Organization
EAST TEXAS OMFS TRAUMA CONSULTANTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STEPHANIE LASSETER (FINANCIAL COORDINATOR)
(903) 534-1414
Entity
Organization
Contact information
Practice address
2550 ELKTON TRL, TYLER, TX 75703-0594
(903) 534-1414
(903) 534-1415
Mailing address
2550 ELKTON TRL, TYLER, TX 75703-0594
(903) 534-1414
(903) 534-1415
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
03/19/2020
Last updated
03/19/2020
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