NPI age
17 years
Enumerated 2009-05-14
● Active Type 2 · Organization
Subpart
East Texas Medical Center Henderson
East Texas Medical Center Henderson is 1 of 689 clinic/center organizations in Texas.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Leitner
Administrator
Last NPPES update
2011-01-31
Source: monthly bulk 2026-05
How this organization compares
Across 689 active clinic/center providers in Texas.
NPI age
17 years
↑ 3 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2009 → 2026
2009-05Enumerated in NPPES
2009
2026
Where they practice
Primary practice location
300 Wilson St
Henderson, TX 756525956
Mailing address
300 Wilson St
Henderson, TX 756525956
Authorized official
Mark S Leitner
Administrator
📞 9036553616
Individual providers at this organization
16 individual providers on file at this primary practice address.
- Jathan Cantu, M.D. Family Medicine NPI 1932174596
- Joseph Carver, D.O. Family Medicine NPI 1720408909
- Glena Davis, D.O. Obstetrics & Gynecology NPI 1932383981
- Nino Fuller, AGACNP-BC Nurse Practitioner NPI 1962974469
- Mark Hackbarth, MD Anesthesiology NPI 1629071527
- Dwight Hall, CRNA Nurse Anesthetist, Certified Registered NPI 1770582736
- Mica Norman, PMHNP-BC, FNP-C Nurse Practitioner NPI 1053953794
- Cheryl Polkowski, M.D. Family Medicine NPI 1194882241
- Adam Ranginwala, MD Emergency Medicine NPI 1114422623
- Bruno Romeo Miramon, MD Obstetrics & Gynecology NPI 1366564148
- Shawna Sharp, NP Nurse Practitioner NPI 1255954509
- Nicole Stanley, NP Nurse Practitioner NPI 1730732942
- Amanda Trubey, MSN, FNP-C Nurse Practitioner NPI 1205569761
- Gordon Uretsky, MD Family Medicine NPI 1477512820
- Angela Vera, RD, LD Dietitian, Registered NPI 1356626782
- Jerry Wheeler, CRNA Nurse Anesthetist, Certified Registered NPI 1376672006
Specialties
-
Clinic/Center PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 0047SP | BLUE CROSS BLUE SHIELD |
| 05 (TX) | 208755301 |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
ETMC Henderson FHC
Practice context
Multi-provider organization. 16 individual providers on file at this primary address.
Subpart of East Texas Medical Center Henderson.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.