EAST TEXAS MEDICAL CENTER HEALTHCARE ASSOCIATES (NPI# 1124062484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124062484 |
| Entity Type | Organization |
| Organization Name | EAST TEXAS MEDICAL CENTER HEALTHCARE ASSOCIATES |
| Other Organization Name | FIRST PHYSICIANS |
| Practice Address |
901 Turtle Creek Dr Tyler TX 75701 |
| Mailing Address |
Po Box 9477 Tyler TX 75711-9477 |
| Practice Telephone | 9035963555 |
| Practice Fax Number | 9035963560 |
| Mailing Telephone | 9035942450 |
| Mailing Fax Number | 9039390610 |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2017-04-11 |
| Authorized Official Name | REBECCA MANGUM (VP) |
| Authorized Official Telephone | 9035963594 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | 4278 | TX | Chiropractic Providers |
| N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE CROSS | 00T07K | 01 |
| TX | 130864502 | 05 | |
| TX | PALMETTO DME | 4944030003 | 01 |
| TX | RAILROAD MEDICARE | CD9882 | 01 |
| TX | 085332701 | 05 | |
| TX | RAILROAD MEDICARE | CC6186 | 01 |
| TX | 130864507 | 05 | |
| TX | RAILROAD MEDICARE | CC7791 | 01 |
| Other Name | Type Code |
|---|---|
| First Physicians | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518287499 | East Texas Medical Center Healthcare Associates | Durable Medical Equipment & Medical Supplies | 203 Nacogdoches St Ste 150, Jacksonville, TX 75766-2453 | 2010-06-02 |
| 1760710263 | East Texas Medical Center Healthcare Associates | Durable Medical Equipment & Medical Supplies | 108 Parker St Ste 400, Quitman, TX 75783-2103 | 2009-11-23 |
| 1528234721 | East Texas Medical Center Healthcare Associates | Durable Medical Equipment & Medical Supplies | 1028 E Idel St Ste A, Tyler, TX 75701-2024 | 2008-05-07 |
| 1699719872 | East Texas Medical Center Healthcare Associates | Emergency Medicine | 1000 S Beckham, Tyler, TX 75701 | 2006-06-16 |
| 1326082892 | East Texas Medical Center Healthcare Associates | Emergency Medicine | 6210 S Broadway Ave, Tyler, TX 75703-4413 | 2006-06-15 |
| 1619917481 | East Texas Medical Center Healthcare Associates | Spec/Tech, Pathology | 904 S Beckham Ave, Tyler, TX 75701-1906 | 2006-06-08 |
| 1427366855 | East Texas Medical Center Healthcare Associates | Durable Medical Equipment & Medical Supplies | 1318 Clinic Dr, Tyler, TX 75701-2119 | 2010-09-20 |
| 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 |
| 1013245414 | East Texas Medical Center Healthcare Associates | Durable Medical Equipment & Medical Supplies | 700 Olympic Plaza Cir Ste 600, Tyler, TX 75701-1954 | 2009-11-23 |
| 1952639452 | East Texas Medical Center Healthcare Associates | Durable Medical Equipment & Medical Supplies | 1123 S Palestine St, Athens, TX 75751-3646 | 2009-11-23 |
| Street Address |
901 TURTLE CREEK DR |
| City | TYLER |
| State | TX |
| Zip Code | 75701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598054397 | James David Franklin | Emergency Medicine | 901 Turtle Creek Dr, Tyler, TX 75701 | 2011-04-01 |
| 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 | 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 |
|---|---|---|---|---|
| 1922632553 | Christina Kay Baker | Family Medicine | 2333 Dueling Oaks Dr, Tyler, TX 75703-0326 | 2020-02-21 |
| 1174155477 | Choice Supportive Care Team Inc. | Family Medicine | 4293 Kinsey Drive, Tyler, TX 75703 | 2020-02-05 |
| 1396389870 | Shelly Lynn Williams | Family Medicine | 1420 W Southwest Loop 323 Ste 100, Tyler, TX 75701-9347 | 2019-10-29 |
| 1891354494 | Beverly Diann Butler | Family Medicine | 5604 Old Bullard Rd Ste 107, Tyler, TX 75703-4359 | 2019-06-07 |
| 1851846018 | Thomas Mason Worthington Jr. | Family Medicine | 9141 Chisholm Trl, Tyler, TX 75703-0409 | 2016-08-17 |
| 1881069557 | The Bradley Clinic of Texas, Pllc | Family Medicine | 1402 Rice Rd, Suite 100, Tyler, TX 75703-3260 | 2015-12-07 |
| 1750764189 | Diabetic Renewal Center LLC | Family Medicine | 1015 Pruitt Pl Ste 105, Tyler, TX 75703-1154 | 2015-07-02 |
| 1013306273 | Pure Radiance Laser Retreat | Family Medicine | 6722 S Broadway Ave, Tyler, TX 75703-4730 | 2015-01-12 |
| 1023412988 | James Kent Gray | Family Medicine | 14843 Big Oak Bay Rd, Tyler, TX 75707-7309 | 2014-10-21 |
| 1346640182 | Morris Mht LLC | Family Medicine | 2030 Stonegate Blvd, Tyler, TX 75703-0103 | 2014-08-29 |
| Find all providers in TYLER | ||||
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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.