ETMC PHYSICIAN GROUP INC. (NPI# 1891285946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891285946 |
| Entity Type | Organization |
| Organization Name | ETMC PHYSICIAN GROUP INC. |
| Other Organization Name | UT HEALTH EAST TEXAS PHYSICIANS |
| Practice Address |
1318 Clinic Dr Tyler TX 75701-2119 |
| Mailing Address |
1 Burton Hills Blvd Ste 250 Nashville TN 37215-6195 |
| Practice Telephone | 9035979622 |
| Mailing Telephone | 6152963000 |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2018-05-15 |
| 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 |
|---|---|---|---|---|
| 1821588047 | Etmc Physician Group Inc. | Durable Medical Equipment & Medical Supplies | 612 N High St Ste A, Henderson, TX 75652-5914 | 2018-05-14 |
| 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 |
1318 CLINIC DR |
| City | TYLER |
| State | TX |
| Zip Code | 75701-2119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851399331 | Thomas F Mccloskey | Podiatrist | 1318 Clinic Dr, Tyler, TX 75701-2119 | 2005-07-08 |
| 1427366855 | East Texas Medical Center Healthcare Associates | Durable Medical Equipment & Medical Supplies | 1318 Clinic Dr, Tyler, TX 75701-2119 | 2010-09-20 |
| 1144406596 | Thomas F Mccloskey | Podiatrist | 1318 Clinic Dr, Tyler, TX 75701-2119 | 2008-01-16 |
| 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 | 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 |
|---|---|---|---|---|
| 1720698186 | Momentum Dme, LLC | Durable Medical Equipment & Medical Supplies | 121 S Broadway Ave Ste 606, Tyler, TX 75702-7281 | 2020-07-31 |
| 1174166615 | Kalos Health Services LLC | Durable Medical Equipment & Medical Supplies | 2961 Elkton Trl Ste D, Tyler, TX 75703-0675 | 2019-10-28 |
| 1245777895 | Wal-mart Stores Texas LLC | Durable Medical Equipment & Medical Supplies | 450 S Southeast Loop 323, Tyler, TX 75702-8646 | 2017-01-20 |
| 1285006544 | Wal-mart Stores Texas LLC | Durable Medical Equipment & Medical Supplies | 2151 Frankston Hwy, Tyler, TX 75701-3808 | 2015-10-27 |
| 1457722779 | Wal-mart Stores Texas LLC | Durable Medical Equipment & Medical Supplies | 5976 Old Jacksonville Hwy, Tyler, TX 75703-0582 | 2015-10-13 |
| 1033598065 | Nanovibronix, Ltd | Durable Medical Equipment & Medical Supplies | 977 Pruitt Pl, Tyler, TX 75703-1153 | 2015-05-22 |
| 1871917278 | Roger Rivers | Durable Medical Equipment & Medical Supplies | 16428 Kingston Ct, Tyler, TX 75703-7335 | 2014-02-06 |
| 1417211525 | Fredrick J. Platt, Dds, Pllc | Durable Medical Equipment & Medical Supplies | 2020 Lindbergh Dr, Tyler, TX 75703-1714 | 2012-07-03 |
| 1033490776 | Psi Premier Specialties, Inc. | Durable Medical Equipment & Medical Supplies | 1825 Troup Hwy, Tyler, TX 75701-5870 | 2011-09-08 |
| 1932495652 | Trinity Mobility, LLC | Durable Medical Equipment & Medical Supplies | 1007 West Gentry Parkway, Tyler, TX 75702 | 2011-06-21 |
| 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.