# EAST TEXAS PHYSICIAN ASSISTANT SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ETPAS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407273428
- **Authorized official:** MR. JASON DAVID LAYNE PA-C (PHYSICIAN ASSISTANT)
- **Authorized official phone:** (903) 504-5353

## Contact information

- **Practice address:** 5380 OLD BULLARD RD STE 600-125, TYLER, TX 75703-3607
- **Practice address phone:** (903) 504-5353
- **Mailing address:** 5380 OLD BULLARD RD STE 600-125, TYLER, TX 75703-3607
- **Mailing address phone:** (903) 504-5353

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA04135 | TX | Yes |

## Other

- **Enumeration date:** 03/27/2014
- **Last updated:** 03/27/2014