Organization
PULMONARY DISEASES MEDICINE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BECKY WATKINS (OFFICE MANAGER)
(903) 792-3660
Entity
Organization
Contact information
Practice address
921 TEXAS BLVD STE D, TEXARKANA, TX 75501-5163
(903) 792-3660
(903) 793-3187
Mailing address
921 TEXAS BLVD STE D, TEXARKANA, TX 75501-5163
(903) 792-3660
(903) 793-3187
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0055R
TX BCBS
TX
05
—
1415531 01
—
TX
01
—
200092730A
OK CAID
OK
01
—
8P083
AR BCBS
AR
01
—
90815000040
QUAL CHOICE
AR
01
—
DA7905
RR MEDICARE
TX
Enumeration date
03/23/2007
Last updated
04/28/2008
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