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Organization
PINECREST EYE CENTER, INC
Active
Organization
PINECREST EYE CENTER, INC
Active
Other names
Outpatient Surgisite
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARVIN KENNETH HALL III M.D. (MEDICAL DIRECTOR)
(903) 938-8989
Entity
Organization
Contact information
Practice address
401 E PINECREST DR UNIT A, MARSHALL, TX 75670-7207
(903) 938-8989
(903) 938-9409
Mailing address
405 E PINECREST DR UNIT A, MARSHALL, TX 75670-7200
(903) 938-8989
(903) 938-9409
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
000173
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085891201
—
TX
01
—
HH1313
BLUE CROSS
TX
Enumeration date
08/17/2006
Last updated
08/22/2022
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