Organization
EAST TEXAS MEDICAL CLINIC,P.A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AJITHA CHANDRAMOHAN M.D (MEDICAL DIRECTOR)
(936) 591-8888
Entity
Organization
Contact information
Practice address
1743 SOUTHVIEW CIR, CENTER, TX 75935-9324
(936) 591-8888
(936) 591-8884
Mailing address
1743 SOUTHVIEW CIR, CENTER, TX 75935-9324
(936) 591-8888
(936) 591-8884
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
K7000
TX
Other
Enumeration date
12/24/2014
Last updated
12/24/2014
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