EAST TEXAS MEDICAL CENTER JACKSONVILLE
NPI: 1821366170
· JACKSONVILLE, TX 75766
· Rural Health Clinic/Center
· NPI assigned 12/01/2011
$0.00
Total Medicaid Paid
Provider Details
| Authorized Official | ENDRES, JACK (ADMINISTRATOR) |
| NPI Enumeration Date | 12/01/2011 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
34 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
34 |
34 |
$0.00 |