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Methadone Clinic of East Texas LLC

Methadone Clinic in Tyler, TX · enumerated 2010 · authorized official Rupert Mccormac, Chief Executive Officer.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1104144088

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Registry record

Entity type Organization (Type 2)
Legal business name Methadone Clinic of East Texas LLC
Other name <Unavail>
Practice address 1510 S Vine Ave, Tyler, TX, 75701
Phone (800) 805-6989
Enumeration date May 17, 2010
Last updated in NPPES Sep 3, 2024

Taxonomy & classification

251S00000X Community/Behavioral Health Agency Agencies Secondary
261QM0801X Mental Health Clinic/Center (Including Community Mental Health Center) Ambulatory Health Care Facilities Secondary
261QM1300X Multi-Specialty Clinic/Center Ambulatory Health Care Facilities Secondary
261QM2800X Methadone Clinic Ambulatory Health Care Facilities · License 000039 (TX) Primary
261QP2300X Primary Care Clinic/Center Ambulatory Health Care Facilities Secondary
261QR0405X Substance Use Disorder Rehabilitation Clinic/Center Ambulatory Health Care Facilities Secondary

Authorized official

Name Rupert Mccormac
Title Chief Executive Officer
Phone (800) 805-6898

Other identifiers

Identifier Type State Issuer
2121550 Medicaid TX -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.
What type of organization is Methadone Clinic of East Texas LLC?
Methadone Clinic of East Texas LLC is registered in NPPES as a Methadone Clinic (its primary provider taxonomy).

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2024-09-03.