Organization
EAST TEXAS MEDICAL SPECIALTIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH ADAMS (OFFICE MGR)
(936) 564-2710
Entity
Organization
Contact information
Practice address
3226 N UNIVERSITY DR STE 200, NACOGDOCHES, TX 75965-2698
(936) 564-2710
(936) 564-2791
Mailing address
3226 N UNIVERSITY DR STE 200, NACOGDOCHES, TX 75965-2698
(936) 564-2710
(936) 564-2791
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
K9503
TX
208VP0014X
Interventional Pain Medicine Physician
Primary
K4263
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142409501
—
TX
Enumeration date
08/31/2006
Last updated
01/21/2011
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