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EAST TEXAS CLINIC INC
NPI 1851045595
Clinic/Center - Methadone in Longview, TX

Active since February 11, 2022CLIA 45D2040082 · Waiver
201 PINE TREE RD, LONGVIEW, TX 75604(903) 759-4966 Get Directions Write a Review

NPPES record last updated: April 11, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 11, 2022, Feb 11, 2022 (2 updates tracked since 2022).

About East Texas Clinic Inc NPPES

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

EAST TEXAS CLINIC INC (NPI 1851045595) is a healthcare organization registered as a methadone in Longview, Texas and active in the NPI registry since February 2022. The organization holds a CLIA Waiver certificate valid through April 22, 2028 and lists Jason Stalnaker, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1851045595
Entity TypeOrganization
Primary Taxonomy261QM2800X
Legal Business NameEAST TEXAS CLINIC INC
Location Address201 PINE TREE RDLongview, TX 75604-4140
Mailing AddressPo Box 9486Longview, TX 75608-9486 · (903) 759-4966
Phone(903) 759-4966
Organization SubpartNo
Authorized OfficialJason StalnakerExecutive Director · (903) 759-4966
Enumeration DateFebruary 11, 2022
Last NPPES UpdateApril 11, 20222 updates tracked since enumeration
NPPES CertifiedApril 11, 2022
✔ NPI 1851045595 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · MethadoneAmbulatory Health Care Facilities
Taxonomy Code261QM2800X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.
201 PINE TREE RD, Longview, TX 75604
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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 of Waiver 45D2040082

East Texas Clinic · Longview, TX
Active · expires Apr 22, 2028
CLIA Number45D2040082
Laboratory TypeNarcotic Trmt Program
Certificate Effective DateApril 23, 2026
Certificate Expiration DateApril 22, 2028
Laboratory DirectorMichael C. Leath
Laboratory Phone(903) 759-4966
Laboratory LocationEast Texas Clinic201 Pine Tree Road, Longview, TX 75604
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only 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.

TRACEY WISDOM LCDC
Counselor (Addiction (Substance Use Disorder))
201 PINE TREE RD
LONGVIEW, TX 75604
Gregg County (903) 759-4966
CARLTON SMITH LCDC
Counselor (Addiction (Substance Use Disorder))
201 PINE TREE RD
LONGVIEW, TX 75604
Gregg County (903) 759-4966
LYNETTE VICKERY LCDC
Counselor (Addiction (Substance Use Disorder))
201 PINE TREE RD
LONGVIEW, TX 75604
Gregg County (903) 759-4966

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is East Texas Clinic Inc's NPI number?

The NPI number for East Texas Clinic Inc is 1851045595. It was assigned to this organization in the NPPES registry on February 11, 2022.

Where is East Texas Clinic Inc located?

East Texas Clinic Inc is located at 201 Pine Tree Rd, Longview, TX 75604. The listed phone number is (903) 759-4966.

What is East Texas Clinic Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Methadone, with taxonomy code 261QM2800X.

Does East Texas Clinic Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2040082) is associated with this NPI, valid through April 22, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does East Texas Clinic Inc accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list East Texas Clinic Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for East Texas Clinic Inc was last updated on April 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.