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Organization
PINEY WOODS ER III LLC
Active
Organization
PINEY WOODS ER III LLC
Active
Other names
EXCEL ER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER KWON M.D. (MANAGER)
(903) 792-0911
Entity
Organization
Contact information
Practice address
4102 GIBSON LANE, TEXARKANA, TX 75503
(903) 792-0911
Mailing address
4102 GIBSON LANE, TEXARKANA, TX 75503
(903) 792-0911
(903) 792-0353
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160258
DEPARTMENT OF STATE HEALTH SERVICES
TX
Enumeration date
08/03/2015
Last updated
09/01/2016
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