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Organization

PINEY WOODS ER II LLC

Active
Other names
EXCEL ER
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHRISTOPHER KWON M.D. (MANAGER)
(903) 553-0911
Entity
Organization

Contact information

Practice address
120 EAST LOOP 281, LONGVIEW, TX 75605
(903) 553-0911
Mailing address
120 EAST LOOP 281, LONGVIEW, TX 75605
(903) 553-0911
(903) 236-5075

Taxonomy

Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
160267
STATE HEALTH SERVICES
TX
Enumeration date
08/03/2015
Last updated
09/01/2016
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