East Texas Medical Center

NPI #1962483453 in Crockett, Texas

Provider Information

NPI Number: 1962483453
Entity Type: Organization
Organization Name: East Texas Medical Center
Primary Specialty: Clinic/Center - Rural Health
Enumeration Date: Nov 10, 2005
Last Updated: Feb 24, 2015

Practice Location

Address: 1100 E LOOP 304
Address 2: SUITE 200
City: Crockett
State: Texas
ZIP Code: 75835-1810
Phone: (936) 544-5132

Authorized Official

Name: MR. TERRY CUTLER
Title: ADMINISTRATOR
Phone: (936) 546-3862

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Rural Health — Rural Health	261QR1300X	Primary

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