Organization
IVAN NOE PAWLOWICZ MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN PAWLOWICZ MD (OWNER)
(903) 331-0506
Entity
Organization
Contact information
Practice address
615 CLINIC DR, LONGVIEW, TX 75605-5172
(903) 212-3105
Mailing address
3314 CELEBRATION WAY, LONGVIEW, TX 75605-5192
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
N1829
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N1829
TEXAS MEDICAL LICENSE
TX
Enumeration date
03/22/2018
Last updated
03/22/2018
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