METHADONE CLINIC OF EAST TEXAS LLC
METHADONE CLINIC OF EAST TEXAS LLC is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1104144088, based in Tyler, TX. The organization lists 6 taxonomy classifications, with Methadone Clinic recorded as primary.
Getting there
The practice address on file is 1510 S VINE AVE, Tyler, TX 75701. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 000039 | TX | Methadone Clinic primary |
This provider holds licence 000039 issued in TX. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Part B Supplier - Opioid Treatment Program (otp)
- PAC ID
- 4981039179
Medicare enrolment is recorded as approved under the provider type Part B Supplier - Opioid Treatment Program (otp). This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Methadone covers
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. NUCC Health Care Provider Taxonomy, code 261QM2800X
All registered taxonomy codes
This provider registers 6 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 261QM2800X | Methadone Clinic Methadone | 000039 | TX | primary |
| 251S00000X | Community/Behavioral Health Agency | — | — | |
| 261QP2300X | Primary Care Clinic/Center Primary Care | — | — | |
| 261QR0405X | Substance Use Disorder Rehabilitation Clinic/Center Rehabilitation, Substance Use Disorder | — | TX | |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) Mental Health (Including Community Mental Health Center) | — | — | |
| 261QM1300X | Multi-Specialty Clinic/Center Multi-Specialty | — | — |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1104144088 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | May 17, 2010 |
| Last updated | Sep 3, 2024 |
| Status | Active |
| Practice address |
1510 S VINE AVE Tyler, TX 75701 (800) 805-6989 |
| Mailing address |
PO BOX 749057 Atlanta, GA 30374 |
| Other identifiers |
2121550
(TX) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 1 | 0 | 4 | 1 | 4 | 4 | 0 | 8 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 1 | 0 | 4 | 2 | 4 | 8 | 0 | 7 |
Sum = 52 · next multiple of 10 = 60 · check digit = 8 · actual last digit = 8
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.