| East Texas Border Health Clinic | |
|
1011 S William St Atlanta TX 75551-3245 | |
| (903) 796-2868 | |
| (903) 796-0826 |
| Full Name | East Texas Border Health Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1011 S William St, Atlanta, Texas |
| Authorized Official Name and Position | Carla Roadcap (CEO) |
| Authorized Official Contact | 9039273782 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Texas Border Health Clinic Po Box 1326 Marshall TX 75671-1326 Ph: (903) 927-3782 | East Texas Border Health Clinic 1011 S William St Atlanta TX 75551-3245 Ph: (903) 796-2868 |
| NPI Number | 1366828303 |
|---|---|
| Provider Enumeration Date | 07/31/2015 |
| Last Update Date | 06/13/2024 |
| Medicare PECOS PAC ID | 8820038565 |
|---|---|
| Medicare Enrollment ID | O20151006000350 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366828303 | NPI | - | NPPES |
| 350919201 | Medicaid | TX | |
| 211408002 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Ellington Memorial Clinic, Llp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1011 South Williams Street, Atlanta, TX 75551 Phone: 903-796-2868 Fax: 903-796-0826 | |
Christus Health Ark-la-tex Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1007 S William St, Atlanta, TX 75551 Phone: 903-614-4200 Fax: 903-614-4244 | |
Atlanta Family Practice Clinic Association Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 506 W Main St, Atlanta, TX 75551 Phone: 903-796-4133 Fax: 903-796-5001 |