EAST TEXAS COMMUNITY CLINIC, INC.
NPI 1033752456
Clinic/Center - Federally Qualified Health Center (FQHC) in Gun Barrel City, TX

NPI Status: Active since October 18, 2019

Contact Information

801 W MAIN ST
GUN BARREL CITY, TX
ZIP 75156
Phone: (903) 887-1011
Fax: (903) 340-8410

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  • Organization
  • Clinic/Center
  • Federally Qualified Health Center (FQHC)
  • Accepts Insurance
  • CLIA Number: 45D2174764
  • CLIA Cert. Type: Federally Qualified Health Center
  • CLIA Exp. Date: 11-06-2025

About EAST TEXAS COMMUNITY CLINIC, INC.

This page provides the complete NPI Profile along with additional information for East Texas Community Clinic, Inc., a primary care provider established in Gun Barrel City, Texas operating as a Clinic/center, focusing in federally qualified health center (fqhc) . The healthcare provider is registered in the NPI registry with number 1033752456 assigned on October 2019. The practitioner's primary taxonomy code is 261QF0400X. The provider is registered as an organization and their NPI record was last updated one year ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Glen W Robison (Ceo)

NPI
1033752456
Provider Name
EAST TEXAS COMMUNITY CLINIC, INC.
Entity Type
Organization
Location Address
801 W MAIN ST GUN BARREL CITY, TX 75156
Location Phone
(903) 887-1011
Location Fax
(903) 340-8410
Mailing Address
PO BOX 1610 ATHENS, TX 75751
Mailing Phone
(903) 603-9851
Mailing Fax
(903) 340-8410
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-18-2019
Last Update Date
05-30-2024
Code Navigator

A primary care provider (PCP) like East Texas Community Clinic, Inc. sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Secondary Locations

  • 115 Medical Cir Ste 100
    Athens, TX 75751
    (903) 603-7067
  • 400 E State Highway 243 Ste 18
    Canton, TX 75103
    (903) 287-5011

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Federally Qualified Health Center (FQHC)

Taxonomy Code
261QF0400X
Type
Ambulatory Health Care Facilities

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

 
2261QC1500XAmbulatory Health Care Facilities

Clinic/Center
Community Health

 

Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Silver - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Choice Bronze HSA (QualChoice) - POS
  • Complete Gold - PPO
  • Complete Gold + Vision + Adult Dental - PPO
  • Complete Silver (QualChoice) - POS
  • Connected Silver - PPO
  • Connected Silver (QualChoice) - POS
  • Connected Silver (QualChoiceLife) - PPO
  • Connected Silver + Vision + Adult Dental - PPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold - PPO
  • Elite Gold + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Everyday Gold - PPO
  • Everyday Gold + Vision + Adult Dental - PPO
  • Focused Silver - PPO
  • Focused Silver + Vision + Adult Dental - PPO
  • Blue Advantage Bronze HMO? 204 - HMO
  • Blue Advantage Bronze HMO? 301 - HMO
  • Blue Advantage Bronze HMO? Standard - HMO
  • Blue Advantage Gold HMO? 206 - HMO
  • Blue Advantage Gold HMO? 603 - HMO
  • Blue Advantage Gold HMO? Standard - HMO
  • Blue Advantage Plus Bronze? 303 - POS
  • Blue Advantage Plus Bronze? 305 - POS
  • Blue Advantage Plus Bronze? Standard - POS
  • Blue Advantage Plus Gold? 203 - POS

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

GLEN W ROBISON

Authorized Official Title
CEO
Authorized Official Phone
(903) 603-9851

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
45D2174764
Facility Type
Federally Qualified Health Center
Certificate Effective Date
November 07, 2023
Certificate Expiration Date
November 06, 2025
Laboratory Director
DOUGLAS W. CURRAN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to East Texas Community Clinic, Inc. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for EAST TEXAS COMMUNITY CLINIC, INC.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1033752456
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
20631454410
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 6 + 3 + 1 + 4 + 5 + 4 + 4 + 1 + 0 + 24 = 54
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 54 = 66

The NPI number 1033752456 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 7 providers are registered at the same or nearby location.

MRS. DEBRA JEAN ROSSELL RN MSN CFNP

Nurse Practitioner

(Family)

801 W MAIN ST
GUN BARREL CITY, TX
ZIP 75156

(903) 887-6252

HEALTH TEXAS PROVIDER NETWORK

Clinic/Center

(Rural Health)

801 W MAIN ST
GUN BARREL CITY, TX
ZIP 75156

(903) 887-6252

MR. JAIME JAMES CACERES NP-C

Nurse Practitioner

(Family)

801 W MAIN ST
GUN BARREL CITY, TX
ZIP 75156

(469) 800-3800

DR. CHARLES TED METTETAL M.D.

Family Medicine

801 W MAIN ST
GUN BARREL CITY, TX
ZIP 75156

(903) 887-1011

DR. DOUGLAS W CURRAN MD

Family Medicine

801 W MAIN ST
GUN BARREL CITY, TX
ZIP 75156

(903) 887-1011

GARRETT HILL FNP-BC

Nurse Practitioner

(Family)

801 W MAIN ST
GUN BARREL CITY, TX
ZIP 75156

(903) 887-1011

VICTORIA MARIE GROUNDS P.A.

Physician Assistant

801 W MAIN ST
GUN BARREL CITY, TX
ZIP 75156

(903) 887-1011

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1033752456, enumerated as an "organization" on October 18, 2019.

The provider is located at 801 W MAIN ST GUN BARREL CITY, TX 75156 and the phone number is (903) 887-1011.

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

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