Provider Demographics
NPI:1356461032
Name:HEALTH OPPORTUNITIES FOR THE PEOPLE OF EAST TEXAS
Entity Type:Organization
Organization Name:HEALTH OPPORTUNITIES FOR THE PEOPLE OF EAST TEXAS
Other - Org Name:THE HOPE PROJECT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:DIEBOLT
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN, FNP
Authorized Official - Phone:936-248-4673
Mailing Address - Street 1:157 WALL ST
Mailing Address - Street 2:
Mailing Address - City:TENAHA
Mailing Address - State:TX
Mailing Address - Zip Code:75974-5413
Mailing Address - Country:US
Mailing Address - Phone:936-248-4673
Mailing Address - Fax:936-248-4646
Practice Address - Street 1:157 WALL ST
Practice Address - Street 2:
Practice Address - City:TENAHA
Practice Address - State:TX
Practice Address - Zip Code:75974-5413
Practice Address - Country:US
Practice Address - Phone:936-248-4673
Practice Address - Fax:936-248-4646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1942210315OtherNPI
TX1487667143OtherNPI
TX164735601Medicaid
TX1942210315OtherNPI
TX1487667143OtherNPI
TXS64639Medicare UPIN
TX8G3893Medicare ID - Type Unspecified