Organization
TEXAS SPINE & JOINT HOSPITAL LONGVIEW CLINIC
Active
Parent organization
TEXAS SPINE & JOINT HOSPITAL, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
TEXAS SPINE & JOINT HOSPITAL, LLC
Authorized official
JENETHA D MORAN (OFFICER / AUTHORIZED OFFICIAL)
(972) 763-3893
Entity
Organization
Contact information
Practice address
725 N 4TH ST, LONGVIEW, TX 75601-5412
(903) 525-3422
(903) 525-3397
Mailing address
725 N 4TH ST, LONGVIEW, TX 75601-5412
(903) 525-3422
(903) 525-3397
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
162459501
—
TX
05
—
162459502
—
TX
01
—
HH1021
BCBS
TX
Enumeration date
02/24/2011
Last updated
09/23/2020
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