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Organization

ANGELINA SURGICAL ASSOCIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BETTY MARIE GRIMES (ADMINISTRATOR)
(936) 634-8216
Entity
Organization

Contact information

Practice address
109 WESTSIDE MEDICAL BLVD, LUFKIN, TX 75904-1461
(936) 634-8216
(936) 888-2201
Mailing address
PO BOX 150507, LUFKIN, TX 75915-0507
(936) 634-8216
(936) 888-2201

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0010EV
BLUE CROSS
TX
05
079667401
TX
Enumeration date
01/11/2007
Last updated
03/05/2026
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