# EAST TEXAS HEALTH AND WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** EAST TEXAS PRECISION MEDICINE, PLLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1073163549
- **Legal business name:** EAST TEXAS PRECISION MEDICINE, PLLC
- **Authorized official:** KIMBERLY D BARBOLLA DO (MANAGING MEMBER)
- **Authorized official phone:** (903) 320-3200

## Contact information

- **Practice address:** 1600 S WASHINGTON AVE, MARSHALL, TX 75670-6852
- **Practice address phone:** (903) 320-3200
- **Practice address fax:** (903) 471-8655
- **Mailing address:** PO BOX 45, MARSHALL, TX 75671-0045
- **Mailing address phone:** (903) 320-3200
- **Mailing address fax:** (903) 471-8655

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/17/2019
- **Last updated:** 09/17/2019