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EAST TEXAS BORDER HEALTH CLINIC
NPI 1023630969
Clinic/Center - Federally Qualified Health Center (FQHC) in Marshall, TX

Active since May 14, 2020CLIA Certified · 2 labs
622 S GROVE ST, MARSHALL, TX 75670(903) 702-7900(903) 702-7904 Get Directions Write a Review

NPPES record last updated: August 28, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 28, 2023, Jul 7, 2022, Sep 3, 2020 and 1 more (4 updates tracked since 2020).

About East Texas Border Health Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EAST TEXAS BORDER HEALTH CLINIC (NPI 1023630969) is a healthcare organization registered as a federally qualified health center (fqhc) in Marshall, Texas and active in the NPI registry since May 2020. The organization holds 2 active CLIA laboratory certificates and lists Carla Roadcap, Ceo, as its authorized official.

NPPES Registry Identity

NPI1023630969
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameEAST TEXAS BORDER HEALTH CLINIC
Location Address622 S GROVE STMarshall, TX 75670-5251
Mailing AddressPo Box 1326Marshall, TX 75671-1326 · (903) 927-3782 · Fax (903) 927-1764
Phone(903) 702-7900
Fax(903) 702-7904
Organization SubpartYes
Authorized OfficialCarla RoadcapCeo · (903) 927-3782
Enumeration DateMay 14, 2020
Last NPPES UpdateAugust 28, 20234 updates tracked since enumeration
NPPES CertifiedAugust 28, 2023
✔ NPI 1023630969 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
622 S GROVE ST, Marshall, TX 75670
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D0993333

East Texas Border Health Clinic Dba Genesis Primecare · Marshall, TX
Active · expires Nov 11, 2027
CLIA Number45D0993333
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateNovember 12, 2025
Certificate Expiration DateNovember 11, 2027
Laboratory DirectorJeffory W. Beaty
Laboratory Phone(903) 927-3782
Laboratory LocationEast Texas Border Health Clinic Dba Genesis Primecare805 Lindsey Drive, Marshall, TX 75670
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 45D0720060

East Texas Border Health Clinic Dba Genesis Primecare-Marshall Ob · Marshall, TX
Active · expires Jan 24, 2028
CLIA Number45D0720060
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateJanuary 25, 2026
Certificate Expiration DateJanuary 24, 2028
Laboratory DirectorJeffory W. Beaty
Laboratory Phone(903) 928-3782
Laboratory LocationEast Texas Border Health Clinic Dba Genesis Primecare-Marshall Ob1900 North East End Blvd, Marshall, TX 75670
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DOUGLAS STEPHENSON DO
Internal Medicine
622 S GROVE ST
MARSHALL, TX 75670
Harrison County (903) 927-6183
JASMINE HICKS LMSW
Social Worker
622 S GROVE ST
MARSHALL, TX 75670
Harrison County (903) 702-7900

Frequently Asked Questions

What is EAST TEXAS BORDER HEALTH CLINIC's NPI number?

The NPI number assigned to this healthcare provider is 1023630969, enumerated as an "organization" on May 14, 2020.

Where is the provider located?

The provider is located at 622 S GROVE ST MARSHALL, TX 75670 and the phone number is (903) 702-7900.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).

What insurance does EAST TEXAS BORDER HEALTH CLINIC accept?

The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Ambetter. Please consult your insurance carrier or call the provider to verify.