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Organization

EAST TEXAS FOOT ASSOCIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EDDY GENE CORSE (DPM)
(936) 632-5252
Entity
Organization

Contact information

Practice address
200 S. JOHN REDDITT DR., LUFKIN, TX 75904
(936) 632-5252
(936) 632-5284
Mailing address
200 S. JOHN REDDITT DR, LUFKIN, TX 75904
(936) 632-5252
(936) 632-5284

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0540
TX
213E00000X
Podiatrist
1590
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14HZ
BCBS
05
151320201
TX
05
373459201
TX
Enumeration date
12/08/2006
Last updated
11/07/2017
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