EAST TEXAS MEDICAL CENTER QUITMAN (NPI# 1134115660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134115660 |
| Entity Type | Organization |
| Organization Name | EAST TEXAS MEDICAL CENTER QUITMAN |
| Other Organization Name | ETMC FIRST PHYSICIANS CLINIC VAN |
| Practice Address |
113 W Main St Van TX 75790-2883 |
| Practice Telephone | 9039638303 |
| Practice Fax Number | 9039635863 |
| Mailing Telephone | 9039638303 |
| Mailing Fax Number | 9039635863 |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2010-06-14 |
| Authorized Official Name | MR. THOMAS O'GORMAN (REGIONAL CFO) |
| Authorized Official Telephone | 9039465500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 063353901 | 05 | |
| TX | 017625701 | 05 |
| Other Name | Type Code |
|---|---|
| ETMC First Physicians Clinic Van | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508871278 | East Texas Medical Center Quitman | Clinic/Center | 1220 N Pacific St, Mineola, TX 75773-1054 | 2006-07-30 |
| 1639184369 | East Texas Medical Center Quitman | Clinic/Center | 1220 N Pacific Ave, Ste 2, Mineola, TX 75773-1054 | 2006-07-30 |
| 1396748430 | East Texas Medical Center Quitman | General Acute Care Hospital | 117 N Winnsboro St, Quitman, TX 75783-2144 | 2005-05-23 |
| 1447615943 | East Texas Medical Center Quitman | Clinic/Center | 801 N Waldrip St, Grand Saline, TX 75140-1024 | 2015-12-28 |
| 1730513672 | East Texas Medical Center Quitman | Clinic/Center | 711 Titus St, Gilmer, TX 75644-1738 | 2013-08-28 |
| 1508871245 | East Texas Medical Center Quitman | Clinic/Center | 117 N Winnsboro St, Quitman, TX 75783-2144 | 2006-07-30 |
| Street Address |
113 W MAIN ST |
| City | VAN |
| State | TX |
| Zip Code | 75790-2883 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689624512 | Gina Maria Blount | Nurse Practitioner | 113 W Main St, Van, TX 75790-2883 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851842116 | Van Senior Care LLC | Skilled Nursing Facility | 169 S. Oak St., Van, TX 75790 | 2016-10-20 |
| 1093933061 | Van Isd | Local Education Agency (LEA) | 549 E. Texas, Van, TX 75790 | 2007-04-23 |
| 1275606501 | Brookshire Grocery Company | Pharmacy | 706 West Main, Attention Pharmacy Dept, Van, TX 75790 | 2006-11-16 |
| 1487105052 | Edge Medical Services | Clinic/Center | 170 W Ohio St, Van, TX 75790-2504 | 2016-10-19 |
| 1124670567 | Stephanie Renee Garland | Speech-Language Pathologist | 104 N Oak St, Van, TX 75790-2682 | 2019-07-16 |
| 1053811877 | Shauna Williams | Licensed Vocational Nurse | 400 Alaska St, Van, TX 75790-2906 | 2018-02-19 |
| 1275809238 | Jose G Cano Jr. | Counselor | 894 E Main St, Van, TX 75790-2944 | 2012-03-23 |
| 1811985617 | Country Inn Healthcare | Skilled Nursing Facility | 1085 E Main St, Van, TX 75790-2949 | 2005-10-06 |
| 1578515201 | Senior Living Properties LLC | Skilled Nursing Facility | 1085 E Main St, Van, TX 75790-2949 | 2006-05-17 |
| 1023515608 | Kimberly Kay Raglin | Licensed Vocational Nurse | 704 E Pennsylvania Ave, Van, TX 75790-2966 | 2018-04-10 |
| Find all providers in zip 75790 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639776586 | West Texas Family Medicine, Pllc | Clinic/Center | 315 W Cleveland St, Hale Center, TX 79041 | 2020-10-05 |
| 1780298547 | Coryell County Memorial Hospital Authority | Clinic/Center | 498 Avenue E, Moody, TX 76557-3579 | 2020-08-31 |
| 1760005953 | Eastland Memorial Hospital District | Clinic/Center | Walnut Street Clinic, 200 Walnut Street Clinic, Ranger, TX 76448-7644 | 2020-05-21 |
| 1023631306 | Eastland Memorial Hospital District | Clinic/Center | Emh Regional Healthcare Clinic, 2314 W. Commerce Street, Eastland, TX 76448-7644 | 2020-05-21 |
| 1346862752 | Ascension Seton | Clinic/Center | 249 Sportsplex Dr., Suite 204, Dripping Springs, TX 78620-2350 | 2020-05-08 |
| 1255977211 | Frio Hospital Association | Clinic/Center | 801 Fm W 117, Dilley, TX 78017 | 2019-11-25 |
| 1700447950 | Scott & White Hospital - Marble Falls | Clinic/Center | 105 Fm2342, Kingsland, TX 78639-6010 | 2019-06-27 |
| 1275193005 | Brenham Family Practice and Obstetrics Pa | Clinic/Center | 601 Medical Pkwy Ste D, Brenham, TX 77833-5430 | 2019-06-14 |
| 1588137103 | Nocona Hospital District | Clinic/Center | 108 E Boggess St, Saint Jo, TX 76265-0238 | 2019-01-07 |
| 1033687900 | Gainesville Community Hospital, Inc. | Clinic/Center | 801 N Grand Ave Ste 1&4, Gainesville, TX 76240-3573 | 2018-11-08 |
| 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.