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Organization
T COE BRANCH MD ASSOCIATED
Active
Organization
T COE BRANCH MD ASSOCIATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
T COE BRANCH MD (OWNER)
(806) 293-5161
Entity
Organization
Contact information
Practice address
2404 YONKERS ST, SUITE 7, PLAINVIEW, TX 79072-1820
(806) 293-5161
(806) 296-5321
Mailing address
2404 YONKERS ST, SUITE 7, PLAINVIEW, TX 79072-1820
(806) 293-5161
(806) 296-5321
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0078RP
BLUE CROSS BLUE SHIELD
TX
Enumeration date
06/17/2008
Last updated
11/04/2008
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