East Texas Medical Center Crockett
NPI 1619941291 · Ambulatory Surgical Clinic/Center · Crockett, TX
East Texas Medical Center Crockett is a Ambulatory Surgical Clinic/Center organization in Crockett, TX (NPI 1619941291).
Provider details
- NPI number
- 1619941291
- Entity type
- Organization
- Primary specialty
- Ambulatory Surgical Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Stacy Dise, Business Office Director(936) 546-3810
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-02-13
- Last updated
- 2020-08-22
Frequently asked questions
- What is East Texas Medical Center Crockett's NPI number?
- East Texas Medical Center Crockett's National Provider Identifier (NPI) is 1619941291, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is East Texas Medical Center Crockett?
- East Texas Medical Center Crockett is classified in the NPPES registry as Ambulatory Surgical Clinic/Center (Ambulatory Health Care Facilities).
- Where is East Texas Medical Center Crockett located?
- East Texas Medical Center Crockett's practice location on file with NPPES is 1100 E Loop 304, Crockett, TX 75835-1810.
- What is East Texas Medical Center Crockett's phone number?
- The practice phone number listed in the NPPES registry for East Texas Medical Center Crockett is (936) 546-3862.
- Who is the authorized official for East Texas Medical Center Crockett?
- The authorized official listed on East Texas Medical Center Crockett's NPPES record is Stacy Dise, Business Office Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is East Texas Medical Center Crockett's NPI active?
- Yes — East Texas Medical Center Crockett's NPI (1619941291) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.