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Organization
EAST TEXAS FOOT ASSOCIATES
Active
Organization
EAST TEXAS FOOT ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDDY GENE CORSE (DPM)
(936) 632-5252
Entity
Organization
Contact information
Practice address
200 S. JOHN REDDITT DR., LUFKIN, TX 75904
(936) 632-5252
(936) 632-5284
Mailing address
200 S. JOHN REDDITT DR, LUFKIN, TX 75904
(936) 632-5252
(936) 632-5284
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0540
TX
213E00000X
Podiatrist
1590
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14HZ
BCBS
—
05
—
151320201
—
TX
05
—
373459201
—
TX
Enumeration date
12/08/2006
Last updated
11/07/2017
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