EAST TEXAS COMMUNITY CLINIC, INC.
NPI 1497568513
Clinic/Center - Federally Qualified Health Center (FQHC) in Canton, TX

NPI Status: Active since January 31, 2025

Contact Information

400 E STATE HIGHWAY 243 STE 18
CANTON, TX
ZIP 75103
Phone: (903) 287-5011
Fax: (903) 802-7125

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  • Organization
  • Clinic/Center
  • Federally Qualified Health Center (FQHC)
  • CLIA Number: 45D2325487
  • CLIA Cert. Type: Federally Qualified Health Center
  • CLIA Exp. Date: 06-12-2027

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 Canton, Texas operating as a Clinic/center, focusing in federally qualified health center (fqhc) . The healthcare provider is registered in the NPI registry with number 1497568513 assigned on January 2025. 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 authorized official of this NPI record is Glen W Robison (Ceo)

NPI
1497568513
Provider Name
EAST TEXAS COMMUNITY CLINIC, INC.
Entity Type
Organization
Location Address
400 E STATE HIGHWAY 243 STE 18 CANTON, TX 75103
Location Phone
(903) 287-5011
Location Fax
(903) 802-7125
Mailing Address
PO BOX 1610 ATHENS, TX 75751
Mailing Phone
(903) 603-9851
Mailing Fax
(903) 802-7125
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
01-31-2025
Last Update Date
01-31-2025
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

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

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
45D2325487
Facility Type
Federally Qualified Health Center
Certificate Effective Date
June 13, 2025
Certificate Expiration Date
June 12, 2027
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.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1497568513, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
7
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
6
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
5
Unchanged
Pos 9
1
Doubled → 2
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 5 → 10 → 1 8 → 16 → 7 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 1 + 8 + 7 + 1 + 0 + 6 + 1 + 6 + 5 + 2 + 24 = 67

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 67 is 70. The difference is the calculated check digit.

70 - 67 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1497568513.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Family Medicine
400 E STATE HIGHWAY 243 STE 18
CANTON, TX 75103
Nurse Practitioner (Family)
400 E STATE HIGHWAY 243 STE 18
CANTON, TX 75103

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1497568513, enumerated as an "organization" on January 31, 2025.

The provider is located at 400 E STATE HIGHWAY 243 STE 18 CANTON, TX 75103 and the phone number is (903) 287-5011.

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