ETMC PHYSICIAN GROUP INC. (NPI# 1821588047) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821588047 |
| Entity Type | Organization |
| Organization Name | ETMC PHYSICIAN GROUP INC. |
| Other Organization Name | UT HEALTH EAST TEXAS PHYSICIANS |
| Practice Address |
612 N High St Ste A Henderson TX 75652-5914 |
| Mailing Address |
1 Burton Hills Blvd Ste 250 Nashville TN 37215-6195 |
| Practice Telephone | 9036571441 |
| Mailing Telephone | 6152963227 |
| Mailing Fax Number | 6152966227 |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2018-05-14 |
| Authorized Official Name | STEPHEN C. PETROVICH (EVP) |
| Authorized Official Telephone | 6152963000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| UT Health East Texas Physicians | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891285946 | Etmc Physician Group Inc. | Durable Medical Equipment & Medical Supplies | 1318 Clinic Dr, Tyler, TX 75701-2119 | 2018-05-15 |
| 1104316322 | Etmc Physician Group Inc. | Durable Medical Equipment & Medical Supplies | 203 Nacogdoches St Ste 150, Jacksonville, TX 75766-2453 | 2018-05-14 |
| 1720578941 | Etmc Physician Group Inc. | Durable Medical Equipment & Medical Supplies | 1000 E 5th St Ste 400, Tyler, TX 75701-3362 | 2018-05-14 |
| 1609382662 | Etmc Physician Group Inc. | Durable Medical Equipment & Medical Supplies | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2017-12-28 |
| Street Address |
612 N HIGH ST STE A |
| City | HENDERSON |
| State | TX |
| Zip Code | 75652-5914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255373338 | Ruston Bray | Physician Assistant | 612 N High St Ste A, Henderson, TX 75652-5914 | 2006-06-12 |
| 1346560224 | East Texas Medical Center Healthcare Associates | Durable Medical Equipment & Medical Supplies | 612 N High St Ste A, Henderson, TX 75652-5914 | 2010-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184264384 | John Etakibuebu | Pharmacist | 2415 Hwy 79 S, Henderson, TX 75652 | 2020-01-15 |
| 1841758596 | Janet Juanita Ray | Registered Nurse | 1987 Fm 2276 N, Henderson, TX 75652 | 2019-03-12 |
| 1912490483 | Matthew Davis Acres | Dentist | 1910 Tx-43, Henderson, TX 75652 | 2018-06-11 |
| 1467863407 | Counseling Services | Counselor | 1103 Wilson Street, Henderson, TX 75652 | 2014-05-13 |
| 1285900852 | Linda June Pool | Music Therapist | 6861 Fm 1251 E., Henderson, TX 75652 | 2012-03-28 |
| 1780992586 | Furqueron & Jackson Dentistry Partnership | Dentist | 1910 State Hwy 43 East, Henderson, TX 75652 | 2010-09-15 |
| 1235396359 | Crystal Touchstone | Physical Therapy Assistant | 1010 W Main, Henderson, TX 75652 | 2008-05-16 |
| 1609082379 | D&s Residential Services | Intermediate Care Facility, Mentally Retarded | 103 Truman, Henderson, TX 75652 | 2007-05-16 |
| 1790997302 | Billy George Brown | Dentist | 300-b North High Street, Henderson, TX 75652 | 2007-05-04 |
| 1043379761 | Donna G Mason-mcfalll | Counselor | 1103 Wilson St, Henderson, TX 75652 | 2006-12-08 |
| Find all providers in zip 75652 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356969885 | Aircare Health Inc | Durable Medical Equipment & Medical Supplies | 12231 S Eastern Ave, Henderson, NV 89052-4414 | 2020-07-10 |
| 1124675848 | Nevada Limb & Brace LLC | Durable Medical Equipment & Medical Supplies | 1505 Wigwam Pkwy Suite 141, Henderson, NV 89074-8195 | 2019-08-19 |
| 1003377953 | Hearing Centers of Nevada | Durable Medical Equipment & Medical Supplies | 76 W Horizon Ridge Pkwy Ste 125, Henderson, NV 89012-5330 | 2019-03-25 |
| 1437603958 | Albertsons LLC | Durable Medical Equipment & Medical Supplies | 2910 Bicentennial Pkwy, Henderson, NV 89044-4477 | 2016-08-12 |
| 1568828655 | Albertsons LLC | Durable Medical Equipment & Medical Supplies | 190 N Boulder Hwy, Henderson, NV 89015-5308 | 2016-01-06 |
| 1699174862 | Deaconess Hospital, Inc. | Durable Medical Equipment & Medical Supplies | 2202 Us Highway 41 N, Unit B, Henderson, KY 42420-2399 | 2014-08-13 |
| 1881009199 | Williams Bros. Health Care Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 426 E. Elm Street, Henderson, KY 42420-2932 | 2014-06-25 |
| 1598038945 | Dewitt J. Paul IIi | Durable Medical Equipment & Medical Supplies | 10520 S Eastern Ave # 100, Henderson, NV 89052-3900 | 2012-02-15 |
| 1669758660 | Ipower Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 375 N Stephanie St Ste 1411, Henderson, NV 89014-8909 | 2011-10-24 |
| 1841596129 | Ideal Diabetic Supplies LLC | Durable Medical Equipment & Medical Supplies | 3031 Scenic Valley Way, Henderson, NV 89052-3092 | 2011-02-02 |
| Find all providers in HENDERSON | ||||
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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.