Organization
COLON & RECTAL CLINIC OF EAST TEXAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY DEWAYNE MCCLAIN M.D. (CEO)
(608) 443-9420
Entity
Organization
Contact information
Practice address
617 RUSSELL BLVD, NACOGDOCHES, TX 75965-1247
(936) 205-5900
(936) 205-5909
Mailing address
617 RUSSELL BLVD, NACOGDOCHES, TX 75965-1247
(936) 205-5900
(936) 205-5909
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
N3408
TX
Other
Enumeration date
09/15/2009
Last updated
09/15/2009
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