EAST TEXAS BORDER HEALTH CLINIC (NPI# 1811485055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811485055 |
| Entity Type | Organization |
| Organization Name | EAST TEXAS BORDER HEALTH CLINIC |
| Other Organization Name | GENESIS PRIMECARE |
| Practice Address |
815 S Washington Ave Ste 203 Marshall TX 75670-5341 |
| Mailing Address |
Po Box 1326 Marshall TX 75671-1326 |
| Practice Telephone | 9039276850 |
| Mailing Telephone | 9039273782 |
| Mailing Fax Number | 9039271764 |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2020-09-03 |
| Authorized Official Name | TRACEY ENGEL (ENROLLMENT SPECIALIST) |
| Authorized Official Telephone | 9039273782 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | PENDING | 05 |
| 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 |
| 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 |
| 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 |
815 S WASHINGTON AVE STE 203 |
| City | MARSHALL |
| State | TX |
| Zip Code | 75670-5341 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912536988 | Christopher Hurd | Counselor | 1006 E East End Blvd N, Marshall, TX 75670 | 2020-04-02 |
| 1912547274 | Katie Bennett | Pharmacist | 300 E End Blvd, Marshall, TX 75670 | 2020-01-14 |
| 1083263677 | Fresh Start East Texas Counseling Services | Clinic/Center | 202 S. Alamo Blvd. Suite A, Marshall, TX 75670 | 2019-09-06 |
| 1376045831 | Tonja Deem | Nurse Practitioner | 815 S Wahshington Ave Ste 302, Marshall, TX 75670 | 2018-03-01 |
| 1609399641 | Michael Alan Rich Jr. | Specialist/Technologist | One Tiger Drive, East Texas Baptist University, Marshall, TX 75670 | 2017-07-21 |
| 1902359987 | Marshall Smiles Pllc | Dentist | 900 E End Blvd N, 200, Marshall, TX 75670 | 2016-07-26 |
| 1669871158 | Marshall Dental PC | Dentist | 900 East End Blvd., Suite 200, Marshall, TX 75670 | 2014-08-20 |
| 1629486717 | Winnie-stowell Hospital District | Skilled Nursing Facility | 1007 South Washington Avenue, Marshall, TX 75670 | 2014-08-01 |
| 1558636407 | Valerie Butler | Internal Medicine | 815 South Washington Avenue, Ste 100 Internal Medicine Marshall, Marshall, TX 75670 | 2012-03-11 |
| 1730478686 | John Lloyd English | Nurse Practitioner | 618 S Grove St Ste 100-300, Marshall, TX 75670 | 2011-03-31 |
| Find all providers in zip 75670 | ||||
| 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 |
| 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 |
| 1720096027 | Boston Mountain Rural Health Center Inc | Clinic/Center | 2263 Highway 65 North, Marshall, AR 72650-1060 | 2006-08-03 |
| 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.