Organization
EAST TEXAS FIRST SURGICAL SUPPORT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEN KAMINSKI (MANAGER)
(903) 939-7792
Entity
Organization
Contact information
Practice address
3414 GOLDEN RD, TYLER, TX 75701-8336
(210) 598-4262
Mailing address
1141 N LOOP 1604 E # 105-612, SAN ANTONIO, TX 78232-1339
(210) 598-4262
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
12/04/2019
Last updated
09/07/2023
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