MID COAST MEDICAL CENTER CROCKETT INC – NPI #1003303983
Clinic/Center

MID COAST MEDICAL CENTER CROCKETT INC is an AHC clinic located in CROCKETT, TX. NPPES has assigned the NPI number 1003303983 to MID COAST MEDICAL CENTER CROCKETT INC on April 17, 2018. It is a Type-2 NPI, indicating this NPI number is associated with an organization. This provider is also associated with 2 additional names listed below. The primary taxonomy selected by this provider is 261QR1300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Rural Health

The NPI profile was last updated on Feb 24, 2026. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MID COAST MEDICAL CENTER CROCKETT INC below.

NPI Profile for
MID COAST MEDICAL CENTER CROCKETT INC

NPI Number
1003303983
Enumeration Date

(more than 8 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MID COAST MEDICAL CENTER CROCKETT INC
Other name(s)
All associated names:
Doing Business As (dba)
Crockett Medical Center Clinic
Former Legal Business Name
Crockett Medical Center LLC
Primary location
1050 E LOOP 304 STE 201
CROCKETT, TX 75835-1814
Phone: (936) 546-3890 Fax:
Mailing address
1050 E LOOP 304 STE 200
CROCKETT, TX 75835-1800
Phone: (936) 546-3890 Fax:
Organization Subpart
No
Authorized Official
CARRIE CORNETT
CHIEF FINANCIAL OFFICER
Phone: (979) 543-6251
Updated
Certification Date
Feb 24, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QR1300X
- Clinic/Center / Rural Health (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.