Organization
RADIOLOGY CONSULTANTS OF NACOGDOCHES LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLEN GRISSON M.D. (PRESIDENT)
(936) 569-0841
Entity
Organization
Contact information
Practice address
1204 N MOUND ST, RADIOLOGY DEPARTMENT, NACOGDOCHES, TX 75961-4027
(936) 568-8514
(903) 663-9960
Mailing address
PO BOX 5370, LONGVIEW, TX 75608-5370
(903) 663-4800
(903) 663-9960
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112622901
—
TX
Enumeration date
05/09/2006
Last updated
04/25/2024
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