Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

East Texas Out-Patient PLLC

Organization Family Medicine Physician · NPI 1417511593

East Texas Out-Patient PLLC is a Family Medicine Physician in Edgewood, Texas. Registered with an NPI since 2019.

In the registry since
2019
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

116 N Houston St
Edgewood, TX 75117-1555
Phone: (903) 962-3419
Fax: (903) 385-3340
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1417511593
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jimmy Dailey — Owner · (903) 567-1910
NPI enumeratedApril 24, 2019
Last updated in NPPESJuly 1, 2025
Certification dateJuly 1, 2025
Mailing addressPo Box 76, Canton, TX 75103-0076

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