Organization
PINECREST EYE CENTER, INC
Active
Other names
Outpatient Surgisite
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARVIN KENNETH HALL III M.D. (MEDICAL DIRECTOR)
(903) 938-8989
Entity
Organization
Contact information
Practice address
401 E PINECREST DR UNIT A, MARSHALL, TX 75670-7207
(903) 938-8989
(903) 938-9409
Mailing address
405 E PINECREST DR UNIT A, MARSHALL, TX 75670-7200
(903) 938-8989
(903) 938-9409
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
000173
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085891201
—
TX
01
—
HH1313
BLUE CROSS
TX
Enumeration date
08/17/2006
Last updated
08/22/2022
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