Organization
EAST TEXAS INFUSION CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN LYNN HICKRESON MD (PRESIDENT)
(903) 592-4473
Entity
Organization
Contact information
Practice address
935 S BAXTER AVE, TYLER, TX 75701-2245
(903) 592-4473
(903) 592-4474
Mailing address
935 S BAXTER AVE, TYLER, TX 75701-2245
(903) 592-4473
(903) 592-4474
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Enumeration date
04/18/2018
Last updated
04/18/2018
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