Healthcare Provider Details

I. General information

NPI: 1578779658
Provider Name (Legal Business Name): HEALTH OPPORTUNITIES FOR THE PEOPLE OF EAST TEXAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 06/24/2022
Certification Date: 06/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 WALL ST
TENAHA TX
75974-5413
US

IV. Provider business mailing address

P.O. BOX 1584
CENTER TX
75935-1584
US

V. Phone/Fax

Practice location:
  • Phone: 936-248-4673
  • Fax: 936-248-4646
Mailing address:
  • Phone: 936-248-4673
  • Fax: 936-248-4646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberBNE221153
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberBNE524069
License Number StateTX

VIII. Authorized Official

Name: JEAN Y DIEBOLT
Title or Position: CEO
Credential: RN FNP
Phone: 936-248-4673