Organization
CITIMED EAST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. POHN P INTHANOUSAY D.O. (OWNER/DOCTOR)
(817) 704-6930
Entity
Organization
Contact information
Practice address
3310 S. WATSON ROAD, ARLINGTON, TX 76014
(817) 704-6930
(817) 704-6935
Mailing address
3310 S.WATSON ROAD, ARLINGTON, TX 76014
(817) 704-6930
(817) 704-6935
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J9103
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8H8600
BLUECROSS AND BLUE SHIELD
TX
Enumeration date
02/24/2009
Last updated
02/24/2009
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