Organization
EAST TEXAS FAMILY MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANNY R ALLISON (PRACTICE MGR)
(903) 723-8533
Entity
Organization
Contact information
Practice address
4201 S LOOP 256, PALESTINE, TX 75801-8476
(903) 723-8533
(903) 723-5190
Mailing address
4201 S LOOP 256, PALESTINE, TX 75801-8476
(903) 723-8533
(903) 723-5190
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121032002
—
TX
01
—
CS1114
RAILROAD MEDICARE
—
Enumeration date
02/01/2007
Last updated
05/20/2008
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