Individual
DR. JACK ROY ERWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4740 NE STALLINGS DR, NACOGDOCHES, TX 75965-1615
(936) 569-8246
(936) 564-3246
Mailing address
4740 NE STALLINGS DR, NACOGDOCHES, TX 75965-1615
(936) 569-8246
(936) 564-3246
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
D4105
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D4106
LICENSE
TX
Enumeration date
07/24/2006
Last updated
07/08/2007
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