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Individual

LOUIS C. ROACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2026 S JACKSON ST, JACKSONVILLE, TX 75766-5822
(903) 541-4500
(903) 589-1594
Mailing address
PO BOX 5500, TYLER, TX 75712-5500
(903) 324-6450

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
J2762
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
034106702
TX
01
8M6644
BCBS-JACKSONVILLE
TX
Enumeration date
07/24/2006
Last updated
07/15/2013
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