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ETMC PHYSICIAN GROUP INC.
NPI 1235706581
Clinic/Center - Rural Health in Chandler, TX

Active since June 07, 2021CLIA 45D0922994 · Microscopy
125 STATE HIGHWAY 31 E, CHANDLER, TX 75758(903) 549-3862(903) 843-4965 Get Directions Write a Review

NPPES record last updated: June 7, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Etmc Physician Group Inc. NPPES

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

ETMC PHYSICIAN GROUP INC. (NPI 1235706581) is a healthcare organization registered as a rural health in Chandler, Texas and active in the NPI registry since June 2021. The organization holds a CLIA Microscopy certificate valid through December 10, 2026 and lists Stephen C. Petrovich, Evp, General Counsel, as its authorized official.

NPPES Registry Identity

NPI1235706581
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameETMC PHYSICIAN GROUP INC.
Location Address125 STATE HIGHWAY 31 EChandler, TX 75758-2376
Mailing Address1 Burton Hills Blvd Ste 250Nashville, TN 37215-6195 · (615) 296-3594
Phone(903) 549-3862
Fax(903) 843-4965
Organization SubpartNo
Authorized OfficialStephen C. PetrovichEvp, General Counsel · (615) 296-3594
Enumeration DateJune 7, 2021
NPPES CertifiedJune 7, 2021
✔ NPI 1235706581 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
125 STATE HIGHWAY 31 E, Chandler, TX 75758
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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

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 for Provider-Performed Microscopy Procedures (PPMP) 45D0922994

Etmc Physician Group, Inc · Chandler, TX
Active · expires Dec 10, 2026
CLIA Number45D0922994
Laboratory TypeOther
Certificate Effective DateDecember 11, 2024
Certificate Expiration DateDecember 10, 2026
Laboratory DirectorSamuel Raborn
Laboratory Phone(903) 849-3862
Laboratory LocationEtmc Physician Group, Inc125 Highway 31 East, Chandler, TX 75758
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 3

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

SAMI MALAE HARRIS NP
Nurse Practitioner
125 STATE HIGHWAY 31 E
CHANDLER, TX 75758
Henderson County (903) 849-3862
DANA ANN CARNS DNP APRN FNP-C
Nurse Practitioner (Family)
125 STATE HIGHWAY 31 E
CHANDLER, TX 75758
Henderson County (903) 849-3862
ANA RUTE BLOCH MURADAS MD
Pediatrics
125 STATE HIGHWAY 31 E
CHANDLER, TX 75758
Henderson County (903) 849-3862

Frequently Asked Questions

What is ETMC PHYSICIAN GROUP INC.'s NPI number?

The NPI number assigned to this healthcare provider is 1235706581, enumerated as an "organization" on June 07, 2021.

Where is the provider located?

The provider is located at 125 STATE HIGHWAY 31 E CHANDLER, TX 75758 and the phone number is (903) 549-3862.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QR1300X and a focus in Rural Health.

What insurance does ETMC PHYSICIAN GROUP INC. accept?

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