Provider Demographics
NPI:1699289785
Name:EAST TEXAS MEDICAL CENTER
Entity type:Organization
Organization Name:EAST TEXAS MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:DON
Authorized Official - Last Name:SWITZER
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN, FNP-C
Authorized Official - Phone:903-423-0652
Mailing Address - Street 1:117 N WINNSBORO ST
Mailing Address - Street 2:
Mailing Address - City:QUITMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75783-2144
Mailing Address - Country:US
Mailing Address - Phone:903-763-6220
Mailing Address - Fax:
Practice Address - Street 1:117 N WINNSBORO ST
Practice Address - Street 2:
Practice Address - City:QUITMAN
Practice Address - State:TX
Practice Address - Zip Code:75783-2144
Practice Address - Country:US
Practice Address - Phone:903-763-6220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-28
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health