NPI age
16 years
Enumerated 2010-03-22
● Active Type 2 · Organization
East Texas Medical Center Jacksonville
East Texas Medical Center Jacksonville 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
Endres
Administrator
Last NPPES update
2011-10-31
Source: monthly bulk 2026-05
How this organization compares
Across 689 active clinic/center providers in Texas.
NPI age
16 years
↑ 2 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2010 → 2026
2010-03Enumerated in NPPES
2010
2026
Where they practice
Primary practice location
1325 N Dickinson Dr
Rusk, TX 757851051
Mailing address
501 S Ragsdale St
Jacksonville, TX 757662434
Authorized official
Jack R Endres
Administrator
📞 9035415100
Individual providers at this organization
3 individual providers on file at this primary practice address.
- Shana Brown, CNP Nurse Practitioner NPI 1669294039
- Misty Fergusson Nurse Practitioner NPI 1336507169
- Lisa Trawick, NP Nurse Practitioner NPI 1265904411
Specialties
-
Clinic/Center PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 283515901 | |
| 01 (TX) | 283515902 | THSTEPS |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
ETMC First Physicians Clinic Rusk
Practice context
Multi-provider organization. 3 individual providers on file at this primary address.
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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.