| Ut East Texas Urgent Care Centers, Pllc | |
|
301 E State Highway 243 Ste 121 Canton TX 75103-2418 | |
| (903) 567-4692 | |
| Not Available |
| Full Name | Ut East Texas Urgent Care Centers, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 301 E State Highway 243 Ste 121, Canton, Texas |
| Authorized Official Name and Position | Stephen C. Petrovich (EVP, GENERAL COUNSEL) |
| Authorized Official Contact | 6152963594 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ut East Texas Urgent Care Centers, Pllc 340 Seven Springs Way Ste 100 Brentwood TN 37027-5697 Ph: (615) 296-3594 | Ut East Texas Urgent Care Centers, Pllc 301 E State Highway 243 Ste 121 Canton TX 75103-2418 Ph: (903) 567-4692 |
| NPI Number | 1356974281 |
|---|---|
| Provider Enumeration Date | 02/19/2020 |
| Last Update Date | 10/22/2024 |
| Medicare PECOS PAC ID | 7517385388 |
|---|---|
| Medicare Enrollment ID | O20200910000672 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356974281 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Primary |
| Provider Name | Gary D Babbitt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326018797 PECOS PAC ID: 5092786137 Enrollment ID: I20040803001163 |
| Provider Name | Bethany G Starks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245419001 PECOS PAC ID: 8820176431 Enrollment ID: I20080423000225 |
| Provider Name | Howard K Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659548402 PECOS PAC ID: 7214092147 Enrollment ID: I20090213000394 |
| Provider Name | Jonathan W Pino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124356613 PECOS PAC ID: 8628112992 Enrollment ID: I20100224000713 |
| Provider Name | Michael E Hellemn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881887057 PECOS PAC ID: 3577748581 Enrollment ID: I20110505000782 |
| Provider Name | Sylvain Nitcheu Tientcheu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346632239 PECOS PAC ID: 8729306733 Enrollment ID: I20150422001623 |
| Provider Name | Joseph C Bass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043608540 PECOS PAC ID: 8123348000 Enrollment ID: I20150515001231 |
| Provider Name | Valarie M Chambless |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215423397 PECOS PAC ID: 3476802919 Enrollment ID: I20180816002798 |
| Provider Name | Brandi Jo Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265095202 PECOS PAC ID: 3779914007 Enrollment ID: I20200520002222 |
| Provider Name | Kellie Soria |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801496328 PECOS PAC ID: 7810305844 Enrollment ID: I20210412002695 |
| Provider Name | Chandler Mccarty Hrobar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912570524 PECOS PAC ID: 7911302609 Enrollment ID: I20210818001637 |
| Provider Name | Jennifer Ann Hamilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457809709 PECOS PAC ID: 3173916046 Enrollment ID: I20220217001424 |
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Dailey Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1108 S Buffalo St, Canton, TX 75103 Phone: 903-567-1910 Fax: 903-567-1497 | |
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