| Street Address |
1000 S BECKHAM AVE |
| City | TYLER |
| State | TX |
| Zip Code | 75701-1908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740280510 | Aleksandra Olsson-detwiler | Internal Medicine | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2005-07-22 |
| 1831706431 | Kalana Sanders | Registered Nurse | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2020-09-28 |
| 1992333975 | Graceanne M. Dimon | Physical Therapist | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2020-03-27 |
| 1760021976 | Gerardo Tapia Hernandez | Nurse Practitioner | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2020-01-06 |
| 1861950057 | Brittany Mason Ferguson | Nurse Practitioner | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2019-03-06 |
| 1255801189 | Shane Ashley Correa | Nurse Practitioner | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-12-04 |
| 1174000962 | David Matthew Burkland | Nurse Practitioner | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-07-24 |
| 1598251209 | Kelsey Rene Morton | Nurse Practitioner | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-07-05 |
| 1063915916 | Tyler Regional Hospital LLC | Surgery | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-03-16 |
| 1437650264 | Tyler Regional Hospital LLC | Nurse Anesthetist, Certified Registered | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-02-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| 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 |
|---|---|---|---|---|
| 1942292255 | Texas Spine and Joint Hospital, LLC | General Acute Care Hospital | 1814 Roseland Blvd, Tyler, TX 75701-4262 | 2005-08-22 |
| 1407364847 | Tyler Regional Hospital LLC | General Acute Care Hospital | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-01-19 |
| 1891245734 | Rene Richter | General Acute Care Hospital | 703 S Fleishel Ave, Suite 5000, Tyler, TX 75701-2015 | 2016-10-04 |
| 1306182563 | Mother Frances Hospital | General Acute Care Hospital | 800 E Dawson St, Tyler, TX 75701-2036 | 2012-12-17 |
| 1578850145 | Joseph S. Wassef, M.d., P.C. | General Acute Care Hospital | 2010 Sybil Ln Ste 150, Tyler, TX 75703-1830 | 2011-07-05 |
| 1184832891 | Tyler Healthcare Center Dba Tyler Healthcare Pharmacy | General Acute Care Hospital | 240 Willow St., Tyler, MN 56178 | 2007-05-18 |
| 1679578439 | Mother Frances Hospital Regional Health Care Center | General Acute Care Hospital | 800 E Dawson St, Tyler, TX 75701-2036 | 2005-06-17 |
| 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 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on EAST TEXAS MEDICAL CENTER.
| 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.