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Organization

BLOOD AND CANCER CENTER OF EAST TEXAS PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GARY EDWARD GROSS M.D. (OWNER)
(903) 597-2273
Entity
Organization

Contact information

Practice address
825 MEDICAL DR, TYLER, TX 75701-2143
(903) 597-2273
(903) 597-2466
Mailing address
825 MEDICAL DR, TYLER, TX 75701-2143
(903) 597-2273
(903) 597-2466

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
207RH0003X
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
156974101
TX
Enumeration date
07/01/2005
Last updated
07/15/2010
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