Organization · Type 2 NPI

East Texas Community Clinic, Inc.

Federally Qualified Health Center (FQHC) · Canton, TX

NPI number 1497568513 Active

Practice location

400 E State Highway 243 Ste 18
Canton, TX 75103-2445

Call (903) 287-5011 Map

Fax (903) 802-7125

Mailing address

PO Box 1610
Athens, TX 75751-1610

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

2 other providers at this address

NPI record

NPI: 1497568513
Entity type: Organization (Type 2)
Issued: Jan 31, 2025
Last updated: Jan 31, 2025
Status: Active
Subpart: Yes of East Texas Community Clinic, Inc.

Other names

East Texas Community Clinic, Inc. · former legal business name

Authorized official

Glen W Robison
CEO
(903) 603-9851

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1497568513

East Texas Community Clinic, Inc.'s National Provider Identifier is 1497568513, issued on Jan 31, 2025. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Canton, TX. The record was last updated on Jan 31, 2025.