# EAST TEXAS INFECTIOUS DISEASE CONSULTANTS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912907353
- **Authorized official:** MS. CAROL CONOVER (ADMINISTRATOR)
- **Authorized official phone:** (903) 592-4473

## Contact information

- **Practice address:** 935 S BAXTER AVE, STE 103, TYLER, TX 75701-2245
- **Practice address phone:** (903) 592-4473
- **Practice address fax:** (903) 592-4474
- **Mailing address:** PO BOX 131629, TYLER, TX 75713-1629
- **Mailing address phone:** (903) 592-4473
- **Mailing address fax:** (903) 592-4474

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | 207R10200X | TX | Yes |

## Other

- **Enumeration date:** 07/28/2005
- **Last updated:** 04/02/2008