EAST TEXAS BORDER HEALTH CLINIC (NPI# 1700134996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700134996 |
| Entity Type | Organization |
| Organization Name | EAST TEXAS BORDER HEALTH CLINIC |
| Other Organization Name | GENESIS PRIMECARE |
| Practice Address |
1500 W. Grand Ave. Marshall TX 75671 |
| Mailing Address |
Po Box 1326 Marshall TX 75671-1326 |
| Practice Telephone | 9039273782 |
| Practice Fax Number | 9039271764 |
| Mailing Telephone | 9039273782 |
| Mailing Fax Number | 9039271764 |
| Enumeration Date | 2012-08-21 |
| 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 |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| 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 |
| 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 |
| 1053845636 | East Texas Border Health Clinic | Clinic/Center | 618 S Grove St Ste 100&300, Marshall, TX 75670-5294 | 2017-04-20 |
| Street Address |
1500 W. GRAND AVE. |
| City | MARSHALL |
| State | TX |
| Zip Code | 75671 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093315806 | Jacob Hoelscher | Pharmacist | 108 Kyden Drive, Marshall, IL 62441 | 2020-10-30 |
| 1073111696 | Brittany Adams | Registered Nurse | 106 Yvonne Ln, Marshall, TX 75672-8326 | 2020-10-15 |
| 1467050575 | Yoalnda Cherie Escobedo | Licensed Vocational Nurse | 4905 Buck Sherrod Rd Lot 44, Marshall, TX 75672-3221 | 2020-10-12 |
| 1003413774 | Mikeayla Pellegrino | Speech-Language Pathologist | 103 E Mansion St Ricketson Building, Marshall, MI 49068 | 2020-10-06 |
| 1396352225 | Elizabeth Ferrall Consulting LLC | Dietitian, Registered | 10200 17 Mile Rd, Marshall, MI 49068-9797 | 2020-09-24 |
| 1598371346 | Carolyn Lajoyce Brents | Licensed Vocational Nurse | 807 Slone Dr, Marshall, TX 75672-2459 | 2020-09-17 |
| 1467067827 | Melita Ruth Scott | Registered Nurse | 12800 23 Mile Rd, Marshall, MI 49068-9714 | 2020-09-12 |
| 1679187538 | Batista Perkins | Licensed Vocational Nurse | 3534 Tolivar Rd, Marshall, TX 75670-2669 | 2020-09-08 |
| 1801400726 | Fresh Start East Texas Counseling Services | Community/Behavioral Health | 202 S Alamo Blvd Ste A, Marshall, TX 75670-4259 | 2020-09-08 |
| 1881207447 | Markita Johnson | Occupational Therapy Assistant | 320 Airlite Rd, Marshall, TX 75670-5763 | 2020-08-24 |
| Find all providers in MARSHALL | ||||
| 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 |
|---|---|---|---|---|
| 1780295741 | East Texas Border Health Clinic | Clinic/Center | 705 S Grove St, Marshall, TX 75670-5220 | 2020-08-13 |
| 1134695372 | Regional Health Care Clinic, Inc. | Clinic/Center | 313 E Eastwood St, Marshall, MO 65340-1413 | 2018-10-15 |
| 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 |
| 1811964729 | Hot Springs Health Program, Inc. | Clinic/Center | 80 Guntertown Rd, Marshall, NC 28753-7806 | 2006-03-01 |
| 1023630969 | East Texas Border Health Clinic | Clinic/Center | 622 S Grove St, Marshall, TX 75670-5251 | 2020-05-14 |
| 1053845636 | East Texas Border Health Clinic | Clinic/Center | 618 S Grove St Ste 100&300, Marshall, TX 75670-5294 | 2017-04-20 |
| 1548794134 | East Texas Border Health Clinic | Clinic/Center | 707 S Grove St, Marshall, TX 75670-5220 | 2017-04-20 |
| 1922532555 | East Texas Border Health Clinic | Clinic/Center | 620 S Grove St Ste 105, Marshall, TX 75670-5295 | 2017-04-20 |
| 1972981942 | Regional Health Care Clinic, Inc | Clinic/Center | 1825 Atchison Ave, Marshall, MO 65340-9752 | 2015-05-11 |
| Find all providers in MARSHALL | ||||
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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.