EAST TEXAS BORDER HEALTH CLINIC (NPI# 1528616992) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528616992 |
| Entity Type | Organization |
| Organization Name | EAST TEXAS BORDER HEALTH CLINIC |
| Other Organization Name | GLENWOOD PHARMACY |
| Practice Address |
1400 College Dr Texarkana TX 75503-3536 |
| Mailing Address |
Po Box 1326 Marshall TX 75671-1326 |
| Practice Telephone | 9037928296 |
| Mailing Telephone | 9039271764 |
| Mailing Fax Number | 9039271764 |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2020-09-03 |
| Authorized Official Name | TRACEY ENGEL (PROVIDER ENROLLMENT SPECIALIST) |
| Authorized Official Telephone | 9039273782 |
| Is Organization Subpart | Y |
| Parent Organization Name | EAST TEXAS BORDER HEALTH CLINIC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| Glenwood Pharmacy | 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 |
| 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 |
1400 COLLEGE DR |
| City | TEXARKANA |
| State | TX |
| Zip Code | 75503-3536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063417822 | Thomas Alston | Internal Medicine | 1400 College Dr, Ste 202, Texarkana, TX 75503-3575 | 2005-06-17 |
| 1649898354 | Sarah Khrystine Prine | Dentist | 1400 College Dr, Texarkana, TX 75503-3536 | 2020-07-09 |
| 1104361781 | East Texas Border Health Clinic | Dentist | 1400 College Dr, Texarkana, TX 75503-3536 | 2017-01-05 |
| 1407196264 | Dannah M Smith | Nurse Practitioner | 1400 College Dr, Suite 204, Texarkana, TX 75503 | 2013-02-15 |
| 1053663690 | East Texas Border Health Clinic | Clinic/Center | 1400 College Dr, Texarkana, TX 75503-3536 | 2012-10-05 |
| 1184929622 | Andrea K Heflin | Nurse Practitioner | 1400 College Dr, Ste 202, Texarkana, TX 75503-3536 | 2011-01-13 |
| 1356665988 | Kelli Lynn Cook | Social Worker | 1400 College Dr, Texarkana, TX 75503-3536 | 2010-03-25 |
| 1619103058 | Mary Mbonu | Family Medicine | 1400 College Dr, Texarkana, TX 75503-3536 | 2009-05-29 |
| 1033359088 | Ashli Kay Sutton | Counselor | 1400 College Dr, Texarkana, TX 75503-3536 | 2009-03-04 |
| 1689702334 | Glenwood Pharmacy | Pharmacy | 1400 College Dr, Texarkana, TX 75503-3534 | 2007-03-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770049397 | Jeffery Nash | Nurse Practitioner | #4 Valley View Circle, Texarkana, TX 75503 | 2019-02-19 |
| 1821583501 | Brandy D Acker | Psychologist | 3615 Richmond Rd, Texarkana, TX 75503 | 2018-06-26 |
| 1366935066 | Samantha Lee Harris | Nurse Practitioner | 4116 Mcknight Rd, Texarkana, TX 75503 | 2018-06-07 |
| 1811416910 | Heather Alison Gerber | Nurse Practitioner | 5903 Brenda Street, Texarkana, TX 75503 | 2017-09-11 |
| 1952838682 | John Kyle Abney | Counselor | 4134 Mcknight Rd, Texarkana, TX 75503 | 2017-05-12 |
| 1699151514 | Piney Woods Er IIi LLC | Clinic/Center | 4102 Gibson Lane, Texarkana, TX 75503 | 2015-08-03 |
| 1609282433 | Colby Rebecca Pair | Physician Assistant | 2604 St. Michael Dr., Suite 310, Texarkana, TX 75503 | 2014-07-01 |
| 1265842496 | Healthcare Express, LLP | Clinic/Center | 3513 Richmond Rd, Texarkana, TX 75503 | 2014-04-28 |
| 1134540628 | Eagle Dental Center of Texarkana Pllc | Dentist | 4009 Moores Ln, Texarkana, TX 75503 | 2013-12-30 |
| 1326481664 | Juancarlo S. Pascual | Family Medicine | 604 St. Michael Dr, Suite 340, Texarkana, TX 75503 | 2013-04-16 |
| Find all providers in zip 75503 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235114208 | Village Apothecary, Inc | Pharmacy | 100 East St, Texarkana, AR 71854-6304 | 2005-12-13 |
| 1639560444 | Wal-mart Stores Texas LLC | Pharmacy | 3520 Richmond Rd, Texarkana, TX 75503-0705 | 2015-02-16 |
| 1972908127 | Wpm Community Pharmacies, LLC | Pharmacy | 113 East St, Texarkana, AR 71854-6303 | 2014-10-30 |
| 1689702334 | Glenwood Pharmacy | Pharmacy | 1400 College Dr, Texarkana, TX 75503-3534 | 2007-03-02 |
| 1740342385 | Collom & Carney Clinic Association | Pharmacy | 5002 Cowhorn Creek Rd, Suite B, Texarkana, TX 75503-9766 | 2006-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831790575 | Nextlevel Pharmaceuticals LLC | Pharmacy | 1110 Texas Pkwy, Stafford, TX 77477-6419 | 2020-11-06 |
| 1629679410 | Duehan Tran Ngo | Pharmacy | 403 W Sam Houston Pkwy N, Houston, TX 77024-4736 | 2020-11-06 |
| 1679174882 | Comanche County Medical Center Company | Pharmacy | 1870 State Hwy 36, Rising Star, TX 76471 | 2020-11-04 |
| 1629679717 | Edith Achebodt | Pharmacy | 2233 Avenue J Ste 103b, Arlington, TX 76006-5884 | 2020-11-04 |
| 1356942767 | Rxassist Pharmacy, Inc. | Pharmacy | 17020 Beaver Springs Dr Ste 8, Houston, TX 77090-2398 | 2020-11-03 |
| 1154921864 | Mbepe Health LLC | Pharmacy | 301 S 9th St Ste 121, Richmond, TX 77469-3448 | 2020-10-30 |
| 1639779366 | Mens African Investors | Pharmacy | 6355 S Peek Rd Ste 300, Katy, TX 77450-7195 | 2020-10-30 |
| 1861091977 | A Medizona Pharmacy | Pharmacy | 3700 Barker Cypress Rd, Suite 700, Houston, TX 77084 | 2020-10-20 |
| 1952900078 | Nudo Pharmacy LLC | Pharmacy | 104 Industrial Blvd Ste 201, Sugar Land, TX 77478-3174 | 2020-10-20 |
| 1194324277 | Rite Scripts Pharmacy Inc | Pharmacy | 13835 Westhollow Park Dr Apt 2805, Houston, TX 77082-1885 | 2020-10-20 |
| Find all providers with the same taxonomy | ||||
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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.