# EAST TEXAS WOMEN'S CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CHARLES L FOUGEROUSSE MD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942484712
- **Authorized official:** MRS. DONNA KAY GRIMES (OFFICE MANAGER)
- **Authorized official phone:** (936) 639-4463

## Contact information

- **Practice address:** 401 GASLIGHT BLVD, LUFKIN, TX 75904-3132
- **Practice address phone:** (936) 639-4417
- **Mailing address:** 401 GASLIGHT BLVD, LUFKIN, TX 75904-3132
- **Mailing address phone:** (936) 639-4463
- **Mailing address fax:** (936) 639-4417

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | F1548 | TX | Yes |

## Other

- **Enumeration date:** 12/28/2007
- **Last updated:** 12/28/2007