Organization
DMCTX2, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DELLA VICTORIA BUMSTEAD (ADMINISTRATOR)
(409) 429-8457
Entity
Organization
Contact information
Practice address
410 GASLIGHT BLVD, LUFKIN, TX 75904-3123
(936) 635-1127
Mailing address
410 GASLIGHT BLVD, LUFKIN, TX 75904-3123
(936) 630-8813
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Enumeration date
03/27/2019
Last updated
09/14/2021
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